Is it better to give my baby as much breast milk as possible in 6 months or space it out in smaller amounts for a year?

[bubbles328]

@sagarjackey Anecdote but I lost quite a bit of weight during the first six months of breastfeeding BUT, my daughter had CMPA and I was too afraid to eat anything not homemade and I had no time to look up new recipes and make what I actually wanted to eat LOL. Someone else was cooking the main meal of the day from scratch but otherwise I ate fruit, rice crackers with peanut butter, oatmeal, eggs on toast, salad, etc. I also have IBS and have my own food intolerances. I’m sure things would have been different if I could have unleashed my hunger on whatever I wanted, which is what I really wanted to do because I was super super hungry all the time.

 

[elijahrhodes]

@sagarjackey I am the opposite - I dropped weight very quickly and actually ended up lighter than my pre-pregnancy weight but, like you, my appetite went through the roof. And because I was just dropping weight, I could eat whatever I wanted without issue.

Now that I’m weaning, I haven’t taken the time to fix my diet and the weight is slowly starting to creep back up

 

[kyleeak]

@drizzt777 I know I read this . You apparently did not. Look at the groups being compared then the original comment

 

[stageandgrace]

@kyleeak The WHO’s guidelines on breastfeeding are broad and always skew towards under developed countries to account for people who don’t have access to safe drinking water and nutrient dense food. Of course if you live in rural Africa or Indian (where one of the leading causes of death is gastro due to unsafe drinking water) breastfeeding your child until 2 or beyond is going to be the best option. This is what the WHO’s guidelines are targeted towards. However, if you’re in a first world country like the US or Australia and have access to safe drinking water to safely make formula and have access to nutrient dense foods than 100% the benefits of breastfeeding beyond ~6months start to drop and drop further after 12months for baby. There are continued benefits for mum beyond 12months.

EDIT - I should clarify- I 100% think breast is best if you have the option to do it. Breast is not best for everyone though. Personally, I breastfeed by son until 12months so I 100% see the benefits in it.

I’m also not saying there are 0 benefits to breastfeeding beyond 12 months, there are a range of benefits to the mother for prolonged breastfeeding and a small amount of benefits to baby for prolonged breastfeeding. I’m saying the benefits reduces over time and reduces a lot after 12 months.

 

[kyleeak]

@stageandgrace Provide source for your claims. Argue with the AAP and CDC. Go on now.

 

[stageandgrace]

@kyleeak This table from AAP shows most of the benefits of breastfeeding for baby occur after breastfeeding for 6 months
https://publications.aap.org/view-large/7179806

This article discusses if there’s access to safe drinking water and nutrient dense food beyond 12months, the benefits of breastfeeding is unclear:
https://www.annualreviews.org/content/journals/10.1146/annurev-nutr-043020-011242

This article concluding there isn’t a lot of good evidence supporting the benefits of breastfeeding beyond 12 months:
https://pubmed.ncbi.nlm.nih.gov/34115518/

Obviously this is an under researched area and there’s still a lot of work to be done. It’s difficult to research prolonged breastfeeding and adjust for controls and differences in toddlers complimentary diets/lifestyles/cultures/economic status etc etc.

Again, I’m not saying there are 0 benefits to prolonged breastfeeding because there definitely are benefits and if you can / want to continue breastfeeding beyond 12 months go for it. I’m just saying the benefits decrease over time and the WHO recommendations are skewed towards developing countries.

 

[kyleeak]

@stageandgrace Source. Provide source to back up your statements. Provide source addressing the AAP and CDC recommendations.

Again, I do not care if you personally breastfeed. Even if you didn’t simply because you do not want to. That is your right and I fully respect and support it. But you do not get to spread BS to make yourself feel better about it

 

[echopark]

@kyleeak I work with WHO and 99% of their work caters to developing countries, the person above is 100% right. That’s the main reason why WHO was not recommending face masks in the beginning of the pandemic: they thought it would be inequitable towards high-income countries which could easily afford masks and make the whole population use them.
On the breastfeeding side, the team working on breastfeeding guidelines is full of fundamentalists (or was a few years ago) who would rather ban formula than admit to its full benefits, which is also compounded by the very valid concern around marketing of formula and the risks of developing countries around non safe drinking water (again, as OP mentioned above) and formula affordability.

Check the WHO SAGE position papers on the different vaccines if you want a source for WHO geographical focus/bias.

 

[kyleeak]

@echopark Address my other concerns. Provide source for all of the above claims.

 

[echopark]

@kyleeak I was addressing the WHO bias in everything they do, not talking about those person’s data sources (which have ben discussed in this sub a few times). The time you are spending being so confrontational is the time you should use to look for the data yourself, plus no one will want to share anything with you because you will simply keep being confrontational. You don’t want info, you want to be right.

 

[stageandgrace]

@echopark This.

But also I’ve shared some links again

 

[kapr]

@kyleeak You really need a basic refresher on levels of evidence .

Science requires EVIDENCE and a well performed meta analysis is the highest level of evidence there is.

Multiple tiers lower is expert opinion. Guidelines and expert options can be helpful to review but absolutely do not replace primary evidence. Guidelines are absolutely subject to bias, vested interests/group think and can be slow to adapt, even when current evidence has moved on.

When we are talking about science, we should try to talk about actual evidence (in the context of existing guidelines sure), but guidelines themselves ARE NOT evidence and are NOT themselves science

 

[kyleeak]

@kapr You’re right. The AAP and CDC do not base their guidelines on evidence. You a random redditor cherry picking studies from pub med are far more qualified than those scientists that constantly review the entire body of literature and update recommendations…I mean clowns. /s in case that wasn’t extremely clear

Meta analyses are not actually the highest level of evidence. How this actually works is that people that are qualified to do so perform a review of the entire body of literature on a topic. That is the highest level, not a single meta analysis. It is perfectly possible to have meta analyses that come to different conclusions.

You are DKing “science” very hard right now.
AAP and CDC guidelines are not on the same tier as expert opinion. Is this actually confusing for you?

 

[kapr]

@kyleeak You're free to argue the underlying evidence that a guideline is based on. But guidelines themselves are NOT evidence. Asserting that is idiotic.

Guidelines are frequently subject to bias and can be fundamentally flawed.

• For example the European Society of Cardiology had guidelines for anticoagulation that lead to a 3x increase in bleeding events compared to American guidelines. This flawed recommendation would have led to actual patient death. ESC is a national specialty organization that would be the equivalent AAP for it's specialty in Europe.
• Sticking in the parenting realm, we have literally dealt with flawed guidelines directly from AAP. AAP had longstanding recommendations on delaying the introduction of peanut-containing foods until the age of 3 years. "this recommendation was based on expert opinion only and likely resulted, at least in part, to the increase in peanut allergy over the last 20 years."
• This article has a nice review of WHY guidelines can be flawed if you want to educate yourself

Experts options and guidelines are not evidence. Feel free to discuss the evidence. What are the specific methodological flaws or concerns you have with the meta analysis provided? What are the benefits of breast feeding you feel are not captured by the study linked and can you find evidence to support this?

DKing “science”

Lmao what is this even supposed to mean??

 

[kyleeak]

@kapr I am not asserting that guidelines are evidence. Wow you are really confused.

I explained my issue with the meta analysis above. Feel free to read it.

DK-Dunning Kruger

 

[kapr]

@kyleeak

I am not asserting that guidelines are evidence.

​

Meta analyses are not actually the highest level of evidence. How this actually works is that people that are qualified to do so perform a review of the entire body of literature on a topic. That is the highest level

You're contradicting yourself multiple times here. Why the heck would an expert review/guideline ever be considered evidence, or as you state "the highest level". What are you even referring to here as the highest level if it isn't expert opinion?

What's funny is your /s sarcastic comment that "The AAP and CDC do not base their guidelines on evidence" is LITERALLY true as I provided you a direct example of an AAP guideline that had no backing by evidence and created direct harm.

Your concern for meta analysis having different results makes absolutely no sense. A meta analysis involves a systematic review of all the data and aggregating the data across all studies to increase the N and provide a more accurate picture of reality. Your belief that 2 concurrently performed meta analysis would provide different results is literally nonsense. You're free to provide any examples of contradicting meta analysis.

I've provided you multiple examples already of contradicting guidelines/reviews.

DK is right

 

[kyleeak]

@kapr The paragraph you quote doesn’t refer to guidelines?

The guidelines in question are based on evidence? I’m not talking about every guideline to ever be put out by any org

The meta analysis in question is an example of meta analyses not comprehensively covering the entire body of evidence on a topic as large as the benefits/risks of different types of infant feeding. That is too broad of a topic to be covered in a single metal analysis. See my original point

Also your own peanut allergy example does not support your claim. Did you read it or just skim for sentences you thought would support?

 

[kapr]

@kyleeak I'm not sure why I have to do your reading for you....

In 2000, the American Academy of Pediatrics (AAP) recommended delaying the introduction of peanut until 3 years of age [3]. This advice was based on expert opinion rather than on prospective clinical trials, and likely contributed to the increase in the prevalence of peanut allergy in recent decades. In 2008, the AAP partially reversed the 2000 recommendation, stating that the introduction of allergenic foods “should not be delayed” [11]. However, there was insufficient data available at that time to strongly recommend that peanut “should” be introduced at approximately 6 months of age, resulting in continued confusion regarding implementation of this guideline recommendation.

1. American Academy of Pediatrics. Committee on Nutrition Hypoallergenic infant formulas. Pediatrics. 2000;106(2 Pt 1):346–349.
2. Greer FR, Sicherer SH, Burks AW, American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Allergy and Immunology Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods and hydrolyzed formulas. Pediatrics. 2008;121(1):183–191. doi: 10.1542/peds.2007-3022