Pediatrician’s perspective on pumped breast milk

[nyki_t]

@sarebear1992 Other studies (that control for socioeconomic factors) suggest long-term benefits around allergies:

https://www.annallergy.org/article/S1081-1206(22)00400-8/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635702/

I’m curious what the source of your confident initial reply was. Oster’s book?

 

[sarebear1992]

@nyki_t I mean I cited them. And also OPs pediatrician (and mine as well) agree. But the vast majority of studies that account for socio-economic status show no lasting or serious differences between formula fed or breastfed babies. PROBIT is the largest cohort study. The sibling studies are particularly persuasive because they lost account for familial differences. So the one I cited was EXTREMLY large sample size compare to the ones you cited with 12,000 children from diverse backgrounds followed through age 14.

https://www.sciencedirect.com/science/article/abs/pii/S0277953614000549

But here are several more:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361236/

https://pubmed.ncbi.nlm.nih.gov/34445041/

The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity.

And from 2019: The association between the duration of breastfeeding and child development was not statistically significant in the model with the inclusion of confounding variables.

https://pubmed.ncbi.nlm.nih.gov/30829342/

https://www.sciencedirect.com/science/article/pii/S2352827318300223

We were able to replicate findings from prior research that linked breastfeeding with positive infant health outcomes (Ip et al., 2007), and this finding persisted even when controlling for a rich set of observable characteristics. However, the inclusion of the prenatal intentions variable fully accounted for this initial association. Mothers who intended to breastfeed but did not actually breastfeed had infants with statistically equivalent ear infections, RSV episodes, and incidents of antibiotic usage in the first year of life compared to infants who were breastfed. It is particularly striking that prenatal intentions were strongly linked with infant health irrespective of whether the infant was actually breastfed. This indicates that the omission of this variable from models quantifying the “effect” of breastfeeding on infant health outcomes make breastfeeding appear overly protective, and further suggests the importance of accounting for maternal advantage in future research. This finding is consistent with a growing body of literature suggesting that the benefits of breastfeeding are overstated due to positive maternal selection bias (Colen and Ramey, 2014, Der et al., 2006, Evenhouse and Reilly, 2005).

https://pubmed.ncbi.nlm.nih.gov/37375684/ Longitudinal models did not show associations between breastfeeding and the respective allergies from 5 to 20 years of age.

Also the rhinitis study you cited has some serious flaws in that all the members of the study had rhinitis. So there was no healthy group to compare them with.

And if there were such DRASTIC health differences between formula fed and breastfed babies, we would expect to see them across the adult population. But we don’t. No doctor asks if you were formula or breast fed as baby. There’s really no discernible long term difference in health outcomes or IQ between the feeding options.

 

[nyki_t]

@sarebear1992 There’s a saying that goes something like, let me define the terms and I’ll win any argument. This seems to be your approach.

Most scientists would say peer reviewed, statically significant evidence is evidence of something. Proof? No. Is it strong evidence? No. But can we say there is no evidence? Well, it depends how you define evidence.

 

[emygdius]

@nyki_t I actually like this reply, it's getting into the nity-grity (?) of reaserch.

As someone who worked in a HUGE R1 reaserch lab, this is a great thing to point out. Bc let me tell you, as someone scientifically minded and who supports and conducts reaserch, it should ALL ALWAYS be taken with a grain of salt. All of it.

 

[tamalyn]

@sophiahrz I had low supply and held out pumping until 6 months. I remember the thought of giving up being devastating. But once I actually made the switch to formula, I honestly just felt silly for not doing it sooner. My mental health improved significantly, baby started gaining weight at a better rate, everyone felt better.

 

[o_mlly]

@tamalyn Exactly the same for me. I was even obsessed with building a freezer stash, despite my low supply, which I didn’t even end up using.

 

[hurrix]

@sophiahrz Your pediatrician gave you great advice; this sounds like an excellent doctor and I hope you feel that you can trust her.

Also can I just say, when I see the letters BM, I think bowel movement. It’s so funny to me that people use it to mean breastmilk.

 

[jeraldine]

@sophiahrz I've seen lots of people say that after accounting for affluence there isn't a difference between formula fed & breast fed, but I also saw a meta analysis that concluded that breast feeding protects against chron's disease & ulcerative colitis and the longer you do it, the better. I have both chron's disease and ulcerative colitis in my family so I'm continuing in hopes of preventing it for my child since she is probably predisposed to it. If you have those in your family, you might consider reading about it before you decide to wean. Here is the meta analysis so you can decide if it seems legit to you.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688338/

 

[jaenalyn]

@jeraldine Briefly looking at that paper, I did not see discussion of early supplemental food introduction, which you would expect to be correlated to early breastfeeding cessation or inadequate infant weight gain while breastfeeding.

Aka, baby who ate rice cereal at 2 months because breastfeeding was going poorly develops UC as an adult, may not have been related to the duration of breastfeeding at all.

 

[shadowwolf7592]

@sophiahrz Anecdotal here, but I was in the same position as you, though my low supply by this time was 60/40 bm and formula. I actually stopped at 6 months with the same discussion from my pediatrician. In short, mine said it never helps if I feel drained from the experience with my child, and as they need more than I was supplying, it was okay to start letting go. She also reminded me that as they get closer to 6 months and can start eating real foods, it might be beneficial to put my energy into that so I can avoid picky eating.

It was hard. I cried and felt like a failure, but I had a supportive partner who agreed that this was not helping with my stress or making good use of time. Once I was done pumping officially and had two weeks to grieve, I felt amazing and had my "life" back. It was miraculous how it really turned my life around. The best advice I got is that we all need to stop at some point and to pick the time that is best for you, not your child, as long as they are being fed well.

 

[sophiahrz]

@shadowwolf7592 Thank you so much. I have never heard that piece of advice before and I love it. It’s hard to know the right time to stop but really exciting to think maybe there’s more normalcy on the other side- whenever that is.

 

[dcg]

@sophiahrz I wanted to jump on the end of this thread and say that I feel like I can hear a lot of worry/anxiety in your tone of this post.

I think the bottom line here is that your baby can be safe, happy and healthy whether they receive formula or breast milk for the next 1.5 months. In the meantime, I really do encourage you to reflect on how you are feeling and coping!

If the idea of waiting till 6 months makes you feel secure/at ease, then that’s great. But if pumping is affecting your stress levels, sleep, mood and overall well-being, it might be best to take a step back and see if that feels right.

You seem to say you felt relieved when your Ped gave you “permission” to wean early, and to me that says you are having a hard time with the current arrangement, and are maybe clinging to something that isn’t working/feeling right for you.

You are a good mum, your baby will be okay. Your needs, health and well-being matter too. And it’s also worth considering that a happy, healthy, well-rested mum has positive effects on baby as well.

I have never given birth, but I can only imagine how anxiety inducing it must be to go from being the sole source/provider of your baby’s physical needs (you literally grew them inside you and then fed them with your body!!) to then take the next step in weaning them off of your body, and trust that they will be okay.

But they will be okay! And you will too. Youre a good mom, You’re trying your best, and this will work out, whichever path you decide to take. But don’t discount your own needs here, they matter too x

 

[klf45]

@sophiahrz I exclusively pumped from like 6 or 8 weeks (when I officially gave up on breastfeeding working out and was producing enough to not need formula) until she was 14 months old. Despite that long amount of time, I still felt guilty stopping. Your hormones do wild and crazy things. I only pumped that long because I was able to pump a lot in a relatively short amount of time. My friend had a crazy long letdown and stopped pumping at 4 months. If you put her 3 year old next to my almost 2 year old, nobody would be able to tell which had breast milk for 14 months and which had it for 4. Do what is best for you and your mental and physical well-being

 

[anlytcphil]

@sophiahrz Everyone here has had good comments. As someone who exclusively pumped for 10m (started around 7wks - so basically 1 yr of breastfeeding) I didn’t enjoy pumping but did place a lot of value on breastfeeding if that makes sense. Personally, being able to do something for my baby while I was at work, being able to feed her (indirectly) from my body and being able to comfort nurse for 6ish months were all reasons I continued pumping.

There were also financial benefits to our family personally not exclusively using formula. Because while I replaced pump parts, they are not as expensive as formula lol

Just to say that these parenting decisions don’t need to be totally based on scientific studies when it’s not a question of health / safety etc.

 

[casper3496]

@sophiahrz Here’s the deal. You cannot walk into a kindergarten or fourth grade or high school classroom and pick out which kids were breastfed vs formula fed. Your child will be fine no matter what you choose.

You owe it to yourself and your baby to be the happiest version of yourself and if pumping is interfering with that, it behooves you both for you to stop.

I say this with all love and empathy, as I am coming from the same place, but do you think you struggle with postpartum anxiety? Your post sounded a bit like the mental spirals I experienced. Just something to consider.

 

[masterofjuice]

@sophiahrz TBH, your baby benefits from a happy, chill parent big time. If switching to formula will make you happier, totally do it! You gotta do you! Can you tell who was breastfed in class? Nope! Chill mom vibes = happy kid. Don't guilt trip yourself. Just love that baby and be good to yourself. Pumping stress? Skip it! BM or formula, your kid will be good. Remember, mental health first. You got this!

 

[mrseme]

@sophiahrz I EP’d for over 2 years and still felt guilty about stopping, I think as moms we feel guilty over everything. My kid was still sick nonstop and i wished I had stopped sooner for my own mental health.

 

[indy62]

@sophiahrz The number one thing your kid benefits from is a happy, well-regulated parent. If you will be a happier mom by switching to formula, do it!!

I have read that the major immunity benefits from BM come from actually breastfeeding (not pumping) because the saliva-to-nipple transfer informs the immunities produced by BM. So I think it’s questionable that your pumped milk is going to benefit him much when he’s sick (maybe a diff story if you are sick?).

I exclusively breast fed for 14 months and my kid gets sick just as often as other kids. Including a hospitalization for RSV around 12mo. I will say that it was a huge benefit for bonding and so easy and sweet for us, so I have no regrets. But I would also have zero regrets doing formula. Your kid needs a happy mom! That’s 100% the most important thing IMO.

 

[tanuki_elex]

@sophiahrz I know breastmilk has benefits beyond the first 6 months that have to do with health, but I believe your pediatrician is right, that the correlations are more fuzzy after a certain point and it really comes down to what works best for you and your family.

Anecdotal/sharing my experience exclusively pumping & deciding to wean before 1 yr:

My daughter is 7.5 almost 8mos & I just decided to wean BM and give mostly formula. This decision coincided with a lot of factors:

1. Returning to work & my LO crawling and pulling herself to standing super early at 6 mos (both making it harder to manage pumping by having to pump while she naps and lugging around a pump everywhere)
2. Getting my first period & my supply tanking (although it recovered a little after my period was done)
3. My LO tolerating a slow increase in BM:formula ratios (I've always been a slight undersupplier and was doing about 90% breastmilk until around 6 months, & now it's about 25-50% breastmilk)
4. My LO becoming MUCH more interested in food and doing well eating solids
5. Going from a "I don't really mind pumping too much, I can keep doing this" mindset to a DEEP longing to stop & thinking about how much I can DO if I don't have to pump and clean pump parts every day, plus all the mental energy it takes to coordinate pumping alongside feeding baby (and feeding myself lol I'm always hungry)
6. Being out of the age range for increased risk of sids.

That being said, I'm going to go slow and try to give her some breastmilk as long as I can, primarily because we are heading into cold/flu season and I know BM can be beneficial for antibodies. Going to 3 PPD & I'm going to stop pumping at work, and basically shift my mindset to "providing as much breastmilk as possible" to "providing any amount of breastmilk is fine."

 

[tanuki_elex]

Adding to say that I'm also mourning the idea of weaning! As much as I don't want to pump I'm sad about it?? Motherhood is weird, but in my gut I know I'm ready to be done