Wednesday, May 15, 2013

When breast ISN'T best: Feeding babies both formula and breast milk immediately after birth can help mothers breastfeed for longer

Feeding underweight newborns formula milk alongside breast milk can help mothers to breastfeed for significantly longer, a controversial new study has found.

NHS guidance states that women should exclusively breastfeed for the first six months of a child’s life.

However, the new study has found that a combination of formula milk and breast milk can help both the mother and baby persevere with breastfeeding.

The research found that 79 per cent of babies who were fed formula alongside breast milk in the first few days of life were still breastfeeding three months later.

In contrast, only 42 per cent of babies who did not receive the milk formula were still being breastfed at three-months-old.

The study suggests that if women feel able to give their babies some formula milk alongside breast milk they are more likely to persevere with breastfeeding.

It is thought that many women give up breastfeeding completely in favour of formula milk because they are worried they are not producing enough milk.

Researchers at the University of California analysed 40 underweight babies aged between two-days-old and four-days-old.

The babies were randomly assigned either early limited formula (ELF), which consisted of one-third of a pound of infant formula, followed by breastfeeding, or breast milk alone.

The formula was stopped when the mothers began producing mature milk, after a few days.

After a week, all the babies in both groups were still breastfeeding, but only one in ten of the ELF babies had been given formula in the last 24 hours, compared with half of the control group.

Three months later, the ELF babies were almost twice as likely to still receive breast milk.

Dr Valerie Flaherman, at the University of California, San Francisco, said: ‘Formula use has the potential to be a slippery slope to breastfeeding discontinuation, but ELF is a different way to envision using it.

‘Rather than giving full bottles of formula that make it hard for the baby to return to the breast, ELF is a small amount of supplementation with a clear end point that alleviates some of the stress new mothers feel about producing enough milk.’

She said new mothers whose babies lose weight can be put off breastfeeding because they believe their child is not receiving enough food and is hungry, or simply fussy.

She said: ‘This study suggests that giving those babies a little early formula may ease those concerns and enable them to feel confident continuing to breastfeed.

‘Based on our findings, clinicians may wish to consider recommending the temporary use of small amounts of formula to new mums whose babies are experiencing significant early weight loss.’

The NHS, which pushes a ‘breast is best’ agenda, carries no advice on its website for combining formula milk with breastfeeding.

Instead, it suggests ways for women to tackle breastfeeding problems so they can continue with it, saying: ‘The solution is as simple as changing your baby’s position or feeding them more often.’

The website states: ‘Exclusive breastfeeding (giving your baby breast milk only) is recommended for around the first six months of your baby’s life.

‘After that, giving your baby breast milk alongside other food will help them continue to grow and develop.  ‘Every day you breastfeed makes a difference to you and your baby.’

Breastfeeding is associated with a range of health benefits, including reducing the risk of infections and allergies, and provides the right balance of nutrients to make babies stronger.

Yesterday, critics were cautious about the results of the survey.

Dr James Taylor, of the University of Washington Medical Center’s Newborn Nursery, said: ‘The results of this study are provocative and challenge conventional wisdom.

‘It is crucial that we have more randomised controlled trials on interventions to increase breastfeeding rather than relying on heavily confounded observational studies or biased expert opinion.’


The shockwaves that can cure erectile dysfunction

Now that there is a report in an acdemic journal, widespread adoption of the procedure could soon be underway

Shockwaves could be a novel way to treat impotence. Scientists say a new device that releases thousands of energy waves may help by increasing blood flow.

The painless treatment, which uses the same technology as that used to zap kidney stones, helps create new blood vessels. Early studies suggest a good success rate.

A healthy blood supply is crucial for creating and maintaining an erection. If the blood vessels narrow — usually because they become furred up with fatty deposits — it can significantly reduce blood flow in the penile tissue, as the blood vessels there are very small.

Lifestyle changes and medications such as Viagra can help (though there is thought to be an 80 per cent chance of a  drug working, they are not effective for everyone).

The new non-drug treatment uses a technology called extracorporeal shockwave therapy. With kidney stones, the energy waves cause the stones to shatter and they can then be passed naturally out of the body.

The erectile dysfunction device — which resembles a mobile phone — uses 10 per cent of the power of kidney stone machines.

The device was developed after studies suggested that shockwaves stimulate blood flow in damaged heart tissue.

In patients with angina, the treatment was found to promote the growth of new blood vessels.

How the treatment works is unclear, but one theory is that the energy waves cause tiny amounts of damage, which triggers the body’s repair systems to release compounds called growth factors.

These stimulate the development of new blood vessels.

The treatment sessions last about 20 minutes, with around  5,000 shockwaves delivered each time (this is comparable to other treatments, such as those for kidney stones, but in this case the shockwaves are weaker), causing a slight tingling sensation.

Most men are given four sessions of treatment. In one study at Rambam Hospital, Israel, published in the journal European Urology, the device was used on 20 men, aged 33 to 68, who had suffered impotence for an average of three years.

There was a significant increase in the duration of erection and  penile rigidity, and half of the men no longer required drug  therapy six months after the treatment.

In a second study by the same hospital, the treatment was compared to placebo in 84 men.

Those having the treatment saw a significant improvement in their ability to achieve and maintain an erection — three times greater than compared to those who had the sham therapy.

The treatment will not, however, help those who suffer from nerve damage, for instance as a result of prostate cancer.

Commenting on the technology, Professor Raj Persad, urological surgeon at Bristol Royal Infirmary, said: ‘Any means of improving penile blood flow to enhance or restore erectile function is good if it can be non-invasive, as this is a delicate area.

‘Initial results are encouraging and suggest that this approach is  safe and effective. We need to wait for long-term data. The health of blood vessels depends on many factors — diabetes, blood pressure and smoking are the chief influences.’

The device, which is available only for use in clinics and is supplied by British company Vertec, is expected to be used  in the first UK clinic in the next six months.


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