|my son as a newborn, right before I told the nurse who rolled a pump in to roll it right back out...|
I definitely don't think ELF should be routinely recommended, even for babies who require supplemenation, despite this study. One reason why is that I question the study methodology, such as the ridiculously small sample size. There were fewer than 20 families within each group, so each mama counted for a very high percentage of the overall results. This is going to result in skewed data. To be fair, the researchers have acknowledged this and are not trying to change the current medical recommendations based on their small study. But because of the media hype and the countintuitive result they got, I thought it was worth adressing the issue anyway.
The second, bigger, point is that when supplementation is medically necessary, formula is NOT the best option. Most pro-breastfeeding sites I've seen advocate ranking best options if supplementation is necessary as:
- Your own pumped breastmilk
- Donor milk
The La Leche League, for example, states:
Whenever a non-human milk is used, alterations in the baby's gut flora occur and will cause changes in the frequency, odor and consistency of baby's stool as well as how the baby settles after a feed (Kleessen et al 1995). In order to reduce the likelihood of an adverse reaction, the baby whose family has a history of allergies should not be exposed to non-human milk if it can be avoided (Saarinen & Kajosaari 1995; Gustafsson et al 1992). In this case, the longer the delay before first exposure, the better.We know formula is NOT optimal for babies. For me to take a study like this seriously they would need to have additional control groups receiving pumped breastmilk from the mamas in question and donor milk.
I also question their threshold determining whether supplementation was necessary in the first place. It is widely accepted that the use of IV fluids in labor inflates birth weights. If babies are otherwise healthy and nursing well (i.e. good coloring, not overly lethargic for a newborn, good number of wet diapers, etc.), I don't think any temporary supplemenation is necessary in most cases. When it is, a supplemental nursing system that encourages the baby to suck at his mother's nipple, even if weakly and with a poor latch, to get his food, is probably the best option to contine to stimulate the natural supply and demand that makes breastfeeding work, and pumping is probably second best. Letting the baby get milk in a way that does not stimulate the mother's breasts is not going to keep her supply where it should be unless she is naturally blessed with oversupply.
Formula certainly has a place in our society and has undoubtedly saved many lives. And ELF in particular sounds far superior to simply switching to bottles of formula. But it shouldn't be a first, second, or even third option, and to promote it based on this study would be unwarranted in my opinion.
In summary, I find this study to have far too small of a sample size for the findings to be reliable and I find the control group choice questionable. I personally do not think this study is consistent with other existing medical literature on breastfeeding other than the mere fact that when supplementation is necessary, supplementing will positively affect the baby, and I think futher study would reveal that formula should continue to be a last resort for optimum baby health.
*I am not a medical professional of any kind. Please do lots of research and make educated decisions with your family and doctors and not based on my opinion!