Talk:Breastfeeding/Archive 3

How much milk should/does a baby drink (perhaps depending on its weight/age)
The other side of this, which is more relevant is how much is produced. I would have thought that information that answers this general inquiry should be close to the top of the article. --Dmg46664 (talk) 11:38, 21 August 2010 (UTC)

Milk Ejection Reflex Redirect
I would suggest that 'Milk Ejection Reflex' redirect to 'Lactation' rather than to this article, 'Breastfeeding'. The term 'Milk Ejection Reflex' currently redirects to here, but there is nothing about the Milk Ejection Reflex in this article. Instead, the article 'Lactation' contains information about the Milk Ejection Reflex. 120.89.82.213 (talk) 01:51, 26 August 2010 (UTC)

biased
This article is severely biased, and appears to have been written by someone from some bizarre pro-breastfeeding organization. There is not even one drawback mentioned, and I know there are several. It is written as if breastfeeding is a clear choice over bottle feeding. —Preceding unsigned comment added by Laplacian54 (talk • contribs) 10:36, 9 October 2010 (UTC)

Why don't you mention one? 98.26.32.220 (talk) 01:45, 12 October 2010 (UTC)

How much do babies eat?
It would be nice to see a section in here with an expert opinion on how much babies need. Seems like an obvious omission. 98.26.32.220 (talk) 01:44, 12 October 2010 (UTC)

Possible eurocentricism
Is it just me or does it look slightly 'europeans are the norm' here with all those Caucasian women having no note of the location or ethnicity but all others having things like 'in Kenya' or 'Zanzibar' attached to it? Shouldn't that include like 'German mother' or 'United States infant' or what-not with it? Rajakhr (talk) 07:52, 14 November 2010 (UTC)

Where did you get the idea that the article is eurocentric? If anyone just browses through the article, looking at the pictures, it would seem that only African women breastfeed. Can we have pictures of women of other ethnicities breastfeeding? —Preceding unsigned comment added by 184.57.31.53 (talk) 22:00, 4 December 2010 (UTC)


 * The commenter above you already recognizes those pictures. What Rajakhr is saying is that it is common to label and identify minorities (of power) and accept majorities as the status-qua. However in response to Rajakhr, while I appreciate your argument, your concern doesn't really follow here as infants rarely have an cultural identity other than what is ascribed to them and in those pictures of white infants their parents weren't featured. Robopologist (talk) 04:07, 24 December 2010 (UTC)

Fewtrell study
http://www.sciencedaily.com/releases/2011/01/110113213100.htm

Is this yet another study 100% financed by the baby food industry? Hcobb (talk) 21:16, 16 January 2011 (UTC)

Infant weight gain
I think this section needs revising. Here are some of the problems:

The advice on average weight gain appears to be at odds with that of the literature. Take this article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1511152/pdf/archdisch00623-0016.pdf It says that monitoring infant weight gain is not as simple as it seems. The solution proposed was to convert weight to a standard deviation score, and this might be the way to go in this article.


 * The advice on average weight gain is not attributed to any authority, reliable or not.
 * The advice is only expressed in ounces, whereas the medical literature is in grams.

I think this needs revision by someone with medical knowledge. Michael Glass (talk) 23:12, 11 January 2011 (UTC)


 * Indeed not so simple as it appears . There are links between too much weight gain diabetes, obesity and many other adverse outcomes . Feeding techniques may have less influence than prenatal and other factors . I am too busy to look at it anytime soon - keep in mind quite often less information is better. Richiez (talk) 12:19, 23 February 2011 (UTC)

Agreed. I have removed the section. Michael Glass (talk) 05:38, 25 February 2011 (UTC)

Palin vs Palin
Worth a mention? Hcobb (talk) 22:39, 24 February 2011 (UTC)

Removing content from introduction
It says "Recent British research" but is so confusingly formulated that it is not clear which recent research and not needed anyway. Richiez (talk) 00:19, 27 February 2011 (UTC) Recent British research suggested that though breastfeeding was still recommended for 4 months, solid food should be introduced after that to reduce the incidence of iron deficiency, allergies to peanuts and early onset coeliac disease. However, the British Department of Health stated, "Breast milk provides all the nutrients a baby needs up to six months of age and we recommend exclusive breastfeeding for this time." The WHO recommendation for exclusive breastfeeding for 6 months is important in developing countries where there is a higher incidence of gastroenteritis. This research has been criticized as biased as the paper states three of the four authors "have performed consultancy work and/or received research funding from companies manufacturing infant formulas and baby foods within the past three years".

it was a review of old research not a new study anyway

Hormones
Do babies always get a whole lot of estrogen from the milk, or is that just a rare occurrence? I've heard of, like, babies lactating, and that makes me worry what might happen if a kid kept nursing for years, which otherwise sounds like the common sense thing to do indefinitely. —Preceding unsigned comment added by 75.73.70.113 (talk) 16:44, 22 April 2011 (UTC)

Biological norm
The current article strongly transmits cultural values of artificial substitutes being the norm for feeding children. This is expressed in the wording like "benefits", "fewer infections", etc. I suggest the article is reworded to have a biological norm of breastfeeding as the norm and all other forms of feeding measured against the norm. As it is done in all fields of biology and medicine.НаташаВ (talk) 19:06, 28 June 2011 (UTC)

Progress
It's been a long time since I worked on this article. The progress made has been excellent and I applaud those of you who have been working on it. violet/riga (t) 21:20, 2 August 2011 (UTC)

Potential source on US practices
The following citation was added to the further reading list.

I moved it here because I am not sure that it merits coverage there, but it might serve as a useful source for information to incorporate into the article. 04:21, 12 September 2011 (UTC)

This may be apropos the item under "Race and culture," which needs a citation. Zodon (talk) 06:30, 12 September 2011 (UTC)

Average age for weaning being 4 years is suspect.
In fact the cited source for this, Baldwin, Elizabeth N. (2001). "Extended Breastfeeding and the Law". Breastfeeding Abstracts 20 (3): 19–20, cites a different source (Ester Davidowitz, "The Breastfeeding Taboo," Redbook (July 1992): 114.) for this claim, so at the very least the source should be updated. Furthermore this stat is seemingly contradicted by the sections on this entry which discuss breast feeding in other cultures. It would be good to get a consensus view for this stat instead of relying on one expert. — Preceding unsigned comment added by 92.236.181.33 (talk) 10:53, 26 October 2011 (UTC)

Fore-milk and hind-milk
I am not trying to be pedantic but this should not be oversimplified. Looking at the article there are bigger problems than that, the whole layout is a bit strange. IMO first and foremost should come a section describing lactation. Benefits, Pro & Con sections and WP:MAN have currently too much weight. Richiez (talk) 10:18, 1 November 2011 (UTC)

Just noticed that fore-milk and hind-milk are described in breast milk. Richiez (talk) 10:30, 1 November 2011 (UTC)

Quick Questions for senior editors
I put in an external link (the last one, "Breastfeeding support" by celebrities, with photos and captions) and the left part is not in blue like the other external links listed. I look at the code and cannot see why. tia, Charles Edwin Shipp (talk) 00:22, 4 April 2012 (UTC)

Frequent feeding and foremilk
It is incorrect to state that frequent breastfeeding would result in too much formilk as when breasts are frequently emptied the milk does not separate into fore and hind and the overall fat content is actually higher, see http://www.drmomma.org/2010/01/case-for-cue-feeding.html how can i make more milk my baby like to eat — Preceding unsigned comment added by 108.216.13.122 (talk) 03:24, 28 April 2012 (UTC)

Human-animal breastfeeding
Editors here might be interested in seeing the new article Human-animal breastfeeding. I have not got the slightest idea of how I can work it into this article, though, so I'm afraid I'll have to leave that to others. Prioryman (talk) 21:31, 4 May 2012 (UTC)


 * I've added it to the see also section for now. Graham 87 05:08, 5 May 2012 (UTC)

Useful source
Here a recent New Yorker piece with lots of sources within it, if anyone wants to add bits to our article: . Mothers Milk content  — Preceding unsigned comment added by 120.60.161.207 (talk) 20:52, 1 September 2012 (UTC)

Public awareness and acceptance
The section 12 "sociological factors" and 12.1 "breastfeeding in public" has a tag asking for more content. There is a current article (probably many) about nursing mothers in the military, this one with a great picture: two infant sons nursing left and right breasts of a very photogenic military mom standing next to another photogenic military mom nursing an infant daughter—a great picture. They are poising outside, in uniform, smiling down at their three babies. The title is "Military Moms Breastfeeding in Uniform Stirs Controversy" — Charles Edwin Shipp (talk) 14:02, 1 June 2012 (UTC)

Undid revision 499874321 by 95.149.92.28 (talk) Please discuss on talk page.
I think you need to be more selective in your deleting of referenced material. Much of this simply needs to be rewritten, but does not fall outside the scope of the topic, IMO. — Preceding unsigned comment added by Rgambord (talk • contribs) 18:02, 30 June 2012 (UTC)

Risks
Hi, I realize that the benefits of breastfeeding outweigh the risks involved... I'm not trying to say otherwise, however I am concerned that the article seems to have whitewashed or ignored the risks in order to endorse breastfeeding. To my knowledge, Wikipedia is not supposed to provide endorsements, but neutral articles that contain all the facts. For example the US Agency for Toxic Substances and Disease Registry has found that breast milk contains dangerously high levels of dioxins (much higher than those found in formula or cow's milk). It notes that the benefits of breastfeeding outweigh the risks. http://www.atsdr.cdc.gov/ToxProfiles/tp.asp?id=366&tid=63. --Lacarids (talk) 13:19, 24 October 2012 (UTC)

Amounts
The FITS 2008 study provides amounts, which should probably be added:

"For breastfed infants, the estimate is based on amounts of breast milk typically consumed per day (26.4 fl oz for those aged 0 to 5.9 months, and 20.7 fl oz for those aged 6 to 11.9 months), minus the consumption of breast milk substitutes. For toddlers, 3 fl oz per breastfeeding occasion is assumed for ages 12 to 17.9 months, and 2 fl oz is assumed for ages 18 to 41.9 months."

The source has the free full text online at http://www.journals.elsevierhealth.com/periodicals/yjada/article/S0002-8223%2810%2901660-3/fulltext or. WhatamIdoing (talk) 18:11, 3 December 2012 (UTC)

Re-order?
Right now this page reads like a pamphlet pushing breastfeeding. Breastfeeding is good, but this page should not be about making that point. The sections which list the benefits of breastfeeding to infants and mothers, and the listing of which organizations support those positions, should be at the end of the article. Descriptive information like the sections on methods, diet, and differences around the world should take priority. This is especially true since while some of the "benefits" section documents accepted facts, others reference findings supported by only a handful of studies, and which are still contested in the medical community. I don't propose removing any of these sections, as they all provide relevant information, but the article should certainly be re-ordered to present the description of breastfeeding and worldview first. Any objections? — Preceding unsigned comment added by Kamahaoma (talk • contribs) 04:40, 16 December 2012 (UTC)


 * This is a huge article with quite a few related articles and unfortunately few editors have the time to properly watch it and keep in shape. Now a complete re-ordering is a huge task and given that you appear to be quite new here I would suggest to read through the articles that are related and gather experience trying to improve one of the smaller ones, perhaps Human breast milk. Even if you simply watch all related articles and make sure that no new nonsense is introduced that would help quite a bit. It is not just about this article - somehow the whole framework needs to be sorted so that content is not duplicated all over the place. On the other hand content such as lactogenesis is hard to find unless you know what you are looking for and human lactogenesis somewhat lacking. Breastfeeding difficulties could also use a sweep. Richiez (talk) 12:21, 16 December 2012 (UTC)

HIV reference in intro
Hi, I am completely new, and would not have a clue about editing, but this line here in the intro is directly contradicted by the whole section on HIV further down the article.

"In developed countries with access to infant formula and clean drinking water, maternal HIV infection is an absolute contraindication to breastfeeding (regardless of maternal HIV viral load or antiretroviral treatment) due to the risk for mother-to-child HIV transmission."

Can someone clean this up?

Thanks 180.150.96.31 (talk) 10:20, 11 April 2013 (UTC)


 * Hi there and thanks for your note. I have been working on this article little by little and I am unhappy with the HIV section as a whole.  I believe that it is far too detailed for this article and should be moved to the Breastfeeding difficulties or its own article.  I would keep only the WHO section with a short introduction.  What do you think?


 * Re the statement, I fixed it. I get the idea that thinking is currently changing re nursing with HIV and that it is being gradually accepted that a woman that is taking medication can safely nurse her infant but that everyone is still afraid to come right out and state it as a fact and a recommendation.  Here is a study.


 * OK, now I'm starting to understand why there is so much confusion. This information comes from the International Breastfeeding Journal


 * Conclusions: The papers together highlight some of the key challenges that emerged in the wake of WHO's 2001 HIV and infant feeding guidelines. They reveal the complexity of dilemmas and the adverse effects that can be generated by global policy guidelines that are very distant from local lives.  The WHO infant feeding guidelines have changed considerably since the studies in this issue were carried out. In light of new evidence, operational experiences and increased availability of ARV both for prophylaxis and treatment, one may ask how relevant the results in the present papers are to current and future PMTCT programme implementation. Recent guidelines have a broader approach than the 2001 version. The protection of maternal prenatal and postnatal health, viral load and CD4 status have been included in addition to HIV-free survival of the child [28]. The infant feeding recommendations are also dramatically altered. Despite such radical changes, it remains a legacy of the decade that the 2001 guidelines became extremely influential as they coincided with the large scale roll-out of the PMTCT programme, and were fundamental in the training of a generation of postnatal PMTCT counsellors. It is most probable that the ambiguous policy on breastfeeding launched in these guidelines will have long lasting repercussions for public health efforts on infant feeding in sub-Saharan Africa for years to come. It may take years for national programmes and health services to overcome the confusions created in the wake of the WHO's 2001 infant feeding recommendations. It may take even longer to return breastfeeding to its social position as the "the only way to feed an infant" [34], as a condition for child survival and as a fundamental commitment of motherhood [36]. Gandydancer (talk) 14:47, 11 April 2013 (UTC)

total one-sidedness in article, and prompt deleting of any attempts to provide balance
Whoever you are, as you know, you have several times completely deleted my attempts to provide neutrality and balance to your article. You apparently feel it's OK to do that, but it isn't. You haven't suggested any alternatives to my attempts to provide neutrality, you merely promptly delete everything I do. Do you deny that this is a valid description of what you have done many times? PollutionAction (talk) 03:44, 29 July 2013 (UTC)

Split HIV section?
This article is well beyond the recommended length. I've talked to a couple of experienced editors (Doc James and WhatamIdoing) and they agree that the HIV section should be split to a separate article. I've never done a split and have no special interest in learning, but I'd be glad to tidy up both this article and the split article if someone were willing to do the actual split. Anyone? Gandydancer (talk) 15:35, 23 April 2013 (UTC)
 * What page name do you want? It's just a matter of copying and pasting, with an edit summary like "copied from Breastfeeding".  WhatamIdoing (talk) 15:09, 20 June 2013 (UTC)

Sorry to take so long to get back to this. How's this:

Breastfeeding with HIV infection
Breastfeeding remains a common practice in parts of the world where the occurrence of HIV is highest and the fewest alternative feeding options exist. The difficult dilemma faced by the HIV-positive mother is whether to breastfeed her infant in keeping with cultural norms but in doing so risk transmitting the virus through breast milk, or to pursue formula feeding, which comes with its own set of risks, including a higher rate of infant mortality from diarrheal illnesses, while reducing transmission of HIV. More recently, treatment of mothers and/or their infants with antiretroviral drugs has become an option, but the effect of these agents when taken during breastfeeding is a newer field of study. Where antiretroviral treatment is not available, it known that exclusive breastfeeding is much safer than mixed feeding (the supplementation of breastfeeding with other foods), and should be encouraged. Recent research regarding maternal treatment with highly active antiretroviral therapy (HAART) suggests maternal HAART can drastically reduce the risk of transmission of HIV. Infant prophylaxis has been intensively studied in several trials and has been shown to be as effective as maternal treatment with antiretrovirals, reducing the transmission rate after 6 weeks to as low as 1.2%. There is hope that perinatal HIV transmission may be greatly reduced in breastfeeding populations worldwide through a combination of behavioral interventions that encourage exclusive breastfeeding and pharmacologic interventions with antiretrovirals for mothers and/or their infants. here:

I went ahead and deleted my previous attempt and my conversation about it--people don't have time to read my mistakes and chatter. I hope this one is better. Gandydancer (talk) 22:37, 26 July 2013 (UTC)

When this summary is entered into the article I will also add some WHO sources. Also, for now I have completely sidestepped the following information:

''The only definite exception to the [information on being ill/taking medications] is HIV infection in the mother. Until we have further information, it is generally felt that the mother who is HIV positive not breastfeed, at least in the situation where the risks of artificial feeding are considered acceptable. There are, however, situations, even in Canada, where the risks of not breastfeeding are elevated enough that breastfeeding should not be automatically ruled out. The final word is not yet in. Indeed, recently information came out that exclusive breastfeeding protected the baby from acquiring HIV better than formula feeding and that the highest risk is associated with mixed feeding (breastfeeding + artificial feeding). This work needs to be confirmed.''

This article is extremely long and we need to discuss further splits. Gandydancer (talk) 23:42, 26 July 2013 (UTC)


 * I think this proposal is okay, assuming you're happy with the source. I haven't had time to read up.  I'm concerned about the "About.com" information and would omit it in favor of WHO and other major sources.
 * I think it would be worthwhile giving this text a small copyedit to remove language like difficult dilemma or drastically reduced. WhatamIdoing (talk) 23:30, 8 August 2013 (UTC)


 * Well, actually this information was not so easy to put together as one might think. The WHO gave out what it now considers bad information a few years ago and is still trying to correct it.  Furthermore, some new info suggests that breastfeeding, even by an infected mother, may not be so dangerous as once thought. I don't know why I used the word "drastic"--perhaps the source used it without being more specific.  But I will try to correct it.  As for "difficult", from memory I remember that in Africa it is a very difficult (cultural--if only we could have that problem in the US...) decision.  It would be great if someone with an interest in HIV would work on the article.  As for myself, it seems that every year I find that I have less and less time to work on stuff that gives me pleasure and find myself in long drawn-out disagreements related to corporate articles, etc.  Frustrating.  How you manage to get all the work done that you do I will never understand!  Gandydancer (talk) 00:03, 9 August 2013 (UTC)

prompt deleting of all attempts to provide balance to a one-sided article
Every time I try to present evidence that contradicts the one-sided promotion of breastfeeding, it is promptely reverted. There are many studies in reputable scientific journals that show adverse effects of breastfeeding. What gives you the right to delete whatever evidence I present? You say nothing specific about any problem with any of my edits.PollutionAction (talk) 20:08, 6 August 2013 (UTC)
 * Hi there. The reason that you keep getting reverted is that you have not provided any of the studies that you say exists.  Please do so here on the talk page and we can discuss.  Gandydancer (talk) 21:03, 6 August 2013 (UTC)

studies cited in edits that keep getting deleted
Hello Gandydancer,

I'm glad to see you finally responding, but it would be better if what you said were not obviously untrue. (I use those words knowing that we are supposed to be collegial; they are not meant to be insulting, they are merely factual in description of what you wrote to me.) If you look at what I inserted, you will see citations of and links to several studies that support a balanced presentation of evidence on this topic. I included citations to only a few of the many studies that support the alternative viewpoint, but if you would prefer I'll cite many more. Can you go back and review what I wrote before and see what I am referring to, or do I need to send it again? Would it be better if I included all 30 of the studies indicating adverse effects of breastfeeding? I could also link to a separate web page listing those studies separately, at www.breastfeeding-studies.info, if you would prefer that the article not be cluttered with footnotes. You can also go to that web page to see the studies that I feel are relevant.PollutionAction (talk) 21:43, 6 August 2013 (UTC)
 * Thank you so much for your quick response. I would very much appreciate it if you would introduce your studies here on the talk page and we could then discuss them.  Gandydancer (talk) 21:59, 6 August 2013 (UTC)

Breastfeeding Orgasm
Some women experience orgasm during breast-feeding, despite not being sexually aroused, due to the stimulation of the nipples and the release of oxytocin, a hormone that causes uterine contractions. Source: Touch Me There! By Yvonne K. Fulbright http://books.google.ca/books?id=ngakMuLJO7wC&pg=PP1&dq=touch+me+there+by+yvonne+k+fulbright. — Preceding unsigned comment added by Bosniak (talk • contribs) 00:22, 21 June 2009 (UTC)‎

listing of easily-found studies negative to effects of breastfeeding
Autism: (1) The following study examined data from all 50 U.S. states and 51 U.S. counties and concluded that there was a direct correlation between exclusive breastfeeding and autism, and that the correlation became stronger as duration of exclusive breastfeeding became longer. "Autism rates associated with nutrition and the WIC program." Shamberger R.J., Phd, FACN, King James Medical Laboratory, Cleveland, OH J Am Coll Nutr. 2011 Oct;30(5):348-53. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/22081621 The full text, including the quoted passages, can be purchased for $7 or reference librarians at local libraries could probably obtain it at no charge.

(2) Trends in Developmental, Behavioral and Somatic Factors by Diagnostic Sub-group in Pervasive Developmental Disorders: A Follow-up Analysis, pp. 10, 14  Paul Whiteley (Department of Pharmacy, Health & Well-being, Faculty of Applied Sciences, University of Sunderland, UK), et al. Autism Insights 2009:1 3-17 at http://www.la-press.com/trends-in-developmental-behavioral-and-somatic-factors-by-diagnostic-s-article-a1725). This U.K. study found that 65% of autistic cases had been exclusively breastfed for four weeks. Two other sources (Patterns of breastfeeding in a UK longitudinal cohort study, Pontin et al., and Infant Feeding 1995, Foster et al.) are compatible in showing a 28% comparable rate of breastfeeding in the general U.K. population.

(3) Breastfeeding and Autism P. G. Williams, MD, Pediatrics, University of Louisville, and L. L. Sears, MD, presented at International Meeting for Autism Research, May 22, 2010, Philadelphia Marriot  https://imfar.confex.com/imfar/2010/webprogram/Paper6362.html)   This study found a 37% rate of breastfeeding among children diagnosed with autism, as compared with 14% with comparable breastfeeding in that state's (Kentucky's) population.

ADHD:

The study cited just below, of effects of PBDEs in breast milk, found that children who had consumed breast milk with first and second quartile levels of PBDEs showed over three and two times the likelihood of later having ADHD, based on behavior test scores, compared with children who had consumed breast milk with below-median levels of PBDEs. (Lactational Exposure to Polybrominated Diphenyl Ethers and Its Relation to Social and Emotional Development among Toddlers Hoffman, et al., Environ Health Perspect. 10/2012; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491946/ )

The studies from here down to footnote 11x relate to asthma and/or allergies

(11a) duration is a risk factor for atopic eczema. Bergmann RL et al., Clin Exp Allergy. 2002 Feb;32(2):205-9. Found at http://www.ncbi.nlm.nih.gov/pubmed/11929483

(11b) Breastfeeding and allergies: time for a change in paradigm? Duncan JM, et al., Curr Opin Allergy Clin Immunol. 2008 Oct;8(5):398-405. doi: 10.1097/ACI.0b013e32830d82ed. found at http://www.ncbi.nlm.nih.gov/pubmed/18769191

(11c) The association between infant feeding practices and subsequent atopy among children with a family history of asthma, Mihrshahi S, et al., Clin Exp Allergy. 2007 May;37(5):671-9. found at http://www.ncbi.nlm.nih.gov/pubmed/17456214

(11d) Long-term relation between breastfeeding and development of atopy and asthma in children and young adults: a longitudinal study. Sears MR, et al., Lancet. 2002 Sep 21;360(9337):901-7. Found at http://www.ncbi.nlm.nih.gov/pubmed/12354471

(11e) Risk factors for atopic dermatitis in New Zealand children at 3.5 years of age. Purvis DJ, et al., Br J Dermatol. 2005 Apr;152(4):742-9. http://www.ncbi.nlm.nih.gov/pubmed/15840107

(11f) Breastfeeding and risk of atopic dermatitis, by parental history of allergy, during the first 18 months of life. Benn CS, Am J Epidemiol. 2004 Aug 1;160(3):217-23. Found at http://www.ncbi.nlm.nih.gov/pubmed/15257994

(11g) Breastfeeding and atopic eczema in Japanese infants: The Osaka Maternal and Child Health Study. Miyake Y, et al., Pediatr Allergy Immunol. 2009 May;20(3):234-41. doi: 10.1111/j.1399-3038.2008.00778.x. Found at http://www.ncbi.nlm.nih.gov/pubmed/19438982

(11h) Maternal asthma status alters relation of infant feeding to asthma in childhood. Wright AL et al., Adv Exp Med Biol. 2000;478:131-7. Found at http://www.ncbi.nlm.nih.gov/pubmed/11065066

(11j) Gene polymorphisms, breast-feeding, and development of food sensitization in early childhood. Hong X, J et al., Allergy Clin Immunol. 2011 Aug;128(2):374-81.e2. doi: 10.1016/j.jaci.2011.05.007. Found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149737/

(11k) Breastfeeding history and childhood allergic status in a prospective birth cohort. Wegienka G, et al., Ann Allergy Asthma Immunol. 2006 Jul;97(1):78-83. Found at http://www.ncbi.nlm.nih.gov/pubmed/16892786

(11m) The Asthma Epidemic, Waltraud Eder, M.D., et al, New England Journal of Medicine, N Engl J Med 2006;355:2226-35. Copyright © 2006 Massachusetts Medical Society.found at http://physio.ucsf.edu/GEMS/courses/Immunology/materials/fa11_essential_immunology/september_6_asthma/elder_nejm.pdf


 * NOTE: The studies listed in footnotes 11n and 11p were found in Breastfeeding and allergies: time for a change in paradigm? Duncan JM, et al., Curr Opin Allergy Clin Immunol. 2008 Oct;8(5):398-405. doi: 10.1097/ACI.0b013e32830d82ed. found at http://www.ncbi.nlm.nih.gov/pubmed/18769191


 * (11n) Prolonged exclusive breastfeeding is associated with increased atopic dermatitis: a prospective followup study of unselected healthy newborns from birth to age 20 years. Pesonen M et al., Clin Exp Allergy 2006; 36:1011–1018.*


 * (11p) Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood. Wright AL,et al., Thorax 2001; 56:192–197. Also: Effect of breastfeeding on lung function in childhood and modulation by maternal asthma and atopy. Guilbert TW et al., Am J Respir Crit Care Med 2007; 176:843–848.*

(11r) Interactions between breast-feeding, specific parental atopy, and sex on development of asthma and atopy. Mandhane PJ et al., J Allergy Clin Immunol. 2007 Jun;119(6):1359-66. Epub 2007 Mar 13. Found at http://www.ncbi.nlm.nih.gov/pubmed/17353035/

(11s) Breast-feeding and atopic disease: a cohort study from childhood to middle age. Matheson MC, et al., J Allergy Clin Immunol. 2007 Nov;120(5):1051-7. Epub 2007 Aug 31. Found at http://www.ncbi.nlm.nih.gov/pubmed/17764732

(11t) Infant Feeding Practices and Nut Allergy over Time in Australian School Entrant Children, Jessica Paton, et al., Int J Pediatr. 2012; 2012: 675724. Published online 2012 July 3. doi: 10.1155/2012/675724 found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3397206/

(11u) Relation between Breastfeeding and the Prevalence of Asthma: The Tokorozawa Childhood Asthma and Pollinosis Study, Yousuke Takemura et al., Oxford Journals Medicine American Journal of Epidemiology Volume 154, Issue 2 Pp. 115-119. American Journal of Epidemiology aje.oxfordjournals.org Am. J. Epidemiol. (2001) 154 (2): 115-119. doi: 10.1093/aje/154.2.115 found at http://aje.oxfordjournals.org/content/154/2/115.abstract?ijkey=119530f7421c3b14e82a501acb68c2f174e4b041&keytype2=tf_ipsecsha

(11v) Risk factors for early, persistent, and late-onset wheezing in young children. Rusconi F,, et al. Am J Respir Crit Care Med 1999; found at http://www.atsjournals.org/doi/pdf/10.1164/ajrccm.160.5.9811002

(11w) Feeding practices of babies and the development of atopic dermatitis in children after 12 months of age in Armenia: is there a signal? Sahakyan A, et al., Eur J Epidemiol. 2006;21(9):723-5. Epub 2006 Oct 18. Found at http://www.ncbi.nlm.nih.gov/pubmed/17048079

(11x) Infant feeding practices and physician diagnosed atopic dermatitis: a prospective cohort study in Taiwan. Chuang CH et al., Pediatr Allergy Immunol. 2011 Feb;22(1 Pt 1):43-9. doi: 10.1111/j.1399-3038.2010.01007.x. Found http://www.ncbi.nlm.nih.gov/pubmed/20573037

Diabetes-related studies:

(8k) Lack of association between early exposure to cow's milk protein and beta-cell autoimmunity. Diabetes Autoimmunity Study in the Young (DAISY) Norris JM et al., JAMA. 1996 Aug 28;276(8):609-14.

(8l) Indian J Pediatr.2001 Feb;68(2):107-10. IDDM and early exposure of infant to cow's milk and solid food. Esfarjani F et al., National Nutrition and Food Technology Research Institute, Shaheed Beheshti University, Tehran, IR, Iran. http://www.ncbi.nlm.nih.gov/pubmed/11284175

(8m) IDDM and early infant feeding. Sardinian case-control study. Meloni T et al., Diabetes Care. 1997 Mar;20(3):340-2. Istituto di Clinica Pediatrica e Neonatologica, University of Sassar, Italy.

(8n) Early infant feeding and type 1 diabetes. Savilahti E et al., Eur J Nutr. 2009 Jun;48(4):243-9. doi: 10.1007/s00394-009-0008-z. Epub 2009 Mar 5. Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland

(8o) The relation of early nutrition, infections and socio-economic factors to the development of childhood diabetes. Telahun M et al., Department of Paediatrics and Child Health, Faculty of Medicine, Addis Abeba University. Ethiop Med J. 1994 Oct;32(4):239-44. At

(8p) IDDM and Early Infant Feeding: Sardinian case-control study Tullio Meloni, MD (+5 other MDs and one PhD) Istituto di Clinica Pediatrica e Neonatologica, University of Sassari Sassari American Diabetes Assn., Diabetes Care, Copyright © 1997 by the American Diabetes Association

PollutionAction (talk) 23:06, 6 August 2013 (UTC)


 * I see that there is a web site:  Is this your site? Gandydancer (talk) 23:23, 6 August 2013 (UTC)


 * Yes. But let's discuss the topic at hand, which is why you keep deleting my well-documented edits, thereby preserving the total one-sidedness of the article.PollutionAction (talk) 13:26, 7 August 2013 (UTC)


 * OK, let's try to discuss the last changes that you made that were reverted. First, you changed "Experts" to "Some experts"...  To do that you will need to provide a source that is more reliable than the WHO, the CDC, the AAP, and the NHS.  Please expain your reasoning.  Gandydancer (talk) 14:44, 7 August 2013 (UTC)


 * You are making up a requirement that I am confident does not exist in Wikipedia. However, note the following: "Breastfeeding is not as beneficial as once thought" (06.01.2010) published by the Norwegian University of Science and Technology, at http://www.ntnu.edu/news/breastfeeding Their statement was based on findings of the PROBIT study in Belarus. (This article, on the website of the Norwegian University of Science and Technology, indicated no author; it therefore appears to be an established, official statement of the University, dated 2010 and accessed in 2013.)  Also,

A U.S. study of all 50 U.S. states and 51 U.S. counties, carried out by a PhD and Fellow of the American College of Nutrition, found that "exclusive breast-feeding shows a direct epidemiological relationship to autism" and also, "the longer the duration of exclusive breast-feeding, the greater the correlation with autism." Autism rates associated with nutrition and the WIC program. Shamberger R.J., Phd, FACN, King James Medical Laboratory, Cleveland, OH J Am Coll Nutr. 2011 Oct;30(5):348-53. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/22081621

To promote a productive discussion, please do not make up your own rules.PollutionAction (talk) 16:14, 7 August 2013 (UTC) Please also don't deliberately drag this out, while the propaganda piece that you have reverted to continues in place. One response from you consists of nothing but a non-productive question about a website I am affiliated with. Another response from you consists of challenging me about a change of just one or two words, out of many things that you will probably end up challenging. At that rate, you will be able to drag out this back and forth for a very long time. The productive thing would be to state all your objections at once. Please do so.PollutionAction (talk) 21:37, 7 August 2013 (UTC)


 * I will continue to revert you if you do not provide acceptable refs with the changes that you make in the article. Gandydancer (talk) 23:50, 7 August 2013 (UTC)


 * OK, tell me which changes you consider not to have acceptable refs, and say specifically why each of the refs I have already provided are not acceptable.72.73.47.110 (talk) 15:24, 8 August 2013 (UTC)


 * I already did. You changed "Experts" to "Some experts"... To do that you will need to provide a source that is more reliable than the WHO, the CDC, the AAP, and the NHS.  Gandydancer (talk) 16:09, 8 August 2013 (UTC)


 * OK, so that's your only complaint about my edits, that's your complete reason for reverting all my edits?

Who, besides you, says that in order to say "some experts" instead of "experts," one must provide sources that somebody else will agree are MORE reliable than others?PollutionAction (talk) 16:36, 8 August 2013 (UTC)


 * Wikipedia policy says that at WP:Reliable sources. I will revert anything you add that does not comply with WP:Reliable sources.  Gandydancer (talk) 20:16, 8 August 2013 (UTC)


 * Wikipedia does not appear to say any such thing at WP:Reliable sources. Please tell me which paragraph at that link says anything of the kind, i.e.,that in order to say "some experts" instead of "experts," one must provide sources that somebody else will agree are MORE reliable than others.

To repeat my earlier question: Is that complaint about saying "some experts" your only complaint about my edits, that's your complete reason for reverting all my edits?PollutionAction (talk) 21:44, 8 August 2013 (UTC)
 * I think this conflict can do with some third and fourth and fifth opinions, so I posted an attention-getting note on WP:ANI--not for you two to hash it out there, but to bring outsiders in. Thank you, and carry on, Drmies (talk) 21:51, 8 August 2013 (UTC)


 * Yes, I agree wholeheartedly. Thank you very much.PollutionAction (talk) 22:05, 8 August 2013 (UTC)


 * Comment I saw Drmies' notification on AN/I and found this conversation. Unfortunately it looks a little too complex for me to get involved as I'm short on time but scanning it briefly I do have a couple comments.  For one, words like "some" should generally be avoided per WP:WEASEL.  In fact, if you changed it to "some experts" within a week someone will have added a  template.  Secondly, it seems as though the sources provided by PollutionAction are WP:PRIMARY studies and as such can not be used to make anything close to a controversial statement.  Instead, WP:SECONDARY studies published in peer reviewed journals would be required to keep the article in line with WP:MEDRS.  With that said, there are most likely experts who disagree with the NIH, WHO, etc, and though they might not be as "reliable" as the the aforementioned groups, I don't see the problem with attributing "experts" a la "Experts from major health organizations such as the [WHO, NIH, whatever] recommend that children..."


 * To be clear, this is not an endorsement of adding controversial/contradictory information to the article, but rather a recognition that universal statements such as "experts agree" are inaccurate if even a single expert disagrees. It may be the case that such a hypothetical expert's opinion shouldn't be included in the article, but it does render any universal obsolete and thus our article inaccurate.  N o f o rmation  Talk  22:30, 8 August 2013 (UTC)


 * (Edit conflict)


 * :(Edit conflict) I was in the process of a long edit to try to explain Wikipedia sourcing but will skip it. It is my impression that this editor is not attempting to bias the article but that s/he does not understand the difficulties that sourcing can present.  Although as far as I can see (I have not read everything that s/he has offered), the info seems to be fringe, but that is not to say that there may not be a way to briefly mention it. It will be good to have others look at the info as well.  Gandydancer (talk) 22:39, 8 August 2013 (UTC)
 * This is the part I can't really comment on as I'm not up to date on the latest breastfeeding science so I really don't know if any of this warrants a mention. I just think the sourcing should be attributed, and as Summer points out below it makes a more compelling statement than simply "experts." @PollutionAction: after reading the links I provided above regarding primary and secondary sources, if you have any secondary sources would you please post the highest quality and most recent here for review?  We're all volunteers here so few people are willing to wade through such a long list just to see if any of it is usable.   N o f o rmation  Talk  22:52, 8 August 2013 (UTC)


 * You seem to misunderstand me because I am certainly not arguing that the sourcing should not be attributed.   However the WHO, CDC, etc., need to be mentioned rather than "nearly all" or similar because there is not a single authority that suggests that babies best form of nutrition for the first six months is anything but mother's milk. Gandydancer (talk) 00:40, 9 August 2013 (UTC)

(edit conflict) We do not know if all experts believe anything (there's always at least one "expert" who believes vaccines caused a faked moon landing...). Likewise, we don't know if it's only "some" either. We do know that "The World Health Organization, the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the National Health Service state..." Bonus: This is more compelling that the vague "experts". - Sum mer PhD  (talk) 22:44, 8 August 2013 (UTC)
 * The problem with "some experts" is that it is generally understood to mean "not-most experts". In this case, it would be accurate to say "nearly all" experts hold the mainstream view that breastfeeding is highly desirable, and "only a tiny minority" believe otherwise.  WhatamIdoing (talk) 23:54, 8 August 2013 (UTC)


 * Some of these are potentially usable, but most are not. Generally speaking, on a major subject area like this, if you go to PubMed and click on "Publication Types, MeSH Terms, Substances, Grant Support" under the abstract, you can consider sources that say "Review" and should reject almost everything that doesn't.
 * PollutionAction, I'm sure this isn't going to please you, but if this article puts forward the viewpoint that the typical healthcare professional holds about health (notice that's not usually the same as the viewpoint held by the leading-edge researchers), then it correctly describes the subject per WP:NPOV and WP:DUE. Wikipedia is not trying to change the world and resists WP:RECENTISM.  WhatamIdoing (talk) 23:50, 8 August 2013 (UTC)


 * Comment from a passerby. PollutionAction needs a thorough review of WP:MEDRS and WP:FRINGE. PollutionAction, please obtain consensus on this Talk page before making any other controversial edits. The next incident of edit warring will be met with an extended block. -- Laser brain  (talk)  00:19, 9 August 2013 (UTC)
 * Thank you all. I'd appreciate it if you were to continue improving this article. 's remark is very, very valid and points to real writing suggestions. On a personal note, mine were nursed until 2, and I'm wondering if it helps turns kids into jerks. Or does it just come naturally? Summer, you can come baby-sit ANY time. Warning: number 3 has a penis, and I'm sure he thinks it's huge. Drmies (talk) 01:33, 9 August 2013 (UTC)
 * I'm not sure if I should mention it or not, but I'm gonna: There is some similar discussion over at Talk:Breast milk.
 * As for your theory about yer youngins, Doc, n=3 doesn't allow for strong conclusions. Besides, we have confounding variables (your genes, decreasing numbers of pirates, etc.) to consider before tying this to your wife's contributions. - Sum mer PhD  (talk) 02:22, 9 August 2013 (UTC)

Breastfeeding promotion article expansion
Hi all, I am a student at Rice University and am planning to revise the Breastfeeding promotion article for a class assignment. Some of the changes I plan to make are adding a section at the beginning detailing different promotion techniques (such as peer support, lactation consultants, and social marketing), the cultural and social determinants of breastfeeding promotion, reorganizing the article so that worldwide initiatives (Baby Friendly Hospital Initiative, La Leche League, WHO recommendations, etc) are billed as such and not just mentioned in one country's subsection, and focusing on breastfeeding promotion in a diverse group of countries. This article would be focused more on the social/economic determinants of breastfeeding promotion than a strictly medical article (although sections such as Breastfeeding and HIV would also be included). For example, the Sociological factors subsection in this article has similar information to that which might be included in the Breastfeeding promotion article. If any of y'all have feedback, ideas that you think should be included, or want any clarification, please let me know - I'd love any help you have to give! Thanks, Ktpost68 (talk) 16:22, 7 October 2013 (UTC)
 * Hi there and welcome. It's good to have you here.  Let me know how I may be able to help.  I have a few ideas but I will wait to see how your editing is coming along... One thing, I noticed that user Whatamidong mentioned on the project page that it would be a good idea to get something into this article that directs readers to your improved page.  I note that this article gets around 45000 hits a month but the promotion page gets only around 500--it would be good to see that number go up! Gandydancer (talk) 00:42, 10 October 2013 (UTC)
 * I've made the first round of edits to Breastfeeding promotion, adding sections on Peer support and counseling, Cultural and social factors, and Worldwide efforts. My planned outline for the article can be found here. If there's anything I'm leaving out or if you have any suggestions let me know. Ktpost68 (talk) 14:53, 24 October 2013 (UTC)

Lead Section / Context
I added context for the "up to 2 years" recommendation as follows: I first confirmed that the recent Cochrane Database of Systematic Reviews article restricts conclusions to breastfeed for 6 months; I updated the citation to "Save the Children" and added context for "up to 2 year" recommendation they give because of the reality of global chronic malnutrition. The same source, however, acknowledges that this is not the context in developed nations. I checked with AAP and added their recommendation (which is repeated in detail under organizational endorsements, but I think it belongs in the lead section because it appropriately qualifies that "up to 2 years" recommendation in the lead section. Benutzer41 (talk) 16:34, 26 October 2013 (UTC)

Image of physiology of breast-feeding
Could this image be relevant (it is quite large and would need to be large to show the entire text. File:2922 Let Down Reflex-new.jpg CFCF (talk) 21:02, 16 December 2013 (UTC)


 * It's a nice image but this article is already more than twice the suggested length. Why don't you try it at Lactation and see if it would work?  As long as the text is readable when one clicks the image, the size need not be so large...  Gandydancer (talk) 17:10, 17 December 2013 (UTC)

Breastfeeding Fashion
I think it would be interesting to add Breastfeeding Fashion to this article. One can definitely find fashionable clothes that have nursing systems and mothers can also use these nursing systems to avoid the unwanted attention when breastfeeding in public without using their scarf to cover up. Fabiola Grojan (talk) 10:50, 21 January 2014 (UTC)
 * You would need to find reliable sources discussing "breastfeeding fashion" to add it to the article. - Sum mer PhD  (talk) 00:25, 22 January 2014 (UTC)
 * I will try to make that happen when I have more time on my hands and I will keep in mind your advice and try to use references for everything I say. Thank you Fabiola Grojan (talk) 13:42, 22 January 2014 (UTC)

An Arabian country makes breastfeeding the law
Headline: United Arab Emirates forces new mothers to breastfeed by LAW (and gives husbands right to SUE if they don't) "The group also pointed out that is has not been made clear who will be responsible for assessing who is and is not able to breastfeed, especially as lactation specialists can be hard to find in the UAE." — FYI, Charles Edwin Shipp (talk) 23:48, 31 January 2014 (UTC)
 * http://www.dailymail.co.uk/news/article-2549580/New-mothers-breastfeed-babies-two-years-new-Emirates-laws-husbands-able-SUE-dont.html
 * The UAE Federal National Council passes Child Rights Law;
 * The law includes a clause requiring mothers to breastfeed;
 * UAE mothers must breastfeed children for at least two years;
 * Law could lead to husbands suing their wives if they do not.

Copyright problem removed
Prior content in this article duplicated one or more previously published sources. The material was copied from: http://www.thehindu.com/news/national/only-37-of-199-nations-fully-adhere-to-breastfeeding-code/article4971121.ece. Copied or closely paraphrased material has been rewritten or removed and must not be restored, unless it is duly released under a compatible license. (For more information, please see "using copyrighted works from others" if you are not the copyright holder of this material, or "donating copyrighted materials" if you are.) For legal reasons, we cannot accept copyrighted text or images borrowed from other web sites or published material; such additions will be deleted. Contributors may use copyrighted publications as a source of information, and according to fair use may copy sentences and phrases, provided they are included in quotation marks and referenced properly. The material may also be rewritten, but only if it does not infringe on the copyright of the original or plagiarize from that source. Therefore such paraphrased portions must provide their source. Please see our guideline on non-free text for how to properly implement limited quotations of copyrighted text. Wikipedia takes copyright violations very seriously, and persistent violators will be blocked from editing. While we appreciate contributions, we must require all contributors to understand and comply with these policies. Thank you. Diannaa (talk) 23:03, 12 June 2014 (UTC)

Breast/bottle controversy study
A 2014 study was conducted by Cynthia Colen and David Ramey from the Department of Sociology at Ohio State University and it was published in the Journal Social Science and Medicine. It was used to question the results of numerous studies that suggest that breastfeeding offers numerous advantages and to add a new controversy section. I have deleted all mention of it because too much importance was given to a single primary study. I would like to see this study included because from my POV its important to cover information that has gained importance because it was widely covered in the press even though it fails Wikipedia's "primary studies aren't to be mentioned per MED:RS". IMO, when any info is widely covered in the press we should include it in our science-related articles.

This site discusses the study. I'd like to add to our article but am not willing to go to all the work and have it deleted. Gandydancer (talk) 23:42, 25 July 2014 (UTC)

Quality sources to restore sections
I'm looking at the literature and pulling what I consider high quality reports and reviews. After removing MEDRS violations there is little left concerning resistance to infection so I thought I'd start there. Everything is from 2009 or later: -- CFCF  🍌 (email) 00:35, 8 February 2015 (UTC)
 * Breastfeeding protects against infectious diseases during infancy in industrialized countries. A systematic review

Inflammatory bowel disease:
 * Systematic review: the role of breastfeeding in the development of pediatric inflammatory bowel disease

General: SIDS: Allergies: Risks:
 * The risks of not breastfeeding for mothers and infants
 * Support for healthy breastfeeding mothers with healthy term babies
 * The influence of natural feeding on human health: short- and long-term perspectives.
 * Exclusive breastfeeding for six months: the WHO six months recommendation in the Asia Pacific Region.
 * Being baby friendly: evidence-based breastfeeding support.
 * Breastfeeding and reduced risk of sudden infant death syndrome: a meta-analysis
 * Risk and Protective Factors for the Development of Childhood Asthma.
 * Breastfeeding and allergy: the evidence.
 * Understanding the evidence for and against the role of breastfeeding in allergy prevention
 * Preventing breastfeeding-associated hypernatraemia: an argument for supplemental feeding (Editorial)
 * Reply from the Baby Friendly Initiative:   Gandydancer (talk) 06:15, 8 February 2015 (UTC)

Could be used to support non-MEDRS content -- CFCF  🍌 (email) 09:34, 8 February 2015 (UTC):
 * Effects of socio-economic status on breastfeeding duration and exclusivity 2010
 * Shame if you do – shame if you don't: women's experiences of infant feeding 2015
 * Exploration of Guilt Among Mothers Who Do Not Breastfeed: The Physician's Role 2008
 * "I wanted to do a good job": experiences of 'becoming a mother' and breastfeeding in mothers of very preterm infants after discharge from a neonatal unit. 2007
 * For Shame: Feminism, BreastfeedingAdvocacy, and Maternal Guilt – Philosophical review 2011
 * Ethics and Ideology in Breastfeeding Advocacy Campaigns

MEDRS-content on societal factors -- CFCF  🍌 (email) 09:34, 8 February 2015 (UTC):
 * Existential vulnerability can be evoked by severe difficulties with initial breastfeeding: a lifeworld hermeneutical single case study for research on complex breastfeeding phenomena. 2014
 * Is Breastfeeding Truly Cost Free?Income Consequences of Breastfeeding for Women 2012

Sourcing and major work
This article seems to have fallen into a state of disrepair. There is so much poorly sourced content that when removed there is little left. We need to work hard to give a proper balance to benefits of breast-feeding as well as showing the actual real errors in the reasoning of certain promoters. It is too easy to rest on the WHO and CDC without taking into account the entire literature, much of which argues against exclusive breastfeeding post month 3 in developed nations where there is a near total lack of many water-borne diseases. I will try to compile new up to date sources that can balance the article. -- CFCF  🍌 (email) 20:50, 7 February 2015 (UTC)


 * I'm looking forward to your list of sources that can balance the article. Gandydancer (talk) 22:53, 7 February 2015 (UTC)


 * CFCF you state that there is a great deal of information "which argues against exclusive breastfeeding post month 3 in developed nations where there is a near total lack of many water-borne diseases."  I'd like to see the information which you state will show the errors of "certain promoters".  Thanks.  Gandydancer (talk) 05:52, 8 February 2015 (UTC)
 * Well despite finding a whole lot of evidence that exclusive breastfeeding is desirable even in the developed world at least one of the reviews below admit there is a debate, which I think is the level where we should be as well. Also while organizations like La Leche League etc. have good intentions they represent advocacy groups that we should refrain from citing. -- CFCF  🍌 (email) 09:11, 8 February 2015 (UTC)


 * You found one article, an editorial review, but it was not a debate regarding the evidence for exclusive breastfeeding for the first six months. It is a debate about supplementing formula in the first days of an infant's life if the infant does not appear to be getting sufficient breast milk. I offered a reply by the WHO and UNICEF that finds faults in the report and offers alternative suggestions.  As editors it would be a mistake for us to give equal weight to both opinions and suggest that we need to take a middle ground and be of an opinion that controversy exists, when if fact it does not.  As far as the Le Leche League, I'm not sure why you suggest that they "have good intentions" but appear to be misinformed since as far as I remember they are not even used for facts anywhere in the article.  Gandydancer (talk) 15:32, 9 February 2015 (UTC)

Using NYtimes for medical statements
You're pushing on WP:3RR, and have restored content using the NYtimes to state: However, according to a study conducted by the CDC, the results of which were published in the journal Pediatrics, as of 2013 in the USA reliance on out-dated recommendations and considerations of convenience and cost sometimes resulted in inappropriate earlier attempts to switch to solid food.

-- -- CFCF  🍌 (email) 23:29, 7 February 2015 (UTC)
 * 3rr is the least of our worries here. You violated 3rr twice by undoing my reverts. You're supposed to start a discussion, not edit war. At least now we're discussing and I hope you realize that any return to previous editing attempts must not happen until we reach a consensus decision. Smart admins know that 3rr violations help determine exactly which edit was the first in an edit war, and they'll count up to 3rr is that as their guide.


 * That content was a very small part of much larger content you deleted in one deletion. I concede that it's entirely possible that some bits of MEDRS type content might be in there, but that doesn't justify deletion of large blocks of content that is mostly not governed by MEDRS and then using "MEDRS" as an edit summary. You need to be very specific in your editing, otherwise it looks like vandalism and removal of lots of content. That's a slap in the face to all the editors who did the hard work. Respect their efforts by AGF that they were trying to do what is right. I'm sure this article needs improvement, but try to preserve as much content, and especially references, as possible. Tweak rather than delete. -- Brangifer (talk) 23:42, 7 February 2015 (UTC)
 * I was slightly too aggressive in removing the sociological factors content. On the other hand it did include a completely unreferenced section since 2009, so violating WP:RS as well. I'm reviewing all my edits, but that would be it as far as going to far I think. -- CFCF  🍌 (email) 23:46, 7 February 2015 (UTC)

Possibly aggressive removal
This doesn't fall under MEDRS, but parts of it are far from neutral. I'm reluctant to restore it therefor: These movements in the West towards earlier weaning, however, are recent. Breastfeeding beyond the age of 1 year old was at one time a very common practice worldwide. Dr. Martin Stein wrote in Parental Concerns about Extended Breastfeeding in a Toddler that "The discussion about extended nursing is similar to that of co-sleeping. They are both characteristics of child rearing that are closely linked to time and place. In most cultures before the 20th century, both practices were the norm. Changes in social, economic, and sexual expectations altered our views of the meaning of breastfeeding and bed sharing." Extended breastfeeding was encouraged in Ancient Greek, Hebrew, and Muslim cultures. The Koran, the Talmud, and the writings of Aristotle all recommend breastfeeding for 2 to 3 years. In Breastfeeding Beyond 6 Months: Mothers' Perceptions of the Negative and Positive Consequences, Dr. S. B. Reamer states that "Over the past 100 years of American history, the acceptance of unrestricted nursing decreased and the age acceptable for weaning dropped dramatically, until the average weaning age was 3 months in the 1970s."

In reaction to the move in the West towards earlier weaning, several organizations have been founded in Western countries to support mothers who practice extended breastfeeding. These organizations include the International Childbirth Education Association and La Leche League International.

-- -- CFCF  🍌 (email) 23:51, 7 February 2015 (UTC)

2013 article about slick marketing of infant formula
' .  .  .  East Asia and the Pacific is seen as a lucrative new market for the baby food industry, with the proportion of women in the region who breastfeed falling from 45% in 2006 to 29% in 2009. Globally, the baby food industry is worth about $35bn (£22.6bn) a year, with around $25bn coming from the sale of milk formula for infants.

'In a poll of 2,400 mothers and 1,200 health workers in Pakistan, 20% of employees said they had received gifts from companies to encourage them to promote formula, while 11% of mothers said they had seen or read promotional literature while in hospitals or clinics. Both practices breach the international code. . .  '

' .  .  .  But, as well as criticising the promotion of formula milk, the report cites community and cultural pressures not to breastfeed, a shortage of health workers to advise mothers, and lack of maternity leave and pay as key reasons why some women turn to formula. . ' from "Formula milk firms accused of targeting mothers and health workers with gifts," Feb. 17, 2013, The Guardian http://www.theguardian.com/global-development/2013/feb/17/formula-milk-firms-mother-breastfeeding

There is also a separate Feb. 15, 2013, article in The Guardian: http://www.theguardian.com/world/2013/feb/15/babies-health-formula-indonesia-breastfeeding


 * posted by Cool Nerd (talk) 23:51, 2 February 2015 (UTC)
 * It might make more sense for information about Infant formula to go into the article about infant formula. WhatamIdoing (talk) 16:13, 4 February 2015 (UTC)
 * What about here as obstacles to breastfeeding? And at this point, I am just in the beginning stages of reading, excerpting, and summarizing the article.  Cool Nerd (talk) 19:24, 4 February 2015 (UTC)

--

2013 report from Save the Children: http://www.savethechildren.org.uk/sites/default/files/images/Superfood_for_Babies_UK_version.pdf


 * Hi there Cool Nerd, long time no see! The "Role of marketing" section mentions this study (3rd para).  I wonder if you should include this source?  Gandydancer (talk) 20:28, 4 February 2015 (UTC)


 * Hi Gandydancer, the Save the Children study I'm just beginning to familiarize myself with. In due time, I'll be more than happy to include it.  My next immediate project is to go back to the article cite in the 3rd paragraph, specifically the part where it talks about that formula is not really a good substitute for modest income families, not just because of lack of access to clean water which I'm familiar with, but because the family can't really afford enough formula and the baby too often ends up malnourished.  The article does mention free samples.


 * Now, does the company give just enough free samples till the mother's milk dries up? The article does not say that, and I dare not include that.  I will just go with what the article says.  Cool Nerd (talk) 19:34, 5 February 2015 (UTC)
 * As I understand it, the companies have no control over who gets the free samples, and therefore cannot control how long the supply lasts. In some countries, the companies themselves aren't even providing the free samples.  Clinics and hospitals all across the developed world buy formula out of their own pockets.
 * Also, if (as in the single case that has been so inappropriately detailed repeatedly in this article) there are pre-existing problems with supply, then giving a free sample might be helpful for low-income families. There's nothing inherent about giving a free sample for use as a partial supplement that forces the mother to stop nursing entirely, rather than using it to keep the baby alive until her supply improves (e.g., by switching to non-hormonal contraception, in the case cited).
 * This may make more sense to you in a specific example: A low-income mother presents in clinic.  The baby is undernourished right now.  Your choices are:
 * Give the baby some free infant formula and instruct the mother to keep nursing. Problem:  The mother might decide to stop nursing even if you tell her not to.
 * Tell the mother to "just keep trying". Problem:  The baby might well starve to death as a result of your advice.  Supply problems that are due to physiological defects like breast hypoplasia are never solved by "trying harder".
 * Tell the mother to take money she can't spare and go buy some formula right now. Problem:  She might or might not actually do that, i.e., your advice might lead to the baby starving to death.  Even if she does, she might stop nursing exactly like she would have in Option #1, except that you've now given her the burden of paying for all of it, instead of just most of it.
 * None of those are happy choices, but I can understand why a midwife might choose the first: It's the option that is least likely to result in the baby dying this week.  WhatamIdoing (talk) 03:57, 8 February 2015 (UTC)


 * I am not a doctor nor any other type of medical professional. My background is in sales and retail management.  What I do is take a source, excerpt and summarize it, and try to stay close to the original source.  What I do have experience with are companies who preach a good game about having the highest code of ethics and then push their employees for numbers, and who don't want to look too closely at the details.  And even if you don't have a background in retail management, you may have also witnessed organizations run in this fashion.


 * From the Feb. 15th, 2013, Guardian article: http://www.theguardian.com/world/2013/feb/15/babies-health-formula-indonesia-breastfeeding "Some mothers formula feed because they're not eating enough themselves, and don't feel confident that they're producing enough milk." Of course, the obvious solution is for the mother to eat more. And maybe the midwife is solving the immediate problem for this week like you say, but it just puts the mother in a more difficult position of then trying to buy both food for herself and formula for her baby.  I would go ahead and make a poker read that the midwife is playing on insecurities in order to sell formula.  And admittedly, I do not know that for sure, which is why I'm calling it a poker read.


 * and for the same article, the main case study where the mother spends 50% of family income to feed one infant: "She started feeding Riska formula, rather than breastfeeding her, when her daughter was two months old; she was on contraceptives, and thought it was interfering with her milk supply. The midwife agreed, and gave her a free sample of formula milk." Maybe the contraceptives truly were interfering with the mother's milk supply. But since the midwife does have a conflict of interest, again, perhaps she was playing off insecurities to sell formula.


 * What is missing is coaching a person through difficulties and insecurities, just like coaching a first-year teacher as well as a hundred other things in life.


 * Alright, your example of the low-income mom with undernourished baby who presents at clinic, I'd say somewhere between 1 and 2, both of them if possible. Some supplemental feeding as well as coaching and teaching in breastfeeding.  And it's not a one-shot interaction, or at least it shouldn't be.  A midwife who doesn't have conflicts of interest should be available to visit the home on a somewhat regular basis, and maybe enlist the help of a sister, aunt, or grandmother to help instruct and encourage the mother.  I know family members sometimes visit a doctor together in order to better remember what the doctor says.  And I can refer you to a WHO annex which talks about recommendations for a mother to relactate, although it's easier if the breastfeeding has only been slowed and not stopped.  Cool Nerd (talk) 21:06, 9 February 2015 (UTC)


 * I kind knew about Nestlé, that in the bad old days of the 1970s, they had marketing reps in white coats who would claim infant formula was better for babies, when the company knew full well that the low-income parents did not have regular access to clean water. But I didn't really know about, that after the free samples, the formula is really expensive and takes a significant chunk of family income.  And I'm relatively well-informed.  So, I think it's well worth including.  So, for the time being, let's perhaps try this:  include in general terms that it takes a significant percentage of family income, that families are highly motivated to try and stretch the product, and that a fair number of babies and children end up malnourished.  And let's invite people to discuss whether it's worth including the one specific example highlighted in The Guardian article, perhaps included either in a footnote or in the reference itself.  For the time being I won't include it in the reference, although I kind of lean toward maybe we should.  Because the 50% of family income just blew me out of the water, although that should be part of what we all discuss, etc.  Cool Nerd (talk) 23:11, 9 February 2015 (UTC)

General statements from Feb. 15th, 2013, Guardian article  http://www.theguardian.com/world/2013/feb/15/babies-health-formula-indonesia-breastfeeding

'She seemed to be a pretty good example of one of the main problems of formula feeding in Indonesia. Even the cheapest brands punch a huge hole in a poor family's budget, and they end up over-diluting it, which leaves the babies malnourished.'

'A paediatrician in a separate Jakartan clinic, Dr Asti Praborini, said: "Selling formula is like the killing fields, in my opinion. The babies will die of diarrhoea and they will die of malnutrition."'


 * I'm seeing a lot of assumptions in your "poker read". For example, you assert that the midwife (i.e., the one player in the story who does not sell infant formula) somehow has a conflict of interest.  What kind of COI?  Do you think she's somehow getting kickbacks from the grocery store or pharmacy?  Do you think that the formula manufacturer just guesses which midwife is responsible for how much sales in the local stores, and they send her an envelope of cash every quarter?
 * Also, you assert that midwives who don't have this alleged financial COI are all available to make time-consuming home visits, but those who have a COI somehow aren't? That makes no sense at all.  If anything, a midwife who gets no money at all from the formula companies should be the one who has the least amount of time, because she needs to spend her time efficiently with paying customers.
 * I realize that it's hard for middle-class people in wealthy countries to remember that this kind of poverty exists. The fact that a month's supply of infant formula costs 50% of the family income does not surprise me.  In other cases, it costs 100%.  Or 200%.  Or 500%.  Or an infinite amount, because your actual income is exactly zero.  It happens, and not just for infant formula.  I hope that it will happen less and less as corruption is rooted out and education spreads and safety nets improve, but the fact that you simply cannot buy enough food, medicine, clean water, heat, shelter, or other basic things that we take for granted is everyday reality for half the world.
 * How much of the family income do you think that the midwife charges for a home visit? Your calculation seems to assume that the remarkably scarce resource of a trained healthcare professional is not only readily available, but also free.  WhatamIdoing (talk) 04:05, 10 February 2015 (UTC)
 * I do like your proposed solution. This article could easily accommodate information that isn't specific to any particular place or person.  The most relevant point—that formula can cost more than impoverished families, especially in low-income countries, can afford to pay—seems very reasonable and appropriate to this subject.  The other information I think should go in the article about Infant formula.
 * What do you think about putting this in a section called ==Alternatives==? Modern commercial infant formula isn't the only alternative (although it is the most expensive and the most nutritious alternative).  WhatamIdoing (talk) 07:14, 10 February 2015 (UTC)

From the Feb 15th article http://www.theguardian.com/world/2013/feb/15/babies-health-formula-indonesia-breastfeeding  'The Guardian has seen a spreadsheet detailing the number of new mothers contacted, the amount of 0-6 months formula sold, and the proportion of their target this represents. Danone commented: "That may still be happening, that's something we need to address."' Now maybe here, as we kick around ideas, I might be making assumptions, as you might be also. But in the summary I include in our article, I am staying very close to the article. Cool Nerd (talk) 18:49, 10 February 2015 (UTC) And I will do my part. I will go back one more time and summarize what I think are the most important parts in a way which is shorter overall. Cool Nerd (talk) 20:00, 10 February 2015 (UTC)
 * The same source says that the gifts to midwives "are unconditional upon the sales of any formula". Unconditional gifts may be good marketing, but it does not mean that the midwife has a COI.
 * Your latest quotation is positioned to imply that only free infant formula causes the "vicious cycle" of reduced demand leading to reduced supply, which is biologically impossible. WhatamIdoing (talk) 22:11, 10 February 2015 (UTC)

1992 WHO reference that mothers can (sometimes?) relactate
THE TREATMENT OF DIARRHOEA, A manual for physicians and other senior health workers, World Health Organization, 2005, page 41 (45 in PDF).

http://whqlibdoc.who.int/publications/2005/9241593180.pdf

ANNEX 6: HOW TO HELP A MOTHER TO RELACTATE

" .  .  .  If her baby refuses to suckle on an `empty' breast, help her to find a way to give the baby milk while he is suckling. For example, with a dropper or a syringe.  .  .  "

" .  .  .  If a baby has been breastfeeding sometimes, the breastmilk supply increases in a few days. If a baby has stopped breastfeeding, it may take 1-2 weeks or more before much breastmilk comes."

Reference: Helping mothers to breastfeed by F. Savage King. Revised edition 1992. African Medical and Research Foundation (AMREF), Box 30125, Nairobi, Kenya. Indian adaptation by R.K. Anand, ACASH, P.O. Box 2498, Bombay 400002)


 * I suspect that we could find a more recent source for the fact that a brief interruption need not be permanent for all women. I wonder if we can find one that says how long of a break is possible.  WhatamIdoing (talk) 22:21, 10 February 2015 (UTC)

The only current reference in our article on relactating is this 1981 abstract (currently footnote 23): "Relactation by mothers of sick and premature infants". Pediatrics https://www.ncbi.nlm.nih.gov/pubmed/6789296

I'm going to try and include both of these in a brief section on relactating after the Exclusive breastfeeding subsection. Cool Nerd (talk) 23:18, 13 February 2015 (UTC)
 * I see that there is a 1997 Review to the right... Gandydancer (talk) 23:40, 13 February 2015 (UTC)