Major Journal Warns Calling Breastfeeding "Natural" Will Discourage Vaccine and Formula Use; Orwell Spins In His Grave

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A study published in the journal Pediatrics raises concern over the use of the term "natural" to describe breastfeeding, even though the weight of evidence (and common sense) indicates prioritizing breastfeeding over man-made formulas or vaccines is the best way to protect your child and the mother's health. 

As Martucci and Barnhill (2016) misguidedly suggest in their article, [1] "Unintended Consequences of Invoking the "Natural" in Breastfeeding Promotion," calling breastfeeding "natural" poses countless risks for public health officials and those who wish to promote their "synthetic" or "factory-made" formulas or vaccines. They want to ban the word "natural," as calling breastfeeding the "natural" option will not "align with public health goals". They should be concerned. "Natural" breastfeeding benefits highly outweigh "factory-made" formula feeding and has been linked to lower infant mortality, particularly in Sudden Infant Death Syndrome (SIDS). Vaccine manufacturers mistakenly suggest delaying breastfeeding [2] (and all its health benefits) due to breastmilk's immune properties interfering with vaccine-induced antibody titer elevations (a proxy measure of efficacy used to justify the vaccine schedule but which is falsely equated with bona fide immunity).

Breastfeeding is one of the most highly recommended strategies by public health officials for good reason. It works around the world, and has since time immemorial (when vaccines were non-existent). [3] It is has vast scientific support. [4] It is natural and offers a wide array of health benefits. There are many overall health benefits for the infant and the mom when breastfeeding and more recent research highlights advantages of breastfeeding over formula feeding [5] for infections, cardiovascular diseases, obesity and dietary health, brain health, diabetes, and cancer. Many adverse health effects of vaccinations [6] have been researched and some of the most significant studies are highlighted in the breastfeeding vs vaccines debate.

Overall Health Benefits

"If an infant needs one vaccine that is 100% safe and effective -- that would be breast milk" - Dr. Tetyana Obukanych PhD Immunologist

The overall health benefits of breastfeeding - the natural alternative to formula - are well summarized in an article by Brahm and Valdez (2017) entitled "The Benefits of Breastfeeding and Associated Risks of Replacement with Baby Formulas". [7] Benefits asserted include reducing the risk of infectious and cardiovascular diseases, leukemia, celiac disease, inflammatory bowel disease (IBD), diabetes, attention deficit disorder, sudden infant deaths syndrome (lowered by 36%), and preventing 13% of infant mortality worldwide.

Lonnerdal (2016) [8] points out that the reduced incidence and duration of illnesses, (i.e. obesity, diabetes, and cardiovascular disease), nutrient status, and cognitive development are also benefits of breastfeeding during the first year of an infant's life. Breast milk proteins, such as "lactoferrin, α-lactalbumin, milk fat globule membrane proteins, and osteopontin", have bioactivities ranging from "infection protection to nutrient acquisition" (p. S4).

Infections

In a large scale prospective[1] study [9] conducted in Greece of 926 infants followed for 12 months, those who were exclusively breastfed for 6 months had a significantly lower number of infectious episodes, such as acute otitis media (AOM), acute respiratory infection (ARI), gastroenteritis, urinary tract infection, and conjunctivitis, and hospital visits for infections during infancy. In the Generation R Study of over 4,000 infants in the Netherlands, those who were breastfed exclusively until the age of 4 months and partially thereafter (or exclusively for 6 months) had lower risks of infections [10] in the upper respiratory (URTI), lower respiratory (LRTI), and gastrointestinal tracts (GI) compared to non-breastfed infants. Exclusively breastfeeding for 3 months reduced the risk of developing childhood respiratory allergy and allergic asthma in a longitudinal study (Bigman, 2019) [11] in the US of over 1,000 six year olds. In the UK's Millennium Cohort Study[12] of nearly 16,000 children, the monthly risk of hospitalization (for both diarrhea and lower respiratory tract infection - LRTI) was found to be significantly lower for infants breast-fed compared with those who were formula-fed.

Fichtner and his research team in Germany (2011) [13] showed a significantly higher risk of developing infectious diseases like infantile diarrhea and necrotizing enterocolitis for non-breast-fed preemies. By incubating rat neurons in breast milk protein extracts, the researchers demonstrated that protein extracts of breast milk increased the amount of surviving enteric neurons as well as neurite outgrowth. In addition, the number of nestin and S100-expressing glial cells increased significantly, which provides evidence that breast milk proteins support and develop the enteric nervous system (ENS).

A total of 52 mother-child pairs were drawn from a racially diverse cohort in Detroit, Michigan in 2017 to study breastfeeding's immune protection. Breast milk and neonatal stool specimens were collected at 1-month postpartum. Breast milk transforming growth factor (TGFβ1, TGFβ2) were assayed using enzyme-linked immunosorbent assays, whereas neonatal gut microbiome [14] was profiled using 16S rRNA sequencing, and results showed breastfeeding was linked to a rich, even and diverse gut microbiome, providing possible immune effects.

Cardiovascular Disease

In a UK comparison study by the University of Oxford of 204 pre-term infants fed exclusively breast milk Lewandowsky and others (2016) [15] found decreased long-term cardiovascular risk (i.e. increased cardiac structure and function in adults 23 to 28 years old who were premature infants) as measured by left and right ventricular end-diastolic volume (VEDV) index[2] (+9.73%, P = .04 and +18.2%, P<.001) and stroke volume index - SVI (+9.79%, P = .05 and +22.1%, P = .01) compared with preterm-born adults who were exclusively formula-fed as infants. This means that breastfeeding was linked to a lower risk for heart disease (a 10% risk for breastfed vs 18% risk for formula-fed preterm adults when compared to full term young adults) as measured by VEDV, the volume of blood left in the ventricles before the heart contracts.

The left ventricle is the thickest of the heart's chambers and is responsible for pumping oxygenated blood to tissues all over the body, whereas, the right ventricle solely pumps blood to the lungs. Preterm adults fed breast milk also had significantly longer left ventricles compared to those fed formula (p< .001), meaning again that the heart's structure was more compromised and at risk for formula-fed adults.

Likewise, breast-fed preterm infants had an 18% risk but formula-fed infants had a higher risk of heart disease (22%) developing in adulthood as measured by SVI, which is the amount of blood pumped from each ventricle with each heartbeat and an indicator of how the heart is functioning. The risk differential (25%) was even greater when comparing formula fed preterm adults to breastfed full term adults. The American Academy of Pediatrics continues to recommend that preterm infants be given donor breast milk rather than preterm formula if a mother cannot provide adequate breast milk volume, due to the wide scientific evidence. [16]

Long before the atherosclerosis is manifested clinically, the disease has a long pre-clinical phase pathological changes developing in the arteries of children and young adults. Cardiovascular disease risk can be impacted by nutritional factors for infants and children. "Breast-feeding in particular is associated with benefits for long-term cardiovascular risk factors possibly as a consequence of a slower pattern of growth in breast-fed compared to formula-fed infants" according to research by Singhal (2009, p. 51). [17]

Brain Health

 Ferguson and Molfese (2007) [18] compared breast-fed infants to bottle-fed infants (at 6 months) and found evidence to support that breastfeeding has an advantage over using formula for language development and cognition. They used Event-Related Potentials (ERPs), which are measured brain responses to particular stimuli through electroencephalography (EEG). This non-invasive procedure measures the brain's electrical activity through the use of electrodes placed on the scalp. Babies' brains respond to different types of stimuli. For example, infants view images of faces on a computer screen while wearing an elastic cap embedded with electrodes that makes scalp recordings of brain activity. This allows researchers to measure brainwaves so that they can discern how the brain works while the infant is processing the presented stimuli of faces information (i.e. mother's face, stranger's face).

 Event Related Potential (ERP) waveforms in this study showed important differences between the breast-fed and formula-fed infants. The ERPs recorded from breast-fed infants differentiated between all speech sounds, and generated differences in scalp recordings across all regions recorded across both brain hemispheres. In fact, cognitive development and neurodevelopmental advantages of breastfeeding persist into old age, and duration of breastfeeding (longer than 3 months) seems to increase verbal reasoning ability, (p. 337) into adulthood. 

Obesity, Celiac and Dietary Health

In a meta-analysis of 10 trials with more than 76,000 infants, primarily in the US and Europe, 'ever having breastfed in the first year' shows a 15% decrease in the risk for childhood overweight and obesity; 'exclusively breastfed for 6 months' resulted in 30 to 40% lower risk (Gunnel, 2016).[19] In addition, a 2012 meta-study of 90 citations reiterated that breastfeeding during the introduction of gluten to an infant's diet had a protective effect against developing celiac disease (CD) [20] in predisposed infants.

Children who have been breastfed have healthier dietary patterns [21] compared to formula-fed children, even after controlling for relevant sociodemographic characteristics, such as healthier diet and lifestyle. Breastfeeding gives children a "jump start" on developing "preferences for a wide array of healthy foods when compared to children who are formula-fed" (Ventura, 2017, 15) [21]. Mothers transfer flavors to their children through the amniotic fluid and breastmilk. Flavor learning and flavor preference development showed more varied and healthier food preferences in breast-fed infants.

Diabetes

Additional research has also found that non-breastfed children have two times the risk of childhood diabetes or Type 1 diabetes [22] as compared to those who have been breastfed. In a study of 1,010 women who had Gestational Diabetes Mellitus (GDM) within 35 weeks into their pregnancy, and who were without (DM) Type 2 diabetes [23] the 6-9 month check-up after the birth of their child was used as a baseline. They were evaluated 2 years later (959, 95%) but 113 (11.8%) had developed incident diabetes (DM). Lower 2-year incidences of Type 2 diabetes (DM) were associated with higher lactation intensity and longer duration in breastfeeding.

Cancer

Maternal cancer risk has been shown to be lower with breastfeeding. A meta-analysis of 65 studies was conducted (studies between 2005 and 2015 in PubMed and EBSCOhost) by breastfeeding mode and menopausal and parity status. The summary relative risk (SRR) for breast cancer in parous women (those producing offspring) who breastfed exclusively was 0.72, 95% confidence interval (CI) [0.58, 0.90], versus parous women who had never breastfed. For parous women who breastfed in any mode, the risk was lower in both premenopausal women and postmenopausal women. Results showed that exclusive breastfeeding among parous women reduced the risk of breast cancer [24] compared with those who did not breastfeed exclusively.

A meta-analysis study by Jordan et al. (2017) [25] included 8,981 women with endometrial cancer and 17,241 women in a control group, after excluding nulliparous (never having birthed a child) women from the sample. Ever breastfeeding was associated with an 11% reduction in endometrial cancer risk (pooled OR 0.89, 95% CI 0.81-0.98). Longer average duration of breastfeeding per child was associated with lower risk of maternal endometrial cancer, although the effect leveled off beyond 6 months.

Vaccines

Exposure to aluminum (Al) from vaccines was compared to breast milk for 6 month old infants in Brazil by Dorea and Marques (2010). [26] Breastfed infants receiving a full recommended schedule of immunizations showed an exceedingly high exposure of Al (225 to 1750 μg per dose) when compared with estimated levels absorbed from breast milk alone (2.0 μg). This alarming elevation (more than 100 to 800 times) of aluminum phosphate adjuvant from vaccinations [27] raises concerns about the long-term effects of early exposure to neuro-toxic substances on the developing brain of infants.

In addition to vaccine's toxic ingredients [28] outlined in 367 abstracts at GreenMedInfo, there are also adverse health effects related to vaccines, which could add to the rates of infant mortality and morbidity. [29] [30] For example, in a study of over 10,000 infants, girls who received both Bacille Calmette Guerin (BCG) and diphtheria, tetanus, polio (DTP) vaccines experienced higher mortality [31] than those who received only one of the two vaccines (hazards ratio 2.4; 95% confidence interval 1.2-5.0).

It is true that infants who have been breastfed have increased immunity against diseases and in fact, this healthy benefit has been shown to lower the antigenicity of vaccines, [32] but that is not a good reason to delay breastfeeding but rather to question the use of vaccines, particularly early in infancy.

In a comprehensive review of federally administered Vaccine Adverse Event Reporting System (VAERS), from 1990 to 1997, 1,266 fatalities were temporally related to vaccines. The overall median age was 4.8 months with over 600 deaths reported as sudden infant death syndrome (SIDS).[33]

Polio Global Eradication Initiative's statistics monitored through the World Health Organization (WHO) [34] showed that in 2010, India reported 42 cases of wild-type polio (WPV) and vaccine-induced cases of polio paralysis were estimated at 100-180 cases, giving evidence that vaccine-induced polio is 3 or 4 times more likely to occur than the wild-type of polio.

Despite knowing that the oral polio vaccine (OPV) may cause vaccine-derived polioviruses (VDPVs) and non-polio acute flaccid paralysis (NPAFP), WHO will not discontinue the protocols in developing countries such as India where nearly 10 doses [35] (6 doses of OPV and 4 doses of inactive polio vaccine –IPV) are recommended for children before the age of 5.

Adverse effects of vaccines have been documented and early scheduling of vaccines to infants only exacerbates the problem. Sen and team (2001) studied vaccine frequency, severity and adverse reactions [36] in the UK following DPT/Hib (diphtheria and tetanus toxoids and pertussis/Haemophilus influenzae type B conjugate) immunization in very preterm infants. Of 27 babies vaccinated at 70 days or less, 9 (33.3%) developed major events compared with none when vaccinated over 70 days. Adverse events were noted in 17 of 45 (37.8%) babies: 9 (20%) had major events, i.e. apnea, bradycardia or desaturations, and 8 (17.8%) had minor events, i.e. increased oxygen requirements, temperature instability, poor handling and feed intolerance. Babies with major events were significantly younger (p<0.05), had a lower postmenstrual age (p<0.05) and weighed less (p<0.05) at the time of vaccination compared with babies without major events. The evidence presented makes a compelling case for prioritizing natural breastfeeding (with its overriding benefits) over vaccinations and man-made formulas.

For additional research on the health benefits of breastfeeding in reducing the risk of 80+ diseases use the GreenMedInfo research database on Breastfeeding Health Benefits.


References

[1] Jessica Martucci and Anne Barnhill (2016). Unintended Consequences of Invoking the "Natural" in Breastfeeding Promotion. Pediatrics Perspective, April, 137(4): 1-7, https://pediatrics.aappublications.org/content/137/4/e20154154.

[7] Paulina Brahm, Verónica Valdés. [The benefits of breastfeeding and associated risks of replacement with baby formulas]. Rev Chil Pediatr. 2017 Feb ;88(1):7-14. PMID: 28288222

[8] Bo Lönnerdal. Bioactive Proteins in Human Milk: Health, Nutrition, and Implications for Infant Formulas. J Pediatr. 2016 Jun ;173 Suppl: S4-9. PMID: 27234410

[9] Fani Ladomenou, Joanna Moschandreas, Anthony Kafatos, Yiannis Tselentis, Emmanouil Galanakis. Protective effect of exclusive breastfeeding against infections during infancy: a prospective study. Arch Dis Child. 2010 Sep 27. Epub 2010 Sep 27. PMID: 20876557

[10] Liesbeth Duijts, Vincent W V Jaddoe, Albert Hofman, Henriëtte A Moll. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. J Med Food. 2010 Jun;13(3):589-98. PMID: 20566605

[12] M A Quigley, Y J Kelly, A Sacker. Infant feeding, solid foods and hospitalisation in the first 8 months after birth. Arch Dis Child. 2009 Feb ;94(2):148-50. Epub 2008 Oct 1. PMID: 18829618

[13] Michael Fichter, Markus Klotz, David L Hirschberg, Bärbel Waldura, Otto Schofer, Sabrina Ehnert, Lukas K Schwarz, Chris Van Ginneken, Karl-Herbert Schäfer. Breast milk contains relevant neurotrophic factors and cytokines for enteric nervous system development. Mol Nutr Food Res. 2011 Aug 2. Epub 2011 Aug 2. PMID: 21809438

[14] Alexandra R Sitarik, Kevin R Bobbitt, Suzanne L Havstad, Kei E Fujimura, Albert M Levin, Edward M Zoratti, Haejin Kim, Kimberley J Woodcroft, Ganesa Wegienka, Dennis R Ownby, Christine L M Joseph, Susan V Lynch, Christine C Johnson. Breast Milk Transforming Growth Factorβ Is Associated With Neonatal Gut Microbial Composition. J Pediatr Gastroenterol Nutr. 2017 Sep ;65(3):e60-e67. PMID: 28827481

[15] Adam J Lewandowski, Pablo Lamata, Jane M Francis, Stefan K Piechnik, Vanessa M Ferreira, Henry Boardman, Stefan Neubauer, Atul Singhal, Paul Leeson, Alan Lucas. Breast Milk Consumption in Preterm Neonates and Cardiac Shape in Adulthood. Pediatrics. 2016 Jun 14. Epub 2016 Jun 14.https://www.pediatrics.org/egi/content/full/129/3/e827 PMID: 27302980

[16] Johnston M, Landers S, Noble L, Szucs K, Viehmann L. Breast feeding and the use of human milk. Pediatrics. 2012 Mar; 129(3); e827-41. doi: 10.1542/peds.2011-3552. PMID: 22371471.

[17] Atul Singhal. The early origins of atherosclerosis. Adv Exp Med Biol. 2009;646:51-8. PMID: 19536662

[18] Melissa Ferguson, Peter J Molfese. Breast-fed infants process speech differently from bottle-fed infants: evidence from neuroelectrophysiology. Dev Neuropsychol. 2007;31(3):337-47. PMID: 17559328

[19] Lindsay Gunnell, Jon Neher, Sarah Safranek. Clinical Inquiries: Does breastfeeding affect the risk of childhood obesity? J Fam Pract. 2016 Dec ;65(12):931-932. PMID: 28149981

[20] Camilla Henriksson, Anne-Marie Boström, Ingela E Wiklund. What effect does breastfeeding have on coeliac disease? A systematic review update. Evid Based Med. 2012 Aug 4. Epub 2012 Aug 4. PMID: 22864373

[21] Alison K Ventura. Does Breastfeeding Shape Food Preferences? Links to Obesity. Ann Nutr Metab. 2017 ;70 Suppl 3:8-15. Epub 2017 Sep 14. PMID: 28903109

[22] Husby, Lars C Stene. Infant Feeding and Risk of Type 1 Diabetes in Two Large Scandinavian Birth Cohorts. Diabetes Care. 2017 07 ;40(7):920-927. Epub 2017 May 9. PMID: 28487451

[23] Gunderson EP, Hurston SR, Ning X, Lo JC, Crites Y, Walton D, Dewey KG, Azevedo RA, Young S, Fox G, Elmasian CC, Salvador N, Lum M, Sternfeld B, Quesenberry CP Jr; Study of Women, Lactation and Progression to Type 2 Diabetes Mellitus After Gestational Diabetes Mellitus: A Prospective Cohort Study. Ann Intern Med. [ 2015]163: 889–898. doi: 10.7326/M15-0807 PMID: 26595611

[24] Mishel Unar-Munguía, Gabriela Torres-Mejía, M Arantxa Colchero, Teresita González de Cosío. Breastfeeding Mode and Risk of Breast Cancer: A Dose-Response Meta-Analysis. J Hum Lact. 2017 May ;33(2):422-434. Epub 2017 Feb 14. PMID: 28196329

[25] Susan J Jordan, Renhua Na, Sharon E Johnatty, Lauren A Wise, Hans Olov Adami, Louise A Brinton, Chu Chen, Linda S Cook, Luigino Dal Maso, Immaculata De Vivo, Jo L Freudenheim, Christine M Friedenreich, Carlo La Vecchia, Susan E McCann, Kirsten B Moysich, Lingeng Lu, Sara H Olson, Julie R Palmer, Stacey Petruzella, Malcolm C Pike, Timothy R Rebbeck, Fulvio Ricceri, Harvey A Risch, Carlotta Sacerdote, Veronica Wendy Setiawan, Todd R Sponholtz, Xiao Ou Shu, Amanda B Spurdle, Elisabete Weiderpass, Nicolas Wentzensen, Hannah P Yang, Herbert Yu, Penelope M Webb. Breastfeeding and Endometrial Cancer Risk: An Analysis From the Epidemiology of Endometrial Cancer Consortium. Obstet Gynecol. 2017 Jun ;129(6):1059-1067. PMID: 28486362

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[31] Lawrence H Moulton, Lakshmi Rahmathullah, Neal A Halsey, R D Thulasiraj, Joanne Katz, James M Tielsch. Evaluation of non-specific effects of infant immunizations on early infant mortality in a southern Indian population. Trop Med Int Health. 2005 Oct;10(10):947-55. PMID: 16185228

[32] Sung-Sil Moon, Yuhuan Wang, Andi L Shane, Trang Nguyen, Pratima Ray, Penelope Dennehy, Luck Ju Baek, Umesh Parashar, Roger I Glass, Baoming Jiang. Inhibitory effect of breast milk on infectivity of live oral rotavirus vaccines. Pediatr Infect Dis J. 2010 Oct;29(10):919-923. PMID: 20442687

[33] L E Silvers, S S Ellenberg, R P Wise, F E Varricchio, G T Mootrey, M E Salive. The epidemiology of fatalities reported to the vaccine adverse event reporting system 1990-1997. Pharmacoepidemiol Drug Saf. 2001 Jun-Jul;10(4):279-85. PMID: 11760487

[34] World Health Organization, statistics on polio in India in 2010, Retrieved on September 26, 2019 at https://extranet.who.int/polis/public/CaseCount.aspx

[35] ParentTree, list of vaccines in India, Retrieved on September 26, 2019 at https://www.parentree.in/Blogs/51-Immunization-schedule-in-India

[36] S. Sen, Y Cloete, K Hassan, P Buss. Adverse events following vaccination in premature infants. Acta Paediatr. 2001 Aug ;90(8):916-20. PMID: 11529542

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