Reconciling AAP Comments

[teacup]

I was checking out threads here and kellymom.com for toddler nursing support and found that a lot of support is based on comments made by the AAP. If you're AP, how do you (or do you at all) reconcile the anti-cosleeping, pro-pacifier advisements with the pro-BFing comments? I am not asking any one person in particular, but I am looking for help debating the topic of toddler BFing, and I can't very well say (and win the debate), "The AAP says," and embrace that, then throw out some other piece of wisdom the organization offers.

And if anyone can offer links or help regarding emotional/cognitive development, nursing in other first-world countries, and extended BFing, I'd appreciate it.

Thanks.

[grumpyshoegirl]

I personally don't put much stock in anything the AAP says. I was already leery of them when we ran into some issues with our pediatrician (dd now sees a FP), and with this latest news that they are refusing to endorse a bill to remove thimerosal from vaccines because "people may not want to vaccinate" just obliterates any of the trust I had in the organization.

That they support breastfeeding and delaying solids until 6 months is nice, but not main reason I have made those decisions. If I'm quoting the AAP, it's usually to convince some anti-AP, anti-BF person who is impressed with what they have to say.

I put a lot of stock in Dr. Sears. Dr. Jay Gordon, kellymom, LLL and the WHO. They seem to balance AP with solid evidence for all their claims. I particularly like Dr. Sears's stance on adapting AP philosophies to work for your own family.

[Momtwice]

You raise a great question teacup.

If you look through the old posts in the misc. breastfeeding forums you will find some great resources.

I used to love Dr. Sears until he became a spokesperson for the company that puts DHA in baby formula. He is no longer ethical about that issue, sadly, although he is still a great resource in general. (Again, there are old posts here about it.)

Have you checked http://www.kellymom.com ?

[grumpyshoegirl]

Originally Posted by Momtwice

I used to love Dr. Sears until he became a spokesperson for the company that puts DHA in baby formula. He is no longer ethical about that issue, sadly, although he is still a great resource in general. (Again, there are old posts here about it.)

Say it ain't so! That's terrible!:

[mom2tig99Nroo03]

kellymom is one of my fave places, as is lll's site.

dr sears is okay, but i prefer dr gordon's stuff more. he seems more okay with putting parents in charge of their children's health, and i feel would be more of a partner in caring for the whole child comapred to dr sears. dr newman also is great as far as bf info goes.

[rmzbm]

Originally Posted by grumpyshoegirl

I personally don't put much stock in anything the AAP says.

:

[Sustainer]

The only time the AAP's guidelines have value to me is when I'm trying to convince other people that toddlers benefit from breastfeeding, because I know that other people respect authority. I definitely don't use authorities such as the AAP as a source of parenting advice for myself. So far, no one has tried to turn it around on me by saying "yeah but the AAP also says (something anti-AP)." Most people don't have a clue what the AAP recommends. If anyone ever does try to turn it around on me, though, I will just turn it right back around on them, by saying: "All that proves is that the AAP is not an Attachment Parenting organization, which means that if EVEN THEY admit that toddlers benefit from breastfeeding, then it's even *more* significant!"

[pinky]

The thing to remember is that the AAP isn't this monolithic organization--it's a whole lot of different physicians. The breastfeeding group, as I understand it, are sometimes viewed as kind of "out there" relative to the rest of the organization--and they're the ones who wrote the bf position statement. I could be wrong, but I think that the head of that group even came out with a statement *against* the position on co-sleeping and pacifiers.

I don't have links (kellymom.com is a great source), but here is some info from a handout that I put together; PM me if you would like the complete references.

How long should a child breastfeed?
AAP (2005): Breastfeed for at least a year, and as long as mutually desired by mother and baby. There are no negative consequences known for nursing into the third year and beyond.
AAFP (2004): Breastfeed for at least a year. Physicians should support mothers who wish to nurse beyond infancy, nurse during pregnancy, and/or tandem nurse.
WHO (2002): Breastfeed for a minimum of two years.
Dettwyler (1995) Based on a comparison with other primates, the biological age of weaning in humans is between 2-1/2-7 years

What are the medical benefits of breastfeeding beyond the first year?
Human milk is a nutritious food for toddlers:
•A significant source of protein, fats and most vitamins (Dewey 2001)
•The fat and calorie content of breastmilk increases as duration of lactation increases (Mandel et al. 2005).
Nursing Toddlers are Healthier:
•Nursing toddlers between 18-36 months of age have fewer and shorter illnesses than their non-nursing counterparts (Gulick 1986).
•Antibodies and immune factors in milk increase in the second year (Harnosh et al 1991; Goldman 1983).
Health benefits to the child have been shown to be dose-dependent, including:
•decreased risk of childhood leukemia (Tripathy et al. 2004; Guise at al. 2005)
•improved adult cardiovascular health for women nursed as babies (Williams et al. 2006).
•improved IQ scores and cognitive development (Slykerman et al. 2005; Angelsen et al. 2001)
•decreased risk of childhood obesity (Harder et al. 2005; Arenz et al. 2004)
•reduced environmental allergies (Obihara et al. 2005).
•reduced rates of malocclusion (Labbok & Hendershot 1987)
Health benefits to the mother are also dose-dependent, including:
•Lowered risk for breast cancer (Collaborative Group on Hormonal Factors in Breast Cancer, 2002; Freund et al., 2005), particularly for carriers of the BRCA-1 mutation (Jernstrom et al., 2004)
•Lowered risk for ovarian cancer (Wiltemore, 1994; Gwinn et al., 1990).
•Lowered risk for rheumatiod arthritis (Karlson et al., 2004)
•Lowered risk for endrometrial cancer (Rosenblatt & Thomas, 1995).
•Increased maternal weight loss (Kac et al., 2004; Akkus et al., 2005).
•Lowered risk of future osteoporosis and hip fractures (Cumming & Klineberg, 1993; Huo et al., 2003).
•Reduced risk of Type II Diabetes (Steube et al., 2005).

What about breastfeeding toddlers who are falling on the growth charts?
There is no research that supports the clinical recommendation to discontinue breastfeeding due to slowed growth (e.g.Gonzalez 2005), particularly given the health benefits for continued nursing (see above).
•The growth charts are not based on breastfeeding toddlers, and in fact we don’t really know what normal growth patterns are for these children (Huffman 1985).
•In matched cohort studies, breastfeeding toddlers are taller and healthier than their weaned counterparts (Prentice, 1994; Castillo et al., 1996; Marquis et al., 1997; Onyango et al., 1999).
•When differences are seen between the growth of nursing and non-nursing toddlers, they disappear by the end of the second year (Habich, 2000).

Does extended breastfeeding cause dental decay?
•The American Academy of Pediatric Dentistry says maybe, and recommends limiting nursing at night and on demand once teeth emerge. However, not all research supports this recommendation.
•Humans are the only mammals whose young suffer from dental decay, and prehistoric human skulls—before the introduction of a more processed diet—show no incidence of dental caries (Palmer 2000).
•Population-based studies that control for confounding factors like diet and oral hygiene do not support a relationship between extended breastfeeding and early childhood caries (Weeheijm, 1998; Slavkin, 1999).
•Human milk is not cariogenic in vitro; however, it buffers poorly and is very cariogenic in combination with other carbohydrates--so oral hygiene is especially important in a breastfeeding child (Erickson, 1999)

[velcromom]

Katherine Dettwyler is a great source for info on extended bf - here's her site with lots of research from an anthropological standpoint on bf and other topics:

http://www.kathydettwyler.org/dettwyler.html

Quote from:
Beyond Toddlerhood: The Breastfeeding Relationship Continues
by Priscilla Young Colletto
http://www.lalecheleague.org/lllead...FebMar98p3.html

"The scientific evidence on extended breastfeeding is just now beginning to accumulate. A number of the health benefits are now being found to be related to the length of nursing with an increasing amount of benefit correlating with increased duration. This is the case, research has indicated, with breastfeeding's protective effect in maternal breast cancer, osteoporosis, childhood ear infections and malocclusion anomalies (misaligned teeth).
The word "benefit" is perhaps misleading here, for these "benefits" are what nature intended to be the human norm. Breastfeeding is normal. It is artificial feeding substitutes and premature weaning that are, in fact, abnormal from a biological viewpoint. It is these abnormal practices that place the child at increased risk of illness and compromised intelligence. "


American Academy of Family Physicians:

"If the child is younger than two years of age, the child is at increased risk of illness if weaned." http://www.aafp.org/x6633.xml



According to Sally Kneidel in "Nursing Beyond One Year" (New Beginnings, Vol. 6 No. 4, July-August 1990, pp. 99-103.):
" One study that dealt specifically with babies nursed longer than a year showed a significant link between the duration of nursing and mothers' and teachers' ratings of social adjustment in six- to eight-year-old children (Ferguson et al, 1987). In the words of the researchers, 'There are statistically significant tendencies for conduct disorder scores to decline with increasing duration of breastfeeding.'"


And from milkofhumankindness.orgno longer a valid link, if anyone finds a current web address for this site I'd love to have it.)

"Cross-cultural research indicates a positive correlation between a culture's norm for duration of breastfeeding and a its level of peacefulness. Breastfeeding also promotes development in the parts of the human brain that regulate emotions and help us solve problems non-violently."