Studies about expressed milk vs. direct bf'ing?? - Page 2

[Sandstress]

Originally Posted by wasabi

Yes it's not the baby touching your breast. It's the antigens traveling up the milk ducts that causes the response. Having your baby suck on your finger definitely will not cause your milk to change in response. I do think there have been studies because I know there is a hierarchy starting with feeding at the breast-->exclusive fresh breastmilk feeding-->refriged BM-->frozen BM-->formula. Now exclusive pumping is still sooooo much better than formula that I think we sometimes hesitate to even acknowledge that there is a difference but there is. To get the full benefits to both mother and child actually BFing is required. Which is not at all to say that there are not incredible benefits to EPing but it is not the same.

Of course there is a difference between nursing and EPing. (I would also propose that people be careful of their use of the term "breastfeeding" instead of "nursing" because I *am* a breastfeeding mom. My baby is exclusively breastfed. She just drinks from a bottle.) I'm not saying that EPing is immunologically identical to nursing. There are definite disadvantages because the immunologic factors in breastmilk do break down fast.

QUOTE: "Having your baby suck on your finger definitely will not cause your milk to change in response."

I'm not sure this is true. The antigens traveling up the milk ducts as the baby nurses definitely will expose mom to whatever antigenic stimulus there is. However, that is certainly not the only exposure that mom gets from baby. The cells responsible for making antibodies do not start out in the breast- they travel there after being selected for their specific antibody production. The antigen presenting cells are basically the same in the skin (breast or otherwise) and the epithelium of the milk ducts, so I'm not sure that there's a big difference regarding exactly where in the body the antigens are encountered.

But as far as the exposure to antigens, I haven't seen data to support that there's something different about infant mouth-nipple interaction that makes it different than any other baby-mother exchange of bodily fluids (as I wrote before, sneezing, big sloppy kisses, etc. )

And to reiterate the questions of the original poster:
"I'm looking for information or studies that talk about the differences between a mom who expresses her milk to give her child via bottle instead of directly nursing him from her breast."

YES!!! Big ditto here. I'm still looking for those studies too. I'm just going on the basics of immunology.

-Sandstress

[wasabi]

I was told the appropriate term was human/breast milk feeding so I apologize if I use the incorrect term. I know that the germs travel up the breast and then result in a change in milk in very short order. I find it hard to believe that my baby chewing on my finger is as effective. I mean how would it get into your body? The milk ducts are the entryway into the breast so that makes sense but I don't see the pathway with the skin. Are germs really just absorbed through our skin because I really didn't think that was the case. : Certainly I would guess that your baby giving you a big sloppy kiss would probably work the same way I'm just not sure. I mean I think there is something in the specific pathway that causes that response. I don't know that I get spit in my mouth and my body automatically puts it into my breastmilk but maybe it does. I will try to find some links though because there have to be some out there. If nothing else there have been studies about what happens to the antigens as BM is stored for longer periods of time. Wouldn't that largely address those issues?

[Fiercemama]

ENTEROMAMMARY CIRCULATION. (I can't imagine *why* that little phrase skipped my mind ). That's what we're talking about.

I've just been cruising the archives at Lactnet, and Sandstress, I think you are probably right. Its not the nipple/saliva contact that's important, but the general closeness between mama and baby that counts. Which of course means that a mum and nursling who are ep'ing can certainly enjoy that benefit. Thanks for opening my eyes!

[bri276]

Originally Posted by wasabi

Yes it's not the baby touching your breast. It's the antigens traveling up the milk ducts that causes the response. Having your baby suck on your finger definitely will not cause your milk to change in response. I do think there have been studies because I know there is a hierarchy starting with feeding at the breast-->exclusive fresh breastmilk feeding-->refriged BM-->frozen BM-->formula. Now exclusive pumping is still sooooo much better than formula that I think we sometimes hesitate to even acknowledge that there is a difference but there is. To get the full benefits to both mother and child actually BFing is required. Which is not at all to say that there are not incredible benefits to EPing but it is not the same.

what makes you think EP'ed milk is always refrigerated? dd is fed the milk immediately after it's pumped, and I often take a swab of her saliva, dollop it on the nipple while pumping. I often get sloppy kisses as well that definitely are transferring whatever is in her system! and time to time, I'll hand express directly into her mouth (cuz it cracks DH up and it's a like a game to dd).

she's had one fever and one cold that lasted two days in her 16 months of life, so it appears the antibodies are working well. I absolutely think if you get spit containing a virus in your mouth, the antibodies will appear in your breastmilk. Otherwise the only germs you'd be able to protect your baby from were ones she was exposed to. And we know that's not true, because breastmilk contains antibodies to illnesses we had before the baby was even born.

eta okay I see your hierarchy started with feeding at breast, not fresh milk feeding. I just have a very hard time believing that it matters if I walk over to dd and squirt some milk in her mouth it's soooo much better for her than if I squirt that same milk into a bottle and immediately feed it to her.

[wasabi]

The rubbing the saliva on the nipple sounds like it would work just fine. I don't know why it wouldn't. It was the sucking on a finger that I was doubting. I don't think that EPing is necessarily refrigerated milk that's why it was the first step down from nursing while friged milk was the next down from that. I don't set this hierarchy so I'm certainly not trying to set a ranking. I'm just giving the hierarchy that has been set. I know nursing is at the top and formula is the fifth choice rather than the second as much of our society seems to assume. And my hats definitely off to any EPers. I've only had to pump when I had severe mastitis and it was very hard to manage with two kids and everything else. I'm just saying that I do believe there are studies out there if someone can find the links. Otherwise why would lactivist groups still acknowledge that there are some differences? It certainly isn't to make EPers feel inferior or bad about themselves or their milk. I'm actually frustrated right now that LLL has changed their FAQ page and I can't seem to find anything any more. I know they had a link that dealt with exclusive pumping but it is either not there any more or is under some category that is by no means intuitive.

[Sandstress]

Originally Posted by wasabi

I was told the appropriate term was human/breast milk feeding so I apologize if I use the incorrect term. I know that the germs travel up the breast and then result in a change in milk in very short order. I find it hard to believe that my baby chewing on my finger is as effective. I mean how would it get into your body? The milk ducts are the entryway into the breast so that makes sense but I don't see the pathway with the skin. Are germs really just absorbed through our skin because I really didn't think that was the case. : Certainly I would guess that your baby giving you a big sloppy kiss would probably work the same way I'm just not sure. I mean I think there is something in the specific pathway that causes that response. I don't know that I get spit in my mouth and my body automatically puts it into my breastmilk but maybe it does. I will try to find some links though because there have to be some out there. If nothing else there have been studies about what happens to the antigens as BM is stored for longer periods of time. Wouldn't that largely address those issues?

As for the term, I'm particularly attuned to what people refer to as breastfeeding, because usually they only mean nursing. EPers are such a hidden group to begin with (my LC had no idea) that I always want to make sure that people regard us as "breastfeeding moms" too. No worries, just wanted to point that out.

As for entryway into the body, the nipple and breast are lined by an epithelium, much the way your digestive tract or respiratory tract is. The breast resembles sweat glands in that the product (milk) is made deep within the tissues (in the lobules) and then excreted through the ducts out of the body. My understanding of the anatomy of the breast is that those same cells that encounter infectious agents and "present" the antigens to the B cells that then make antibodies are the same whether you're in the gut, skin, breast, uterus, etc. and I don't know if there's actually a difference in the "quality" of encounter whether they're through the nipple during nursing or though my nose and eyes when my baby sneezes on me.

That being said, it certainly seems the most natural and easy way to acquire your baby's germs. And I am not opposed to following GooeyRN's lead and trying a little saliva-nipple rubbing myself, just in case! I still am looking forward to seeing any information anyone has (and there are other threads right now in "breastfeeding" about this same topic). The problem is, I just don't think the studies are out there about this. Who would pay for it- formula companies? Just kidding. It just doesn't seem to be that hot of a topic. There is a new journal names "Breastfeeding medicine" that started this year, and is searchable through pubmed.gov. Maybe something on this topic will appear in that forum soon!

Also, the studies I've seen about the longevity of antibodies and other immune factors in the breast milk have been using other substances, and then extrapolating the results (like, how hearty a protein is if you shake it, freeze it, etc.) to breast milk. Again, we need research funding!!!!

OK, that's my soapbox.
Sandstress

[bri276]

I know you didn't set the hierarchy, I'm not mad about it or anything. it's just something I've given a lot of thought to (cuz I've had a lot of time to think what with the pumping ) and I don't doubt there are jaw development benefits, but I wonder if when they set that hierarchy they tried having someone swab the saliva while pumping, or if they really tested the milk or just assumed it wasn't as good, yk? I really wouldn't have an issue with it if I could see proof that it was true. I mean, if I'm feeding DD previously frozen milk (which has only happened a few times) I'm thinking to myself "not as good as fresh." same w/ refrigerated. I just wonder whether it's scientifically solid or just one of those general lactavist "breast is always best" things- lets face it, the majority of the time, it IS, someone who's going out to a movie and pumps isn't going to think twice about swabbing saliva on their boob.

[wasabi]

I know the studies about milk storage have to do with the surviving number of live cells. I remember one a year or two ago which did show that quite a few die in frozen milk that has been frozen more than some period of time. Even then though it still had more than formula of course which has none! And absolutely the occasional pumper doesn't rub saliva on her nipple and the EPer doesn't need to do it with every feed either. It's just more of a checking in from time to time. I doubt seriously that they have done any tests with rubbing the saliva on the nipple. That would really be a great one to do a study on to determine how what effects it caused. Definitely there needs to be more money to fund more studies but yeah who's going to pay for it?

[Sandstress]

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