03 Feb 2015
February 3, 2015

Mythbuster: breastfeeding and bottles

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“Breastfeeding is stressful for newborns, and even more  for preterms”.

“Give the baby a bottle, it is a much safer way to feed.”

There is good clinical evidence that bottle feeding is harmful in low birth weight babies. Breastfeeding is regulating, not stressful. And yet: hospitals in our country (and all over the world) persist in this practice.

The Journal of Human Lactation has published a study (link below) which will serve as our example here. They had 25 preterm babies all below 1800g in weight, and they were all stable, being about 8 weeks after birth. For each baby, some done once, some more often for a total of 80 comparisons, the same baby drank from breast and from bottle while being observed every minute. The abstract states succinctly enough:

  • Oxygen saturation and body temperature of the preterm infants were significantly higher when they were directly breastfed.
  • There were 2 episodes of apnoea (breath pause more than 20 seconds) and 20 episodes of oxygen desaturation (PaO 2< 90%) during bottle-feeding
  • and none during breastfeeding.
  • We conclude that breastfeeding is a more physiological feeding method for the preterm infant and bottle-feeding may be more stressful

Breastfeeding combines several factors to make it safer. First is the mother’s body that ensures a higher temperature, which in turn means all the energy is being used for growth and keeping calm. Breastfeeding also stimulates the vagal nerve, which is the one that controls the mouth and the stomach and the digestion. The milk itself contains oxytocin which makes for health and well-being, over and above protective factors.

Bottlefeeding on the other hand is unphysiological. To over-simplify: our larynx refers to that part of the throat we use to breathe, and the pharynx what we use when we eat. When we bottle feed, we use laryngeal muscles to help the pharyngeal, and this makes the risk for aspiration and problems such as apnoea (stopping breathing) and desaturations (no oxygen in the blood).

Bottle feeding in preterms and low birth weight babies is therefore dangerous.

Bigger babies cope with bottlefeeding … mostly … but why should they be stressed by that which should be most soothing, time to suckle at mother’s breast on mother’s milk?

Link to Pubmed