Comment by kaitai | Hacker News Reader

Comment by kaitai | Hacker News Reader

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That's not the whole story (re: immunoglobulin). You're right in broad-brush strokes. The abstract at https://www.ncbi.nlm.nih.gov/pubmed/12850343 has some quick notes on the broader context. For immunoglobulin in particular, when you say "doesn't survive digestion," you're missing the substantial amounts of IgA (ok, milk sIgA) in the intestine. There it will bind with lots of bad stuff, preventing said bad stuff from causing an immune response. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257684/ is one place to read about this.)

You also must consider all the leukocytes in breast milk. Both maternal and infant infections cause huge increases in leukocyte production. There is a theory (hard to test) that babies like to stick their hands in mom's mouth while breastfeeding so that mom gets baby germs, and then mom will make appropriate leukocytes. Bizarrely, baby backwash (into the breast! while feeding!) also leads to maternal immunological response. Fun fact: breast milk from the same mom can vary in color dramatically (from blue to white to yellow) and a lot of that has to do with the contents, with yellow in particular generally having a high leukocyte content.

That's fascinating and good info.

I'm a little biased. We got a lot of information pushing us not to supplement from health professionals and organizations, and nothing on the risks of failure to thrive or the case for supplementation. We had a calorie deficit no one caught, because measuring breast milk consumption is opaque, and no one talks about low consumption with the same fervor. They should though, it's an issue that drove an entire industry of wet nurses before formula (who were in turn criticised as unnatural in their day). They say breast if possible, but never detail how to tell the difference between just doing the hard work, or just banging your head against an immovable wall.

This inconsistency in advice, even though calorie deficits are incredibly dangerous, and more clearly so,[0] worries me there's a bias against technological development that keeps us from giving advice about both risks (or really much at all about the more important risk here).

[0] insofar as there are conflicting metaanalyses on breastmilk, but the signal is far stronger here, no one is publishing research suggesting failure to thrive is no big deal.

Don’t overlook the benefits to Mom too. Breastfeeding lowers risk of breast cancer:

https://www.mdanderson.org/publications/focused-on-health/oc...

That's actually a great example of what troubles me.

If you click through to read the underlying research you get a massive jumble of conflicted studies, including several meta-analyses that fail to find any significant results.

This gets reduced to "breastfeeding lowers the risk of breast cancer" in parenting lit without any context about how radically uncertain this area is.

Becoming a parent and actually reading the underlying lit has nearly destroyed my faith in medical research.

What's troubling is that there is no rational discussions, its always "breast is best" or "emotional impact statement here"

Of course we can all agree that in ideal circumstances, breast milk is the best thing for babies, its unique biologically adapted (even between feeds) formula is impossible to mass manufacture and biologicals like leukocytes are impossible to add in.

However, if the mother does not produce enough milk, then failure to thrive concerns take over, supplement.

If mother is post partum, dad can take over and supplement.

People just eat the tagline these days instead of doing a basic cost/benefit analysis and thinking a little bit for themselves.

Add to that the seeming acceptance of bad science and you end up with anti-vaxxers.

Highly interesting, thanks!

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