Breastfeeding And Infants: A Case Study

Is immunity compromised in babies who are formula fed for their first year compared to babies who are breastfed for the first year?
Anastasia J. Jorgensen
LCC Nursing 165

Is immunity compromised in babies who are formula fed for their first year compared to babies who are breastfed for the first year?
Many hospitals are now implementing a “Baby Friendly” environment in their delivery and mother-baby units. This initiative promotes breastfeeding as the priority feeding method to new mothers and leaves formula feeding by the wayside. Is formula feeding hurting these children or all of the children who have been formula fed up to this point? One study suggests that there is a high use of laxatives in formula-fed infants (Gitte Zachariassen, 2013).
While another sets out to prove that formula containing galactose, galactooligosaccharides (GOS) would help reduce infections and allergic manifestations with a prebiotic effect on intestinal microbiota (Carlos Sierra, 2014).
Purpose
In Sierra’s et al.’s (2014) article, which reviews the effect of prebiotic’s during the first year of life in formula fed infants, a randomized, double-blind, placebo-controlled trial is performed to assess the effects of prebiotic supplements on intestinal micro bacteria and the incidence of infections and allergic reactions during the first year of life. In Gitte Zachariassen’s et al.’s (2013) article on preterm infant diet and the high use of laxatives among the formula-fed infants, a study was performed to see what the effects of formula were on the infant gastrointestinal system versus infants who were given breastmilk along with formula and breastmilk alone. This study included the number of meals given, number and amount of regurgitation, number of stools, and amount of laxatives used daily.
Summary of Studies1
Population. The first study, Carlos Sierra et al. (2014), consisted of infants less than 2 months old and healthy term infants from eight Spanish hospitals. These infants ranged in gestational age of 37 to 42 weeks and weighed more than 2500 grams. The infants were then placed into different groups to monitor the effects of the different food given whether it was formula or breastmilk. In the next study, Gitte Zachariassen et al. (2013), parents of very preterm infants (<32 +0 weeks) who were healthy were asked to fill out a questionnaire and the information collected from the forms was analyzed.
Intervention and Comparison. In Sierra et al’s (2014) study the infants were fed formula only for at least 15 days prior to the beginning of the study. These infants were then put into groups where some infants were given infant formula for until they were six months of age and then either formula with GOS or without until twelve months. Supplemental feeding with breastmilk was allowed after four months. In Zachariassen et al. (2013) preterm infants were studied and the parents were asked to fill out a questionnaire every day for five days. These parents were not instructed to feed their infants formula rather than breastmilk but the information they provided did ask what type of nutrition they were receiving. The parents were also asked to document how often the infant regurgitated, how many stools they had, and if any laxatives were used for the infant.
Outcome. The outcome of the Sierra et al. (2014) study showed that the infants who received formula with GOS had a decrease in intestinal pH and an increase in both acetic acid and Bifidobacterium. The formula with GOS also showed an improvement in the frequency and consistency of stools but did not show any significance in the occurrence of infection or allergies. The outcome of the Zachariassen et al. (2013) study showed that the groups of infants that were fed breastmilk were fed more often than the formula groups. The infants who were given breastmilk along with formula had a significantly higher occurrence of regurgitation than the infants only given formula. The stool of the infants who were breastfed passed more stools per day than the formula fed infants and had less use of laxatives.
Conclusion
These studies both included excellent information regarding the effects of breastmilk and formula on infants.
They both showed that there is a benefit to breastfeeding over formula feeding in regard to the reaction on the infants’ intestinal function but did not show any significant data on the infants’ immunity or allergies. I think that it would be beneficial to track these groups longer to see the incidence of infection and food related allergies in the long term. The education that is being given out now regarding breastfeeding is important but I believe that more information should be provided about formula feeding and the problems that can occur. Specifically, I think parents should be informed that their infant could be more irritable because they are gassy or constipated if they are only formula fed, this may deter some parents from the use of formula or at least encourage them to supplement with breastmilk. I also think that they should be informed that breastfeeding, while it does contribute to passive immunity, is not the only way to keep your infant healthy. Formula, while more convenient to use at times, is not going to make your infant less healthy but it will not increase their immunity
eith er. References
Carlos Sierra, M.-J. B.-I.-L.-M. (2014). Prebiotic effect during the first year of life in healthy infants fed formula containing GOS as the only prebiotic: a multicentre, randomised, double-blind and placeboi-controlled trial. Springerlink.com, 11.
Gitte Zachariassen, J. F.-G. (2013). Preterm dietary study: meal frequency, regurgitation and the surprisingly high use of laxatives among formula-fed infants following discharge. ACTA Paediatrica, 7.