Breast Milk = Brainy Babies?

Nearly everyone agrees that breast milk is unmatched as the optimum source of nutrition for infants. Human milk not only provides the perfect balance of vitamins, minerals, protein, carbohydrates and fat, it also contains valuable antibodies from the mother that have been proven helpful in preventing infection in infants.

Despite the best efforts of researchers and scientists, none have been able to duplicate the nutritional composition of breast milk in the production of commercial infant formulas.

"There is no dispute that breast milk is the gold standard and that, as a Nutritionist, it would be my wish that every child born in the U.S. could have the opportunity to obtain their nutrition through their mothers' milk," says Dr. Barbara Levine, director of the Nutrition Information Center at The New York Hospital-Cornell Medical Center. "However, the reality is that 20 percent of mothers will breastfeed for 8 weeks or longer, and certainly not for the duration, which would be 1-2 years."

What about the mother who can't or chooses not to breastfeed?

Aside from the health benefits of breast milk, research has shown IQ levels in babies who were breastfed to be superior to those of their formula-fed counterparts. One such study found that supplementing infant formula with two essential fatty acids found in human milk, docosahexaenoic acid (DHA) and arachidonic acid (AA), have significantly enhanced IQ scores in a study involving a group of 18-month old children.

Denise Wager, mother to Jack and Abigail, offers, "I have had many problems breastfeeding, so formula has been my children's main source of food during the first year of their lives." She adds, "I would welcome a better formula because I know from my personal experience that, while I may want to or intend to breastfeed, it may not work out as I had planned."

Carol Lammi-Keefe, nutritional sciences professor and head of the department at the University of Connecticut, has conducted research focusing on the levels of DHA in pregnant and nursing mothers. She found that the mother is a baby's major source of DHA during the first two years after birth, as babies are unable to produce sufficient amounts of the nutrient on their own. Not only is DHA crucial to the development of fetal nervous systems and brain development, in her most recent study, Lammi-Keefe found that a newborn's sleep patterns are also a functional measure of DHA. While she maintains that adding DHA to an infant's diet won't necessarily yield a genius, when asked about taking steps to ensure that an infant receives these critical nutrients, she says, "You are giving your child an edge."

During pregnancy, DHA and AA are delivered through the placenta and have been shown to be a significant factor in fetal development in a number of areas. After birth, the acids are secreted through breast milk and have shown to play an integral role in development during the first year of life, when an infant's brain nearly triples in size. Over 60 countries have received approval for enriching infant formulas with DHA and AA, but the practice, currently under review by the Food and Drug Administration, has not yet been approved in the U.S.

The study, conducted by the Retina Foundation of the Southwest in Dallas and funded by the National Institute of Child Health and Human Development (NICHD), is currently in progress to evaluate the safety and value of fortifying infant formulas with the two acids. "This study is an important step in the comprehensive array of studies needed to determine whether these substances should be added to infant formula," said Duane Alexander, M.D., Director of the NICHD. The study tested the IQ scores of 56 children who were enlisted within 5 days of birth and divided randomly into three groups. Over a period of 17 weeks, the first group was fed infant formula fortified only with DHA, the second received infant formula fortified with both DHA and AA, and the third were fed a standard, non-supplemented infant formula. At the end of the 17-week period, all of the infants were fed the standard infant formula without the DHA or AA.

At the age of 18 months, the children were tested on a variety of skills using the Bayley Scales of Infant Development (BSID), a standardized test used to evaluate the development of young children. The study found that while no differences related to large motor skills, such as jumping and walking, were seen between the three groups, the subjects showed considerable differences in areas involving the Mental Development Index (MDI), which measures memory, problem-solving abilities and language skills. In fact, those in the test group who received unfortified infant formula scored an average of 98, which is below the national average of 100 for U.S. children.

The DHA group, however, received an average score of 102.4, while those in the DHA and AA group scored an average of 105. According to Eileen E. Birch, an author of the study, the IQ results of the DHA and AA group were nearly identical to those of the results of exclusively breastfed infants in a past study. She points out, however, that although the infants on supplemented formula scored significantly higher than the standard formula-fed group, the study did not prove that there will be similar IQ differences as the children age.

"This was considered a landmark study in that it was one of the first that compared fortified vs. unfortified formula rather than breast milk vs. unfortified formula," maintains Dr. Levine.

Jen Highland, avid breastfeeding mother of 9-month old, Evan says, "Although I am very anti-formula -- in my ideal society, it would be available by prescription only -- I think that for society's sake, formula should be the best it can be."

Does the study prove that breastfed babies or those who receive infant formulas fortified with DHA and AA will be smarter than standard formula-fed infants? Not necessarily. But testing will continue at ages 4 and 9 to determine if the enhanced early brain development translates into higher IQs among school-aged children.

"Artificial baby milk will never be able to duplicate the perfect food for human infants," advises Carol Huotari IBCLC, and manager at Le Leche League International. "Moreover, if infant formula ever could duplicate human milk, the delivery system which provides the opportunity for the intimate bonding between the nursing couple, the changes in the infant and the mother's hormonal status would still be lacking." However, in discussing the reality that some women are either unable or will choose not to breastfeed, she adds, "We all want healthy and intelligent children, and if making artificial baby milk more like human milk will further that cause, who could truly be against it?"

Some may argue that the addition of these essential fatty acids to commercial infant formulas may influence more women to choose formula over breast milk, but for some, the prospect of improving infant formula is a hopeful one. Liza Geeter, adoptive mother to 5 month old daughter, Lauren says, "Despite my efforts to attempt to lactate before we brought Lauren home, I never produced nearly enough to sustain her." She adds, "Any steps taken to fortify formula so that it's more like breast milk could only be positive. She deserves as many of the benefits of breast milk as possible, even though she's not able to have mine."