DAVID E BRATT

I had in­tend­ed writ­ing some­thing on gas–the in­testi­nal kind, the one that we are full of these days, not the one that comes out of the ground, so re­spon­si­ble for many of the mis­for­tunes we dai­ly face–when two re­mark­able ar­ti­cles on breast­feed­ing, one in the morn­ing on ba­by's brains and the oth­er late in the evening on women's health, came rolling over my desk and, de­spite the an­guished cries of my three or four friends des­per­ate for some­thing to laugh at in the Trinidad of to­day, they are too im­por­tant to ig­nore. We'll laugh an­oth­er day, fel­lows.

The first ben­e­fits ba­bies and is about ba­bies' brains and MRI ma­chines. Some guys at the Ad­vanced Ba­by Imag­ing Lab at Brown Uni­ver­si­ty in Prov­i­dence, Rhode Is­land looked at the brain growth of 133 ba­bies rang­ing in age from ten months to four years us­ing spe­cialised, "ba­by-friend­ly" mag­net­ic res­o­nance imag­ing (MRI) or "qui­et" MRI ma­chines–and if you have ever been in­side a MRI ma­chine, or tried very hard not to wake up a sleep­ing ba­by, you will un­der­stand the rel­e­vance of that term "qui­et MRI"!The ba­bies were split in­to three groups: those ex­clu­sive­ly breast­fed for at least the first three months of life, a group fed a com­bi­na­tion of breast­milk and for­mu­la, and those fed for­mu­la alone. Brain MRIs were con­sec­u­tive­ly done on all ba­bies over the years that the study last­ed.

By age two, the ba­bies breast­fed ex­clu­sive­ly for at least three months had en­hanced de­vel­op­ment in key parts of the brain, in the or­der of 20 to 30 per cent, com­pared to the oth­er two groups.

The MRIs specif­i­cal­ly looked at the brain's white mat­ter, the tis­sue that con­tains long nerve fi­bres and helps dif­fer­ent parts of the brain com­mu­ni­cate with each oth­er and is re­spon­si­ble for the bil­lions of con­nec­tions among brain cells.The MRIs look for amounts of myelin, a fat­ty ma­te­r­i­al that in­su­lates nerve fi­bres and speeds elec­tri­cal sig­nals as they zip around the brain and pro­duce faster pro­cess­ing time.The ex­tra growth in myelin was most pro­nounced in the parts of the brain as­so­ci­at­ed with lan­guage, emo­tion­al func­tion and cog­ni­tion.

As ex­pect­ed, the com­bined feed­ing group came sec­ond and the for­mu­la-fed ba­bies last.There were three oth­er points that came out of the study.The dif­fer­ences were ap­par­ent al­most from the very first MRIs. So my moth­er-in-law's en­cour­ag­ing words for our first ba­by, to "give her a lit­tle bit, nuh, just a lit­tle bit," was true. Even a lit­tle breast­feed­ing seems worth­while. The dif­fer­ences were di­rect­ly re­lat­ed to the length of breast­feed­ing. Un­for­tu­nate­ly the au­thors were not able to look at ba­bies who breast­fed for more than one year so we have no idea if the dif­fer­ences be­come greater the longer the ba­by breast­feeds. The team then backed up their imag­ing stud­ies with a set of cog­ni­tive tests on the old­er chil­dren and found in­creased lan­guage per­for­mance, vi­su­al re­cep­tion and mo­tor con­trol per­for­mance in the breast­fed ba­bies.

There have been many re­ports of en­hanced brain func­tion in breast­fed chil­dren but this is the first to ac­tu­al­ly doc­u­ment phys­i­cal changes in the brains of breast­fed ba­bies. Fur­ther stud­ies on oth­er or­gans are planned.The sec­ond study, en­thu­si­as­ti­cal­ly en­ti­tled Cost Analy­sis of Ma­ter­nal Dis­ease As­so­ci­at­ed With Sub­op­ti­mal Breast­feed­ing, came out last week too, in the Jour­nal of the Amer­i­can Col­lege of Ob­ste­tri­cians and Gy­ne­col­o­gists, Ob­stet­rics and Gy­ne­col­o­gy and I urge the doc­tors in the Gov­ern­ment to read it. On­ly med­ical re­searchers, by the way, could come up with a ti­tle like that. It should have been called Women Who Don't Breast­feed Get Sick­er.They want­ed "to es­ti­mate the US ma­ter­nal health bur­den from cur­rent breast­feed­ing rates both in terms of pre­ma­ture death as well as eco­nom­ic costs."So they took all the in­for­ma­tion that is known about the health ben­e­fits that ac­crue to women who breast­feed–less breast can­cer, less ovar­i­an can­cer, less hy­per­ten­sion, less type 2 di­a­betes mel­li­tus and my­ocar­dial in­farc­tion.

Through com­put­er analy­sis, they mod­elled the health out­comes and costs ex­pect­ed for a US co­hort of 15-year-old fe­males fol­lowed to age 70 and com­pared the out­comes ex­pect­ed if 90 per cent of moth­ers were able to breast­feed for at least a year af­ter each birth with out­comes un­der the cur­rent one-year breast­feed­ing rate of 23 per cent.The re­sults were eye-open­ing. Cur­rent breast­feed­ing rates re­sult in 4,981 ex­cess cas­es of breast can­cer, 53,847 cas­es of hy­per­ten­sion, and 13,946 cas­es of my­ocar­dial in­farc­tion com­pared with a co­hort of 1.88 mil­lion US women who op­ti­mal­ly breast­fed. They al­so looked at di­rect costs, in­di­rect costs, and cost of pre­ma­ture death (be­fore age 70) ex­pressed in 2011 dol­lars. Sub­op­ti­mal breast­feed­ing in­curs a to­tal of US$17.4 bil­lion in cost to so­ci­ety re­sult­ing from pre­ma­ture death, US$733.7 mil­lion in di­rect costs, and US$126.1 mil­lion in in­di­rect mor­bid­i­ty costs.How­ev­er, they found on­ly a mi­nor dif­fer­ence in num­ber of deaths be­fore age 70 un­der cur­rent breast­feed­ing rates.If ap­plied to the small­er pop­u­la­tion of T&T, the re­sults would be much less dra­mat­ic. Un­less, of course, you are the one with the can­cer, high blood pres­sure, di­a­betes or heart at­tack.