Round Table Discussion

Chairman Smith: In their approach to breast feeding, as to religion, pediatricians might be classified in 3 groups. There are the firm believers, with serene faith that all women ought to nurse their babies because "breast feeding is best feeding." At the other extreme, certain agnostics hold that it makes no important difference whether a baby is breast fed or given a formula. Much the most numerous are the third group, who would be glad to have a faith to stand up for if the rational basis of such a faith were revealed to them. These conscientious physicians, anxious to give sound scientific advice, find themselves falling back among traditions and impressions, in the absence of modern factual knowledge. Much new data concerns only premature infants, for whom it is quite possible that Nature did not design human milk. Obviously we need facts. Are the antibodies in human milk significant? Does it protect against neonatal diarrhea? Does suckling cause uterine involution? What constitutes optimum growth in infancy? Does it result with artificial feeding? Without the answers to these and other questions the subject escapes into psychologic and emotional fields since it cannot be properly tackled in physiologic territory. Indeed whether a mother will nurse her baby is now usually decided psychologically rather than physiologically. If 72% of New Hampshire babies leave the maternity hospital on bottle feeding only, compared to 10% of those in South Carolina, the psychology of South Carolina women, and of their doctors, must differ from that of those in New Hampshire.