Monday, March 19, 2012

Cow's milk and the Law of the Lowest Common Denominator

Happy first birthday Baby Seal! First birthday, first ever chocolate cake (with homemade ganache). I appreciated your cake-eating enthusiasm.

As we all know, birthdays are magic and the first birthday is the most magic of all, because at the moment the clock strikes midnight on the day baby turns 12 calendar months old, something strange happens. In the upside-down carnival of the first birthday, all sorts of things which were previously "bad" become "good" and vice versa. Things that were fine to do before suddenly become A Problem. And everything baby does must be interpreted in a different light. Twelve months is officially the age at which solid food stops being "for fun," and becomes an essential nutrition source. Up until that fated birthday, baby's needs were the same as baby's wants; now baby has lost her innocence and becomes capable of manipulation. Pacifiers, which were fine yesterday, are now a Bad Thing. Bottles too (time to drink from a cup). If you are like a lot of westerners, one year old is the age at which breastmilk suddenly loses all nutritional benefit (exactly how is never explained) and the act of breastfeeding becomes something unseemly and not far from Child As Sex Toy. If you are a certain type of lactivist, 12 months is the point at which you will grudgingly tolerate another woman weaning without actually making snarky remarks (possibly).

And then there's cow's milk. There is a lot of confusion on parenting boards about cow's milk, formula and breastmilk...the when and the how and the why (and that's even before you bring in bottles vs. cups and other factors). The American Association of Pediatrics states that "Whole cow's milk is considered an inappropriate option for infants, which FDA defines as babies not more than 12 months old. According to the AAP, cow's milk contains very little iron and the small amount present is poorly absorbed into the body. Starting an infant on cow's milk too early can result in iron-deficiency anemia, particularly if the baby is not given an iron supplement or foods with iron." Formula or breastmilk should be the only milk given to the baby. Meanwhile, this National Health Service (NHS) resource advises us that "Babies shouldn’t drink cow’s milk before 12 months," but adds that "you can add cow’s milk to food before 12 months" and also recommends "full fat, low sugar dairy products like cheese, yoghurt, fromage frais, or custard."

Given this, us ordinary mothers on the discussion boards could be forgiven for being a bit confused. "My health visitor said it was fine to give DS cottage cheese or yogurt. I'm confused; they say no cow's milk before 12 months... why are yogurt and cheese so different?" Someone else will then chime in to speculate that it might be because yogurt and cheese are "cultured" foods which alters the proteins and sugars contained therein. To which someone else will point out that they have been mixing small amounts of cow's milk with their baby's cereal for the last month--with the health visitor's blessing. Surely if cow's milk has these evil iron-destroying powers, they are not going to magically disappear just because you've added a bit of Ready Brek, no?

I think the key to resolving this is to understand that this is an example of a common phenomenon in the world of official childrearing advice: The Law of the Lowest Common Denominator. Basically, what are the AAP and NHS worried about? Well, not about the perfectly healthy children of mothers who are conscientious enough to be on a childrearing-related discussion board in the first place. They worry about the children of parents who are young, poor and a bit clueless. Who might be tempted one day, when looking into the refrigerator, to think "Hey, we've got milk here. In a carton, all ready to drink. I know, why don't we just fill Suzy's bottles up with this stuff instead of fiddling about with that expensive formula bollocks?" Bad idea. Cow's milk and goat's milk, unlike formula/breastmilk, are not a complete diet, and babies fed in this way are at real risk of dehydration, kidney damage and anemia. Even older babies risk iron deficiency if cow's milk starts making up a substantial proportion of their diet. On the other hand.... a bit of cow's milk, for an older baby? No problem. It's essentially no different to any other complementary food. Can you give an older baby apple as a complementary food? Sure. Should you start giving them cupfuls of pureed apple all day long instead of formula/breastmilk? Of course not.

Trouble is, official organizations know perfectly well that if they start wheezing out long-winded explanations about core foods versus complementary foods and iron and how it's okay to give this much milk but not more than this... unless you are giving other dairy products as well, in which case you should probably give less milk... and it depends on how quickly they take to solids, and.... well, people's eyes are going to start glazing over (especially the kind of parents who are most likely to ignore sensible pediatric advice in the first place). On the other hand, if you make a crude blanket rule of "No cow's milk as a drink before 12 months. A bit with cereal is fine, and a bit of yogurt and cheese is fine," then people are more likely to remember the advice and adhere to it.

The same rule governs a lot of other childrearing advice. I remember (pre-baby) pursing my lips disapprovingly when I heard my sister had acquired a baby walker--didn't she know all the official guidelines said they were Bad For Babies? But (as my father pointed out to me) the reason baby walkers have a bad press is because some idiots leave babies in them for hours or use them as a excuse for not supervising, resulting in serious accidents. Used for short periods under supervision like other toys, there is nothing terrible about them. I think a lot of arguing on message boards and within mothers' groups could probably be avoided if the Law of the Lowest Common Denominator was more widely understood.

Anyway, I have been breaking the official recommendations by leaving Baby Seal with a cup of cow's milk plus water and solids whenever I go out in the evening (about once a week) since the age of 10 months. I hate pumping and have the smallest freezer known to man; while I have nothing against formula, there was a recall on Japanese formula at the end of last year due to the radiation scare, and frankly it's put me off a bit. With her only eight weeks to go until her first birthday, it hardly seemed worth dragging British formula all the way home on the plane. Also, I have heard too many stories of babies who were kept away from cow's milk completely during the first year, and then refused it vehemently when their parents tried to introduce it later on. So cow's milk it is. Now all I need to do is to get her drinking it from an open cup without throwing it everywhere. We can but hope.

4 comments:

  1. Good points. I think so much of the advice handed out to us is for that exact reason. Some people just need to stop and think before freaking out. Like water. It's advised to not feed a newborn water. The water isn't bad for the baby, per se. It's just pointless (at least for breastfed babies) and fills up their little bellies with non-nutrition.

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  2. I so very much agree with the Lowest Common Denominator assessment. What's hard, always, is trying to figure out exactly which bits of advice are LCD advice and which are SERIOUS BIZNESS. The no-honey-before-1 advice seems to be the latter (though who can say why 1 is the magic number, again), and I think a lot of the no-sharing-a-bed-no-way-no-how advice seems to be LCD (and, as such, is often extra-ineffective, because it leads to people co-sleeping on really unsafe surfaces like couches because they've heard "no bed-sharing!" so many times). But for any number of other minor things, it can be hard to tell which sort of advice is being given, even for those of us who are reasonably educated.

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  3. Megan, I think this is a good point; from physicians' point of view, it must be a difficult balance--because giving LCD advice can help parents' err on the side of safety, but then if parents realize this and start to become cynical, then they might start ignoring other advice where you really do have to stick to the letter. Tricky.

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