August 14th, 2007
Charts used to check whether babies are the right weight are being revised amid concern that they lead to overfeeding.
Up to now the growth charts used by health visitors have been based on the weight gain of babies given formula milk - which is faster than those being breastfed.
But child health doctors fear that the 20-year-old guidance has been used to pressure some mothers into overfeeding because, according to the charts, their breastfed babies are ‘failing to thrive’.
Some mothers have been told to supplement breast milk with the bottle - or even to stop breastfeeding altogether, it is claimed.
There are fears that overfeeding in infancy brings health problems in later life.
Infants given high-protein bottled milk tend to be larger than those who are breastfeeding, but they may find it harder to shake off the weight in adulthood.
Revising the charts downwards could help slow the obesity epidemic by reflecting the slower weight gain of breastfeeding babies.
The new charts covering children up to the age of two have been drawn up by the World Health Organisation, after a study of 8,000 breastfed babies from six cities around the world, and will be tried out in pilot studies in England before being more widely adopted.
It is estimated the new charts, which are backed by the Royal College of Paediatrics and Child Health, would redefine a quarter of all babies as heavier than the norm.
There will be a lower range of ‘healthy’ weights for all babies, with slightly fewer deemed to be underweight at any age.
For example, under existing charts a healthy one-year-old weighs between 22.5lb and 28.5lb.
But the new chart says the ideal range is from 21lb and 26lb.
Peter Aggett, professor of child health at the University of Central Lancashire, said manufacturers are planning to reduce slightly the calorie content of formula milk to more closely reflect breast milk.
He said: “New mothers often say they feel heavy pressure from health visitors using the old charts to feed up babies they claim are failingto thrive.
“The new charts will be a more accurate guide to what should happen if the babies are being breastfed.
“Formula-fed children tend to gain weight fastest and those who are overweight may end up having health problems in later life such as obesity, high blood pressure, diabetes and heart disease.
“The new charts should prevent babies getting overweight because we’ll be able to warn mothers if their children are overfeeding.”
The Department of Health recommends exclusive breastfeeding up to six months but only 25 per cent of mothers in Britain breastfeed their babies at least some of the time for the first six months.
Many of these also give their babies some formula.
Public Health Minister Dawn Primarolo said: “We are committed to promoting breastfeeding and these new standards will help alleviate mothers’ concerns regarding the difference in growth patterns often observed between breastfed and formula-fed babies.
“Our next step is to consider the practical aspects of implementing them effectively.”
A spokesman for the Infant and Dietetic Foods Association said: “Our main concern is the supply of nutritionally safe infant formula for mothers who cannot or choose not to breast feed.”
He added: “We await the outcome of the pilot study on the implementation of the charts in the UK.”
August 10th, 2007
Women who undergo cosmetic breast augmentation surgeries are three times as likely to commit suicide as those who don’t have surgically enhanced breasts, a new study finds.The increase in suicide risk does not emerge until about 10 years or more after women receive the implants, the research shows.
This latest study adds to a growing body of research finding that women with cosmetic breast implants are much more likely to take their own lives, said study lead investigator Loren Lipworth, a senior epidemiologist at the International Epidemiology Institute in Rockville, Md. “It’s one of five studies that have consistently shown an increased risk of suicide among women with cosmetic breast implants,” she noted.
There’s nothing about the breast implant itself that leads to increased likelihood of suicide, added Lipworth, who is also an assistant professor of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn. “Some women who get them are more likely to have psychiatric problems leading to suicide,” she speculated.
The study is published in the August issue of Annals of Plastic Surgery
Breast augmentation remained the most popular cosmetic surgery procedure in the United States in 2006, according to the latest statistics released by the American Society of Plastic Surgeons. An estimated 329,000 breast augmentation procedures were performed, with the average surgeon charging about $3,600 per procedure, the society found.
In the most recent study, Lipworth’s team tracked outcomes for more than 3,500 Swedish women who underwent cosmetic breast implant surgery in the years 1965 to 1993. They used death certificate information to analyze the causes of death among women with the implants and compared it to data for the general female population.
After a follow-up of almost 19 years, the suicide rate was three times higher for women with implants compared with the general population. There were 24 suicides in the implant group. The risk of suicide was nearly seven times higher for women who got their implants at age 45 or older, the researchers found.
The excess in risk didn’t become significant until 10 years after the implants were placed.
As to why the risk became statistically significant only later on, Lipworth speculated that, “it’s possible that some women who may have had psychiatric illness prior to the implant may experience improvement in psychological functioning in the short term [after implant], but it’s not sustained. So, 10 or 20 years out, there may be a recurrence or worsening of psychiatric problems.”
Lipworth said the five other studies that also found similar trends were done in five different countries: the United States, Sweden, Denmark, Canada and Finland.
Besides the suicide risk, women with enhanced breasts had higher rates of death from psychiatric disorders, including a threefold increase in deaths caused by alcohol or drug dependence. In all, 38 deaths (about a fifth of the total) in the breast implant group were linked with suicide, psychological problems, or drug or alcohol abuse or dependence, Lipworth said.
The American Society of Plastic Surgeons had no immediate comment on the study.
Another expert, David B. Sarwer, associate professor of psychology at the Center for Human Appearance, University of Pennsylvania School of Medicine, Philadelphia, wrote the “invited discussion” that accompanied the study.
In it, he urged physicians to heed the study results and to assess patients before they undergo cosmetic breast implants and other procedures, in particular looking for psychiatric problems. If a woman is under psychiatric treatment, Sarwer also urged the plastic surgeon to contact her mental health professional to assess whether she is stable enough for the surgery.
In an interview, Sarwer said “women thinking about breast implants or any form of cosmetic surgery should ask themselves three basic questions,” including, What is the nature of my concern? Are the areas I want to improve modest defects that others don’t even see when they are mentioned?
The woman should also ask if her motivation is internal or external. For example, if she is getting a breast augmentation to gain a promotion or save a marriage, that’s not a good sign, he said. However, if she believes the breast change will improve her appearance in a reasonable way, that’s a better sign.
Women should also be asked if they have realistic post-op expectations. Those who agree with statements such as “People will find me much more attractive” or “I’ll have more friends” may be in for difficulties later, Sarwer said.
The news isn’t all bad, he added. “Clearly, there are psychological benefits associated with cosmetic surgery and breast implants,” he said. “But, a small minority of patients have these very unfortunate outcomes.”