Recently, I met with top scientists at the FDA in Rockville, Maryland, discussing among other things, breastfeeding. It was their collective opinion that breastfeeding offered psychological nurturing benefits, but nothing more. No immunological factors, etc. Their logic was that all proteins are broken down by strong digestive enzymes. What do you think?

I applaud the critical thinking and intellectual curiosity of these scientists. When immunoglobulins were first discovered in breast milk, the appealing and simple conclusion was drawn that these immunoglobulins would directly improve the immune status of the baby. Indeed, specific antibodies against respiratory and intestinal bacteria and viruses are found in human breast milk. These have been thought to increase a child's resistance to infection. Apparently the aforementioned scientists have pointed out that this reasoning is overly simplistic. In fact, the strong digestive enzymes in the infant and the acid bath awaiting the antibodies in the stomach would tend to denature and digest these antibodies, rendering them useless.

While I admire their reasoning and believe that this line of thinking deserves further exploration, there are currently no good studies that prove that a baby's digestive process renders all antibodies inactive. In fact, there are some studies that suggest a baby's immature digestive system may allow antibodies to make it through the stomach intact.

Regardless of the controversy surrounding the fate of antibodies in the stomach, there is plenty of evidence that shows that breastmilk benefits babies. Therefore, I vehemently disagree with the conclusion that breast milk is essentially no different from formula.

Many studies comparing the frequency of illness between breast- and formula-fed infants have demonstrated fewer illnesses and less severe illnesses in breast-fed infants (Garza et. al Special Properties of Human Milk, Clinics of Perinatology 14:11-32, 1987). While it is very difficult to separate all of the variables of parenting style and environment, mounting evidence shows a striking reduction in the incidence and seriousness of gastrointestinal infections, respiratory infections, and ear infections in breast-fed babies (Duncan et. Al Exclusive Breast Feeding for at Least Four Months Protects Against Otitis Media, Pediatrics 91:867-872 1993.) In evaluating the benefits of breast milk, the American Academy of Pediatrics conducted a review of the literature for evidence of disease reduction with the use of human milk. In their policy statement on breastfeeding, they found "strong evidence" that breast milk reduces the incidence and/or severity of diseases such as diarrhea, lower respiratory infections, ear infections, bacterial meningitis, and urinary tract infections. (American Academy of Pediatrics Work Group on Breastfeeding, Pediatrics 100:1035-1039, 1997)]. Other studies have shown a decrease in non-infectious diseases such as eczema and asthma. If the immunoglobulins are rendered useless by digestion, how could this be?

There are many other ways that breastmilk benefits babies:

1. Psychological factors: You mentioned that these scientists suggest that the only difference between formula and breast milk is psychological. I strongly disagree that this is the only difference, but I agree that the psychological difference can have profound implications.