It is great that we have the data that shows that the use of donor milk banking lowers the use of infant formula. This is an important conclusion. But this study has two fatal flaws that need to be addressed by the authors for future studies. First, the abstract states that "the aim of the study is to assess the impact that a human milk bank has had on the proportion of infants receiving exclusive breast milk at discharge." (1) The conclusion states that, "We demonstrate how milk banks do not cause reduction in the rates of breastfeeding or in promoting its protection and support."(2) The authors defined exclusive breastfeeding and exclusive breast milk as the same. Are they the same? What is the impact on observations and conclusions in a study, when we define them as the same? Did this study demonstrate how milk banks do not cause a reduction in the rates of breastfeeding? There is no data on the rates of breastfeeding, unless you define breastfeeding as equivalent to breast milk feeding. Table 2 of the study shows that exclusive mother's milk in the year 2006 was 40% but in the year 2008 it was 13%. (3) I believe the author's explanation of the earlier use of donor milk in the neonatal unit does not sufficiently relieve my concerns. Definitions of infant feeding methods are critical in understanding outcomes. Science should be clear, we need precise definitions. The aim of the study should match the conclusion of the study. This was not done and makes it a less valuable contribution.
1. Torres et al.,"Does opening a milk bank in a neonatal unit change infant feeding practices? A before and after study,"International Breastfeeding Journal 2010, 5:4 2. Torres et al, IBJ 2010, 5:4 3. Torres et al, IBJ 2010, 5:4, Table 2
Competing interests
no competing interests
Editor's response to comment
Lisa Amir, International Breastfeeding Journal
18 April 2010
I agree that we must be clear about definitions of breastfeeding. I spend a lot of time asking authors to clarify their definitions. In this paper, the authors had initially used the term "breastfeeding" to include breastfeeding at the breast and feeding expressed breast milk. At my request, the authors changed the wording throughout the paper to "breast milk feeding". Unfortunately, the authors and I did not notice the sentence in the Conclusion still referred to "breastfeeding". After publication of the comment by Valerie McLain, the authors asked the publisher to change the wording of that sentence. This sentence has now been corrected. Lisa Amir MBBS MMed PhD IBCLC FABM Editor-in-Chief International Breastfeeding Journal
International Breastfeeding Journal
Breastfeeding is not breast milk feeding
18 March 2010
It is great that we have the data that shows that the use of donor milk banking lowers the use of infant formula. This is an important conclusion. But this study has two fatal flaws that need to be addressed by the authors for future studies. First, the abstract states that "the aim of the study is to assess the impact that a human milk bank has had on the proportion of infants receiving exclusive breast milk at discharge." (1) The conclusion states that, "We demonstrate how milk banks do not cause reduction in the rates of breastfeeding or in promoting its protection and support."(2) The authors defined exclusive breastfeeding and exclusive breast milk as the same. Are they the same? What is the impact on observations and conclusions in a study, when we define them as the same? Did this study demonstrate how milk banks do not cause a reduction in the rates of breastfeeding? There is no data on the rates of breastfeeding, unless you define breastfeeding as equivalent to breast milk feeding. Table 2 of the study shows that exclusive mother's milk in the year 2006 was 40% but in the year 2008 it was 13%. (3) I believe the author's explanation of the earlier use of donor milk in the neonatal unit does not sufficiently relieve my concerns. Definitions of infant feeding methods are critical in understanding outcomes. Science should be clear, we need precise definitions. The aim of the study should match the conclusion of the study. This was not done and makes it a less valuable contribution.
1. Torres et al.,"Does opening a milk bank in a neonatal unit change infant feeding practices? A before and after study,"International Breastfeeding Journal 2010, 5:4
2. Torres et al, IBJ 2010, 5:4
3. Torres et al, IBJ 2010, 5:4, Table 2
Competing interests
no competing interests
Editor's response to comment
18 April 2010
I agree that we must be clear about definitions of breastfeeding. I spend a lot of time asking authors to clarify their definitions. In this paper, the authors had initially used the term "breastfeeding" to include breastfeeding at the breast and feeding expressed breast milk. At my request, the authors changed the wording throughout the paper to "breast milk feeding". Unfortunately, the authors and I did not notice the sentence in the Conclusion still referred to "breastfeeding". After publication of the comment by Valerie McLain, the authors asked the publisher to change the wording of that sentence. This sentence has now been corrected.
Lisa Amir
MBBS MMed PhD IBCLC FABM
Editor-in-Chief
International Breastfeeding Journal
Competing interests
None declared