22 February 2016

Tonsillectomy, breastfeeding, and the risk of obesity

Breast is Best! The NHS hammers that into our head, the WHO too. Recommendations are to exclusively breastfeed your baby for at least 6 months, and yet by saying breast is best, it implies that the alternative is good. This was brought to my attention by science writer Alanna Collen, author of the brilliant book entitled 10% Human.

Although babies’ formulas have been studied extensively these last few years, it is nowhere near as nutritious and protective as mum’s natural milk.

The role of breastfeeding is not only a nutritious one but also a protective one – Would you like to tweet this?

Breast milk contains so many components such as micro-organisms that will colonise the baby’s gut not only to help out with milk digestion but also to help out with immunity (more about it here).

Tonsils are those glands at the back of your throat that contain an army of immune cells. Their job is to investigate any food that comes in in order to educate the immune system on who’s good and who’s bad (wouldn’t want to have an auto-immune reaction against chocolate, now, do we?).

In fact, the tonsils we think are tonsils are only a part of ‘The Tonsils’ but they are the ones that get infected like crazy, and this is due to their surface being formed of deep grooves where bad bacteria can hide and develop leading to frequent infections, sore throats, and respiratory issues.

There is no doubt that in some instances, removing them is the right thing to do (e.g. respiratory obstructions, sleep apnoea); however, those tonsils are essential to educate our immune system, which has an essential role in keeping our heart healthy and controlling our body weight.

The strict recommendations (by the almighty WHO) are to wait until the child turns 7, which is the appropriate age at which the tonsils have had time to educate the immune system on all the stuff it may encounter (outside, school, friends, family, house, shops, etc…)

In fact, many studies have reported children at higher risk of being overweight if they undergo the operation too soon. One of these specifically reported that (adeno)tonsillectomy between 0 and 7 years old was statistically associated with overweight and obesity by 8 years old, and this was not explained by preexisting overweight.*


Coming back to breastfeeding, another study, from 1996 (i.e. we’ve known for a while) showed on the other hand that children undergoing tonsillectomy were less likely to have been breastfed, which effectively means that being breastfed is linked to a lower risk of developing recurrent infections and respiratory issues, which lead to tonsillectomy.**

Risk factors leading to an increased risk of developing each step:
No breastfeeding => Recurrent infections => Tonsillectomy => Obesity

So? Breast is Best? No, it’s the only good option (more about it here) with formula being a back up plan.

Unfortunately, a lot of women encounter difficulties in breastfeeding their baby – And I know what I’m talking about here, having gone through every single difficulty myself! But I believe there is not enough support from: empathic health visitors (who are a bit too rude if you suggest you might try formula), family, or the general public (breastfeeding in public anyone?). Maybe if some steps could be taken there, breastfeeding would be considered the absolute norm (with formula as a back up). Maybe then we would avoid a whole host of future health problems.

Have you undergone tonsillectomy when you were a child? Would you like to share your baby feeding experience?
Feel free to share your thoughts in the comments box, I’d love to read them.

*I got the info on the link between tonsillectomy and obesity from this paper: Wijga AH, et al. Adenotonsillectomy and the development of overweight. Pediatrics 2009; 123: 1095-1101. **And this short article can be found: Pisacane A, et al. Breastfeeding and tonsillectomy. British Medical Journal 1996; 312: 746-747.


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