Why Everyone You Don’t Like Is A Narcissist
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We’ve written before about how psychiatry tends to name disorders after how they affect other people, rather than how they affect the bearer, and this is most exemplified when it comes to personality disorders. For example:
“You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”
“You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”
See also: Miss Diagnosis: Anxiety, ADHD, & Women
Antisocial Diagnoses
These days, it is easy to find on YouTube countless videos of how to spot a narcissist, with a list of key traits that all mysteriously describe exactly the exes of everyone in the comments.
And these days it is mostly “narcissist”, because “psychopath” and “sociopath” have fallen out of popular favor a bit:
- perhaps for coming across as overly sensationalized, and thus lacking credibility
- perhaps because “Narcissistic Personality Disorder (NPD)” exists in the DSM-5 (the US’s latest “Diagnostic and Statistical Manual of Mental Disorders”), while psychopathy and sociopathy are not mentioned as existing.
You may be wondering: what do “psychopathy” and “sociopathy” mean?
And the answer is: they mean whatever the speaker wants them to mean. Their definitions and differences/similarities have been vigorously debated by clinicians and lay enthusiasts alike for long enough that the scientific world has pretty much given up on them and moved on.
Stigma vs pathology
Because of the popular media (and social media) representation of NPD, it is easy to armchair diagnose one’s relative/ex/neighbor/in-law/boss/etc as being a narcissist, because the focus is on “narcissists do these bad things that are mean to people”.
If the focus were instead on “narcissists have cripplingly low self-esteem, and are desperate to not show weakness in a world they have learned is harsh and predatory”, then there may not be so many armchair diagnoses—or at the very least, the labels may be attached with a little more compassion, the same way we might with other mental health issues such as depression.
Not that those with depression get an easy time of it socially either—society’s response is generally some manner of “aren’t you better yet, stop being lazy”—but at the very least, depressed people are not typically viewed with hatred.
A quick aside: if you or someone you know is struggling with depression, here are some things that actually help:
The Mental Health First-Aid You’ll Hopefully Never Need
The disorder is not the problem
Maybe your relative, ex, neighbor, etc really is clinically diagnosable as a narcissist. There are still two important things to bear in mind:
- After centuries of diagnosing people with mental health maladies that we now know don’t exist per se (madness, hysteria, etc), and in recent decades countless revisions to the DSM and similar tomes, thank goodness we now have the final and perfect set of definitions that surely won’t be re-written in the next few years or so ← this is irony; it will absolutely be re-written numerous times yet because of course it’s still not a magically perfect descriptor of the broad spectrum of human nature
- The disorder is not the problem; the way they treat (or have treated) you is the problem.
For example, let’s take a key thing generally attributed to narcissists: a lack of empathy
Now, empathy can be divided into:
- affective empathy: the ability to feel what other people are feeling
- cognitive empathy: the ability to intellectually understand what other people are feeling (akin to sympathy, which is the same but with the requisite of having experienced the thing in question oneself)
A narcissist (as well as various other people without NPD) will typically have negligible affective empathy, and their cognitive empathy may be a little sluggish too.
Sluggish = it may take them a beat longer than most people, to realize what an external signifier of emotions means, or correctly guess how something will be felt by others. This can result in gravely misspeaking (or inappropriately emoting), after failing to adequately quickly “read the room” in terms of what would be a socially appropriate response. To save face, they may then either deny/minimize the thing they just said/did, or double-down on it and go on [what for them feels like] the counterattack.
As to why this shutting off of empathy happens: they have learned that the world is painful, and that people are sources of pain, and so—to avoid further pain—have closed themselves off to that, often at a very early age. This will also apply to themselves; narcissists typically have negligible self-empathy too, which is why they will commonly make self-destructive decisions, even while trying to put themselves first.
Important note on how this impacts other people: the “Golden Rule” of “treat others as you would wish to be treated” becomes intangible, as they have no more knowledge of their own emotional needs than they do of anyone else’s, so cannot make that comparison.
Consider: if instead of being blind to empathy, they were colorblind… You would probably not berate them for buying green apples when you asked for red. They were simply incapable of seeing that, and consequently made a mistake. So it is when it’s a part of the brain that’s not working normally.
So… Since the behavior does adversely affect other people, what can be done about it? Even if “hate them for it and call for their eradication from the face of the Earth” is not a reasonable (or compassionate) option, what is?
Take the bull by the horns
Above all, and despite all appearances, a narcissist’s deepest desire is simply to be accepted as good enough. If you throw them a life-ring in that regard, they will generally take it.
So, communicate (gently, because a perceived attack will trigger defensiveness instead, and possibly a counterattack, neither of which are useful to anyone) what behavior is causing a problem and why, and ask them to do an alternative thing instead.
And, this is important, the alternative thing has to be something they are capable of doing. Not merely something that you feel they should be capable of doing, but that they are actually capable of doing.
- So not: “be a bit more sensitive!” because that is like asking the colorblind person to “be a bit more observant about colors”; they are simply not capable of it and it is folly to expect it of them, because no matter how hard they try, they can’t.
- But rather: “it upsets me when you joke about xyz; I know that probably doesn’t make sense to you and that’s ok, it doesn’t have to. I am asking, however, if you will please simply refrain from joking about xyz. Would you do that for me?”
Presented with such, it’s much more likely that the narcissist will drop their previous attempt to be good enough (by joking, because everyone loves someone with a sense of humor, right?) for a new, different attempt to be good enough (by showing “behold, look, I am a good person and doing the thing you asked, of which I am capable”).
That’s just one example, but the same methodology can be applied to most things.
For tricks pertaining to how to communicate such things without causing undue resistance, see:
Seriously Useful Communication Skills
Take care!
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Tech Bliss – by Clo S., MSc.
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The popular idea of a “digital detox” is simple enough, “just unplug!”, they say.
But here in the real world, not only is that often not practical for many of us, it may not always even be entirely desirable. The Internet (and our devices with all their bells and whistles) can be a source of education, joy, and connection!
So, how to find out what’s good for us and what’s not, in our daily digital practices? Clo. S. has answers… Or rather, experiments for us to do and find out for ourselves.
These experiments range from the purely practical “try this to streamline your experience” to the more personal “how does this thing make you feel?”. A lot of the experiments will be performed via your digital devices—some, without! Others are about online interpersonal dynamics, be they one-on-one or navigating a world in which it seems everyone is out to get us, our outrage, and/or our money. Still yet others are about optimizing what you do get from the parts of your digital experience that are enriching for you.
As the title suggests, there are 30 experiments, and it’s not a stretch to do them one per day for a month. But, as the author notes, it’s by no means necessary to do them like that; it’s a workbook and reference guide, not a to-do list!
(On the topic of it being a reference guide…There’s also an extensive tools directory towards the end!)
In short: this is a great book for optimizing your online experience—whatever that might mean for you personally; you can decide for yourself along the way!
Click here to get a copy of Tech Bliss: 30 Experiments For Your Digital Wellness today!
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Why scrapping the term ‘long COVID’ would be harmful for people with the condition
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The assertion from Queensland’s chief health officer John Gerrard that it’s time to stop using the term “long COVID” has made waves in Australian and international media over recent days.
Gerrard’s comments were related to new research from his team finding long-term symptoms of COVID are similar to the ongoing symptoms following other viral infections.
But there are limitations in this research, and problems with Gerrard’s argument we should drop the term “long COVID”. Here’s why.
A bit about the research
The study involved texting a survey to 5,112 Queensland adults who had experienced respiratory symptoms and had sought a PCR test in 2022. Respondents were contacted 12 months after the PCR test. Some had tested positive to COVID, while others had tested positive to influenza or had not tested positive to either disease.
Survey respondents were asked if they had experienced ongoing symptoms or any functional impairment over the previous year.
The study found people with respiratory symptoms can suffer long-term symptoms and impairment, regardless of whether they had COVID, influenza or another respiratory disease. These symptoms are often referred to as “post-viral”, as they linger after a viral infection.
Gerrard’s research will be presented in April at the European Congress of Clinical Microbiology and Infectious Diseases. It hasn’t been published in a peer-reviewed journal.
After the research was publicised last Friday, some experts highlighted flaws in the study design. For example, Steven Faux, a long COVID clinician interviewed on ABC’s television news, said the study excluded people who were hospitalised with COVID (therefore leaving out people who had the most severe symptoms). He also noted differing levels of vaccination against COVID and influenza may have influenced the findings.
In addition, Faux pointed out the survey would have excluded many older people who may not use smartphones.
The authors of the research have acknowledged some of these and other limitations in their study.
Ditching the term ‘long COVID’
Based on the research findings, Gerrard said in a press release:
We believe it is time to stop using terms like ‘long COVID’. They wrongly imply there is something unique and exceptional about longer term symptoms associated with this virus. This terminology can cause unnecessary fear, and in some cases, hypervigilance to longer symptoms that can impede recovery.
But Gerrard and his team’s findings cannot substantiate these assertions. Their survey only documented symptoms and impairment after respiratory infections. It didn’t ask people how fearful they were, or whether a term such as long COVID made them especially vigilant, for example.
Tens of thousands of Australians, and millions of people worldwide, have long COVID.
New Africa/ShutterstockIn discussing Gerrard’s conclusions about the terminology, Faux noted that even if only 3% of people develop long COVID (the survey found 3% of people had functional limitations after a year), this would equate to some 150,000 Queenslanders with the condition. He said:
To suggest that by not calling it long COVID you would be […] somehow helping those people not to focus on their symptoms is a curious conclusion from that study.
Another clinician and researcher, Philip Britton, criticised Gerrard’s conclusion about the language as “overstated and potentially unhelpful”. He noted the term “long COVID” is recognised by the World Health Organization as a valid description of the condition.
A cruel irony
An ever-growing body of research continues to show how COVID can cause harm to the body across organ systems and cells.
We know from the experiences shared by people with long COVID that the condition can be highly disabling, preventing them from engaging in study or paid work. It can also harm relationships with their friends, family members, and even their partners.
Despite all this, people with long COVID have often felt gaslit and unheard. When seeking treatment from health-care professionals, many people with long COVID report they have been dismissed or turned away.
Last Friday – the day Gerrard’s comments were made public – was actually International Long COVID Awareness Day, organised by activists to draw attention to the condition.
The response from people with long COVID was immediate. They shared their anger on social media about Gerrard’s comments, especially their timing, on a day designed to generate greater recognition for their illness.
Since the start of the COVID pandemic, patient communities have fought for recognition of the long-term symptoms many people faced.
The term “long COVID” was in fact coined by people suffering persistent symptoms after a COVID infection, who were seeking words to describe what they were going through.
The role people with long COVID have played in defining their condition and bringing medical and public attention to it demonstrates the possibilities of patient-led expertise. For decades, people with invisible or “silent” conditions such as ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) have had to fight ignorance from health-care professionals and stigma from others in their lives. They have often been told their disabling symptoms are psychosomatic.
Gerrard’s comments, and the media’s amplification of them, repudiates the term “long COVID” that community members have chosen to give their condition an identity and support each other. This is likely to cause distress and exacerbate feelings of abandonment.
Terminology matters
The words we use to describe illnesses and conditions are incredibly powerful. Naming a new condition is a step towards better recognition of people’s suffering, and hopefully, better diagnosis, health care, treatment and acceptance by others.
The term “long COVID” provides an easily understandable label to convey patients’ experiences to others. It is well known to the public. It has been routinely used in news media reporting and and in many reputable medical journal articles.
Most importantly, scrapping the label would further marginalise a large group of people with a chronic illness who have often been left to struggle behind closed doors.
Deborah Lupton, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, and the ARC Centre of Excellence for Automated Decision-Making and Society, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When You Know What You “Should” Do (But Knowing Isn’t The Problem)
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When knowing what to do isn’t the problem
Often, we know what we need to do. Sometimes, knowing isn’t the problem!
The topic today is going to be a technique used by therapeutic service providers to help people to enact positive changes in their lives.
While this is a necessarily dialectic practice (i.e., it involves a back-and-forth dialogue), it’s still perfectly possible to do it alone, and that’s what we’ll be focussing on in this main feature.
What is Motivational Interviewing?
❝Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behavior.❞
Read in full: Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice
It’s mostly used for such things as helping people reduce or eliminate substance abuse, or manage their weight, or exercise more, things like that.
However, it can be employed for any endeavour that requires motivation and sustained willpower to carry it through.
Three Phases
Motivational Interviewing traditionally has three phases:
- Exploring and understanding the issue at hand
- Guiding and deciding importance and goals
- Choosing and setting an action plan
In self-practice, maybe you can already know and understand what it is that you want/need to change.
If not, consider asking yourself such questions as:
- What does a good day look like? What does a bad day look like?
- If things are not good now, when were they good? What changed?
- If everything were perfect now, what would that look like? How would you know?
Once you have a clear idea of where you want to be, the next thing to know is: how much do you want it? And how confident are you in attaining it?
This is a critical process:
- Give your answers numerically on a scale from 0 to 10
- Whatever your score, ask yourself why it’s not lower. For example, if you scored your motivation 4 and your confidence 2, what factors made your motivation not a lower number? What factors made your confidence not a lower number?
- In the unlikely event that you gave yourself a 0, ask whether you can really afford to scrap the goal. If you can’t, find something, anything, to bring it to at least a 1.
- After you’ve done that, then you can ask yourself the more obvious question of why your numbers aren’t higher. This will help you identify barriers to overcome.
Now you’re ready to choose what to focus on and how to do it. Don’t bite off more than you can chew; it’s fine to start low and work up. You should revisit this regularly, just like you would if you had a counsellor helping you.
Some things to ask yourself at this stage of the motivational self-interviewing:
- What’s a good SMART goal to get you started?
- What could stop you from achieving your goal?
- How could you overcome that challenge?
- What is your backup plan, if you have to scale back your goal for some reason?
A conceptual example: if your goal is to stick to a whole foods Mediterranean diet, but you are attending a wedding next week, then now is the time to decide in advance 1) what personal lines-in-the-sand you will or will not draw 2) what secondary, backup plan you will make to not go too far off track.
The same example in practice: wedding menus often offer meat/fish/vegetarian options, so you might choose the fish or vegetarian, and as for sugar and alcohol, you might limit yourself to “a small slice of wedding cake only; coffee/cheese option instead of dessert”, and “alcohol only for toasts”.
Giving yourself the permission well in advance for small (clearly defined and boundaried!) diversions from the plan, will stop you from falling into the trap of “well, since today’s a cheat-day now…”
Secret fourth stage
The secret here is to keep going back and reassessing at regular intervals. Set your own calendar; you might want to start out weekly and then move to monthly when you’re more strongly on-track.
For this reason, it’s good to keep a journal with your notes from your self-interview sessions, the scores you gave yourself, the goals and plans you set, etc.
When conducting your regular review, be sure to examine what worked for you, and what didn’t (and why). That way, you can practice trial-and-improvement as you go.
Want to learn more?
We only have so much room here, but there are lots of resources out there.
Here’s a high-quality page that:
- explains motivational interviewing in more depth than we have room for here
- offers a lot of free downloadable resource packs and the like
Check it out: Motivational Interviewing Theory & Resources
Enjoy!
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How To Grow In Comfort
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How To Grow (Without Leaving Your Comfort Zone)
“You have to get out of your comfort zone!” we are told, from cradle to grave.
When we are young, we are advised (or sometimes more forcefully instructed!) that we have to try new things. In our middle age, we are expected to be the world’s greatest go-getters, afraid of nothing and always pushing limits. And when we are old, people bid us “don’t be such a dinosaur”.
It is assumed, unquestioned, that growth can only occur through hardship and discomfort.
But what if that’s a discomforting lie?
Butler (2023) posited an idea: “We never achieve success faster and with less effort than when we are in our comfort zone”
Her words are an obvious callback to the ideas of Csikszentmihalyi (1970) in the sense of “flow”, in the sense in which that word is used in psychology.
Flow is: when a person is in a state of energized focus, full involvement, and enjoyment of an activity.
As a necessary truth (i.e: a function of syllogistic logic), the conditions of “in a state of flow” and “outside of one’s comfort zone” cannot overlap.
From there, we can further deduce (again by simple logic) that if flow can be found, and/but cannot be found outside of the comfort zone, then flow can only be found within the comfort zone.
That is indeed comforting, but what about growth?
Imagine you’ve never gone camping in your life, but you want to get outside of your comfort zone, and now’s the time to do it. So, you check out some maps of the Yukon, purchase some camping gear, and off you go into the wilderness. In the event that you survive to report it, you will indeed be able to say “it was not comfortable”.
But, did growth occur? Maybe, but… it’s a folly to say “what doesn’t kill us makes us stronger” as a reason to pursue such things. Firstly, there’s a high chance it may kill us. Secondly, what doesn’t kill us often leaves us incredibly weakened and vulnerable.
When Hannibal famously took his large army of mostly African mercenaries across the Alps during winter to march on Rome from the other side, he lost most of his men on the way, before proceeding to terrorize Northern Italy convincingly with the small remainder. But! Their hard experience hadn’t made them stronger; it had just removed the weaker soldiers, making the resultant formations harder to break.
All this to say, please do not inflict hardship and discomfort and danger in the hopes it’ll make you stronger; it will probably do the opposite.
But…
If, instead of wilderness trekking in the Yukon…
- You start off with a camper van holiday, then you’ll be taking a fair amount of your comfort with you. In effect, you will be stretching and expanding your comfort zone without leaving it.
- Then maybe another year you might try camping in a tent on a well-catered camping site.
- Later, you might try “roughing it” at a much less well-catered camping site.
- And so on.
Congratulations, you have tried new things and undergone growth, taking your comfort zone with you all the way!
This is more than just “easing yourself into” something
It really is about taking your comfort with you too. If you want to take up running, don’t ask “how can I run just a little bit first” or “how can I make it easier” (well, feel free to ask those things too, but) ask yourself: how can I bring my comfort with me? Comfortable shoes, perhaps, an ergonomic water bottle, shade for your head, maybe.
❝Any fool can rough it, but a good soldier can make himself comfortable in any circumstances❞
~ British Army maxim
This goes for more than just physical stuff, too
If you want to learn a new skill, the initial learning curve can be anxiety-inducing, especially if you are taking a course and worried about keeping up or “not being good enough”.
So, “secretly” study in advance, at your leisure, get yourself a head start. Find a degree of comfort in what you’ve learned so far, and then bring that comfort with you into your entry-level course that is now less intimidating.
Discomfort isn’t a badge of honor (and impedes growth)
Take that extra rest stop on the highway. Bring your favorite coffee with you. Use that walking stick, if it helps.
Whatever it takes to bring your comfort with you, bring it.
Trust us, you’ll get further that way.
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Stickers and wristbands aren’t a reliable way to prevent mosquito bites. Here’s why
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Protecting yourself and family from mosquito bites can be challenging, especially in this hot and humid weather. Protests from young children and fears about topical insect repellents drive some to try alternatives such as wristbands, patches and stickers.
These products are sold online as well as in supermarkets, pharmacies and camping stores. They’re often marketed as providing “natural” protection from mosquitoes.
But unfortunately, they aren’t a reliable way to prevent mosquito bites. Here’s why – and what you can try instead.
Why is preventing mosquito bites important?
Mosquitoes can spread pathogens that make us sick. Japanese encephalitis and Murray Valley encephalitis viruses can have potentially fatal outcomes. While Ross River virus won’t kill you, it can cause potentially debilitating illnesses.
Health authorities recommend preventing mosquito bites by: avoiding areas and times of the day when mosquitoes are most active; covering up with long sleeved shirts, long pants, and covered shoes; and applying a topical insect repellent (a cream, lotion, or spray).
I don’t want to put sticky and smelly repellents on my skin!
While for many people, the “sting” of a biting mosquitoes is enough to prompt a dose of repellent, others are reluctant. Some are deterred by the unpleasant feel or smell of insect repellents. Others believe topical repellents contain chemicals that are dangerous to our health.
However, many studies have shown that, when used as recommended, these products are safe to use. All products marketed as mosquito repellents in Australia must be registered by the Australian Pesticides and Veterinary Medicines Authority; a process that provides recommendations for safe use.
How do topical repellents work?
While there remains some uncertainty about how the chemicals in topical insect repellents actually work, they appear to either block the sensory organs of mosquitoes that drive them to bite, or overpower the smells of our skin that helps mosquitoes find us.
Diethytolumide (DEET) is a widely recommended ingredient in topical repellents. Picaridin and oil of lemon eucalyptus are also used and have been shown to be effective and safe.
How do other products work?
“Physical” insect-repelling products, such as wristbands, coils and candles, often contain a botanically derived chemical and are often marketed as being an alternative to DEET.
However, studies have shown that devices such as candles containing citronella oil provide lower mosquito-bite prevention than topical repellents.
A laboratory study in 2011 found wristbands infused with peppermint oil failed to provide full protection from mosquito bites.
Even as topical repellent formulations applied to the skin, these botanically derived products have lower mosquito bite protection than recommended products such as those containing DEET, picaridin and oil of lemon eucalyptus.
Wristbands infused with DEET have shown mixed results but may provide some bite protection or bite reduction. DEET-based wristbands or patches are not currently available in Australia.
There is also a range of mosquito repellent coils, sticks, and other devices that release insecticides (for example, pyrethroids). These chemicals are primarily designed to kill or “knock down” mosquitoes rather than to simply keep them from biting us.
What about stickers and patches?
Although insect repellent patches and stickers have been available for many years, there has been a sudden surge in their marketing through social media. But there are very few scientific studies testing their efficacy.
Our current understanding of the way insect repellents work would suggest these small stickers and patches offer little protection from mosquito bites.
At best, they may reduce some bites in the way mosquito coils containing botanical products work. However, the passive release of chemicals from the patches and stickers is likely to be substantially lower than those from mosquito coils and other devices actively releasing chemicals.
One study in 2013 found a sticker infused with oil of lemon eucalyptus “did not provide significant protection to volunteers”.
Clothing impregnated with insecticides, such as permethrin, will assist in reducing mosquito bites but topical insect repellents are still recommended for exposed areas of skin.
Take care when using these products
The idea you can apply a sticker or patch to your clothing to protect you from mosquito bites may sound appealing, but these devices provide a false sense of security. There is no evidence they are an equally effective alternative to the topical repellents recommended by health authorities around the world. It only takes one bite from a mosquito to transmit the pathogens that result in serious disease.
It is also worth noting that there are some health warnings and recommendations for their use required by Australian Pesticides and Veterinary Medicines Authority. Some of these products warn against application to the skin (recommending application to clothing only) and to keep products “out of reach of children”. This is a challenge if attached to young children’s clothing.
Similar warnings are associated with most other topical and non-topical mosquito repellents. Always check the labels of these products for safe use recommendations.
Are there any other practical alternatives?
Topical insect repellents are safe and effective. Most can be used on children from 12 months of age and pose no health risks. Make sure you apply the repellent as a thin even coat on all exposed areas of skin.
But you don’t need “tropical strength” repellents for short periods of time outdoors; a range of formulations with lower concentrations of repellent will work well for shorter trips outdoors. There are some repellents that don’t smell as strong (for example, children’s formulations, odourless formulations) or formulations that may be more pleasant to use (for example, pump pack sprays).
Finally, you can always cover up. Loose-fitting long-sleeved shirts, long pants, and covered shoes will provide a physical barrier between you and mosquitoes on the hunt for your or your family’s blood this summer.
Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When can my baby drink cow’s milk? It’s sooner than you think
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Parents are often faced with well-meaning opinions and conflicting advice about what to feed their babies.
The latest guidance from the World Health Organization (WHO) recommends formula-fed babies can switch to cow’s milk from six months. Australian advice says parents should wait until 12 months. No wonder some parents, and the health professionals who advise them, are confused.
So what do parents need to know about the latest advice? And when is cow’s milk an option?
What’s the updated advice?
Last year, the WHO updated its global feeding guideline for children under two years old. This included recommending babies who are partially or totally formula fed can have whole animal milks (for example, full-fat cow’s milk) from six months.
This recommendation was made after a systematic review of research by WHO comparing the growth, health and development of babies fed infant formula from six months of age with those fed pasteurised or boiled animal milks.
The review found no evidence the growth and development of babies who were fed infant formula was any better than that of babies fed whole, fresh animal milks.
The review did find an increase in iron deficiency anaemia in babies fed fresh animal milk. However, WHO noted this could be prevented by giving babies iron-rich solid foods daily from six months.
On the strength of the available evidence, the WHO recommended babies fed infant formula, alone or in addition to breastmilk, can be fed animal milk or infant formula from six months of age.
The WHO said that animal milks fed to infants could include pasteurised full-fat fresh milk, reconstituted evaporated milk, fermented milk or yoghurt. But this should not include flavoured or sweetened milk, condensed milk or skim milk.
If you’re choosing cow’s milk for your baby, make sure it’s whole milk rather than skim milk. Mr Adi/Shutterstock Why is this controversial?
Australian government guidelines recommend “cow’s milk should not be given as the main drink to infants under 12 months”. This seems to conflict with the updated WHO advice. However, WHO’s advice is targeted at governments and health authorities rather than directly at parents.
The Australian dietary guidelines are under review and the latest WHO advice is expected to inform that process.
OK, so how about iron?
Iron is an essential nutrient for everyone but it is particularly important for babies as it is vital for growth and brain development. Babies’ bodies usually store enough iron during the final few weeks of pregnancy to last until they are at least six months of age. However, if babies are born early (prematurely), if their umbilical cords are clamped too quickly or their mothers are anaemic during pregnancy, their iron stores may be reduced.
Cow’s milk is not a good source of iron. Most infant formula is made from cow’s milk and so has iron added. Breastmilk is also low in iron but much more of the iron in breastmilk is taken up by babies’ bodies than iron in cow’s milk.
Babies should not rely on milk (including infant formula) to supply iron after six months. So the latest WHO advice emphasises the importance of giving babies iron-rich solid foods from this age. These foods include:
- meat
- eggs
- vegetables, including beans and green leafy vegetables
- pulses, including lentils
- ground seeds and nuts (such as peanut or other nut butters, but with no added salt or sugar).
You may have heard that giving babies whole cow’s milk can cause allergies. In fact, whole cow’s milk is no more likely to cause allergies than infant formula based on cow’s milk.
If you’re introducing cow’s milk at six months, offer iron-rich foods too, such as meat or lentils. pamuk/Shutterstock What are my options?
The latest WHO recommendation that formula-fed babies can switch to cow’s milk from six months could save you money. Infant formula can cost more than five times more than fresh milk (A$2.25-$8.30 a litre versus $1.50 a litre).
For families who continue to use infant formula, it may be reassuring to know that if infant formula becomes hard to get due to a natural disaster or some other supply chain disruption fresh cow’s milk is fine to use from six months.
It is also important to know what has not changed in the latest feeding advice. WHO still recommends infants have only breastmilk for their first six months and then continue breastfeeding for up to two years or more. It is also still the case that infants under six months who are not breastfed or who need extra milk should be fed infant formula. Toddler formula for children over 12 months is not recommended.
All infant formula available in Australia must meet the same standard for nutritional composition and food safety. So, the cheapest infant formula is just as good as the most expensive.
What’s the take-home message?
The bottom line is your baby can safely switch from infant formula to fresh, full-fat cow’s milk from six months as part of a healthy diet with iron-rich foods. Likewise, cow’s milk can also be used to supplement or replace breastfeeding from six months, again alongside iron-rich foods.
If you have questions about introducing solids your GP, child health nurse or dietitian can help. If you need support with breastfeeding or starting solids you can call the National Breastfeeding Helpline (1800 686 268) or a lactation consultant.
Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University; Naomi Hull, PhD candidate, food security for infants and young children, University of Sydney, and Nina Jane Chad, Research Fellow, University of Sydney School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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