The American Academy of Pediatrics recommends it. The World Health Organization recommends it. All major health organizations with a stake in maternal-child health recommend it. The US government recommends it. Hopefully, your obstetrician, midwife, pediatrician or family doctor recommends it. But then you read other news stories saying that breastfeeding isn’t actually as beneficial as it’s portrayed to be. So, who’s right? Is breastfeeding really that great?
A recent issue of the respected medical journal, The Lancet, provides some insight. The authors looked at research to determine if breastfeeding is healthier and if it saves lives and money on a population level. They looked at data from around the world, from low- and high-income countries, and taking into account many confounding factors. They looked at rates of breastfeeding in the first hour of life, exclusive breastfeeding for the first six months, and breastfeeding duration of 12 months and 24 months. They considered morbidity and mortality statistics and healthcare costs. They commissioned their own reviews, as well as looking at reviews and meta-analyses from other researchers.
The good news is that worldwide greater than 80% of babies are breastfed in the first month of life. But the bad news is that only half of those babies are breastfed in the first hour after birth, and that as the months pass, fewer and fewer babies are getting breastmilk (increasing the likelihood of illness). In addition, the researchers found that as a country’s income increases, breastfeeding rates decrease.
The researchers specifically found …
- the longer the period of breastfeeding the fewer infections (especially ear, diarrheal and respiratory) and the higher a child’s intelligence compared to breastfeeding for shorter periods or not at all.
- there is emerging evidence that breastfeeding protects against obesity and diabetes.
- breastmilk acts as a “personalized medicine,” helping to establish baby’s nascent immune system.
- breastfeeding protects moms, too, preventing breast and possibly ovarian cancer, and lowering the risk of diabetes.
- universal breastfeeding might prevent more than 800,000 child deaths and nearly 20,000 breast cancer deaths every year, and can save billions of dollars globally.
On the downside, the authors found that society still lacks enough support for women to meet their breastfeeding goals. They believe we need a paradigm shift for breastfeeding to be thought of as a “collective societal responsibility.” The political and financial investment in breastfeeding promotion and support is one of the most important things that can be done for long-term improvement of society as a whole.
The researchers conclude that six actions can improve global health by improving breastfeeding initiation and continuation:
- Spread the word: disseminate the evidence of breastfeeding’s protective effects on the health of women and children.
- Create a breastfeeding culture: use social media and marketing to support breastfeeding as a “high-value” activity.
- Make it political: governments should protect, promote and support breastfeeding not only to save lives, but also to save money.
- Better regulate the formula industry by implementation and (especially) enforcement of the Code of Marketing of Breastmilk Substitutes worldwide.
- Create better data collection: find ways to more accurately track breastfeeding trends and collect data about the impacts of breastfeeding initiation and duration, and make these methods universal so that statistics from a variety of settings are easier to compare.
- Make it easier for women to breastfeed: Governments need to enact maternity leave and break time polices that help women continue breastfeeding after returning to work. Health care services also need to implement policies that will aid women in initiating and maintaining breastfeeding from pregnancy through the first moments of life and beyond.
Breastfeeding promotion needs to remain a priority globally - women need policies that protect their ability to nourish and nurture their babies at the breast. The authors write, “breastfeeding is generally thought to be an individual’s decision and the sole responsibility of a woman to succeed, ignoring the role of society in its support and protection.” With the continued growth of the formula industry, we cannot expect breastfeeding rates to increase without political and structural support.
What lactation professionals have been saying for years is confirmed yet again – breastfeeding isn’t just best … not breastfeeding is dangerous to mom’s and baby’s health. But breastfeeding moms need more support than they are currently getting.
As a breastfeeding mom, you already know what a special experience nursing your beautiful baby can be. You can also be safe in the knowledge that the science is behind your decision to nurse your baby. And you can take heart that you are providing supportive example to other moms.
Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victoria CG. (2016). Why invest, and what it will take to improve breastfeeding practices?. The Lancet, 387(10017), 491-504.
Victora CG, Bahl R., Barros AJD, França GVA, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490.