By Joseph Hazan,M.D.,FACOG
The WHO has recommended at least 2
years of breastfeeding.
The American College of
Obstetricians and Gynecologists,
The American Academy of Family Physicians and
The American Academy of Pediatrics have
recommended exclusively breastfeeding for at least
six months and to extend this as much as
possible through the first year and thereafter.
Currently only 31.5% of infants are being
exclusively breastfed at 3 months and only
11.9% are exclusively breastfed at six months
in the US.
The public perception of formula feeding
as the norm and a misconception as to
the nutritional values of formula vs breastfeeding
contribute to these low rates.
What needs to be emphasized is
that not breastfeeding poses several
health risks to both the mother and the baby.
There are serious risks involved in
not breastfeeding and the public should
be informed.
The following is a summary of these:
1) Infection Risk
Babies who are formula fed are more
at risk to the flu, pneumonia, intestinal
viruses and bacteria, ear infections
and necrotizing enterocolitis.
Breast milk contains several immune
factors that help protect the baby.
IgA antibodies in mother’s milk help
protect the baby against respiratory and
intestinal pathogens. additionally,
oligosaccharides in breast milk help protect
the baby against H. influenzae and Strep
pneumoniae.
Glycoproteins in breast milk help protect against
E. coli, rotavirus and vibrio cholerae, while
lipids in breast milk help protect against H.
influenzae, Group B strep, G. lamblia, Strep
epidermidis, HSV 1 and RSV.
Glycosaminoglycans
in breast milk help protect against HIV.
Babies who are not breastfed have twice the risk
of ear infection.
Breast milk provides protection
against otitis media due to the oligosaccharides
and antibodies it contains.
Lipids in breast milk help protect the baby
against RSV (respiratory syncytial virus).
Babies who are exclusively breastfed fro 4 months
are protected, while those who are not breastfed
have 3.6 times the risk of being hospitalized
during the first year of life with a lower respiratory
infection.
Babies who are not breastfed also have 1.7
times to 2.8 times higher risk for gastroenteritis.
Preterm babies who are not fed with mother’s
milk have a 2.4 times risk of necrotizing enterocolitis
which is 15% fatal.
2) Metabolic Risk
Babies who are not breastfed are at higher
risk for type 2 diabetes and obesity.
The risk is 1.6 fold.
Metabolic risk also
relates to increased incidence of hypertension
and abnormal cholesterol and triglyceride levels.
Breast milk contains adipokines that help
regulate energy intake.
3) Neurological
Babies that are not breastfed have been
observed to crawl and walk later.
Also at age 6.5 years they have verbal
IQ scores 7.5 points lower according
to one study.
4) SIDS (sudden infant death syndrome)
Risk of SIDS is shown to be 1.6 to 2.1 fold for
babies that are not breastfed.
This increased risk is found to be
attributable to factors associated with
breastfeeding rather than breastfeeding itself.
5) Other isssues
Babies that are not breastfed have higher
incidence of alkaline stools and colonization of
bowel with potentially
harmful bacteria such as C. dificile and B. fragilis.
They also have immune systems that are not
as prepared for defense.
Therefore they seem to have a higher chance
of allergic problems and infectious diseases,
asthma, allergic skin rashes especially
atopic dermatitis.
The risk of type 1 diabetes , childhood leukemia
is also increased in babies who are not breastfed.
IMPACT ON MOTHER’S HEALTH
Mothers who have not breastfed or only
breastfed briefly have higher incidence of breast
and ovarian cancers,
Each year of breastfeeding seems to confer
4.3% reduction of risk for invasive breast cancer.
Mothers who don’t breastfeed have a tougher
time losing weight postpartum , have higher risk
of metabolic syndrome and diabetes.
The following is a useful resource on this topic:
http://www.womenshealth.gov/breastfeeding/
programs/business-case/outreach-marketing-
resources.pdf
