KIDS' STUFF
BREAST IS BEST! BUT WHY…?
AUTHOR Mary Elizabeth Dedman, MD
E
veryone has heard the catchphrase,
“Breast is best,” implying that in choos-
ing to breastfeed her infant, a mother
is providing the ultimate nutrition for
her young child. It makes sense, right?
No breast milk substitute company
could design a more perfect food for
one mother’s individual baby than the mother
herself. After all, she carried this infant in her womb for all of his or
her creation. As physicians, we know that maternal breast milk is
the best possible choice for infant nutrition. But the challenges that
sometimes come with nursing, especially for a first-time mother, can
cause maternal stress that might cut the breastfeeding relationship
short. But, if mothers are aware of the vast benefits of breastfeeding,
they are more likely to choose to seek help and work through their
difficulties than to turn to commercial infant formulas. Physicians,
either in a professional work setting or in a relaxed social setting,
have a unique opportunity to give, at minimum, a few facts and the
verbal support to encourage these mothers and reassure them that
the benefits of breastfeeding make it worth the challenges.
The American Academy of Pediatrics recommends exclusive
breastfeeding for the first six months of life, then continued
breastfeeding with the introduction of complementary foods until at
least a year of age. Most of the benefits of breastfeeding are achieved
with as few as four months of exclusive breastfeeding, but the longer
the nursing relationship endures, the higher the benefit for baby.
The medical advantages when a baby receives maternal breast milk
are very significant. Studies have shown a 72% decrease in the risk
of hospitalization for infants with lower respiratory tract infections
in the first year of life. Breastfeeders have a 74% decreased severity
of respiratory syncytial virus with regard to duration of hospital
stay and supplemental O2 requirement. Breastfed infants enjoy a
23-50% decreased risk of otitis media, depending on duration of
nursing, and a 63% decrease in upper respiratory infections. A 64%
decreased incidence of gastrointestinal infections rounds out the
infectious disease benefits of nursing due to the antibodies found
in maternal breast milk.
which has been shown to be the most important risk factor in SIDS
prevention. It is estimated that over 900 infants lives could be saved
in the United States each year if we could achieve a breastfeeding
rate of 90% for the first six months of age. There is a decreased risk
of asthma, allergies and eczema by at least 27% as well as a 15-30%
reduction in adolescent and adult obesity rates in babies who are
breastfed for any duration. Children who are breastfed generally
achieve higher IQ scores and higher teacher ratings during their
school years and higher school attainment overall. This has been
shown to lead to 12% higher earnings later in life. The neurode-
velopmental benefits are especially pronounced in preterm infants,
making maternal human milk use in the neonatal intensive care
unit very important. Decreased rates of celiac disease, inflammatory
bowel disease, necrotizing enterocolitis, type I and II diabetes, and
childhood leukemia and lymphoma have also been demonstrated.
The baby is not the only recipient of medical advantages in a
strong nursing relationship. The maternal benefits of breastfeeding
are very significant and seem to be attained through cumulative
months of breastfeeding during a mother’s lifetime. Mothers who
breastfeed have a decreased incidence of cardiovascular disease,
hypertension, hyperlipidemia, diabetes, and rheumatoid arthritis.
Women who breastfeed longer than 12 months cumulatively in
their lifetime have a 28% decreased risk of breast cancer and ovarian
cancer. Breastfeeding also reduces a mother’s risk of postpartum
depression.
Recommending breastfeeding to mothers as the sole nutrition for
their infants is an important role that we as physicians can play. We
should also promote support for breastfeeding mothers from their
husbands and families. We should maximize the friendliness of the
workplace to breastfeeding by providing private rooms for pumping
and adequate time in our staff ’s schedules to accommodate this. We
should also limit the influence of breast milk substitutes through
advertising and sampling to new mothers. We should encourage all
of our patients, family members and friends to take advantage of
the benefits of breastfeeding for both mother and baby.
Dr. Dedman is a practicing pediatrician at Growing Healthy Children.
Breastfed infants have a 36% reduced risk of dying from sudden
infant death syndrome (SIDS); this is independent of sleep position,
AUGUST 2019
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