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Breastfeeding Update Stresses Health over Lifestyle Choice


Smoke or don’t smoke, vegetarian or meat eater, exercise daily or be a couch potato—these are lifestyle choices people make. However, according to an updated policy statement from the American Academy of Pediatrics (AAP), when it comes to breastfeeding, “infant feeding should not be considered as a lifestyle choice, but rather as a basic health issue.”

The AAP breastfeeding message grows stronger

Using its strongest language ever, the AAP is urging new moms to make put aside the notion that breastfeeding is a lifestyle choice and recognize it as a wise health choice for their infant. The group has reaffirmed its recommendation that breastfeeding be the sole food source for infants during the first six months of life, and that other foods be added gradually during the following six months or longer.

The updated policy statement, which appears in the March issue of Pediatrics, also urges pediatricians to step up to the plate by advocating and supporting women and breastfeeding. As part of that effort, the AAP offers healthcare providers evidence illustrating the advantages to employers who offer a breastfeeding friendly work environment.

Despite the many documented and apparent health benefits of breastfeeding for both infants and mothers (see “Health benefits of breastfeeding” below), the number of new mothers who breastfeed exclusively during the first six months is dismally low.

The Breastfeeding Report Card 2011: United States, from the Centers for Disease Control and Prevention, reported that while 74.6% of women ever breastfed, the percentage who were breastfeeding exclusively at 3 months was only 35%.

The new Pediatrics article notes that more than 900 infants deaths per year in the United States could be prevented if 90% of mothers would follow the AAP’s recommendation to breastfeed exclusively for the first six months of life. The United States has a huge distance to go to reach that goal, as the Report Card shows only 14.8% of women were exclusively breastfeeding at 6 months.

Health benefits of breastfeeding
Preventing infant deaths is certainly a huge advantage associated with breastfeeding, but there are many more. Breastfeeding has also been associated with the following health benefits for infants:

  • Improves outcomes in cases of neurodevelopment problems, such as autism and Down syndrome
  • Helps with development of immune defenses in preterm infants
  • 72% reduction in hospitalization for respiratory infections
  • 64% reduction in gastrointestinal infections
  • 58-77% reduction in necrotizing enterocolitis
  • 52% reduced risk of developing celiac disease
  • 36-45% reduced risks of sudden infant death syndrome
  • 31% reduced risk of inflammatory bowel disease
  • 30-40% reduced risk of developing diabetes
  • 27-42% reduction in allergic diseases (asthma, atopic dermatitis, and eczema)
  • 23-63% reduction in ear infections (otitis media)
  • 15-30% reduction in obesity in adolescence and adulthood
  • 15-20% reduction in childhood leukemia and lymphoma

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Let’s not forget the advantages for new mothers. Breastfeeding can help them return to their pre-pregnancy weight, improve recovery of the uterus and postpartum blood loss, and lower their risk of type 2 diabetes, breast and ovarian cancer, rheumatoid arthritis, high blood pressure, and cardiovascular disease. In fact, breastfeeding for longer than 12 months has been associated with a 28% decrease in breast and ovarian cancers.

Should EVERY mom breastfeed?
In a limited number of women, breastfeeding is not recommended by the AAP. Mothers who are positive for human T-cell lymphotrophic virus type I or II or untreated brucellosis or who have infectious untreated tuberculosis or active herpes simplex lesions on the breast should not breastfeed. However, expressed milk can be used in some cases.

Breastfeeding is not recommended among HIV-positive mothers in the industrialized world. Cocaine, marijuana, and PCP can pass to infants in breast milk and affect their neurobehavioral development, so breastfeeding is not recommended. Use of alcohol by nursing mothers should be discouraged or at least minimized to occasional use of about 2 ounces of liquor or 8 ounces of wine, as alcohol can affect an infant’s motor development.

More about the AAP policy statement
The AAP statement also outlined a few other recommendations regarding breastfeeding, and one concerns pacifier use. Since early use of pacifiers may result in less successful breastfeeding, the AAP recommends not using them until infants are 3 to 4 weeks old.

Pediatricians are also encouraged to take a more active role. The authors of the AAP report note that “Communicating with families that breastfeeding is a medical priority that is enthusiastically recommended by their personal pediatrician will build support for mothers in the early weeks postpartum.”

This update to the AAP’s policy statement on breastfeeding is the latest attempt to increase the number of women who exclusively breastfeed their infants for at least six months. The AAP’s insistence that breastfeeding not be viewed as a lifestyle choice but rather as a “basic health issue” is a new approach to an old challenge.

American Academy of Pediatrics. Breastfeeding and the use of human milk. Pediatrics 2012 Mar 1; 129(3): e827-e841
Centers for Disease Control and Prevention

Image: Courtesy Wikimedia Commons