The World Health Organization (WHO), the American Academy of Pediatrics (AAP), the United Nations International Children’s Emergency Fund (UNICEF), as well as most other health agencies throughout the world, recommend that breastfeeding be initiated within the first hour of birth and continue for at least the first six months of life. Recently, the AAP has updated its guidelines to recommend that mothers continue to breastfeed their children for up to two years and beyond.
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Composition of breast milk
Colostrum, which is the first secretion from the breasts, is especially rich in many nutritious substances including fat-soluble vitamins, minerals, proteins, and immunoglobulins. In fact, the high antibody content within colostrum provides passive immunity to the infant to protect them against various types of gastrointestinal and respiratory infections.
Transitional milk is considered the second stage of breast milk and typically is produced for two weeks after delivery. As compared to colostrum, transitional milk has a higher calorie concentration and is also high in fat, lactose, and water-soluble vitamins.
The final stage of breast milk is known as mature milk. Despite being about 90% water, which ensures that the breastfeeding infant remains hydrated, the remaining 10% of mature milk consists of carbohydrates, proteins, and fats, all of which are essential for the development of the growing infant.
Mature milk can be further categorized as fore-milk and hind milk. Fore-milk is the initial milk that is produced at the beginning of a feeding and contains water, vitamins, and proteins. Comparatively, hind-milk, which is produced after the initial release of milk, has a significantly greater fat content as compared to fore-milk and plays an important role in the infant’s ability to gain weight appropriately.
Infant health benefits
Breastfeeding confers numerous benefits to the infant.
In terms of its ability to protect against infectious diseases, any amount of breastmilk is associated with a 64% reduction in the incidence of non-specific gastrointestinal infections. In fact, there is evidence that this protective effect is sustained for up to two months after breastfeeding has ceased. As compared to breastfed infants, infants who exclusively consume formula appear to have an 80% increased risk of diarrhea.
A similar level of protection has been reported in breastfed infants against respiratory infections. To this end, non-breastfed children have up to a fifteen-times greater risk of mortality from pneumonia as compared to infants who are exclusively breastfed in their first six months of life. Furthermore, infants who have been exclusively breastfed for at least four months have a reduced risk of hospitalization for lower respiratory infections by about 72%.
Breastfeeding has also been shown to reduce the risk of children developing various allergic conditions including eczema, atopy, asthma, as well as food and respiratory allergies. Several studies have shown that the risk of asthma among breastfed infants is reduced by up to 40%, particularly in children with a family history of asthma.
Breastfeeding is also associated with a significantly reduced risk of infant mortality. Despite medical advancements that have been made over the past several decades, infant mortality remains a significant problem, even within developed Western nations like the United States, where the infant death rate is about 5.8 for every 1,000 live births.
As compared to infants who were exclusively breastfed, non-breastfed infants have a 14-fold greater risk of mortality until they reach two years of age, particularly in developing nations. Breastfeeding, even for as little as two months, is also associated with a reduced risk of sudden infant death syndrome (SIDS) by up to 40%. This protective effect increases to 60% and 64% for infants who are breastfed for at least four months and six months or more, respectively.
Breastfeeding also appears to reduce the risk of children developing leukemia, celiac disease, obesity, cardiovascular disease, hypertension, and type 2 diabetes (DM) in the future.
Maternal benefits
Breastfeeding is also associated with several short- and long-term benefits for the mother. In terms of its short-term benefits, breastfeeding for at least the first six months postpartum is associated with a reduced risk of hemorrhage after delivery and prolonged amenorrhea.
In women without a prenatal diagnosis of depression, breastfeeding appears to reduce the risk of postpartum depression in mothers. More specifically, breastfeeding appears to invoke high positive emotions that are associated with reduced depression symptoms at two, six, and 12 months postpartum. Importantly, mothers who struggle to meet their breastfeeding goals appear to have a greater risk of developing postpartum depression.
A wide range of long-term health benefits has been associated with breastfeeding, some of which include a reduced risk of metabolic syndrome, type 2 diabetes, cardiovascular disease, and hypertension.
Breastfeeding has also been shown to reduce the risk of breast, ovarian, endometrial, and thyroid cancers. In general, the longer that a woman breastfeeds during her reproductive years, the greater benefit it has on her long-term health outcomes.
How mothers can nurse themselves healthy
References
- Breastfeeding overview [Online]. Available from: https://americanpregnancy.org/healthy-pregnancy/breastfeeding/breastfeeding-overview/.
- Louis-Jacques, A. F., & Stuebe, A. M. (2020). Enabling Breastfeeding to Support Lifelong Health for Mother and Child. Obstetrics and Gynecology Clinics of North America 47(3); 363-381. doi:10.1016/j.ogc.2020.04.001.
- Brahm, P., & Valdes, V. (2017). Benefits of breastfeeding and risks associated with not breastfeeding. Revista Chilena de Pediatria 88(1); 15-21. https://scielo.conicyt.cl/pdf/rcp/v88n1/en_art01.pdf.
- Jenco, M. (2017). Study: Breastfeeding for at least 2 months decreases risk of SIDS. AAP News. https://publications.aap.org/aapnews/news/13812?autologincheck=redirected.
- Ware, J. L., Chen, A., Morrow, A. L., & Kmet, J. (2019). Associations Between Breastfeeding Initiation and Infant Mortality in an Urban Population. Breastfeeding Medicine 14(7). doi:10.1089/bfm.2019.0067.
- Breastfeeding [Online]. Available from: https://www.who.int/health-topics/breastfeeding#tab=tab_1.
Further Reading
Direct breastfeeding boosts microbial transfer to very-low-birth-weight infant guts