Benefits of BreastfeedingVirginia Petrikonis

Question #1

• What are the benefits (improved outcomes) of breastfeeding to both the mother and the child?

• Can mothers and babies achieve some of these benefits with a combination of formula and breastfeeding?

Why Breastfeed?

• Breastmilk has every vitamin, mineral, and other nutrient that a baby needs whereas formulas do not (Wiessinger, West, & Pitman, 2010).

AAP & Breastfeeding

• The abundance of new data about the beneficial effects of breastfeeding influenced the American Academy of Pediatrics (AAP) to update its guidelines, now recommending exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant (Rochman, 2012).

BF: Benefits for the child

• Provides antibodies to protect baby from illness.

• Decreased likelihood of allergies.• Decreased likelihood of dental carries.• Benefit from appropriate jaw, teeth, & speech

development as well as overall facial development.

(Benefits of Breastfeeding, 2007)

BF: Benefits for the child

• A study in the Philippines found that "Deaths from respiratory infections and diarrhea were eight to ten times higher in babies who were artificially fed than in those who were even partially breastfed for six months” (p.350).

• Breastfeeding decreases a baby’s risk of infections, intestinal upsets, respiratory problems and SIDS.

(Wiessinger, West, & Pitman, 2010).

BF: Benefits for the child

• Results in less trips to medical doctors and dentists than formula fed babies (Benefits of Breastfeeding, 2007).

• Breastfeeding ensures the best possible health

as well as the best developmental and psychosocial outcomes for the infant (Crase, 2005).

BF: Benefits for the mother

• Lose weight more readily.– Active metabolic process that requires an average of

200 to 500 calories per day.• Less likely to suffer from postpartum depression.• Prolactin appears to produce a relaxation and calmness in

mothers.

• Saves time.– Can breastfeed even during stressful times, i.e. food &

water scarce or unavailable.(Breastfeeding, 2011)

BF: Benefits for the mother

• Immediately after birth, breastfeeding releases oxytocin.– Promotes uterine contractions that prevent postpartum

hemorrhage and promote uterine involution.• Breastfeeding mothers can often stay amenorrheic

for several months.– Prevention of pregnancy.– Conserves iron. The net effect is a decreased risk of iron-

deficiency anemia.(Benefits of Breastfeeding, 2007)

BF: Benefits for the mother

• Miss less work.– Benefit to the employer as well.

• Save money.– Do not have to purchase formula, which averages

$50-$100 per month.• Reduced rates of breast cancer and ovarian

cancer.(Breastfeeding, 2011)

BF: Benefits for Society

• Recent research shows that if 90% of families breastfed exclusively for 6 months, nearly 1,000 deaths among infants could be prevented.

• If 90% of families breastfed, it is estimated that the U.S. would save $13 billion per year because medical care costs are lower for breastfed infants.

• Breastfeeding is better for the environment: less trash and plastic waste than formula cans and bottle supplies.

• Breastfeeding leads to a more productive workforce since mothers miss less work to care for sick infants.

(Breastfeeding, 2011)

Breastfeeding among U.S. children born 2000–2009(Breastfeeding, 2012)

Reasons to supplement with formula• Serious illness of mother or baby.

– Jaundice, cleft lip and/or palate, tongue-tie, or other oral or facial difficulty.

– Babies who are too weak to suck from the breast.– Dehydrated or malnourished babies.

• Baby not gaining sufficient weight.– Very premature or low birth weight babies may require

supplementation.• Mother-baby separation.• Moms with an insufficient supply.• Moms cannot or may not want to pump at work.• Baby begins to self-wean.• Maternal breast surgery or other trauma.

(Supplementing the Breastfeeding Baby, 2007)

Combination of formula & breastfeeding:Benefits

• Helps preserve the baby's health & growth.• Dad can be incorporated into feeding and

bonding.• Baby still receives benefits of breastfeeding.

(Supplementing the Breastfeeding Baby, 2007)

• Psychosocial benefits, i.e. better fit for the family.

Partial Breastfeeding

• Best to begin after the baby is effectively breastfeeding and thriving on mother's milk (Supplementing the Breastfeeding Baby, 2007).

• Studies on Breastfeeding have not been designed to detect the effects of partially Breastfeeding (Wiessinger, West, & Pitman, 2010).

Protective effect of exclusive breastfeeding against infections during infancy: a prospective study

• Large-scale, prospective study that investigated the effects of breastfeeding on the frequency and severity of infections in a well-defined infant population with adequate vaccination coverage and healthcare standards.

• Studied 926 infants, followed up for 12 months, feeding mode and all infectious episodes, including acute otitis media (AOM), acute respiratory infection (ARI), gastroenteritis, urinary tract infection, conjunctivitis and thrush, were recorded at 1, 3, 6, 9 and 12 months of life.

• Results found that exclusive breastfeeding contributes to protection against common infections during infancy and lessens the frequency and severity of infectious episodes. Partial breastfeeding did not seem to provide this protective effect.

• Limitations include interview-based investigations and relied on maternal recall alone.

(Ladomenou, 2010)

Barriers to Breastfeeding• Health professionals lack training, education, & resources to

provide appropriate breastfeeding support. • Worksites generally do not support the needs of lactating

employees, nor are there national laws to require worksite lactation support.

• There is increasing aggressive advertising of human milk substitutes, including widespread hospital distribution.

• The cultural emphasis in the U.S. on the sexuality of the human breast has created significant barriers to the cultural acceptance of breastfeeding.

• Breastfeeding rates are lower among mothers who are young, not college educated, or unmarried.

(A Call to Action on Breastfeeding, 2007)

Breastfeeding: A Public Health Issue

• Economic, cultural, and political pressures often confound decisions about infant feeding (Crase, 2005).

• Breastfeeding is an important public health issue that merits societal support from the hospital to the workplace (Rochman, 2012).

• Data indicate that the rate of initiation & duration of breastfeeding in the U.S. is well below the Healthy People 2010 goals (Crase, 2005).

International Treaties & Conventions Supporting Breastfeeding

• In May 1981, the International Code of Marketing of Breast-milk Substitutes and its resolutions was overwhelmingly approved by the World Health Assembly by a vote of 118:1. The lone vote against the Code came from the U.S., which was concerned that the Code could have a detrimental effect on U.S. business (Cayetano, 2007).

Breastfeeding Report Card:Perspectives on state and national trends in breastfeeding data.

Percent of births at Baby-Friendly facilities in 2011, by state

(Breastfeeding Report Card-United States, 2011)

The Future of Breastfeeding

• Currently, fewer than 12% of U.S. babies are exclusively breastfed for 6 months, despite recommendations from UNICEF and WHO.– A multi-faceted, multi-disciplinary approach to

infant feeding is needed in order to significantly increase breastfeeding rates.

(Breastfeeding: A Vision for the Future, 2011)

BF: How Health Professionals Can Help

• Include lactation consultants on patient care teams.

• Help write hospital policies that help every mother be able to breastfeed.

• Patient education can promote breastfeeding & help legislation succeed.

(Fact Sheet, 2011)• Encourage breastfeeding, even partial

breastfeeding.

BF: Summary• There is an abundance of new data about the beneficial effects of

breastfeeding (Rochman, 2012).• Encourage breastfeeding, even partial breastfeeding since it, too, can

have protective benefits (Supplementing the Breastfeeding Baby, 2007).

• WHO & AAP recommend that infants be exclusively breastfed for the first six months of life (Spatz, 2011).

• According to U.S. Surgeon General Dr. Regina M. Benjamin, the lack of breastfeeding in the United States is a public health crisis (Spatz, 2011).

• APHA reports that hospital-based practices are key to the success of breastfeeding, and the education of healthcare workers can increase the success of breastfeeding (A Call to Action on Breastfeeding, 2007).

Resources• A Call to Action on Breastfeeding: A Fundamental Public Health Issue (2007, November).

American Public Health Association. Retrieved from http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1360.

• Benefits of Breastfeeding (2007). La Leche League International. Retrieved from http://www.lalecheleague.org/faq/advantages.html.

• Breastfeeding (2011, September). Womenshealth.gov. Retrieved from http://www.womenshealth.gov/breastfeeding/why-breastfeeding-is-important/.

• Breastfeeding: A Vision for the Future (2011). United States Breastfeeding Committee. Retrieved from http://www.usbreastfeeding.org/LegislationPolicy/BreastfeedingAdvocacyHQ/BreastfeedingAVisionfortheFuture/tabid/214/Default.aspx.

• Breastfeeding among U.S. children born 2000–2009, CDC National Immunization Survey (2012). Retrieved from http://www.cdc.gov/breastfeeding/data/nis_data/.

• Breastfeeding Report Card-United States (2011). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/breastfeeding/data/reportcard.htm.

• Cayetano, P. (2007, May). International treaties and conventions supporting breastfeeding. Retrieved from http://bestforbabies.wordpress.com/2007/05/09/international-treaties-and-conventions-supporting-breastfeeding/.

Resources• Crase, B. (2005). AAP policy statement: breastfeeding and the use of human milk. Pediatrics

115 (2), 496-506.• Fact Sheet (2011, January). Office of the Surgeon General. Retrieved from

http://www.surgeongeneral.gov/topics/breastfeeding/factsheet.html.• Ladomenou, F., Moschandreas, J., Kafatos, A., Tselentis, Y., & Galankis, E. (2010). Protective

effect of exclusive breastfeeding against infections during infancy: a prospective study. Retrieved from http://adc.bmj.com/content/early/2010/08/24/adc.2009.169912.full.

• Rochman, B. (2012). Why pediatricians say breastfeeding is about public health, not just lifestyle. Retrieved from http://healthland.time.com/2012/02/29/why-pediatricians-say-breast-feeding-is-about-public-health-not-just-lifestyle/.

• Spatz, D. (2011, June). Call to Breastfeeding Action – Policy and Practice for Nurses. Retrieved from http://www.newswise.com/articles/call-to-breastfeeding-action-policy-and-practice-for-nurses.

• Supplementing the Breastfeeding Baby (2007). La Leche League International. Retrieved from http://www.lalecheleague.org/llleaderweb/lv/lvaugsep99p75.html.

• Wiesenger, D., West, D., & Pitman, T. (2010). The womanly art of breastfeeding. New York: Ballantine Books.