Opportunity for Babies:
Breastfeeding as a Strategic Priority by Dr. Peter S. Cook
In March 2005 in Canberra,
three MPs decided to breastfeed their babies while in Parliament
House. This could have stimulated wider understanding of the
far-reaching importance of breastfeeding for human health and
well-being. Yet despite some stir in the media, the underlying issue
of equal opportunity for babies was not recognized. These infants
(officially "strangers in the House") could have reminded
legislators of all those who are disadvantaged at their most
vulnerable ages by social policies that effectively prevent their
mothers from breastfeeding them. For long-term national and
individual well-being, we should support mothers who wish to follow
this natural practice, removing any barriers that stand in their
children's intellectual, mental and physical health prospects in
childhood and throughout life. It promotes bonding between mother
and baby - a foundation for lifetime emotional well-being; it
reduces risks of a wide range of infectious diseases, asthma,
overweight, obesity, diabetes, heart disease, arthritis, and some
malignancies. For mothers it promotes recovery from childbirth, and
reduces some cancer risks and later osteoporosis. A more honest and
valid way of expressing all this is to say that formula feeding of
infants, without breastfeeding, raises the risks of all these
disorders. The promotion of such feeding has been illegal in India
since 1992, following the WHO and UNICEF 1990 Innocenti Declaration
on the Protection, Promotion and Support of Breastfeeding. They
urged that "for optimal maternal and child health and
nutrition, all women should be enabled to practise exclusive
breastfeeding and all infants should be fed exclusively on
breastmilk from birth to 4-6 months of age. Thereafter, children
should continue to be breastfed, while receiving appropriate and
adequate complementary foods, for up to two years of age or beyond.
This child-feeding ideal is to be achieved by creating an
appropriate environment of awareness and support so that women can
breastfeed in this manner." They further urged that "All
governments should develop national breastfeeding policies and set
appropriate national targets …."
The American Academy of
Pediatrics, in their 2005 Statement Breastfeeding and the Use of
Human Milk, documents "diverse and compelling advantages
for infants, mothers, families, and society from breastfeeding and
use of human milk for infant feeding." They say: "These
advantages include health, nutritional, immunological,
developmental, psychological, social, economic and environmental
benefits". They urge exclusive breastfeeding for 6 months and
then, while adding suitable complementary foods, continuing for
"at least the first year and beyond for as long as mutually
desired by mother and child".
Likewise, the Australian
National Health and Medical Research Council, in their 2003 Dietary
Guidelines say: "The total value of breastfeeding to the
community makes it one of the most effective prevention measures
available and well worth the support of the entire community ... it
will contribute to the health of all Australians from birth."
As a "best-buy" to reduce the obesity epidemic, the
National Obesity Task Force (2004) advised increasing breastfeeding.
A program to achieve this is outlined in the Australian
Breastfeeding Association's Leadership Plan.
Breastfeeding is not just a matter
of supplying better milk.
But breastfeeding is not just a matter of
supplying better milk. In Reversing the Real Brain Drain:
the Early Years Study, McCain and Mustard describe the
importance of the experience of breastfeeding, with its
opportunities for skin-to-skin touch and smell stimulation. When a
baby is being breastfed, cuddled and rocked in his mother's arms as
she smiles and coos at him, his brain is busily receiving signals
through the sensations of warmth, touch, taste, sight, sound and
smell. In the first three years, when the brain's pathways are being
"wired", these experiences help to develop structures and
functions of the brain in ways that will set the base for lifelong
effects on learning, behavior, and emotions, influencing his sense
of security and social relationships throughout life. They also
affect the endocrine and immune systems, and hence responses to
stress and risks of disease throughout life; so the quality of the
early sensory stimulation and nurture can have far-reaching effects.
When breastfeeding is not possible for some reason, then holding and
cuddling the baby while feeding, with skin-to skin contact where
convenient can still provide valuable loving sensory experiences for
the nursing couple.
Norway used to have
extensive infant bottle-feeding, but following an active government
program to mobilize community awareness and practical support for
mothers, breastfeeding is now initiated by up to 99% of mothers, and
at 6 months around 80% of mothers continue to breastfeed.
Norway provides generous maternity leave and other work-related
consideration for lactating mothers, as part of the system of social
supports that have enabled this national benefit to be achieved.
Over a span of 35 years it has become a role model for how to swap
bottles for breasts.
Breastfeeding can influence
a nation's way of life in many ways, even possibly improving its
average national IQ by up to six points! In the Journal of the
American Medical Association, Mortensen in 2002 reported on two
large groups born in Copenhagen, whose breastfeeding histories were
known. Independent of a wide range of confounding factors, a
significant positive association between duration of breastfeeding
and intelligence was observed. For example, those who had been
breastfed for nine months averaged six points higher IQ than those
breastfed less than a month. The first group were 2280 18-year old
males, called before the Danish draft board, and the findings were
confirmed in another group of 973 men and women aged around 28
Reducing a nation's overall
average IQ by six points right across the normal distribution curve
has far-reaching costs and implications for the whole of society.
For example, at the upper end, there is the loss of the brightest,
who are all 6% points less intelligent; at the lower end, there are
the remedial education and social costs associated with the
six-point IQ reduction. In emergency or war situations, infants who
are breastfed survive much better than those who are not.
It is a serious shortcoming
of social policies when many women in some of the world's most
affluent societies can no longer afford to breastfeed and mother
their own babies, however much they may wish to do so. The
"economy" is said to require their labor, but who has a
greater claim on a mother's presence than her own baby?
We were all babies once.
The fruits of good mothering and early nurture are among the
greatest blessings a person can have in life. In offering these to
their babies, mothers and fathers are setting patterns of
relationships which can be creative, mutually rewarding and last for
the rest of their lives.
We now have good evidence
that, as well as being sound economics, following the above infant
feeding recommendations can significantly benefit a nation's health
and overall well-being. Is there any more cost-effective way of
spending and investing the health dollar than in promoting this
equal opportunity for babies?
Galtry, J. The impact on breastfeeding of
labour market policy and practice in Ireland, Sweden, and the United
States. Social Science & Medicine, 2003; 57:167-177.
Greve, T. Norway: the breastfeeding top
of the world. Midwifery Today, Int. Midwife, 2003; 67:57-9.
McCain, M. & Mustard, J. Fraser.
Reversing the Real Brain Drain: The Early Years Study - Report to the
Government of Ontario, 1999. Available from The Children's Secretariat,
1075 Bay Street, Suite 601, Toronto, Ontario M7A 1E9.
Mortensen EL et al. The association
between duration of breastfeeding and adult intelligence. Journal of the
American Medical Association, 2002; 287:2365-2371, May 8.
National Health and
Medical Research Council. Dietary Guidelines for Children and
Adolescents in Australia; incorporating the Infant Feeding Guidelines
for Health Workers. The National Health and Medical Research Council.
2003. Canberra. http://www.nhmrc.gov.au/publications/_files/n34.pdf
Smith, Julie. Mothers' milk and markets.
Australian Feminist Studies, 2004;19 (No.45):369-379.