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
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
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
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 years.
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
American Academy of Pediatrics. Policy
Statement. Breastfeeding and the use of human milk. Pediatrics
2005:115:496-506. (216 references).
Alvarez L. Norway leads industrial nations
back to breast-feeding. New York Times. October 2, 2003.
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.
Smith, Julie. Mothers' milk and markets.
Australian Feminist Studies, 2004;19 (No.45):369-379.
This article was published
in the September 2005 edition of Byronchild (now Kindred).
Reprinted with permission.
Peter S. Cook is a retired
consultant child psychiatrist who writes on child and family mental health
Copyright ? Peter S. Cook, Sydney, 2005.
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