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Much ado about breast-milk

For a decade, the WHO maintained that six months of exclusive breastfeeding is best. But a new study says four months is better. Which is it?

It takes a village...

About a decade ago, the World Health Organization (WHO) advised mothers to exclusively breastfeed – that is, nothing but human milk – their infants for the first 6 months of their lives.

They reissued that recommendation in a statement earlier this month – citing “optimal growth, development and health.”

The latest review of this evidence, they say, comes from a 2009 study in the Cochrane Library – which lists benefits of the exclusive 6 months compared with just 4:

  • reduces gastrointestinal infection in infants
  • does not impair infant growth
  • helps the mother lose weight and delays the return of menstrual periods.

But about a week ago, a new review in the British Medical Journal contradicts this guidance, saying that 4 months is best. On babies exclusively breastfed for 6 months, these authors say:

  • higher risk of developing anemia, which is linked to adverse mental, motor and psychosocial problems
  • more food allergies and a higher risk of developing celiac disease
  • But it also notes that babies in western countries who were exclusively breastfed for 6 months were apparently less likely to succumb to infections, such as pneumonia, than those fed for less than 6 months.

While mothers and mothers-to-be were still wading through the conflicting information, the Surgeon General issued a “Call to Action to Support Breastfeeding” last week.

In it, Surgeon General Regina Benjamin outlined steps to remove obstacles women might face. She encouraged more supportive families and communities, baby-adapted hospitals, properly trained clinicians and breastfeeding-friendly employers.

And here are some economic incentives according to the Call:

  • Families who follow optimal breastfeeding practices can save between $1,200–$1,500 in expenditures on infant formula in the first year alone.
  • If 90% of US families breastfed exclusively for 6 months, the country would annually save $13 billion from reduced medical and other costs.
  • Healthcare costs for newborns are 3 times lower for babies whose mothers participate in the company’s employee maternity and lactation program.

It also says that 3 out of 4 mothers start off breastfeeding, but only 13% of babies are exclusively breastfed for 6 months.

“Of course, the decision to breastfeed is a personal one,” Benjamin adds, “no mother should be made to feel guilty if she cannot or chooses not to breastfeed.”

To that end, informal breast-milk shares have popped up about the country.

But breast-milk-sharing isn’t encouraged by the Food and Drug Administration (FDA). The use of donor milk, especially off the internet, according to the agency this past December, poses risk for the baby. This includes:

  • exposure to infectious diseases, including HIV, to chemical contaminants, such as some illegal drugs, and to a limited number of prescription drugs that might be in the human milk, if the donor has not been adequately screened
  • if human milk is not handled and stored properly, like any type of milk, it could spoil.

The alternative could be breast-milk banks – who screen donors and are sometimes state-regulated. There are currently 11 members of the Human Milk Banking Association of America.

Happy Humpday.

Image: Queen Marie Casimire by Jerzy Siemiginowski-Eleuter via Wiki

This post was originally published on Smartplanet.com

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