zen Sutherland
Most new parents want to give their babies the very best start in life. They give careful thought to everything from nursery decorations to choice of family physician. Yet when it comes to their babies' nutrition, relatively few women in the U.S. heed the advice of the American Academy of Pediatrics to breastfeed babies "for at least twelve months, and thereafter for as long as is mutually desired."
"With so much concern for what they put into their own bodies, it may be surprising to learn that almost one-third of all new mothers still don't breastfeed," says John Messmer, a physician with Penn State's Family and Community Medicine center in Hershey, Pennsylvania. "After five months, two-thirds of nursing mothers have stopped breastfeeding altogether."
While there's nothing wrong with formula, says Messmer, even the companies that make it concede that breastfeeding is best. Why?
"Breast milk is designed specifically to feed human babies," he explains. "Breastfed babies digest their mother's milk more easily than formula and absorb more nutrients from it." In contrast to formula, babies are never allergic to their mother's milk.
Unlike formula, the composition of breast milk adapts to the growing baby's changing nutritional needs. Mother's milk contains over one hundred ingredients not found in formula, including crucial types of fatty acids such as RHA and DHA, thought to be responsible for healthy brain and eye functioning.
Judy Hopkinson, assistant professor at the Children's Nutrition Research Center at the Baylor College of Medicine, has observed, "Breast milk is really primarily an immune booster. We think of it as nutrition, but it is really integral to the immune system." Approximately eighty percent of the cells in breast milk are macrophages, cells that kill viruses, fungi and bacteria. Breastfed babies "receive maternal antibodies in the milk that reduce the risk of ear infections and diarrhea, as well as urinary and intestinal infections," comments Messmer.
Most crucially, the mother's body responds to whatever disease is present in the environment by making antibodies that are then passed in the milk to her baby, giving breastfed babies an immune-protective advantage over bottle-fed babies.
What's more, adds Messmer, "breastfed babies are less likely to be overweight or anemic and recent studies suggest that they may have an edge in brain development." Current research from the Centers for Disease Control links breastfeeding with lower rates of Sudden Infant Death Syndrome. And while more research is needed to reach definitive conclusions, initial studies have found that babies who are not breastfed have higher rates of serious health conditions such as diabetes, lymphoma, and bacterial meningitis.
With all these reasons for breastfeeding, asks Messmer, "Why are so many women using formula?" Some say formula is more convenient, "but is it?" he asks. "Formula involves mixing and heating it to the proper temperature and storing any unused portion in the refrigerator, not to mention carrying bottles everywhere and disposing of the cans properly."
In contrast to formula, breast milk is sterile and, straight from the breast, has no chance of becoming contaminated. Says Messmer, "Using formula sounds less convenient when you consider that mother's milk is always there and at the right temperature." In addition, Messmer adds, breastfeeding may have psychological benefits since it "promotes the close physical contact important for developing babies."
Despite the clear evidence of breastfeeding's benefits, the number of nursing moms has been dropping since its peak in the mid 1980s. "In general, there's less support for extended breastfeeding in mainstream American culture than in some other societies," says Kay Hoover of the Penn State Breastfeeding Clinic. Women from countries with strong community support for breastfeeding (Norway, Sweden, Denmark, Poland and Romania top the list) come closer to achieving the World Health Organization's recommendation to breastfeed babies for a minimum of two years.
"When women feel unsupported in their decision to breastfeed, it can undermine their ability to nurse successfully," notes Hoover. "But seeking advice from a lactation consultant and organizations such as La Leche League can improve a new mom's chances of having a positive breastfeeding experience—and that's what is in the best interest of babies."
Messmer agrees. "Ideally, all babies would be exclusively breastfed until six months of age." The undeniable benefits, he says, "make it worthwhile to continue to age twelve months and beyond."
John Messmer, M.D., is associate professor of family and community medicine at Penn State College of Medicine and a staff physician at Penn State Milton S. Hershey Medical Center. He can be reached at jjm23@psu.edu. Kay Hoover is director of the Penn State Breastfeeding Clinic and can be reached at klh31@psu.edu.