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Healthier
Babies
Before
a baby is born, the placenta acts as an interface with
the outside world, protecting the unborn baby by filtering
many of the germs and toxins to which the mother is exposed.
After birth, the mother's breastmilk continues to protect
against many of the viruses, bacteria and parasites to
which the baby is now exposed. Several substances in breastmilk
not only prevent disease, some stimulate and strengthen
the development of the baby's immature immune system.
This results in better health, even for years after breastfeeding
has ended.
Based on scientific evidence, the World Health Assembly
and UNICEF recommend that babies are fed exclusively on
breastmilk until they are about six months old.
Breastfeeding
Breaks and Facilities at the Workplace
Many
employed women still have only a short period of paid
maternity leave. If they want to breastfeed their baby,
this short maternity leave and unfavourable conditions
at the workplace combine to make breastfeeding very difficult.
Breastfeeding breaks allow a mother to continue to breastfeed
her baby after she returns to work, with all the health
and economic benefits that breastfeeding brings.
Adequate hygienic facilities for breastfeeding or the
expression and storage of breastmilk are not difficult
to provide: a quiet, clean room, ensuring safety and privacy,
with running water and a comfortable chair are all that
mothers need. Facilities do not have to be clinically
clean or sterile like in hospitals.
Breastfeeding:
Lower Health Care Costs
Any illness takes an emotional toll on families; sickness
in a newborn baby or a working mother causes even more
worry. Health care costs are constantly increasing. They
represent a strain on the family budget and on the national
budget for health care.
- Infections
A study in the USA showed that each baby who was breastfed
for at least three months had fewer common infections
and saved his/her health insurance an average of US$331-475
in the first year compared with a formula-fed baby (1).
Breastfeeding reduces the frequency of infections of
the middle ear (otitis media).
In the USA, infants from birth to 12 months who were
exclusively breastfed for about four months had only
half the number of ear infections of infants who were
not breastfed (2).
Middle ear infections are one of the most frequent reasons
for seeing the doctor. In France, one visit to a family
doctor (or general practitioner) and prescribed medicines
are estimated at FF360. The French social security system
reimburses 70%, the family pays the remaining 30%. If
we estimate that breastfeeding avoids one middle ear
infection per year, the health care cost for otitis
media alone is significantly reduced (3).
Diarrhoeal diseases: The antibodies in a mother's
breastmilk protect her baby from the germs which cause
diarrhoea. In poor communities, diarrhoea caused by
bottle-feeding is responsible for acute sickness. The
cycle of illness, dehydration and malnutrition weakens
the child, often fatally. In southern Brazilian cities,
babies who are not breastfed are 14.2 times more likely
to die from diarrhoea than breastfed babies (4).
Although diarrhoea is rarely fatal in industrialized
nations, the consequences of repeated bouts of illness
are severe and the costs of treating diarrhoea are high.
An Australian study calculated that if breastfeeding
at three months of age increased in prevalence from
60% to 80%, Australian $3.7 million would be saved on
treating gastro-intestinal diseases (5).
- Allergies
Studies have shown that breastfeeding halved the risk
of attacks in infants at high risk of allergies (6).
Researchers in the Province of Newfoundland, Canada
estimated that improved prevalence of breastfeeding
could save the Province up to Canadian $370,000 per
year on the care of babies with asthma and eczema (7).
Breastfeeding:
Healthy Mothers
Breastfeeding is an integral part of the reproductive
cycle: exclusive breastfeeding, followed by continued
breastfeeding with the addition of appropriate complementary
foods, completes this cycle before the next pregnancy
occurs. Studies have shown that breastfeeding spaces births,
helping to prevent another pregnancy too soon for the
many women for whom contraception is unavailable, unaffordable
or unacceptable. As long as a mother breastfeeds fully
or nearly fully, she is 98% protected against further
pregnancy for the first six months and 96% for up to 12
months, as long as her periods (her menses) have not returned
(8).
Breastfeeding increases the level of oxytocin, resulting
in less blood loss after delivery. Breastfeeding also
reduces the frequency and severity of anaemia, because
breastfeeding mothers find that their monthly periods
return later compared to mothers who bottle-feed (9).
When any cycle is interrupted, there are repercussions
on health, often long-term. Breastfeeding for at least
three months can reduce the risk of pre-menopausal breast
cancer by one half (10). Breastfeeding for at least two
months per child reduces the risk of epithelial ovarian
cancer by 25% (11). The risk of hip fracture in women
over 65 is reduced by half for women who have breastfed.
For women who have breastfeed each of their children for
nine months, the risk is reduced to one quarter (12).
Breastfeeding:
Advantages to Employers and Society
Sick infants and children often oblige the mother or father
to stay away from work to care for their children. Depending
on national legislation, parents take holiday leave or
call in sick themselves. Such absenteeism is costly to
employers – and to national budgets for health care.
A 1995 study in the USA showed that breastfed babies had
statistically fewer episodes of illness than formula-fed
infants and that mothers of breastfed babies had fewer
absences: 25% of all one-day maternal absences were by
mothers breastfeeding compared to 75% for the formula-fed
group (13).
Breastfeeding:
Prevention Against Disease
The burden of avoidable disease can be minimized with
preventive measures early in the child's life through:
- adequate
maternity leave to give babies the natural immunization
they receive through exclusive breastfeeding for about
six months;
- adequate,
hygienic facilities for new mothers to breastfeed their
babies or express breastmilk at the workplace after
their return to work;
- childcare
facilities at or near the workplace.
References:
1.
Ball T.M. and Wright A.L., "Health care costs of
formula-feeding in the first year of life", Paediatrics,
103:4, p. 874, supplement, 1999
2.
Duncan B. et al., "Exclusive breastfeeding for at
least 4 months protects against otitis media", Paediatrics,
91(5): 867-872, 1993
3.
Bitoun P., "The economic value of breastfeeding",
Les Dossiers de l'Obstétrique, 216:12-13, April
1994
4.
Victora C.G. et al., "Evidence for protection by
breastfeeding against infant death from infectious diseases
in Brazil", The Lancet, Aug. 7, 1987: 319-322
5.
Drane D., "Breastfeeding and formula feeding: a preliminary
economic analysis", Breastfeeding Review, 5:1, 7-17,
May 1997
6,
Chandra R.K., "Five year follow-up of high risk infants
with family history of allergy who were exclusively breastfed
or fed partial whey hydrolysate, soy and conventional
cows' milk formulas", Journal of Paediatric Gastro-Enterology
and Nutrition, 24: 380-88, 1997
7.
Marini A. et al., "Effects of a dietary and environmental
prevention programme on the incidence of allergic symptoms
in high atopic risk infants: three years follow-up",
Acta Paediatr Suppl. 414: 1-22, 1996
8.
Kennedy K.I. and Visness C.M., "Contraceptive efficacy
of lactational amenorrhea", The Lancet, 339: 227-230,
1992
9.
American Academy of Pediatrics, "Breastfeeding and
the use of human milk", Pediatrics, 100:1035-9, 1997
10.
United Kingdom National Case-Control Study Group, "Breastfeeding
and the risk of breast cancer in young women", British
Medical Journal, 307:17-20, 1993
11.
Rosenblatt K.A. et al., "Lactation and the risk of
epithelial ovarian cancer", International Journal
of Epidemiology, 22(2): 192-197, 1993
12.
Commings R.G. and Klineberg R.J., "Breastfeeding
and other reproductive factors in the risk of hip fracture
in elderly women", International Journal of Epidemiology,
2(4): 684-691, 1993
13.
Cohen R., Mrtek M.B. and Mrtek R.G., "Comparison
of maternal absenteeism and infant illness rates among
breastfeeding and formula-feeding women in two corporations",
American Journal of Health Promotion, 10(2):148-53, 1995
Acknowledgments
"What scientific research says", IBFAN Action
Pack, December 1998.
"Breastfeeding: A global fact sheet", International
Women Count Network, May 1999.
Nurture, the Center to Prevent Childhood Malnutrition,
"A Guide to assessing the economic value of breastfeeding",
1990.
UNICEF: "Breastfeeding, the Foundation for a Healthy
Future", New York, August 1999
Web
Sites for Further Information
International Baby Food Action Network (IBFAN) www.ibfan.org
or www.gn.apc.org/ibfan
World Alliance for Breastfeeding Action (WABA) www.waba.org.my/working.htm
UNICEF www.unicef.org
International Labour Office (ILO) www.ilo.org
This Fact Sheet was prepared by IBFAN-Gifa, Geneva, with
input from WABA. 11/1999
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