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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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