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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.br/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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