infant feeding schedule|Concept of breast feeding
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infant feeding schedule|Concept of breast feeding
Human breast milk is the healthiest form of milk for human babies.[1] There are few exceptions, such as when the mother is taking certain drugs or is infected with tuberculosis or HIV. Breastfeeding promotes health, helps to prevent disease, and reduces health care and feeding costs.[2][3][4] Artificial feeding is associated with more deaths from diarrhea in infants in both developing and developed countries.[5] Experts agree that breastfeeding is beneficial, but may disagree about the length of breastfeeding that is most beneficial, and about the risks of using artificial formulas.[6][7][8]
Emphasizing the value of breastfeeding for both mothers and children, the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) both recommend exclusive breastfeeding for the first six months of life and then supplemented breastfeeding for at least one year and up to two years or more.[9][10] While recognizing the superiority of breastfeeding, regulating authorities also work to minimize the risks of artificial feeding.[7]
The acceptability of breastfeeding in public varies by culture and country. In Western culture, though most approve of breastfeeding, some mothers may be reluctant to do so out of fear of public opinion[says who?].
Not all the properties of breast milk are understood, but its nutrient content is relatively stable. Breast milk is made from nutrients in the mother’s bloodstream and bodily stores. Breast milk has just the right amount of fat, sugar, water, and protein that is needed for a baby’s growth and development.[11] Because breastfeeding uses an average of 500 calories a day it helps the mother lose weight after giving birth.[12] The composition of breast milk changes depending on how long the baby nurses at each session, as well as on the age of the child. The quality of a mother’s breast milk may be compromised by smoking, alcoholic beverages, caffeinated drinks, marijuana, methamphetamine, heroin, and methadone.[13]
Benefits for the infantScientific research, such as the studies summarized in a 2007 review for the U.S. Agency for Healthcare Research and Quality (AHRQ)[14] and a 2007 review for the WHO[15], has found many benefits to breastfeeding for the infant. These include:
Less necrotizing enterocolitis in premature infants
Necrotizing enterocolitis (NEC) is an acute inflammatory disease in the intestines of infants. Necrosis or death of intestinal tissue may follow. It is mainly found in premature births. In one study of 926 preterm infants, NEC developed in 51 infants (5.5%). The death rate from necrotizing enterocolitis was 26%. NEC was found to be six to ten times more common in infants fed formula exclusively, and three times more common in infants fed a mixture of breast milk and formula, compared with exclusive breastfeeding. In infants born at more than 30 weeks, NEC was twenty times more common in infants fed exclusively on formula.[16] A 2007 meta-analysis of four randomized controlled trials found “a marginally statistically significant association” between breastfeeding and a reduction in the risk of NEC.[14]
Greater immune health
During breastfeeding antibodies pass to the baby[17]. Breast milk contains several anti-infective factors such as bile salt stimulated lipase (protecting against amoebic infections), lactoferrin (which binds to iron and inhibits the growth of intestinal bacteria)[18][19] and immunoglobulin A protecting against microorganisms.[20]
Fewer infections
Among the studies showing that breastfed infants have a lower risk of infection than non-breastfed infants are:
In a 1993 University of Texas Medical Branch study, a longer period of breastfeeding was associated with a shorter duration of some middle ear infections (otitis media with effusion) in the first two years of life.[21]
A 1995 study of 87 infants found that breastfed babies had half the incidence of diarrheal illness, 19% fewer cases of any otitis media infection, and 80% fewer prolonged cases of otitis media than formula fed babies in the first twelve months of life.[22]
Breastfeeding appeared to reduce symptoms of upper respiratory tract infections in premature infants up to seven months after release from hospital in a 2002 study of 39 infants.[23]
A 2004 case-control study found that breastfeeding reduced the risk of acquiring urinary tract infections in infants up to seven months of age, with the protection strongest immediately after birth.[24]
The 2007 review for AHRQ found that breastfeeding reduced the risk of acute otitis media, non-specific gastroenteritis, and severe lower respiratory tract infections.[14]
Less tendency to develop allergic diseases (atopy)
In children who are at risk for developing allergic diseases (defined as at least one parent or sibling having atopy), atopic syndrome can be prevented or delayed through exclusive breastfeeding for four months, though these benefits may not be present after four months of age.[25] However, the key factor may be the age at which non-breastmilk is introduced rather than duration of breastfeeding.[26] Atopic dermatitis, the most common form of eczema, can be reduced through exclusive breastfeeding beyond 12 weeks in individuals with a family history of atopy, but when breastfeeding beyond 12 weeks is combined with other foods incidents of eczema rise irrespective of family history.[27]
Protection from SIDS
Breastfed babies have better arousal from sleep at 2–3 months. This coincides with the peak incidence of sudden infant death syndrome.[28] A study conducted at the University of Münster has shown that breastfeeding reduces the risk of sudden infant death syndrome by approximately 50% at all ages throughout infancy. [29]
Higher intelligence
Studies examining whether breastfeeding in infants is associated with higher intelligence later in life include:
Horwood, Darlow and Mogridge (2001) tested the intelligence quotient (IQ) scores of 280 low birthweight children at seven or eight years of age.[30] Those who were breastfed for more than eight months had verbal IQ scores 6 points higher (which was significantly higher) than comparable children breastfed for less time.[30] They concluded “These findings add to a growing body of evidence to suggest that breast milk feeding may have small long term benefits for child cognitive development.”[30]
A 2005 study using data on 2,734 sibling pairs from the National Longitudinal Study of Adolescent Health “provide[d] persuasive evidence of a causal connection between breastfeeding and intelligence.”[31]
In 2006, Der and colleagues, having performed a prospective cohort study, sibling pairs analysis, and meta-analysis, concluded that “Breast feeding has little or no effect on intelligence in children.”[32] The researchers found that “Most of the observed association between breast feeding and cognitive development is the result of confounding by maternal intelligence.”[32]
The 2007 review for the AHRQ found “no relationship between breastfeeding in term infants and cognitive performance.”[14]
The 2007 review for the WHO concluded “Subjects who were breastfed experienced… higher performance in intelligence tests.”[15]
Two initial cohort studies published in 2007 suggest babies with a specific version of the FADS2 gene demonstrated an IQ averaging 7 points higher if breastfed, compared with babies with a less common version of the gene who showed no improvement when breastfed.[33] FADS2 affects the metabolism of polyunsaturated fatty acids found in human breast milk, such as docosahexaenoic acid and arachidonic acid, which are known to be linked to early brain development.[33] The researchers were quoted as saying “Our findings support the idea that the nutritional content of breast milk accounts for the differences seen in human IQ. But it’s not a simple all-or-none connection: it depends to some extent on the genetic makeup of each infant.”[34] The researchers wrote “further investigation to replicate and explain this specific gene–environment interaction is warranted.”[33]
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In “the largest randomized trial ever conducted in the area of human lactation,” between 1996 and 1997 maternity hospitals and polyclinics in Belarus were randomized to receive or not receive breastfeeding promotion modeled on the Baby Friendly Hospital Initiative.[35] Of 13,889 infants born at these hospitals and polyclinics and followed up in 2002-2005, those who had been born in hospitals and polyclinics receiving breastfeeding promotion had IQs that were 2.9-7.5 points higher (which was significantly higher).[35] Since (among other reasons) a randomized trial should control for maternal IQ, the authors concluded in a 2008 paper that the data “provide strong evidence that prolonged and exclusive breastfeeding improves children’s cognitive development.”[35]
Diabetes
Infants exclusively breastfed have less chance of developing diabetes mellitus type 1 than peers with a shorter duration of breastfeeding and an earlier exposure to cow milk and solid foods.[14][36] Breastfeeding also appears to protect against diabetes mellitus type 2,[14][15][37][38] at least in part due to its effects on the child’s weight.[38]
Obesity
Breastfeeding appears to reduce the risk of extreme obesity in children aged 39 to 42 months.[39] The protective effect of breastfeeding against obesity is consistent, though small, across many studies, and appears to increase with the duration of
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