Breastfeeding

Definition

Breastfeeding is the practice of feeding an infant milk from the mother's breast. According to La Leche League International (LLLI), human milk is “a living fluid that protects babies from disease and actively contributes to the development of every system in [a] baby's body.” Breastfeeding stimulates babies' immune systems and protects against diarrhea and infection.

Global breastfeeding rates: percentage of infants younger than 6 mos. who are breastfed exclusively, by region, 2015 & 2017

Eastern and Southern Africa

54%

South Asia

55%

Latin America and Caribbean

33%

Middle East and North Africa

33%

East Asia and Pacific

30%

West and Central Africa

30%

Central Eastern Europe

30%

United States

52%

SOURCE: UNICEF. Infant and Young Child Feeding. https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding , and U.S. Centers for Disease Control and Prevention, “Breastfeeding Report Card—United States, 2012.” http://www.cdc.gov/breastfeeding/data/reportcard.htm .

Purpose

Breast milk is the ideal food for an infant. It contains appropriate amounts of all the nutrients a baby needs to grow and stay healthy:

The content of breast milk varies from feeding to feeding, at different times of day, and as the baby grows, often adjusting to exactly what is needed by the baby.

Description

The mother's body prepares for breastfeeding while she is pregnant. The fatty tissue of the breast is replaced by glandular tissue that is necessary to produce milk. When a baby suckles the breast, the hormone oxytocin is released. This causes the muscle cells of the breast to squeeze milk from the milk ducts to the nipple.

Origins

Throughout time, millions of mothers have breastfed their babies. During ancient times, mothers breastfed their babies for at least 12–18 months, and often for three or four years, or until the mother became pregnant again. For thousands of years, breastfeeding was the only source of nutrition for the first part of a baby's life. Before the invention of formula, few alternatives were available. Animal milk or mixes of rice and water are not adequate substitutes, and infants who were fed these often failed to thrive or died.

Breastfeeding does not have to be done by a baby's own mother. In many times and places, women customarily hired wet nurses to feed their infants so that they could work or simply not have to breastfeed breastfeeding suppresses fertility, so one result of this was that women had many more children than they would have if they had nursed their own babies.

In the early 1900s, most babies in America were still breastfed, and more than half of them were breastfed for one year or longer. As more women entered the workforce and supplemental methods of feeding were introduced, breastfeeding rates in America decreased. According to a survey from Ross Labs, by 1971 only 24.7% of American babies were breastfed at birth, and of these babies, only 5.4% of them were still breastfed at six months.

Demographics

In 1982, the United States experienced a resurgence in breastfeeding and rates have continued to increase. The National Immunization Survey conducted by the Centers for Disease Control and Prevention (CDC) in 2005 revealed that 72% of American babies were breastfed at birth and 39% were still breastfed at six months. By 2014, these rates had increased to 83% at birth and 55% at six months. Almost 34% of infants were still receiving some breastmilk at 12 months.

The developing world has experienced a decline in breastfeeding rates as well, due to urbanization, social change, and the promotion of formula. Mothers who choose to feed their babies formula often encounter unsafe hygienic conditions in which to prepare the bottles, or they cannot afford to purchase the fuel needed to heat the water. Two of the major causes of infant mortality in developing countries are diarrhea and acute respiratory infections. Both are conditions that breastfeeding can protect against.




Nurse assisting a mother with the breastfeeding of her newborn baby.





Nurse assisting a mother with the breastfeeding of her newborn baby.
(Pierre Ciot/Science Source)

The World Health Organization (WHO) and the United Nations Children Fund (UNICEF) are two organizations working together to bring about a change in the global breastfeeding culture. In 2002, they developed “The Global Strategy for Infant and Young Child Feeding,” which recommends that all babies be exclusively breastfed for the first six months of life with continued breastfeeding up to two years or beyond. Exclusive breastfeeding means that breast milk is the child's only source of nutrition for the first six months of life and that no other solids or liquids, such as formula or water, are introduced at this time, with the exception of liquid vitamins or medicines. Studies show that breastfeeding helps prevent malnutrition and can save the lives of about one million children. The WHO promotes breastfeeding as the best source of nourishment for infants and young children, thus helping to ensure child health and survival.

The WHO reported in 2017 that support for breastfeeding worldwide was still poor and that most countries were not adequately promoting breastfeeding. Worldwide rates had improved since the 2000s, though they were still short of targets. In 2017, about 40% of babies were still exclusively breastfed at six months; the WHO's target is 60% by 2030. Slightly over 70% of babies were still at least partially breastfed at 12 months, and about 43% at two years of age. Only about 42% of newborns were breastfed within an hour of birth, far short of the target of 70%.

During the first week of August, the organization promotes World Breastfeeding Week, celebrated in more than 170 countries “to encourage breastfeeding and improve the health of babies around the world.” The event has been sponsored by WHO and UNICEF since 1990. Additional information about World Breastfeeding Week may be found on their website at http://worldbreastfeedingweek.org .

Benefits for baby

There are a plethora of benefits for the breastfeeding baby, including:

Benefits for mother

Breastfeeding women also enjoy many benefits:

Precautions

Breastfeeding requires lots of energy, and breastfeeding women need to make sure that they are taking in enough calories and consuming a healthy diet. Breastfeeding women should make sure to eat foods that contain lots of calcium, such as dairy products, broccoli, and beans. They should also make sure they eat plenty of iron-rich foods such as red meat, fish, and poultry.

To compensate for the energy they expend breastfeeding their babies, women should add 300–500 extra nutritious calories to their diet each day and drink extra fluids. Breastfeeding mothers should also continue to take prenatal vitamins.

KEY TERMS
Exclusive breastfeeding—
Breast milk is the child's only food source for the first six months of life. No other solids or liquids such as formula or water are introduced at this time, with the exception of liquid vitamins or medicines.
Mineral—
An inorganic substance found in the earth that is necessary in small quantities for the body to maintain health (for example zinc, copper, iron).
Oxytocin—
A hormone that produces a calm, relaxed feeling.
Postpartum—
The period of time after childbirth.
Vitamin—
A nutrient that the body needs in small amounts to remain healthy but that the body cannot manufacture for itself and must acquire through diet.

Interactions

Every substance that a breastfeeding mother puts into her body has the potential to pass to her baby through her breast milk. This includes food, medicine, alcohol, and cigarettes.

Complications

Although breastfeeding is the optimal way to feed an infant, sometimes it is not possible or feasible.

QUESTIONS TO ASK YOUR DOCTOR

A small percentage of women have conditions that prevent breast milk production, such as insufficient development of milk production glands, and cannot breastfeed. Many healthcare providers advise women with HIV against breastfeeding as the virus may be passed to their babies, but the World Health Organization has revised this to encourage women receiving antiretroviral therapy (ART) to breastfeed exclusively for six months and continue with partial breastfeeding for at least one year. Women who are newly diagnosed with infectious tuberculosis should not breastfeed unless they are on medication. Babies with galactosemia, a rare genetic disorder where the infant cannot metabolize the sugar in breast milk, cannot breastfeed.

Parental concerns

Some mothers have difficulty with the baby latching on, or they suffer from sore nipples or an infection. Lactation consultants can help with nursing problems by showing new mothers ways to handle these difficulties. Some parents worry that their babies are not getting enough to eat because they have no way to measure how much their babies drink, but as long as the infants continue to gain weight, that need not be a concern.

See also Alcohol consumption ; Caffeine ; Calcium ; Fats ; Infant nutrition ; Iron ; Malnutrition ; Omega-3 and omega-6 fatty acids ; Protein ; Vitamins .

Resources

BOOKS

La Leche League International. The Womanly Art of Breastfeeding. 8th ed. London, UK: Pinter & Martin, 2010.

Meek, Joan Younger, and Winnie Yu. American Academy of Pediatrics New Mother's Guide to Breastfeeding. New York: Bantam Books, 2017.

Sears, William, Martha Sears, and Robert W. Sears. The Baby Book: Everything You Need to Know about Your Baby from Birth to Age Two. Boston, MA: Little, Brown and Company, 2013.

Shortall, Jessica. Work. Pump. Repeat.: The New Mom's Survival Guide to Breastfeeding and Going Back to Work. New York: Abrams, 2015.

PERIODICALS

Faucher, M.A. “An Updated Scientific Review of the Benefits of Breastfeeding with Additional Resources for Use in Everyday Practice.” Journal of Midwifery & Women's Health 57, no. 4 (July/August 2012): 422–3.

Gunderson, Erica P., Cora E. Lewis, Ying Lin, et al. “Lactation Duration and Progression to Diabetes in Women across the Childbearing Years.” JAMA Internal Medicine 178, no. 3 (May 2018): 328.

Kramer, Michael S., and Ritsuko Kakuma. “Optimal Duration of Exclusive Breastfeeding.” Cochrane Database of Systematic Reviews (August 15, 2012). http://dx.doi.org/10.1002/14651858.CD003517.pub2 (accessed May 7, 2018).

Thompson, John, Kawai Tanabe, Rachel Y. Moon, et al. “Duration of Breastfeeding and Risk of SIDS: An Individual Participant Data Meta-Analysis.” Pediatrics 140, no. 5 (October 2017): 64.

Young, Jeanine, Karen Watson, Louise Ellis, et al. “Responding to Evidence: Breastfeed Baby If You Can—The Sixth Public Health Recommendation to Reduce the

Risk of Sudden and Unexpected Death in Infancy.” Breastfeeding Review 20, no. 1 (March 2012): 7–15.

WEBSITES

Centers for Disease Control and Prevention. “Breastfeeding.” U.S. Department of Health and Human Services. https://www.cdc.gov/breastfeeding/index.htm (accessed May 7, 2018).

Office on Women's Health. “Breastfeeding.” U.S. Department of Health and Human Services. http://www.womenshealth.gov/breastfeeding (accessed May 7, 2018).

World Breastfeeding Week. “Breastfeeding: Foundation of Life.” WABA. http://worldbreastfeedingweek.org (accessed May 7, 2018).

World Health Organization. “Breastfeeding.” WHO.int. http://www.who.int/topics/breastfeeding/en (accessed May 7, 2018).

ORGANIZATIONS

American Academy of Pediatrics (AAP), 345 Park Blvd., Itasca, IL, 60143, (847) 434-4000, (800) 433-9016, Fax: (847) 434-8000, http://www.aap.org .

Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, 30329-4027, (800) CDC-INFO (2324636), cdcinfo@cdc.gov, http://www.cdc.gov .

La Leche League International, 957 N. Plum Grove Rd., Schaumburg, IL, 60173, (800) LA-LECHE (525-3243), http://www.lalecheleague.org .

United Nations Children Fund, 3 United Nations Plaza, New York, NY, 10017, (212) 686-5522, http://www.unicef.org .

World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health, Avenue Appia 20, 1202 Geneva, Switzerland, CH - 1211 Geneva 27, http://www.who.int/about/contact_form/en , http://www.who.int/en .

Jennifer L. Byrnes
Revised by Amy Hackney Blackwell, PhD

  This information is not a tool for self-diagnosis or a substitute for professional care.