By Tisha Felder, Associate Professor of Behavioral Sciences, University of South Carolina; and Joynelle Jackson, Associate Professor of Nursing, University of South Carolina
Columbia, Feb 9 (The Conversation) Four babies are born every second in the world, and there are only two options for their first food at birth: human milk or formula.
Global and US health authorities agree, however, that human milk provides the optimal nutrition for infants. The World Health Organisation and the American Academy of Pediatrics recommend exclusive breastfeeding for the first six months of an infant’s life. Following the introduction of solid foods, these organisations recommend continued breastfeeding up to two years and beyond.
Human milk can be given to infants directly through breastfeeding or by pumping or expressing human milk into a cup or bottle. The health benefits of breastfeeding and human milk for infants stem from its composition, which includes vitamins, minerals and antibodies that can prompt its composition to change over time to meet the growing infant’s needs.
The dynamic nature of human milk leads to commonly known benefits, such as lower risks of ear and gastrointestinal infections among infants who are breastfed.
However, there are other benefits for infants that many people aren’t aware of, as well as for the breastfeeding mother and society.
We are women’s health scholars with combined professional expertise in maternal obstetrics nursing and public health. Together, we co-founded Mocha Mamas Milk, a research and support initiative focused on improving breastfeeding among Black families in South Carolina, a state where just 55.1% of Black infants are breastfed, compared with 75.2% of white infants.
Human milk is personalised medicine that can benefit both the mother and infant. We are personally and professionally passionate about this because many people are not aware that some of these benefits can save lives and reduce persistent health disparities.
Lesser-known benefits of breastfeeding for infants
One significant benefit of breastfeeding not widely known by the public is its ability to lower the risk of sudden infant death syndrome, or SIDS. SIDS, sometimes referred to as “crib death,” is the unexplained death of a baby, usually under 1 year of age.
Some risk factors include stomach- or side-lying sleep, low birth weight, sleeping on a soft surface or overheating. A large analysis of studies found that infants who received any human milk for at least two months had nearly a 50% lower risk of SIDS.
This reduction is notable for two reasons. First, the reduction in risk occurs about 60 days following birth, which is several months before the six-month exclusive breastfeeding guideline is met. Second, the protection from SIDS was the same for infants who were exclusively breastfed compared to infants who may have received formula in addition to any breastfeeding.
In addition, breastfeeding can significantly protect premature infants – those born before 37 weeks of pregnancy – from developing a condition called necrotising enterocolitis, an inflammation of the intestines that can be fatal. While this condition is rare in full-term infants, it occurs in 5% to 15% of preterm infants.
Benefits for mom, too
Breastfeeding also provides important benefits for the mother, such as reducing risks of diabetes and breast and ovarian cancers. Breastfeeding for any length of time compared to never is associated with a 10% decrease in hormone receptor-negative breast cancers, which are more common in younger women.
These cancers cannot be treated with hormonal therapy and often grow faster than the more commonly diagnosed hormone receptor-positive breast cancers.
The reduction in risk from breastfeeding is even greater for Black women, who are more likely to be diagnosed with these hormone receptor-negative breast cancers and have worse prognoses and fewer treatment options. Any way of reducing the risk for Black women is critically important because, compared to white women, Black women are 40% more likely to die from breast cancer, yet 4% less likely to be diagnosed with the disease.
There is also growing research suggesting the positive impact of breastfeeding on a mother’s mental health. One possible reason for this is that oxytocin – often called the “love hormone” because of its association with bonding – plays a role in the maternal-infant bonding process.
After delivery, the release of oxytocin causes human milk to flow – a process called the letdown reflex – and initiate breastfeeding. This release of milk can satisfy the new baby and leave the mom with “warm and fuzzy” feelings toward her baby.
Research also suggests that breastfeeding can reduce the risk of depression. A 2021 study also found that the longer a woman breastfed, the lower her risk for postpartum depression.
Closing racial gaps
Despite the benefits of breastfeeding to both infants and mothers, few US families are able to sustain breastfeeding over time. The Centres for Disease Control and Prevention 2022 Breastfeeding Report Card – the latest data that is currently available – shows that more than 80% of infants start out receiving human milk, yet just over a quarter of them are exclusively breastfed through six months.
Black infant-mother pairs not only have the lowest breastfeeding rates in South Carolina, but they also have the lowest rates nationally, compared to other US racial and ethnic groups.
More recent data from the National Vital Statistics System of US infants born in 2020 and 2021, shows that only 74.5% of Black infants were breastfed, compared with non-Hispanic Asian infants (90.1%), non-Hispanic white infants (84.0%) and Hispanic infants (86.8%), based on analysis of birth records collected by the CDC.
Black infants are also more likely to die from SIDS and to be born prematurely. So increasing breastfeeding among Black families could lead to saving significantly more Black infant lives.
The Southeast US is where the widest racial gaps in breastfeeding exist. In addition, infants living in Southern states are less likely to achieve national goals for breastfeeding at 6 or 12 months old compared to infants living in other regions of the country.
Removing barriers to breastfeeding
Reducing barriers is critical to closing racial and geographic gaps in breastfeeding and allowing US mothers and their infants the opportunity to benefit from the life-saving qualities of human milk. Studies show that addressing work-related barriers by making investments in paid family leave, for example, could increase exclusive breastfeeding rates by 15%.
The US is one of the only countries in the world that does not provide national paid family leave.
Workplaces that support breastfeeding breaks and provide safe and clean spaces for expressing and storing human milk are also important in promoting breastfeeding. Given that US women’s labour force participation rates are at a record high, the importance of reducing barriers in the workplace cannot be overstated.
The US Agency for International Development estimates that every US dollar invested in breastfeeding yields $35 in economic returns.
Societal investments in breastfeeding-friendly workplace policies will not only yield cost savings and extend breastfeeding rates, but they will shift the burden of breastfeeding from simply being an individual choice to being a public health priority. (The Conversation) SCY
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