Equal Opportunity for Babies:
Breastfeeding as a Strategic Priority by Dr. Peter S. Cook
In
March 2005 in Canberra, three MPs decided to breastfeed their babies
while in Parliament House. This could have stimulated wider
understanding of the far-reaching importance of breastfeeding for
human health and well-being. Yet despite some stir in the media, the
underlying issue of equal opportunity for babies was not recognized.
These infants (officially "strangers in the House") could
have reminded legislators of all those who are disadvantaged at
their most vulnerable ages by social policies that effectively
prevent their mothers from breastfeeding them. For long-term
national and individual well-being, we should support mothers who
wish to follow this natural practice, removing any barriers that
stand in their way.
Breastfeeding
improves children's intellectual, mental and physical health
prospects in childhood and throughout life. It promotes bonding
between mother and baby - a foundation for lifetime emotional
well-being; it reduces risks of a wide range of infectious diseases,
asthma, overweight, obesity, diabetes, heart disease, arthritis, and
some malignancies. For mothers it promotes recovery from childbirth,
and reduces some cancer risks and later osteoporosis. A more honest
and valid way of expressing all this is to say that formula feeding
of infants, without breastfeeding, raises the risks of all these
disorders. The promotion of such feeding has been illegal in India
since 1992, following the WHO and UNICEF 1990 Innocenti Declaration
on the Protection, Promotion and Support of Breastfeeding. They
urged that "for optimal maternal and child health and
nutrition, all women should be enabled to practise exclusive
breastfeeding and all infants should be fed exclusively on
breastmilk from birth to 4-6 months of age. Thereafter, children
should continue to be breastfed, while receiving appropriate and
adequate complementary foods, for up to two years of age or beyond.
This child-feeding ideal is to be achieved by creating an
appropriate environment of awareness and support so that women can
breastfeed in this manner." They further urged that "All
governments should develop national breastfeeding policies and set
appropriate national targets …."
The
American Academy of Pediatrics,
in their 2005 Statement Breastfeeding and the Use of Human
Milk,documents "diverse and compelling advantages for infants,
mothers, families, and society from breastfeeding and use of human
milk for infant feeding." They say: "These advantages
include health, nutritional, immunological, developmental,
psychological, social, economic and environmental benefits".
They urge exclusive breastfeeding for 6 months and then, while
adding suitable complementary foods, continuing for "at least
the first year and beyond for as long as mutually desired by mother
and child".
Likewise,
the Australian National Health and Medical Research Council, in
their 2003 Dietary Guidelines say: "The total value of
breastfeeding to the community makes it one of the most effective
prevention measures available and well worth the support of the
entire community ... it will contribute to the health of all
Australians from birth." As a "best-buy" to reduce
the obesity epidemic, the National Obesity Task Force (2004) advised
increasing breastfeeding. A program to achieve this is outlined in
the Australian Breastfeeding Association's Leadership Plan.
Breastfeeding
is not just a matter of supplying better milk.
But
breastfeeding
is not just a matter of supplying better milk. In Reversing
the Real Brain Drain:the Early Years Study, McCain and Mustard describe the
importance of the experience
of breastfeeding, with its opportunities for skin-to-skin touch and
smell stimulation. When a baby is being breastfed, cuddled and
rocked in his mother's arms as she smiles and coos at him, his brain
is busily receiving signals through the sensations of warmth, touch,
taste, sight, sound and smell. In the first three years, when the
brain's pathways are being "wired", these experiences help
to develop structures and functions of the brain in ways that will
set the base for lifelong effects on learning, behavior, and
emotions, influencing his sense of security and social relationships
throughout life. They also affect the endocrine and immune systems,
and hence responses to stress and risks of disease throughout life;
so the quality of the early sensory stimulation and nurture can have
far-reaching effects. When breastfeeding is not possible for some
reason, then holding and cuddling the baby while feeding, with
skin-to skin contact where convenient can still provide valuable
loving sensory experiences for the nursing couple.
Norway
used to have extensive infant bottle-feeding, but following an
active government program to mobilize community awareness and
practical support for mothers, breastfeeding is now initiated by up
to 99% of mothers, and at 6 months around 80% of mothers continue to
breastfeed. Norway provides generous maternity leave and other
work-related consideration for lactating mothers, as part of the
system of social supports that have enabled this national benefit to
be achieved. Over
a span of 35 years it has become a role model for how to swap
bottles for breasts.
Breastfeeding
can influence a nation's way of life in many ways, even possibly
improving its average national IQ by up to six points! In the Journal
of the American Medical Association, Mortensen in 2002 reported
on two large groups born in Copenhagen, whose breastfeeding
histories were known. Independent of a wide range of confounding
factors, a significant positive association between duration of
breastfeeding and intelligence was observed. For example, those who
had been breastfed for nine months averaged six points higher IQ
than those breastfed less than a month. The first group were 2280
18-year old males, called before the Danish draft board, and the
findings were confirmed in another group of 973 men and women aged
around 28 years.
Reducing
a nation's overall average IQ by six points right across the normal
distribution curve has far-reaching costs and implications for the
whole of society. For example, at the upper end, there is the loss
of the brightest, who are all 6% points less intelligent; at the
lower end, there are the remedial education and social costs
associated with the six-point IQ reduction. In emergency or war
situations, infants who are breastfed survive much better than those
who are not.
It
is a serious shortcoming of social policies when many women in some
of the world's most affluent societies can no longer afford to
breastfeed and mother their own babies, however much they may wish
to do so. The "economy" is said to require their labor,
but who has a greater claim on a mother's presence than her own
baby?
We
were all babies once. The fruits of good mothering and early nurture
are among the greatest blessings a person can have in life. In
offering these to their babies, mothers and fathers are setting
patterns of relationships which can be creative, mutually rewarding
and last for the rest of their lives.
We
now have good evidence that, as well as being sound economics,
following the above infant feeding recommendations can significantly
benefit a nation's health and overall well-being. Is there any more
cost-effective way of spending and investing the health dollar
than in promoting this equal opportunity for babies?
Galtry,
J. The impact on breastfeeding of labour market policy and practice in
Ireland, Sweden, and the United States. Social Science & Medicine,
2003; 57:167-177.
Greve,
T. Norway: the breastfeeding top of the world. Midwifery Today, Int.
Midwife, 2003; 67:57-9.
McCain,
M. & Mustard, J. Fraser. Reversing the Real Brain Drain: The Early
Years Study - Report to the Government of Ontario, 1999. Available from
The Children's Secretariat, 1075 Bay Street, Suite 601, Toronto,
Ontario M7A 1E9.
Mortensen
EL et al. The association between duration of breastfeeding and adult
intelligence. Journal of the American Medical Association, 2002;
287:2365-2371, May 8.
National
Health and Medical Research Council. Dietary Guidelines for Children and
Adolescents in Australia; incorporating the Infant Feeding Guidelines
for Health Workers. The National Health and Medical Research Council.
2003. Canberra. http://www.nhmrc.gov.au/publications/_files/n34.pdf
Smith,
Julie. Mothers' milk and markets. Australian Feminist Studies, 2004;19
(No.45):369-379.