Benefits and Challenges of Breastfeeding
Human milk is and has always been considered the optimal source of nutrition for nearly all infants. Research has shown a strong association between decreased rates of breastfeeding and increased rates of infant and maternal morbidity and mortality, healthcare costs, as well as economic losses. In regards to its effect on infant health outcomes, there is strong evidence supporting human milk consumption and reduced risks of nonspecific gastrointestinal infections, upper and lower respiratory tract infections, otitis media, sudden infant death syndrome (SIDS), and necrotizing enterocolitis among premature and low-birth-weight infants. These medical benefits are correlated with the nutrition profile of human milk: low protein and high oligosaccharides content, as well as high bioavailability of essential minerals. Such composition is not only suitable for the immature digestive system of infants, but also beneficial in providing direct and indirect immunity - “serving as substrate for beneficial gut bacteria, stimulating infant gut production of secretory immunoglobulin A and interfering directly with pathogen binding” (Academy of Nutrition and Dietetics 445).
Breastfeeding is also beneficial to improve maternal health, specifically by providing maternal immune factors and appetite-regulating hormones. Such physiological impacts produce immediate outcomes namely the decreased prevalence of postpartum hemorrhage, delayed ovulation and postpartum depression. Long-term effects including reduced risk of breast/ovarian cancer, hypertension and type 2 diabetes have also been recorded. Aside from improving infant and maternal health, numerous cost analyses have predicted a significant economic improvement if optimal breastfeeding practices are achieved. A recent pediatric study, which included both direct and indirect costs of diseases associated with suboptimal breastfeeding practices, revealed that “if 90% of families in the United States breastfed exclusively for 6 months, $13 billion per year could be saved” (Academy of Nutrition and Dietetics 447). Similarly, another study which focused on maternal outcomes showed that $17.4 billion could be saved annually if current breastfeeding rates (23%) are increased to 90%. However, it is worthy to note that these predictions are based on the assumption that breastfeeding recommendations are thoroughly met: infants are exclusively breastfed up to 6 months of age, and then introduced to appropriate complementary foods while still breastfeeding until at least his or her first birthday.
Therefore, current infant feeding trends are highly problematic as “less than 50% of infants are breastfed through 3 months and only 25% are breastfed through 6 months” (Centers for Disease Control and Prevention). Such low rates of breastfeeding practices are caused by numerous obstacles, such as lack of knowledge regarding breastfeeding benefits, social norm of bottle-feeding, poor family or social support, rigid workplace policy, and limited child care facilities. Nonetheless, major deficiencies related to ineffective healthcare provider’s practice style that does not promote breastfeeding is the most concerning. These practices include “a low priority given to support for breastfeeding and education, inappropriate routines and provision of care, fragmented care, and inadequate hospital facilities for women who are breastfeeding” (US Office of the Surgeon General). For instance, nurses in Kings County Hospital located in Brooklyn, New York have been reported to offer birth control to mothers immediately after birth. The estrogen and progesterone used to regulate ovulation in birth control works inversely with mother’s prolactin levels needed for milk production. Another example is the provision of supplemental feeding to healthy, full-term breastfeeding newborns during their postpartum stay, a practice that is unnecessary and detrimental to the duration of breastfeeding. These problems are of utmost priority because hospital is the immediate environment mothers and newborns are exposed to after delivery. A skilled and consistent support for breastfeeding in the hospital setting is paramount in ensuring both breastfeeding initiation and duration.
Research continues to support the beneficial impact of human milk on infant and maternal health outcomes. Even though breastfeeding rates have gradually increased, current rates are still insufficient to decrease infant and maternal morbidity and mortality, as well as the subsequent economic burden. Therefore, collaboration of hospital staff and policy makers is required to ensure that optimal breastfeeding practices are realized and breastfeeding rates are increased.
References
“Breastfeeding Report Card.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 17 Sept. 2020, www.cdc.gov/breastfeeding /data/reportcard.htm.
Office of the Surgeon General (US). “Barriers to Breastfeeding in the United States.” The Surgeon General's Call to Action to Support Breastfeeding., U.S. National Library of Medicine, 1 Jan. 1970, www.ncbi.nlm.nih.gov/books/NBK52688/.
“Promoting and Supporting Breastfeeding.” Eatrightpro, Academy of Nutrition and Dietetics, Mar. 2015, www.eatrightpro.org/-/media/eatrightpro-files/practice/position-and-practice-papers/practice-papers/practicepaperpromotingandsupportingbreastfeeding.pdf?la=en&hash=39B07DA0E25D1703828C1AAF3ADEC410A8E8141F.
