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Breastfeeding Update 1: Immunology, Nutrition, and Advocacy

Wendelin Slusser, MS, MD^*
Nancy G. Powers, MD

^* Assistant Clinical Professor, Department of Pediatrics, UCLA; Director, UCLA Breastfeeding Resource Program at the UCLA Center for Healthier Children, Families, and Communities, School of Public Health, Los Angeles, CA.

Medical Director, Lactation Services, Associates in Neonatology, PA, Columbia Wesley Medical Center, Wichita, KS, and Clinical Associate Professor of Pediatrics, University of Kansas School of Medicine, Wichita.

	IMPORTANT POINTS

 

1. Human milk protects and promotes infant health by its species-specific immune system, which complements the infant's very immature immune system. Formula cannot provide this immune protection.
   
2. The pediatrician can and should be an advocate for the breastfeeding family.
   
3. There are important differences in the nutrient composition of human milk and artificial milk.
   
4. Current recommendations for feeding infants include breastfeeding for at least the first year of life.
   
5. Human milk has a dynamic nature; changes in composition can vary from one feeding to another and over time as the infant matures.
   

	Introduction

 
Most pediatricians are knowledgeable about the advantages of breastfeeding, especially exclusive breastfeeding for the first 6 months of an infant's life. These benefits in developed countries include a reduction in the incidence of infectious disease (in particular, diarrhea, otitis media, upper respiratory tract infections, pneumonia, and urinary tract infections), provision of complete nutrition that sustains adequate growth and hydration of the infant in the first 6 months of life, prevention of disease and allergy, improved child spacing, and psychosocial benefits.

Despite our understanding of the numerous benefits of breastfeeding, a number of studies have found that health-care providers represent one of the major barriers to successful breastfeeding. In 1993, United States statistics revealed breastfeeding initiation rates of 55.9%. At 6 months postpartum, continuation rates for breastfeeding were only 19%. One might ask, "How can so few women breastfeed when the American Academy of Pediatrics (AAP) recommends that all infants be breastfed exclusively for the first 4 to 6 months of life and continue to be breastfed for a year or more?" (The World Health Organization [WHO] and United Nations Children's Fund [UNICEF] recommend continuation for 2 years or more.) However, one might also ask, "How can so many women in the United States successfully breastfeed with little support from health-care . . . [Full Text of this Article]

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