The benefits of breastfeeding
Worldwide there is unanimous agreement about the importance of breastfeeding. It is reflected in the World Health Organization’s recommendation that mums breastfeed exclusively for the first six months of the baby’s life, with continued breastfeeding in addition to solid foods at least for the first two years. Breastfeeding, however, is advantageous beyond its nutritional benefits; it protects the baby against infection, regulates and enhances the physiological systems of the mum and baby, and facilitates bonding between them.
Benefits for mums
Physical contact between the mum and baby during the early postpartum period helps prolong the lactation period and may help adapt the mum’s gastrointestinal tract to increased energy demands during lactation. Breastfeeding increases the mum’s attention to her baby’s needs, accelerates uterine involution after birth and reduces the risk of haemorrhage. It also helps the mum regain her pre-pregnancy weight and decreases the risk of ovarian and breast cancer, cardiovascular disease and type 2 diabetes.
Breastfeeding provides long-term anti-stress effects; during each breastfeed mums experience a reduction in their blood pressure and cortisol levels and lower increases in cortisol in response to physical stress compared with mums who bottle-feed. Breastfeeding mums are more likely to be calmer and more social than other women of similar age who are not breastfeeding or pregnant. In fact, mums who have newborns skin-to-skin immediately after birth spend more time with their babies, interact more with them during breastfeeding and breastfeed for longer.
Benefits for babies
Breast milk provides both optimal nutrition (fat, lactose, protein and macronutrients) to support baby development and growth, and complete protection (biochemical and cellular components) against infection. Term babies who receive human milk have significant improvements in their nutritional status, gastrointestinal maturation and neurodevelopment, as well as less infection and chronic disease, compared with formula-fed babies. Preterm babies who receive human milk experience additional benefits, including a reduced risk of necrotising enterocolitis (NEC), enteral feed intolerance, chronic lung disease, retinopathy of prematurity, neurodevelopmental delays and re-hospitalisation.
Developmentally, breastfeeding benefits babies in a number of ways, including improved neurodevelopment and behaviour ratings and a reduced risk of obesity and type 2 diabetes in adulthood. Additionally, breastfeeding promotes normal oral facial growth in babies, including improved dentition, perioral and masseter muscle activity and palatal growth. It also lowers the risk of otitis media.
The act of breastfeeding also facilitates bonding between the mum and baby. Skin-to-skin contact and tactile stimulation of the nipple, including the act of sucking, result in the release of oxytocin, a critical component of the milk ejection reflex, that creates a bond between mum and baby. Oxytocin release increases blood flow to the mum’s chest and nipple area, increasing the temperature of the skin and creating a warm and nurturing environment for the baby.
Altemus, M. et al. Suppression of hypothalmic-pituitary-adrenal axis responses to stress in lactating women. J Clin Endocrinol Metab 80, 2954-2959 (1995).
Chung, M. et al. Interventions in primary care to promote breastfeeding: An evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 149, 565-582 (21-10-2008).
Diouf, J.S. et al. Influence of the mode of nutritive and non-nutritive sucking on the dimensions of primary dental arches. Int Orthod 8, 372-385 (2010).
Gartner, L.M. et al. Breastfeeding and the use of human milk. Pediatrics 115, 496-506 (2005).
Inoue, N., Sakashita, R. & Kamegai, T. Reduction of masseter muscle activity in bottle-fed babies. Early Hum Dev 42, 185-193 (1995).
Ip, S. et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep) 153, 1-186 (2007).
Kramer, M.S. et al. Effects of prolonged and exclusive breastfeeding on child behavior and maternal adjustment: Evidence from a large, randomized trial. Pediatrics 121, e435-e440 (2008).
Labbok, M.H. and Hendershot, G.E. Does breast-feeding protect against malocclusion? An analysis of the 1981 Child Health Supplement to the National Health Interview Survey. Am J Prev Med 3, 227-232 (1987).
Murray, E.K., Ricketts, S. & Dellaport, J. Hospital practices that increase breastfeeding duration: results from a population-based study. Birth 34, 202-211 (2007).
Nissen, E. et al. Oxytocin, prolactin, milk production and their relationship with personality traits in women after vaginal delivery or Cesarean section. J Psychosom Obstet Gynaecol 19, 49-58 (1998).
Rosenbauer, J., Herzig, P. & Giani, G. Early infant feeding and risk of type 1 diabetes mellitus - a nationwide population-based case-control study in pre-school children. Diabetes Metab Res Rev 24, 211-222 (2008).
Schwarz, E.B. Infant feeding in America: enough to break a mother's heart? Breastfeed.Med. 8, 454-457 (2013).
Sullivan, S. et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr 156, 562-567 (2010).
Uvnas-Moberg, K. and Petersson, M. [Oxytocin, a mediator of anti-stress, well-being, social interaction, growth and healing]. Z Psychosom Med Psychother 51, 57-80 (2005).
Vohr, B.R. et al. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics 120, e953-e959 (2007).
WHO and UNICEF. Global strategy for infant and young child feeding (World Health Organization, Geneva, 2003).
Widstrom, A.M. et al. Short-term effects of early suckling and touch of the nipple on maternal behaviour. Early Hum Dev 21, 153-163 (1990).
Winberg, J. Mother and newborn baby: Mutual regulation of physiology and behavior - a selective review. Dev Psychobiol 47, 217-229 (2005).