Importance of breastfeeding
Breastfeeding is the best source of nourishment for infants and young children. It contributes to a
lifetime of good health, growth and development. Infants who are not breastfed are at an increased
risk of illness that can compromise their growth and raise the risk of death or disability.
Breastmilk meets all the energy and nutrient requirements of the infant for the first six months of life. It continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life. A baby should be fed on demand at least eight times in a 24-hour period, during the day and at night.
Breastmilk contains antibodies that protect infants from common childhood illnesses such as diarrhoea and pneumonia, the two primary causes of child mortality worldwide. Breastfeeding also prevents many chronic diseases such as asthma and allergies. Exclusive breastfeeding helps hasten recovery during illness.
Adults who were breastfed as babies are at lower risk of acquiring noncommunicable diseases such as high blood pressure, obesity and type 2 diabetes in later life.
Breastmilk promotes sensory and cognitive development. Breastfed children achieve higher academic scores and perform better in intelligence tests. Because it is readily available and affordable, breastfeeding helps to ensure that infants get adequate sustenance.
Breastfeeding has benefits for mothers too as it keeps them safe from many physical and emotional health problems. Breastfeeding helps them return to their pre-pregnancy weight faster, lowers rates of obesity, and reduces the risks of depression and anxiety, and breast and ovarian cancer in later life. Exclusive breastfeeding often induces a lack of menstruation, which is a natural (though not fail-safe) method of birth control.
Despite significant benefits, less than 40% of infants under six months of age are exclusively breastfed
globally, leading to a million avoidable child deaths each year.
Some mothers abandon breastfeeding to return to work or because they fear they are not producing enough milk. This exposes a child to the risks of malnutrition and chronic diseases.
Why not infant formula?
Infant formula does not contain the antibodies found in breastmilk and is linked to some risks, such
as water-borne diseases that arise from mixing powdered formula with unsafe water (many families
lack access to clean water). Malnutrition can result from over-diluting formula to “stretch” supplies.
Further, frequent feedings maintain the breastmilk supply. If formula is used but becomes unavailable,
a return to breastfeeding may not be an option due to diminished breastmilk production.
Formula is expensive compared to breastmilk and diverts a family’s income from other needs.
HIV and breastfeeding
Breastfeeding, and especially early and exclusive breastfeeding, is one of the most significant ways
to improve infant survival rates. However, a woman infected with HIV, can transmit the virus to her
child during pregnancy, labour or delivery, and also through breastmilk. In the past, the challenge
was to balance the risk of infants acquiring HIV through breastfeeding versus the higher risk of death
from causes other than HIV, in particular malnutrition and serious illnesses such as diarrhoea and
pneumonia, when infants were not breastfed.
The evidence on HIV and infant feeding shows that giving antiretroviral drugs (ARVs) to either the HIV-infected mother or the HIV-exposed infant can significantly reduce the risk of transmitting HIV through breastfeeding. This enables HIV-infected mothers to breastfeed with a low risk of transmission (1-2%). These mothers can therefore offer their infants the same protection against the most common causes of child mortality and the benefits associated with breastfeeding.
Even when ARVs are not available, mothers should be counselled to exclusively breastfeed in the first six months of life and continue breastfeeding thereafter unless environmental and social circumstances are safe for, and supportive of, replacement feeding.