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HEALTH: Mother’s Milk Saves Lives

Alberto Cremonesi

NEW YORK, Aug 21 2006 (IPS) - Although experts say that breastfeeding gives children the best start in life, protecting them from life-threatening diseases and providing essential nutrients, barely a third of all infants in developing countries are exclusively breastfed for the first six months.

“Breast milk contains exactly the nutrients that the infant needs, helping the infant’s development, with breastfed children performing better on intelligence tests than formula-fed children,” Randa Jarudi Saadeh, a scientist at the Nutrition for Health and Development Department of the World Health Organisation, told IPS.

“Furthermore, breastfeeding helps mother and infant bond,” she said.

Human milk is the ideal nourishment for infants’ survival, growth and development. According to medical studies, exclusive breastfeeding for the first six months of life stimulates babies’ immune systems and protects them from life-threatening diseases such as diarrhea and acute respiratory infections – two of the main causes of infant mortality in developing countries.

“Exclusive breastfeeding means giving the baby nothing other than breast milk – not even water – for the first six months of life,” David Clark, a project officer at the nutrition section of the U.N. children’s agency UNICEF, told IPS.

“Newborns are extremely vulnerable as their immune systems are not yet functioning,” he said. “Breast milk protects the baby by providing him or her with the mothers’ antibodies. The bottom line is that exclusive breastfeeding saves lives.”

But according to UNICEF’s State of the World’s Children report last year, exclusive breastfeeding rates are still very low, just 37 percent worldwide, with more than 60 percent of mothers not exclusively breastfeeding during the crucial six first six months.

Some studies have shown that brochures and free samples distributed by infant formula companies are linked to a significant decrease in the number of women who breast-fed their babies in the first two weeks of life. The marketing campaigns also shortened the breastfeeding duration of women who did not plan to breastfeed for more than 12 weeks.

The World Health Organisation (WHO) reports that there are still nearly 11 million children who die every year from preventable causes. If every baby were exclusively breastfed for the first six months of life, an estimated 1.3 million additional lives would be saved every year, while complementary feeding could prevent another 578,000 deaths.

One problem is that most formula comes in powdered form and must be mixed with water before it is ready. But many mothers in developing countries lack access to clean water, and the formula can end up with bacteria and other contaminants.

Overall, the rates of exclusive breastfeeding have improved, although large variations exist across regions. The highest rates are currently found in the East Asia/Pacific region (43 percent), while the lowest are found in West and Central Africa (20 percent).

Clark notes that in countries where health and community workers were trained to give mothers counseling and support, breastfeeding rates “doubled, tripled, and even quadrupled”.

But despite the high cost of breast milk substitutes, and the fact that they lack natural antibodies to disease, many mothers still use to them as a way to feed their children.

“Common difficulties which hinder breastfeeding are unsupportive environments such as workplaces with inadequate working conditions, or public places where mothers are not allowed to breastfeed,” Dr. Richard Alderslade of the WHO told IPS.

“Cultural and social factors also play a role in influencing infant feeding decisions. Improper marketing and promotion of food products that compete with breastfeeding are important factors that often negatively affect the choice and ability of a mother to breastfeed her infant optimally.”

In fact, there has been a boycott of the Swiss food giant Nestle going on since 1977, with activists charging that the company uses unethical tactics to promote its infant formula, especially in developing countries. Hundreds of European universities, colleges and schools have since banned the sale of Nestlé products from their shops and vending machines.

Of course, breastfeeding is not always possible, and problems can arise with the mother or infant, or both. One major issue is the situation of HIV-positive mothers, when the danger of nursing must be weighed against the consequences of not breastfeeding.

Studies have shown that babies who are breastfed by HIV-positive mothers have a 10 to 20 percent chance of becoming infected, and the longer a child is breastfed, the higher the risk of contracting the virus.

Although some precautions can be taken, such as replacement feeding, home-prepared modified animal milk, heat-treated expressed breast milk, breast milk banks or wet nursing, it remains a frightening dilemma both for mothers and for organisations that promote breastfeeding.

“Guidance is also available for HIV-positive women who choose not to breastfeed on adequate and safe alternatives,” Alderslade explained. “The guidelines, training materials and job-aids on HIV and infant feeding provide detailed instructions on how to prepare, administer and safely store breast-milk substitutes, including commercially prepared infant formula as well as home modified animal milks.”

Clark said that, “In the short term, we would like to see a continued increase in the number of baby-friendly hospitals and of countries with effective legislation to implement the International Code of Marketing of Breastmilk Substitutes and the 2000 Maternity Protection Convention.”

“We would also like to see greater awareness of the risks of artificial feeding. In the long term, we would like to see a world in which mothers, families and other caregivers can make fully informed decisions about optimal infant feeding and receive the support they need to carry them out,” Clarke added.

World Breastfeeding Week 2006, which ended on Aug. 7, also marks the 25th anniversary of the International Code of Marketing of Breastmilk Substitutes, which prohibits advertising and aggressive marketing of formulas, bottles and nipples.

“The fact that there has been an improvement means that the strategies we have been using are working,” Clark said. “However, much more needs to be done. Just over 60 countries around the world have adopted the International Code of Marketing of Breastmilk Substitutes into enforceable national regulations. Clearly more countries need to follow this example.”

Breastfeeding and good nutrition for children are also critical for achievement of the U.N. Millennium Development Goals, particularly the goals relating to child survival, such as reducing child mortality by 50 percent by 2015 and eradicating extreme poverty and hunger.