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Breastfeeding: A No-Cost Investment with Recurring Health Benefits
August 11, 2020

Dr. M. Balasubramanyam, Dean of Research Studies & Senior Scientist at the Madras Diabetes Research Foundation (MDRF), Chennai, India.

How many of us know we observe World Breastfeeding Week(WBW) during August 1st to 7th, every year? World Breastfeeding Week is coordinated by the World Alliance for Breastfeeding Action(WABA), a global network of individuals and organizations concerned with the protection, promotion and support of breastfeeding worldwide.Last week (1-7 August), WABA and breastfeeding advocates in over 175 countries worldwide celebrated the WBW theme of this year: ‘Support Breastfeeding: For a Healthier Planet’.

Despite all this awareness, it is unfortunate that what we see in reality is disheartening efforts and trends of breastfeeding.Over centuries, human milk is evolutionary shaped to nourish the newborn and is regarded as the nutritional gold standard for term infants. Breast-feeding has declined worldwide in recent years, as a result of urbanization, marketing of infant milk formulae and maternal employment outside the home.Studies in India have also shown a decline in breast-feeding trends. As per the international guideline sand the Indian Academy of Pediatrics Policy on Infant feeding, ‘an ideal infant feeding comprises exclusive breastfeeding for 6 months followed by sequential addition of semi-solid and solid foods to complement (not replace) breast milk till the child is gradually able to eat normal family food (around one year).

One more reason for breastfeeding – prevention of diabetes!

It is well conceived that the most important short-term immunological benefit of breastfeeding is protection against infectious diseases. In the last few years, several systematic reviews and meta-analyses have examined the effect of breastfeeding on noncommunicable diseases. There seems to be a definite protective effect of breastfeeding against later overweight and obesity.Recent studies also emphasize that breastfeeding may provide a degree of long-term protection against the development of type-2 diabetes, which could be of public health importance. Longer duration of breastfeeding was shown associated with reduced incidence of type-2 diabetes mellitus in several cohort studies worldwide among different ethnic populations.More research and additional evidence are needed to establish definitively whether breastfeeding protects against diabetes, the extent of protection, and the duration of breastfeeding required. Given other well-established reasons for breastfeeding, renewed efforts to encourage this in populations at high risk for insulin resistance and type-2 diabetes, such as Asian Indians, may have tremendous health benefits.

Breastfeeding is beneficial to both Mother and the Offspring!

Nutrition and protective effects of breast-feeding have mostly been attributed to the health of the child.However,recent findings suggest that mothers can benefit from breast-feeding as well. During gestation, enormous changes occur in women’s metabolism to ensure sufficient supply to the fetus. Breast-feeding is certain to ‘reset’ these metabolic changes in a favorable way both for the mother and the baby. For infants, not being breastfed is associated with an increased incidence of infectious morbidity, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome. For mothers, failure to breastfeed is associated with an increased incidence of premenopausal breast cancer, ovarian cancer, type 2 diabetes, myocardial infarction, retained gestational weight gain, and the metabolic syndrome. More research is needed to address these health issues and their association with lack of breastfeeding.

Breast-milk is Not Only Nutritional but Also Medicinal!

In addition to the nutritional components, breast-milk contains a wealth of ‘bio active components’ that may have beneficial non-nutritional functions and multiple health benefits. This means breast-milk is not only nutritional but also medicinal! & serve as a poly pill! Breastfeeding in the perinatal period has a profound effect on long-term health and this occurs through epigenetic mechanisms as a legacy effect.Human milk oligosaccharides have significant prebiotic effects, selectively serving as a source of energy and nutrients for desired bacteria (microbiome) to colonize the infant intestinal tract. “This means health benefits of breastfeeding are not only nutritional but also epigenetic and even metagenomic”.

COVID-19: To be or not to be; Support Breastfeeding with appropriate caution

During the COVID-19 pandemic, pregnant women infected with SARS-CoV-2 experience fear and uncertainties regarding the care of their child. The good news is that to date, there is no evidence on the presence of SARS-CoV-2 in breast milk of pregnant women with COVID-19 and hence there is lack of evidence on the potential viral transmission via breast milk.Breastfeeding has been shown to be safe when a mom has other viral illnesses like influenza. Interim guidance provided by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) advises that breastfeeding should be determined by the mother in coordination with her family and healthcare providers, with all possible prevention measures to avoid spreading the virus to the infant.Given the known importance and significance of breastfeeding in preventing other childhood illnesses, we need further studies to have more assurance on breastfeeding during viral infection.

So, what’s the take home message? Once considered an ideal nutrition to child, breastfeeding is now linked to ‘Preventing Disease and Saving Resources’ – A No-Cost Investment with Recurring Health Benefits. Breastfeeding is a fundamental public health right because it promotes health, prevents disease and helps contribute to reducing health inequalities.

Therefore, Act Now! Become an Ambassador for Breastfeeding! Protect, Promote and Support breastfeeding.

Citations:

  1. World Alliance for Breastfeeding Action (WABA), website: http://www.waba.org.my/
  2. Balasubramanyam M. One more reason for breastfeeding – prevention of diabetes. Current Science 2008; 95(9):1115-7

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