Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect

Abstract

The importance of breastfeeding in low-income and middle-income countries is well recognised, but less consensus exists about its importance in high-income countries. In low-income and middle-income countries, only 37% of children younger than 6 months of age are exclusively breastfed. With few exceptions, breastfeeding duration is shorter in high-income countries than in those that are resource-poor. Our meta-analyses indicate protection against child infections and malocclusion, increases in intelligence, and probable reductions in overweight and diabetes. We did not find associations with allergic disorders such as asthma or with blood pressure or cholesterol, and we noted an increase in tooth decay with longer periods of breastfeeding. For nursing women, breastfeeding gave protection against breast cancer and it improved birth spacing, and it might also protect against ovarian cancer and type 2 diabetes. The scaling up of breastfeeding to a near universal level could prevent 823,000 annual deaths in children younger than 5 years and 20,000 annual deaths from breast cancer. Recent epidemiological and biological findings from during the past decade expand on the known benefits of breastfeeding for women and children, whether they are rich or poor.

Protective effect of breastfeeding against childhood leukemia in Zhejiang Province, P. R. China: a retrospective case-control study

“…Due to the developments in society and the economy, currently only 37% of infants under 6 months in low- and middle-income countries are exclusively breastfed, and this figure is even lower in high-income countries [22]. The number of children who were given bottled milk powder in the case group (26.3%) was also greater than in the control group (3.7%), which might also affect the prevalence of leukemia.…”

Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300 000 Chinese Women

“…Therefore, breastfeeding may also be a marker of health‐promoting behaviors, rather than a causal determinant of improved cardiometabolic outcomes itself. Several studies in Western populations have demonstrated that women who breastfeed are generally wealthier and more likely to engage in other beneficial health behaviors than women who do not breastfeed 15, 25, 26. However, this pattern is reversed in the present study, in which poorer women from rural areas of China were more likely to breastfeed for a longer duration than their wealthier urban counterparts.…”

“…Although there is increasing recognition of the importance of exclusive breastfeeding, genuine commitment from policy makers is needed to implement strategies in the healthcare system, communities and families, and the work environment that promote and support every woman to breastfeed 32. If effective and sustained, such efforts are likely to confer major benefits to the health of children and women, along with substantial cost savings 15, 32…”

A case study on breastfeeding education in Lebanon’s public medical school: exploring the potential role of social networks in medical education

“…Second, medical schools in developing nations are serving an enormous fraction of the population, and yet they are under researched and do not receive as much attention in the larger medical education literature. Third, physicians in Lebanon are known to be highly influential on patient health practices, and suboptimal breastfeeding rates particularly in developing nations may have drastic consequences on maternal and infant health [8,17,18,21]. Indeed, approximately 38% of infants only are exclusively breastfed during the first month of life and around 2% at 6 months of age in Lebanon [25,26].…”

“…Indeed, approximately 38% of infants only are exclusively breastfed during the first month of life and around 2% at 6 months of age in Lebanon [25,26]. To put this into perspective, this is strikingly lower than ~ 30%, the estimated average exclusive breastfeeding rate at 6 months for infants in countries around the globe which are in the same country income group as Lebanon (upper-middle income) [8]. Additionally, the training hospitals affiliated with the Lebanese public medical school are not designated as Baby-Friendly and do not have policies that enforce the implementation of the majority of the 10 Steps to Successful Breastfeeding [27].…”