Exclusive Breastfeeding

Human milk is all the food a full-term, healthy newborn baby needs for the first few months of his/her life. It is an amazing thing to contemplate! A woman nourishes and grows a baby while he or she lives inside the woman’s body and she can do the same after the baby is born. Some women find it hard to believe that the milk they produce is sufficient for a growing baby for several months. They have doubts and sometimes, their family and friends don’t believe it is possible for a baby to receive only breast milk for the first months of an infant’s life. While we know and understand that there are some women who do indeed have difficulty supplying all the milk their baby needs in the first few months, this kind of a situation is not very common.

Throughout the world, insufficient milk production, mostly perceived, is the main reason for early supplementation and weaning. Whether it is perceived or a fact, for the mother it is a real situation. This perception of a low milk supply leads women to supplement with other liquids or foods and to not practice exclusive breastfeeding. Although this issue will be discussed in future months when other topics are discussed, such as common breastfeeding problems, it is important to discuss it here as well, since supplementation with other foods and liquids obviously interferes with the implementation of exclusive breastfeeding. For this discussion, we would like to talk about the importance of exclusive breastfeeding and the practice of exclusive breastfeeding, while acknowledging that it does not happen for all women.

Several well-known organizations have public statements encouraging exclusive breastfeeding for the first 4-6 months of a baby’s life.

The American Academy of Pediatrics (http://www.aap.org/) says:

“Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months after birth.”http://www.aap.org/policy/re9729.html  

World Alliance for Breastfeeding Action (http://www.waba.org.br/) says:

“Exclusive breastfeeding without other foods or fluids for the first 6 months of life is the best start for all babies.” http://www.waba.org.br/acsh7.htm  

The World Health Organization (http://www.who.int/) and UNICEF (http://www.unicef.org) say in the Innocenti Declaration:

“As a global goal for optimal maternal and child health and nutrition, all women should be enabled to practise exclusive breastfeeding and all infants should be fed exclusively on breastmilk from birth to 4-6 months of age. Thereafter, children should continue to be breastfed, while receiving appropriate and adequate complementary foods, for up to two years of age or beyond. This child-feeding ideal is to be achieved by creating an appropriate environment of awareness and support so that women can breastfeed in this manner.” http://www.infactcanada.ca/whocode/innocent.htm

newYou will find additional information on WHO and UNICEF definitions in our collection of supporting documents.

La Leche League International (http://www.lalecheleague.org/) believes:

“For the healthy, full-term baby, breast milk is the only food necessary until baby shows signs of needing solids, about the middle of the first year after birth.”

The Nursing Mothers’ Association of Australia (http://www.nmaa.asn.au/) says:

“Breast milk is sufficient for the growth and development of healthy, full-term babies for at least six months. Other fluids, solids or vitamins are unnecessary before this unless medically indicated.”

To begin, there are many reasons why simply breastfeeding your baby is so important.

Research shows that breastfeeding your baby confers a host of immunological benefits to the baby. Breastfed babies have a lower risk of developing ear infections, urinary tract infections, asthma, childhood cancers, diabetes and allergies.

We also know that breastfeeding has benefits to the mother as well. By breastfeeding her baby a woman reduces her risk of breast cancer, ovarian cancer and osteoporosis. In addition, many women find breastfeeding as an effective method of preventing pregnancy for the first 4-6 months after delivery.

Breastfeeding a baby is very important, but exclusively breastfeeding (nothing but human milk) a baby is an important piece of the complete breastfeeding experience. There are many reasons why exclusively breastfeeding an infant is so important.

Unnecessary supplementation with infant formula or cow’s milk can interfere with the physiological benefits of exclusive breastfeeding. For example, the additional iron in infant formula can bind with lactoferrin (an important protein in human milk that confers protection against infection) and make it less available to fight infection.

Additionally, delaying the addition of cow’s milk protein and other allergenic foods (such as eggs, wheat and nuts) can reduce the incidence of food-related allergies, asthma and eczema.

Babies who are exclusively breastfed and have unrestricted access to the breast don’t need water. Giving additional water to infants is related to an increased risk of diarrhea, decreased consumption of breast milk (and therefore fewer calories) and a more likely probability to be weaned from the breast before 3 months of age.

Babies who drink enough breast milk to satisfy their caloric and nutritional needs will receive all the water they need, even in very hot and dry parts of the world.

In many countries, where water is scarce and hard to get, being able to just breastfeed without adding water is a convenience for the mother and the family. In addition, there are no bottles or utensils or tools to wash and, therefore, no need for water in that regard.

Finally, by not restricting a baby’s time at the breast and by not offering supplemental liquids or foods, a mother helps maintain her milk supply, reduces the risk of nipple confusion or preference by the baby and thereby helps to ensure she will have a plentiful supply of milk for her baby.

References

Lawrence R.A. 1999. Breastfeeding: A Guide for the Medical Profession (5th ed.) St. Louis, MO: C.V. Mosby Company.

Riordan J., Auerbach K.G., 1993. Breastfeeding and Human Lactation, Sudbury, MA, Jones and Bartlett Publishers.

World Health Organization, 1991. “Breast-feeding and the use of water and teas,” Division of Child Health and Development UPDATE, No .9 (reissued Nov. 1997). Also available at: http://www.who.int/chd/publications/newslet/update/updt-09.htm