Breastfeeding makes head way.

At last, some good news about breastfeeding rates. The National Breastfeeding Awareness Campaign cites an increase in breastfeeding in the United States from 2004 to 2005, based on a national survey of almost 1,000 people. This news was released at the beginning of World Breastfeeding Week in August of 2005. The survey shows that more Americans endorse breastfeeding and are more accepting of women breastfeeding in public. The survey also reflects that men in particular have become more aware and supportive of the benefits of breastfeeding. Some of the statistics gathered in the survey, which was funded and sponsored by the U.S. Department of Health and Human Services, show that:

* In 2005 69% of men were comfortable seeing a baby breastfed in public compared to only 59% of men in 2004

* 63% of men responded that they would be willing to have their own baby breastfeed in public, up from 53% the previous year

* 67% of women and 62% of men felt that breast milk is the best food for a baby, an increase of 7% and 12%, respectively, from 2005

* 59% of women and 65% of men agreed that babies should be breastfed exclusively for their first 6 months of life, an increase of 5% in women and 12% in men from 2004.

And in November, 2005, on the 15th anniversary of the Innocenti Declaration on the Protection, Promotion, and Support of Breastfeeding, signed in Florence, Italy in 1990 by more than 30 world governments, UNICEF released news that breastfeeding rates are up at least 15% around the world since 1990 and that more than six million lives are saved each year by exclusive breastfeeding.

Through the efforts of the Innocenti Declaration and the Baby-Friendly Hospital Initiative, nearly 20,000 hospitals in 150 countries have changed policies, becoming more "baby-friendly." In addition, more than 60 countries have adopted laws or regulations implementing the International Code of Marketing of Breast-Milk Substitutes, and numerous other countries have since formed national breastfeeding authorities.

The Baby-Friend Hospital Initiative is having positive effects in the United States as well, as a new study, published in the journal Pediatrics, in September, 2005 shows. The study found that, on average, 84% of new mothers at hospitals and birth centers with the baby-friendly designation began breastfeeding while at the center, compared to a national rate of 69.5%. The baby-friendly designation is applied only to those facilities in compliance with specific steps laid out by the World Health Organization and United Nations, designed to promote breastfeeding. These steps include providing help to all new mothers with beginning breastfeeding within an hour of birth, allowing rooming-in at all times, and providing food other than breastmilk to newborns only if medically necessary. The Baby-Friendly program has not caught on quickly in the U.S., but there has been more rapid growth recently in the number of facilities adopting the initiative.

Unfortunately a common practice of formula companies is to provide free diaper bags, often with formula samples inside, to new mothers. Several studies, conducted by well-known and prestigious journals and other groups, have shown that these free gifts can cause some mothers to give up breastfeeding altogether or supplement breastfeeding with formula-feeding, which can negatively affect successful breastfeeding. Giving new mothers free formula as they leave the hospital is considered unethical by many groups, including the World Health Organization.

In December 2005, the Massachusetts Public Health Council approved what was believed to have been a first-in-the-nation ban on the distribution of gift diaper bags from formula companies filled with brand name baby formula and other goodies to new mothers. The ban's intent was to promote breast-feeding, but Governor Mitt Romney asked the panel in February 2006 to reverse the ruling, saying mothers should not be denied the option of formula. The nine-member council reversed its ruling, but ordered the Department of Public Health to spend three months reviewing the case.

In April and early May 2006, Governor Romney removed members of the Public Health Council who wanted to ban the gift giveaways and in late May 2006 the Council overruled the ban--making it okay for pharmaceutical companies to give new mothers gift bags including formula as well as other baby products.

However, while the state's policymakers debate whether to ban maternity ward gift bags, a growing number of Massachusetts hospitals are quietly doing away with the formula-filled freebies on their own. The state's busiest maternity unit, at Brigham and Women's Hospital, banished gift bags provided by infant formula companies in February of 2006. In May 2006, Cambridge Health Alliance replaced them with bags emblazoned with the alliance's logo--but without formula. And administrators at Beth Israel Deaconess Medical Center, where 5,000 babies are born each year, intend to eliminate the sample and coupon giveaways by the summer.

More Benefits of Breastfeeding in the News

There have been many reports recently of further benefits of breastfeeding, some of which confirm what many of us conside common-sense. But any help in providing evidence-based information to our clients and students is welcome:

* May protect against celiac disease. According to Dr. Tony Akobeng of the Central Manchester (England) Children's University Hospital, in a review of 15 breastfeeding studies, the longer children are breast-fed the less likely they are to suffer from celiac disease, which causes an intolerance to gluten, a protein found in wheat, rye, and barley. The studies show a 52% decrease in celiac disease in babies who were breastfeeding when first exposed to gluten; howeve, Dr. Akobeng stated scientists are not sure how breastfeeding provides this protection, whether by delaying the onset of symptoms of the disease or by providing permanent protection against it.

* May reduce risk of obesity in adolescence. The journal Epidemiology published a study suggesting that breastfed infants may be less likely to be overweight as teens. Further, the longevity of the breastfeeding period is a factor: every four months of breastfeeding seems to lead to a 6% decrease in the risk of adolescent overweight. The findings show the evidence to be uninfluence by sociocultural factors, as the same results were found even within families where children were breastfed for a longer period than their siblings.

* Protects against AIDS. A study conducted by epidemiologists from Johns Hopkins University, the University of Zimbabwe, and the Harare City Health Department reported that infants exclusively breastfed by their HIV-positive mothers are much less likely to contract HIV themselves. The study compared infants fed a mixed diet including solid foods and animal milk to those fed only breast milk and found that the former group were three times more likely to die of AIDS. Further, infection rates were further reduced by delaying the introduction of solids until at least three months of age.

* Reduces risk of maternal diabetes. Women who breastfeed an infant for one year may reduce their risk of developing Type 2 diabetes by 15%, the Journal of the American Medical Association reported. Because lactation uses an average of 500 calories a day (the equivalent of running four to five miles) and the additional energy required can cause short-term changes in insulin a glucose, breastfeeding may cause important metabolic changes that can influence and decrease the risk of diabetes.

* Lowers blood pressure in breastfed children. Researchers at the University of Bristol, England, have reported that breastfeeding may be as effective in lowering blood pressure as low-salt diets or increased physical activity. Further, the longer a child is breastfed the greater the benefits for its blood pressure

* Keeps blood lead levels low. A study conducted by researchers at Harvard School of Public Health provides evidence that very little lead is secreted in breast milk, even if the breastfeeding mother has been exposed to high levels of the toxin. The study also found that calcium supplements may help to decrease lead levels in breast milk even further. This news provides more evidence for support of breastfeeding as a protective measure from environmental lead exposure.

* Aids in prevention of near-sightedness. Research from the National University of Singapore shows that breastfed children are 50% less likely to suffer myopia, or short-sightedness, due to a substance, Docosahexaenoic acid or DHA, found in breast milk which contributes to early visual development in babies.

REFERENCES

Alfredo Pisacane, et al., A Controlled Trial of the Father's Role in Breastfeeding Promotion; Pediatrics, Vol. 116, No. 4 October 2005, pp. 494-498.

Anne Merewood, et al., Breastfeeding Rates in US Baby-Friendly Hospitals: Results of a National Survey; Pediatrics, Vol. 116, No. 3, September 2005, pp. 628-634.

Geneva/Florence, November 22 2005. Press Release from UNICEF Innocenti Research Centre.

State House News Service, Boston, December 20, 2005.

A K Akobeng, et al., Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies; Archives of Disease in Childhood; 2006; 91: 39-43.

Matthew Gillman, et al., Breast-feeding and Overweight in Adolescence. Epidemiology. 17(1):112-114, January 2006.

Peter Iliff, et al., Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival; AIDS: Volume 19(7) 29 April 2005 p 699-708.

Alison M. Stuebe, et al., Duration of Lactation and Incidence of Type 2 Diabetes; JAMA. 2005;294:2601-2610.

D A Lawlor, et al., Infant feeding and components of the metabolic syndrome: findings from the European Youth Heart Study Archives of Disease in Childhood 2005;90:582-588.

Chong YS, et al., Association between breastfeeding and likelihood of myopia in children. JAMA 2005; 293(24):3001-3002.

Adrienne S. Ettinger, et al., Influence of Maternal Bone Lead Burden and Calcium Intake on Levels of Lead in Breast Milk over the Course of Lactation; American Journal of Epidemiology: 2006 163(1):48-56.

By Jemma Boyle, ALACE Membership Coordinator