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Breastfeeding Benefits – Is there any evidence?

1 Feb 2006 7:56 PM -

As a doctor and a bloke, I have observed many times the angst and guilt that breastfeeding (or the inability to breast feed) can evoke in women after childbirth. Any breastfeeding advocate can rattle off a list of the advantages of breastfeeding to infants, their mothers and society. The list of alleged benefits range from better emotional attachment to a lower risk of childhood leukaemia or crooked teeth. On pondering these many and varied claims, I was interested to find out how many supposed benefits had actually been confirmed by rigorous scientific research.

The constituents of human milk suggest that its biological function is to promote infant health and human growth, particularly to protect children from infections and to support the rapid growth of the human brain. Despite significant advances in science and manufacturing, infant formula will always be a poor copy of human milk, as it is nearly impossible to reproduce the full spectrum of human milk proteins, sugars, immune cells and antibodies programmed by infections in the infant's environment, together with constant variations in nutrient content to meet the needs of the growing infant. But in developed countries such as Australia, with ample clean water and biologically safe artificial feeds, is there adequate scientific justification for the strong push towards breastfeeding, and the resultant angst and guilt felt by those who can't breastfeed their infant?

The trouble is that good quality controlled trials are hard to perform regarding breastfeeding and many of the studies available, both positive and negative, have major flaws. However, there are certainly some interesting results from some of these studies. Several studies since 2000 have shown a reproducible reduction in the risk of rotavirus gastroenteritis in breastfed infants, and it is thought that factors in human milk prevent symptoms in breastfed infants infected with rotavirus by preventing and inhibiting the virus's normal infective processes.

Childhood obesity is the commonest chronic health problem in Australian children. Several large trials since 2001 have demonstrated a lower prevalence of obesity in previously breastfed children, with decreasing risk associated with longer duration of breastfeeding. The second most common chronic health problem in Australian children is asthma. A large Australian study showed a substantial reduction in the risk of childhood asthma in six year olds, if they were exclusively breastfed for at least the first four months of life. This effect was greatest in children who had a strong family history of allergy.

So it does seem that the balance of evidence shows that breastfeeding is of benefit to infants in many ways, and should then be encouraged as the preferred manner of infant feeding wherever possible (in line with World Health Organisation recommendations). However, mothers who can't breastfeed should be reassured that Australian Standard infant formulas are of excellent nutritional quality and most these days contain many of the constituents of human milk that are thought essential for brain development and protection from intestinal infection. Besides, I was bottle fed and I turned out alright …

Source: McVeigh, P. , “Is breastfeeding best practice?”, MJA Vol 177, Aug 2002, 128-129.