Volume 37, Issue 1 , Pages 5-6, January 2007
Foreword
Article Outline
The accompanying article by Lawrence and Pane focuses on the immunologic benefits that should help bolster our vigilance for enthusiastically recommending breastfeeding of infants. Before worrying that this article plunges us into the current scientific intricacies of immunology that are not in our repertoire of daily practice, dive in and appreciate the clarity with which they have presented the material! In the future you may well find yourself referring back to this article to refresh your memory on general principles and important concepts of the human immune system. It is excellently written and concise!
We all know breast milk is the ideal nutrition for most infants. Any PubMed search brings up numerous articles demonstrating the benefits of breastfeeding for the mother, infant, and society. These well-acknowledged advantages include reduced maternal risk for ovarian and breast cancer. Evidence of reduced neonatal and infant infections, sudden infant death, and asthma should enhance a mother’s desire to provide the best nutrition for her infant. The impact of breastfeeding on society is very broad if parental absenteeism in the workplace is factored into this analysis, not to mention the environmental issues associated with the production, transport, and disposal costs of formula.1
It is time for us to reflect not only on the well-established benefits of breastfeeding but what measures we can take to encourage our new mothers to exclusively breastfeed for approximately the first 6 months and continue for at least the first year of life. In discussing this decision with any mother who has been successful with breastfeeding, it is clear that this maternal commitment must be made before delivery. This reinforces the importance of our prenatal visits. How many of our patients have been told that we don’t expect this parent visit before the infant’s birth? All they need to do is let the hospital know to call our practice after delivery. What happened to our desire to know the parents, their family history, their social environment, and possible risk factors for the new infant? Is the issue reimbursement? Maternal education and support for breastfeeding cannot be left to the time following delivery when a woman may be physically exhausted and emotionally overwhelmed. Our support must begin during pregnancy and our colleagues in obstetrics must be aware that we enthusiastically encourage all parents to schedule this prenatal visit.
Why is it that so many of our patients’ mothers who initiate breastfeeding their infants do not continue for at least 6 to 12 months? Clearly there are myriad reasons that affect a mother’s decision to initiate and then continue this form of feeding and perhaps even more that contribute to selecting the alternative of formula-feeding. Could it be that we don’t have enough evidence to establish that the various forms of recommended contraception are equally conducive to successful milk establishment and continued production? Early hospital follow-up is crucial but can we encourage parents to call us before they decide to discontinue breastfeeding?
Individual maternal–infant benefits must outweigh the disadvantages for our advocacy to be successful. Don’t let this opportunity for education slip by. Beyond the clear-cut evidence presented in this article of short-term benefits, there also are accumulating data that demonstrate that breastfeeding has numerous long-term benefits including a protective effect against obesity.2, 3 This major international crisis requires a multi-pronged strategy. Successful treatment of the overweight child and adolescent is challenging. Given the recent finding that individuals with early-onset morbid obesity before 4 years of age with no identified genetic syndrome have significantly lower cognitive function, more behavioral problems, and white-matter lesions on brain MRI raises a real warning flag.4 For those infants yet to be born, let prevention lead the way!
References
- Breastfeeding and the use of human milk. Pediatrics. 2005;115(2):496–506
- . Child Health Information Team (Breastfeeding and lowering the risk of childhood obesity). Lancet. 2002;359:2003–2004
- . Does breastfeeding protect against pediatric overweight? (Analysis of longitudinal data from the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System). Pediatrics. 2004;113(2):e81–e86Available at: www.pediatrics.org/cgi/content/full/113/2/e81.
- Neurocognitive findings in Prader-Willi Syndrome and early-onset morbidity. J Pediatr. 2006;149:192–198
PII: S1538-5442(06)00106-4
doi:10.1016/j.cppeds.2006.10.001
© 2007 Mosby, Inc. All rights reserved.
Volume 37, Issue 1 , Pages 5-6, January 2007
