Why Breast is BestRebecca D. Williams
New parents want to give their babies the very best. When it comes to nutrition, the best first food for babies is breast milk.
More than two decades of research have established that breast milk is perfectly suited to nourish infants, and protect them from illness. Breastfed infants have lower rates of hospital admissions, ear infections, diarrhea, rashes, allergies, and other medical problems than bottle-fed babies.
"There are 4,000 species of mammals, and they all make a different milk. Human milk is made for human infants, and it meets all their specific nutrient needs," says Ruth Lawrence, M.D., professor of pediatrics and obstetrics at the University of Rochester School of Medicine in Rochester, N.Y., and spokeswoman for the American Academy of Pediatrics.
Health experts say increased breast-feeding rates would save consumers money, spent both on infant formula and in health-care dollars. It could save lives as well.
"We've known for years that the death rates in Third World countries are lower among breastfed babies," says Lawrence. "Breastfed babies are healthier, and have fewer infections than formula-fed babies."
Although breast-feeding is still the best nourishment for infants, infant formula is a close enough second that babies not only survive, but thrive.
Commercially prepared formulas are regulated by the Food and Drug Administration.
The nutritional adequacy of commercially prepared formula is also ensured by the agency's nutrient requirements and its safety by strict quality control procedures that require manufacturers to analyze each batch of formula for required nutrients, to test samples for stability during the shelf life of the product, to code containers to identify the batch, and to make all records available to FDA investigators.
The composition of infant formula is similar to breast milk, but it isn't a perfect match, because the exact chemical makeup of breast milk is still unknown.
Human milk is very complex, and scientists are still trying to unravel and understand what makes it such a good source of nutrition for rapidly growing and developing infants.
More than half the calories in breast milk come from fat, and the same is true for today's infant formulas. This may be alarming to many American adults watching their intake of fat and cholesterol, especially when sources of saturated fats, such as coconut oil, are used in formulas. (In adults, high intakes of saturated fats tend to increase blood cholesterol levels more than other fats or oils.) But the low-fat diet recommended for adults doesn't apply to infants.
The reason is that infants have a high energy requirement, and they have a restricted volume of food that they can ingest. The way to meet these energy requirements in a restricted amount of food is to have a high amount of fat.
While greater knowledge about human milk has helped scientists improve infant formula, it has become "increasingly apparent that infant formula can never duplicate human milk," wrote John D. Benson, Ph.D, and Mark L. Masor, Ph.D., in the March 1994 issue of Endocrine Regulations. "Human milk contains living cells, hormones, active enzymes, immunoglobulins and compounds with unique structures that cannot be replicated in infant formula."
Benson and Masor, both of whom are pediatric nutrition researchers at infant formula manufacturer Abbott Laboratories, believe creating formula that duplicates human milk is impossible. "A better goal is to match the performance of the breastfed infant," they wrote. Performance is measured by the infant's growth, absorption of nutrients, gastrointestinal tolerance, and reactions in blood.
Human Milk for Human Infants
The primary benefit of breast milk is nutritional. Human milk contains just the right amount of fatty acids, lactose, water, and amino acids for human digestion, brain development, and growth.
Cow's milk contains a different type of protein than breast milk. This is good for calves, but human infants can have difficulty digesting it. Bottle-fed infants tend to be fatter than breastfed infants, but not necessarily healthier.
Breastfed babies have fewer illnesses, because human milk transfers to the infant a mother's antibodies to disease. About 80 percent of the cells in breast milk are macrophages, cells that kill bacteria, fungi and viruses. Breastfed babies are protected, in varying degrees, from a number of illnesses, including pneumonia, botulism, bronchitis, staphylococcal infections, influenza, ear infections, and German measles. Furthermore, mothers produce antibodies to whatever disease is present in their environment, making their milk custom-designed to fight the diseases their babies are exposed to as well.
A breastfed baby's digestive tract contains large amounts of Lactobacillus bifidus, beneficial bacteria that prevent the growth of harmful organisms. Human milk straight from the breast is always sterile, never contaminated by polluted water or dirty bottles, which can also lead to diarrhea in the infant.
Human milk contains at least 100 ingredients not found in formula. No babies are allergic to their mother's milk, although they may have a reaction to something the mother eats. If she eliminates it from her diet, the problem resolves itself.
Sucking at the breast promotes good jaw development as well. It's harder work to get milk out of a breast than a bottle, and the exercise strengthens the jaws and encourages the growth of straight, healthy teeth. The baby at the breast also can control the flow of milk by sucking and stopping. With a bottle, the baby must constantly suck or react to the pressure of the nipple placed in the mouth.
Nursing may have psychological benefits for the infant as well, creating an early emotional attachment between mother and child. At birth, infants see only 12 to 15 inches, the distance between a nursing baby and its mother's face. Studies have found that infants as young as 1 week prefer the smell of their own mother's milk. When nursing pads soaked with breast milk are placed in their cribs, they turn their faces toward the one that smells familiar.
Many psychologists believe the nursing baby enjoys a sense of security from the warmth and presence of the mother, especially when there is skin-to-skin contact during feeding. Parents of bottle-fed babies may be tempted to prop bottles in the baby's mouth, with no human contact during feeding. But a nursing mother must cuddle her infant closely many times during the day. Nursing becomes more than a way to feed a baby; it's a source of warmth and comfort.
Benefits to Mothers
Breast-feeding is good for new mothers, as well as for their babies. There are no bottles to sterilize and no formula to buy, measure and mix. It may be easier for a nursing mother to lose the pounds of pregnancy as well, since nursing uses up extra calories. Lactation also stimulates the uterus to contract back to its original size.
A nursing mother is forced to get needed rest. She must sit down, put her feet up, and relax every few hours to nurse. Nursing at night is easy, as well. No one has to stumble to the refrigerator for a bottle and warm it while the baby cries. If she's lying down, a mother can doze while she nurses.
Nursing is also nature's contraceptive--although not a very reliable one. Frequent nursing suppresses ovulation, making it less likely for a nursing mother to menstruate, ovulate, or get pregnant. There are no guarantees, however. Mothers who don't want more children right away should use contraception, even while nursing. Women who are breastfeeding can use barrier methods of birth control, such as condoms and diaphragms. Hormone-containing methods are not first choice. These include injections (such as Depo-Provera), implants (such as Norplant), and birth control pills. A woman who breastfeeds should consult her doctor about which type of contraception is appropriate for her until the baby is weaned.
Breastfeeding is economical also. Even though a nursing mother works up a big appetite and consumes extra calories, the extra food for her is less expensive than buying formula for the baby. Nursing saves money while providing the best nourishment possible.Rebecca D. Williams is a writer in Oak Ridge, Tenn. Isadora Stehlin is a member of FDA's public affairs staff.
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