“They convinced our mothers that if a food item came in a bottle — or a can or a box or a cellophane bag — then it was somehow better for you than when it came to you free of charge via Mother Nature. An entire generation of us were introduced in our very first week to the concept that phony was better than real” quotes the Academy-Award winning filmmaker and best-selling author Michael Moore in his book Here Comes Trouble. It is true that despite its numerous benefits for both mother and child, in our days breastfeeding cessation takes place earlier than recommended (Brown et al., 2014).
However, as breast milk is the best food source for optimal infant growth and development (Kramer and Kakuma, 2012; WHO, 2003), mothers should be encouraged to lactate.
Breast milk provides the best regulation of development, growth and metabolism for the neonate. It also provides the best immune protection as it compensates for delays in the development of the infant’s immune system.
More particularly, acquired secretory antibodies, such as immunoglobulins M and G, provide the infant with environment-specific immunoprotection (Newburg and Walker, 2007). Additionally, secretory IgA (sIgA), is present in a form that resists digestion and possesses critical immunoprotective properties (Newburg and Walker, 2007; Chirico et al., 2008) and by phagocytosis or cytotoxicity, sIgA inhibits the penetration of the gastrointestinal tract by pathogens (Brandtzaeg, 2003). In fact, children who breastfeed optimally appear to have lower risk of infection and illness than those who are breastfed for shorter period of time (Dieterich et al., 2013).
What’s more, lactation confers its immunoprotection by promoting the development of a healthy gut microbiome (Isolauri, 2012).
Breast milk contains digestion-resisting components such as microbiota like Bifidobacteria and Lactobacilli, and oligosaccharides, which serve as their fuel (Newgurg and Walker, 2007; Newgurg et al., 2005). Those two components, favor the development of a healthy intestinal microflora, which prevents inflammatory responses (Goldman, 2000) and contributes to regulating the expression of genes affecting adipose deposition and metabolism (Kau et al., 2011). Additionally, hormones, growth factors and neuropeptides contained in breast milk affect self-regulation of food intake (Savino and Liguori, 2008), possibly accounting for the better-regulated food intake observed in breastfed than formula-fed infants (Li et al., 2010). Furthermore, the lower protein concentration of breastmilk can help protecting the infant against adiposity later in life (Singhal and Lanigan, 2007).
Finally, it has been proposed that breastfeeding could be a marker of parenting practices that promote child development (Jacobson et al., 2013) as breastfeeding mothers are more likely to provide a cognitively stimulating environment for their infants (Der et al., 2006). Interestingly, adults who breastfed as children appear to have higher scores in intelligence tests than formula fed ones (Jimenez-Cruz, 2010).
Apart from the benefits for the neonate, lactation presents significant maternal advantages. Greater duration and intensity of breastfeeding is associated with greater postpartum weight loss (Baker et al., 2008). It also improves insulin sensitivity, which decreases during pregnancy and can cause gestational diabetes and even increase the risk for type 2 diabetes later in life (Stuebe and Rich-Edwards, 2009). Additionally, lactation helps to regulate the levels of cholesterol and triglycerides that increase during pregnancy and is associated with lower risk for subsequent metabolic and cardiovascular disease (Stuebe and Rich-Edwards, 2009; Schwarz et al., 2009; Natland et al., 2012). Furthermore, breastfeeding facilitates the bonding between mother and child (Leung and Sauve, 2005). Most importantly, it is found that lactation decreases the risk for reproductive cancers such as ovarian and breast cancer (Dieterich et al., 2012).
However, despite its indisputable contribution to the overall health of both mother and infant, it isn’t rare that women stop lactating before the recommended 6 months. During the first six weeks postpartum, women are at greatest risk of lactation cessation (Kronborg and Vaeth, 2004; Sheehan, 2001). Among the reasons for ceasing to lactate, mothers mention concerns about milk supply and difficulties with breastfeeding technique. Lack of knowledge about breastfeeding as well as lack of previous experience are linked with perceptions of low milk, as primiparous and younger mothers are more likely to report cessation due to low milk supply (Brown et al., 2014). Mothers who smoke appear to have significantly decreased milk production (Blyth et al., 2002) which may account for their decreased motivation to continue breastfeeding (Hopkinson et al., 1992). On the other hand, maternal attitude plays a crucial role in lactation duration. Women who perceive breastfeeding to be healthier, easier and not restrictive breastfeed for longer (Dennis, 2002).
To conclude, breastfeeding can be beneficial for both mother and child in numerous ways. Boosting immunity, promoting a healthy gut microbiome, regulating appetite, reducing the risk for diabetes, facilitating weight loss postpartum are only a few of its contributions. However, many mothers may cease to lactate early, for practical, social and psychological reasons.
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