Breastfeeding is of concern to public health officials and other health professionals, particularly those who work with mothers and infants because of overwhelming evidence of its benefits to individuals, families, communities and society as a whole. The effects of breastfeeding, or lack of, reach far into every nook of our nation and planet.
Former Surgeon Gen. C. Everett Koop and others advocated strongly for breastfeeding as a foundation for a healthy country. Here's what the American Academy of Pediatrics says: "AAP recommends exclusive breastfeeding for approximately the first 6 months of life, continuing to a year or beyond with the addition of complementary foods at about 6 months." (Pediatrics, March 2001)
Studies have over and over again shown that people who were breastfed as infants are generally healthier, leaner and smarter than those who were started on artificial milk (formula). A study in Lancet, the British medical journal, compared 8-year-olds who were given breastmilk in the first month of life to those who were given artificial milk. The children who had begun with breastmilk scored 8.3 IQ points higher. Many other studies have come up with similar results, even when controlling for other factors, such as parents' intelligence, sibling influence or socioeconomic culture.
Why should we care? All that technical information may be entertaining for scientists, geeks and nerds, but what about the rest of us? What about those of us who don't have an infant at home to awaken us for the traditional 3 a.m. feeding? Just give me my coffee or Mountain Dew, and let me get back to building my dreams - never too rich, never too thin. That's the point. Someone else breastfeeding her infant is actually working on building your dream. Some things really are being "set in concrete." A foundation is being laid for your future-our future. As a community, a culture, we are building brain structures that will last for years to come. The construction quality will say something about us, the builders, today and 50 years from now.
The footings and frame of a human is the brain, which doubles in size during the first year of life. A breastfed baby gets nutrition specifically designed to build brains the right way. Mother's milk is the material specified in the blueprints. No other mammal feeds milk from another source to its young. Yet sometimes we try to feed our babies artificial milk, designed for cowsfor quickly putting on bulk, not for building brains.
What kind of brains do I want around me 25 years from now when I, or a loved one, need emergency medical care? How many illnesses like diabetes do I want to indirectly pay for through my health insurance pool? My taxes will eventually be affected by the health, emotional security, and intelligence of the next generation. The costs to society of not breastfeeding have actually been studied in detail and put into numbers. The USDA reported a minimum of $3.6 billion would be saved annually if breastfeeding were increased from current levels to those recommended by the Surgeon General. The societal & economic benefits of breastfeeding include: reduced health care costs, reduced employee absenteeism for the care of sick infants, reduced cost of feeding infants (compared to paying for formula) and reduced waste and environmental pollution. Many other benefits exist, but have not been formally studied.
Most of us were born with a brain made of various types of brain cells. Some types were designed to grow up and out forming a frame, like when a house is first "framed in." This frame helps us do complex tasks like respond in relationships or think ahead. When our mothers held us close and spoke calmly and comforted and fed us our brains were bathed in calming chemicals that helped those pathways grow. The consistency of mom's presence and responsiveness required for breastfeeding build early on the pathways we need to become good citizens. This type of brain-building can happen during breastfeeding or during caring bottlefeeding. The father of the baby can add to baby's development by supporting the duo, and by holding and caring for the baby. Some moms just don't feel like cooing and cuddling. Breastfeeding can change those feelings by flooding the mom with the "mothering" hormone, which is released with milk ejection. It's bonding insurance, a back-up to get the structure framed-in.
While the frame is being built, superior material (mother's milk) adds advantages. In a meta-analysis published in the American Journal of Clinical Nutrition, scientists concluded that breastfeeding was associated with significantly higher scores in neurologic development and thinking skills than artificial feeding, and the benefit was strongest for children of low birth weight. The developmental achievements persisted at least through adolescence. Another recent study tracked the growth and development of over 2,500 West Australianchildren over 16 years. "Even when we adjust the results to take into account other factors such as the parents' socio-economic situation, their education, their happiness and family functioning, we see that children that were breastfed for at least six months are at lower risk of mental health problems," said one of the researchers. In this study, children who were breastfed for less than six months, compared to six months or longer, had anywhere from 61 percent to 37 percent increased risk for brain disorders, or mental illnesses. The study also found that children who were breastfed had noticeably lower rates of delinquent, aggressive and anti-social behavior, and were on average less depressed, anxious or withdrawn. It appears that mother's milk can help any brain, and can even prevent disorders. Longer duration of breastfeeding was shown, in all these studies, to increase benefits for the children.
So, if someone is born with a tendency toward a brain disorder, how do we want to help build that brain? We want to put in the best possible nutrients and experiences. If the blueprint is missing something, a knowledgeable builder can see what's missing, order the right materials, and put up a functional structure. This is how breastfeeding can influence children's mental health. Breastfeeding can build the framework to help anyone develop into the healthiest possible individual.
More and more new mothers are choosing to breastfeed. The Centers for Disease Control statistics for 2005 show 72.9 percent of mothers began the breastfeeding process in the hospital. Five months later, only 19.3 percent were still exclusively breastfeeding. When home, mom and baby often are both learning a new skill. They need other people to take care of the rest of life. It's only been a matter of hours since baby was fed continuously by the placenta. During the two weeks after birth, breastfeeding will be almost continuous, but will space out as time goes on.
The big time investment is temporary, with long-term results. As with summertime road construction, it would be easier for the present moment if there were no slow-downs or delays. But without road work now, next spring we would be complaining about the potholes and car alignment. Breastfeeding may seem like an intrusion to our cultural routine of "faster is better," but we need to get used to it.
If we want to build good brains, we need to give various kinds of support to these pairs of brain-builders. As a culture, and as individuals, we can show respect to families who breastfeed. We can expect women to be tied down for a month after childbirth. We can see breastfeeding as the norm. We can act like breasts are for feeding babies, and explain that to people of all ages.
Minnesota law states, "A mother may breastfeed in any location, public or private, where the mother and child are otherwise authorized to be, irrespective of whether the nipple of the mother's breast is uncovered during or incidental to the breast-feeding." Minnesota law also requires employers, to the best of their abilities, to provide appropriate breaks and places for lactating mothers to care for their needs.
What else can we collectively do? We can help expectant mothers to get all the information they need to make a truly informed decision. We can help new fathers find their roles. Women can invite men to take up their support functions. We can somehow teach this to children. Think about school science curriculum. We can change our attitudes. The brains we help may belong to our doctors in 25 years - or our plumbers, or scarier still, our governor or president! Breastfeeding builds better brains.
Spotlight on Children's Mental Health is provided by the Crow wing County Local Advisory Council on Children's Mental Health.
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