By Dr. M. Balasubramanyam
How many of us know we observe World Breastfeeding Week (WBW) in the first week of August every year? World Breastfeeding Week is coordinated by the World Alliance for Breastfeeding Action(WABA), a global network of individuals and organizations concerned with the protection, promotion and support of breastfeeding worldwide. Last week (1-7 August), WABA and breastfeeding advocates in over 175 countries worldwide celebrated the WBW, with this year’s theme as ‘Support Breastfeeding: For a Healthier Planet’.
Despite all this awareness, it is unfortunate that what we see in reality is disheartening efforts and trends of breastfeeding. Over centuries, human milk is evolutionary shaped to nourish the newborn and is regarded as the nutritional gold standard for term infants. Breastfeeding has declined worldwide in recent years, as a result of urbanisation, marketing of infant milk formula and maternal employment outside the home. Studies in India have also shown a decline in breast-feeding trends. As per the international guidelines and the Indian Academy of Pediatrics Policy on Infant feeding, ‘an ideal infant feeding comprises exclusive breastfeeding for 6 months followed by sequential addition of semi-solid and solid foods to complement (not replace) breast milk till the child is gradually able to eat normal family food (around one year).
One More Reason for Breastfeeding — Prevention of Diabetes
It is well conceived that the most important short-term immunological benefit of breastfeeding is protection against infectious diseases. In the last few years, several systematic reviews and meta-analyses have examined the effect of breastfeeding on non-communicable diseases. There seems to be a definite protective effect of breastfeeding against later overweight and obesity. Recent studies also emphasize that breastfeeding may provide a degree of long-term protection against the development of type-2 diabetes, which could be of public health importance. Longer duration of breastfeeding was shown associated with reduced incidence of type-2 diabetes mellitus in several cohort studies worldwide among different ethnic populations. More research and additional evidence are needed to establish definitively whether breastfeeding protects against diabetes, the extent of protection, and the duration of breastfeeding required. Given other well-established reasons for breastfeeding, renewed efforts to encourage this in populations at high risk for insulin resistance and type-2 diabetes, such as Asian Indians, may have tremendous health benefits.
Breastfeeding is Beneficial to Both Mother and the Offspring
Nutrition and protective effects of breast-feeding have mostly been attributed to the health of the child. However recent findings suggest that mothers can benefit from breast-feeding as well. During gestation, enormous changes occur in women’s metabolism to ensure sufficient supply to the fetus. Breast-feeding is certain to ‘reset’ these metabolic changes in a favorable way both for the mother and the baby. For infants, not being breastfed is associated with an increased incidence of infectious morbidity, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome. For mothers, failure to breastfeed is associated with an increased incidence of premenopausal breast cancer, ovarian cancer, type 2diabetes, myocardial infarction, retained gestational weight gain, and the metabolic syndrome. More research is needed to address these health issues and their association with lack of breastfeeding.
Breastmilk is Not Only Nutritional but Also Medicinal
In addition to the nutritional components, breastmilk contains a wealth of ‘bioactive components’ that may have beneficial non-nutritional functions and multiple health benefits. This means breastmilk is not only nutritional but also medicinal! & serve as a polypill! Breastfeeding in the perinatal period has a profound effect on long-term health and this occurs through epigenetic mechanisms as a legacy effect. Human milk oligosaccharides have significant prebiotic effects, selectively serving as a source of energy and nutrients for desired bacteria (microbiome) to colonize the infant intestinal tract. “This means health benefits of breastfeeding are not only nutritional but also epigenetic and even metagenomic.”
How Safe is Breastfeeding in These Times of Covid-19?
During the COVID19 pandemic, pregnant women infected with SARS-CoV-2 experience fear and uncertainties regarding the care of their child. The good news is that to date, there is no evidence on the presence of SARS-CoV-2 in breast milk of pregnant women with COVID-19 and hence there is lack of evidence on the potential viral transmission via breast milk. Breastfeeding has been shown to be safe when a mom has other viral illnesses like influenza. Interim guidance provided by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) as well as Breastfeeding Promotion Network of India (BPNI) advises that breastfeeding should be determined by the mother in coordination with her family and healthcare providers, with all possible prevention measures to avoid spreading the virus to the infant. There are also no restrictions on the use of milk from a human breast milk bank. Given the known importance and significance of breastfeeding in preventing other childhood illnesses, we need further studies to have more assurance on breastfeeding during viral infection.
So, what’s the take home message? Once considered an ideal nutrition to child, breastfeeding is now linked to ‘Preventing Disease and Saving Resources’: A no-cost investment with recurring health benefits. Breastfeeding is a fundamental public health right because it promotes health, prevents disease and helps contribute to reducing health inequalities.
Therefore, Act Now! Become an Ambassador for Breastfeeding! Protect, Promote and Support breastfeeding.
Dr. M. Balasubramanyam is Disease-Biologist and Dean of Research at Madras Diabetes Research Foundation (ICMR- Centre for Advanced Research on Diabetes), Chennai.
References: (World Alliance for Breastfeeding Action; Breastfeeding Promotion Network of India)
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