April 6 through 12 is National Public Health Week. It might surprise you to find out that breastfeeding is a national public health issue. This includes our county as well. Prior to the turn of the century, nearly all infants were breastfed. Formula feeding gained popularity in the 1930s. Since then, the incidence of breastfeeding has steadily declined reaching an all time low of 25 percent in 1971. The rate of breastfeeding is now rising but far from meeting the Year 2000 Health Objectives of 50 percent. The Central Valley, Los Angeles, and southeastern California have the lowest breastfeeding initiation rates in the state (less than 75 percent). The PRAMS (Pregnancy Risk Assessment Monitoring System) data suggests that about 73 percent of women stop breastfeeding within the first few months.

Why would breastfeeding become a public health issue? Despite overwhelming evidence that supports the numerous health benefits of breastfeeding, too few women nurse their infants beyond the first few weeks of infancy. At the same time, policy makers are increasingly recognizing that breastfeeding can reduce health care costs and enhance maternal and infant well-being. Not only is breastfeeding important for babies and mothers, but it is important for society as well.

Why is breastfeeding so important for infants?

• Human milk is uniquely suited for human infants. Human milk is a living dynamic fluid specifically produced for human infants. It contains nutrients in the amount and quality needed by the infant. No formula has been produced that replicates the composition of nutrients in human milk. In addition to nutrients, human milk contains enzymes, hormones, growth factors, immunological and anti-allergic factors and prostaglandins. Formula contains nutrients but does not contain any of the other components mentioned above. And, the concentration and bioavailability of nutrients are superior in human milk. For example, fatty acids, unique to human milk, may play a role in infant brain and visual development.

• Breastfeeding can save lives.The lack of breastfeeding is a risk factor for sudden infant death syndrome (SIDS). And human milk may protect premature infants from life-threatening gastrointestinal disease.

• Breastfed infants are healthier. For example, infants who are exclusively breastfed for at least four months are half as likely as bottle fed infants to have ear infections in the first year of life. They are less likely to have diarrhea. Breastfeeding has been shown to reduce the incidence and lessen the severity of bacterial infections such as meningitis, lower respiratory infections, and bacteremia. Breastfeeding is protective against infant botulism. Evidence suggests that exclusive breastfeeding for at least two months protects susceptible children from Type I insulin dependent diabetes mellitus.

Why is breastfeeding so important for mothers?

• Breastfeeding helps mothers recover from childbirth. Breastfeeding helps the uterus to shrink to its prepregnancy state and reduces the amount of blood lost after delivery. Mothers who breastfeed for at least three months may lose more weight than bottle-feeding mothers. Breastfeeding mothers usually resume their menstrual cycles 20 to 30 weeks later than bottle-feeding women.

• Breastfeeding can also keep women healthier throughout their lives. Breastfeeding can be an important factor in child spacing among women who do not use contraceptives. Nursing reduces the risk of breast and ovarian cancer. Women who breastfeed their infants are less likely to develop multiple sclerosis. Breastfeeding may reduce the risk of osteoporosis. And during lactation, total cholesterol, LDL cholesterol, and triglyceride levels decline while the beneficial HDL cholesterol level remains high.

Why is breastfeeding so important for society?

• Breastfeeding is economical. The cost of formula has increased 150% since the 1980s. The estimated cost of artificial feeding for one year is $855.00.

• Breastfeeding reduces health care costs. For example, the International Journal of Gynecology and Obstetrics reported in 1994 that $2-4 billion could be saved annually in the US if all women breastfed their babies for 12 weeks. Of the women who initiate breastfeeding, few continue beyond a few weeks. This suggests that women are not receiving adequate support in the efforts.

How can you help? Encourage and support the new mother in your family to breastfeed her infant, the longer, the better (at least through the first year).