Monday, July 13, 2009

Breastfeeding rates still low despite global education

Despite widespread awareness of the importance of breastfeeding to the human child, mothers in developed countries demonstrate low rates of compliance with global recommendations. Nursing past six months is the exception rather than the rule. Bottle-feeding infants has become normal. Exclusive and extensive breastfeeding has become a pastime primarily for the rich with some interesting exceptions. Nordic countries exhibit the overall highest European breastfeeding rate with England ranking lowest. UAE ruling class mothers exclusively breastfeed the longest among Arabs while Iraq suffers the lowest breastfeeding rates. US Whites and Native Americans are most likely to breastfeed while Blacks and Hispanics are the least likely.

Class plays a large role in decision to breastfeed, for far fewer women belonging to the routine and manual labor socio-economic group nurse beyond six weeks than is typical of professional women and full time mothers. Yet, religion and philosophy also affect women’s decision to breastfeed. In Singapore non-Malay Muslim women are 6.7 times more likely to breastfeed than Buddhist women although Malays have the lowest rate. Urban babies receive half the breast milk of rural babies. The youngest mothers tend to supplement with bottles from birth.

The World Health Organization and UNICEF work hard to promote breastfeeding worldwide, but their success is undermined by factors such as free infant formula distribution, hospital practices and lack of personal support. Breastfeeding is a learned skill requiring effort and focus. Good intentions are not always enough to establish lactation. “Baby-friendly hospital” initiatives in many countries have significantly increased breastfeeding but rates are still well below optimum health guidelines.

Almost all new mothers attempt breastfeeding but few continue for the recommended period. According to UNICEF the early introduction of bottle-feeding and complementary food leads to premature weaning, which is the primary cause of malnutrition in children under age two worldwide.

Many women give up nursing in favor of bottle-feeding out of a sense of powerless over the situation. These mothers often wanted very much to nurse their child, but they lost their chance. Hospitals fail to promote exclusive breastfeeding of newborns. Most new mothers receive free samples of formula because of multi-million dollar deals between hospitals and pharmaceutical companies and come home with their babies already addicted to the bottle. Coaxing a newborn child to breastfeed after he has been bottle-fed even just once or twice can be a big struggle. Success may be impossible without the aid of a midwife or lactation counselor because unfortunately even the older generation of mothers lack sufficient knowledge.

When newborns reject the breast, mothers typically try for a while, then give up and supply a bottle. This teaches the baby that refusing to nurse will be rewarded. Parents must exercise “tough love” by declining to give the baby a bottle even if it takes several hours or even days for the baby to nurse willingly. (If the baby gets dehydrated, do give him water with a cup or medicine dropper, but introducing a bottle creates “nipple confusion” which is disastrous for the mother-child relationship).

Some women give up on breastfeeding because the husband insists. This tragedy reveals a stripping away at women’s postnatal rights and sets a dangerous precedent. Nursing a baby is an exhausting and time-consuming job requiring family help, encouragement, and support especially from the father to enable mother and child to be together undisturbed as much as possible particularly during the first 40 days of the baby’s life.

Many women manage to make it through those hardest days in the beginning and then stop breastfeeding after a few weeks out of fear of insufficient milk supply. These mothers need to increase their consumption of calories and to get adequate rest. Under no circumstances should they give their baby a bottle because this will only decrease the supply of breastmilk. Sometimes it is actually the doctor’s advice to start feeding their babies solids before 6 months that leads to premature weaning. A mother needs to weigh the fun of spoon-feeding her infant against the risk of premature rejection of the breast.

Thus bottle-feeding rates remain high despite awareness that breastmilk alone contains all the nutrients, antibodies, hormones and immune factors that a baby needs.

“Encouraging exclusive breastfeeding has to become a high priority in all sectors of society,” said Dr. Mahendra Sheth, UNICEF Regional Health and Nutrition Adviser for the Middle East and North Africa. Exclusive breastfeeding for six months followed by complementary feeding between 6-9 months with continued breastfeeding through the first year could save an estimated 1.5 million lives annually.

Women receiving adequate advice can often prolong nursing even after returning to work outside the home. Premature infants particularly need breast milk for the best odds in life.

Pregnant women should read books on how to breastfeed and understand fully the necessary commitment to avoid making a tragic mistake to be remembered with regret.

Karin Friedemann is a Boston-based writer on Middle East affairs and US politics. She is Director of the Division on Muslim Civil Rights and Liberties for the National Association of Muslim American Women.


Anonymous said...

Maybe you look into the whole UN WHO program that pushed the bottle feeding programs in the first place as a cultural change to be modern. Now WHO wants to reverse the trend. References include:

Hope this little bit of "marketing" helps one to understand the bigger picture$$$$$

Anonymous said...

Regarding your comment "Nursing a baby is an exhausting and time-consuming job" made me wonder if you had breastfed. I found it to be quite the contrary. It was much easier for both my husband and I when I breastfed our three children than to have to deal with bottles, pumping or providing a lower quality "milk". I nursed them until they weaned themselves past two years of age. It wasn't difficult to learn or attempt. It was a very satisfying experience that has returned benefits to all of us - health for me, health for our children. Yes, I "gave up" many material things to spend time with our children. But the ROI has been substantial. Maybe it's an attitude thing - it doesn't help to promote it as exhausting or a difficult job when it isn't. It's a great and rewarding time. You don't need to tell them they need approval from the doctor or hospital. It's already established that it is the appropriate healthy way to feed your infant. Women need good nourishment more than medical expenses. There are "tasks" or businesses a mother can attend to while she is caring for her children that will help the family's bottom line. For example, in Peru I saw women in the shops every day that were nursing. I worked from my home when our children were nursing. I realize there are situations where the culture is demoralized and devastated by war and natural disasters and that all mothers are not the same. Still, breastfeeding is not exhausting and difficult. It is the whole life situation and how the woman deals with it.

Robert Schueler said...

After doing this video for breast cancer awareness and cures..I am pondering THE ISSUE that SEEING breast feeding is good for a person. SEEING the natural mother child relationship owakens primal memories of good health. Instead of sleeping pills, anxiety pills... a good breast feeding lullaby. Life should be simple and easy.

Linda F. Palmer said...

Thank you for your excellent, unbiased summary of the world breastfeeding situation.
linda palmer
author: "Baby Matters," "The Baby Bond"

jenny said...

Nursing a baby is an exhausting and time-consuming job requiring family help, encouragement, and support especially from the father to enable mother and child to be together undisturbed as much as possible particularly during the first 40 days of the baby’s life.

As a nursing mother of a 20-month-old, I feel compelled to comment on this particular part of your excellent article.

Once things are going along nicely for mother and baby, there is no need for 3am trips to the kitchen to mix and warm up a bottle. Sleeping with baby cuts down on night wakings even more.

I recall that it took us close to 24 hours from birth for nursing to begin. Don't let nurses push you around with formula threats! Skin-to-skin contact with baby is also supposed to be a wonderful way to encourage baby toward the breast.

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Anonymous said...

I wonder if breastfeeding rates correlate with average height, because the nordic countries also have the highest average heights in the world.

Anonymous said...

I tried breast feeding my daughter, but I was so exhausted as a new mother I could not function. Mymmother and my husband both told me to feed my baby formula so that my baby would sleep longer and so could I. Believe me I wanted to do every thing right for my baby but vrest feeding I could not do. I take offense to women who say it's so easy why doesn't everyone do it? No, it's not easy. My baby needed me to be able to function and care for her about as much as she needed me to breast feed her. I regret that I did not have the strength to breast feed her. But i that moment in my life I couldn't do it any other way. You need to take in to account in the discussion that some women find it extremly difficult to breast feed. I think that this will ultimately help you to find a better solution to this issue.

Anonymous said...

In the Koran mothers are advised thus 'And the Mothers shall breatfeed their babies for two complete years'. Thank you for your informative article.

Anonymous said...

As long as mothers are in the danger of being even criminalized for breastfeeding, I take you have still a long way to go.

So mothers be careful taking photos breastfeeding your child.

Anonymous said...

Without colostrum(milk from the initial 48-hours after birth) babies are really screwed from the get-go. But hey, where's the money in that?

Anonymous said...

Most Israelis are in favor of public breastfeeding.

I think the attraction of bottle feeding is the ability of the mother to leave the baby for any amount of time. This is part of American culture which praises the woman who works outside the home while devaluing work in the home.

The Native Americans have been excluded from the mainstream and have preserved their own customs as a consequence. You really can use the advice of other women to successfully nurse.

Anonymous said...

Breast feeding is the best option for those who can provide to their baby however requires dedication.

Benefits of healthy breast milk far out weight formula which is a manufactured product with sub quality ingredients etc.

My wife breast feeds up to 14 months per child adding home made baby foods in addition made in our Vitamix blender from 6 months.

Mom lost most of her body fat due to breast feeding since are little one was an aggressive feeder (huge benefit right there ladies!). Baby is growing very well and bigger than most formula fed infants of same age which our doctor says is rare. However feed anyone a sugar product as grains convert to sugars people and you will understand while formula fed kids look bigger (bad fats by the way!). I think better dense nutrition like breast milk beats formula hands down every time. Also don't forget Vitamin D3 every day as well.


Syed Arbab Ahmed said...

In the past mothers used to feel pride in feeding their baby their own milk but now mothers do care more about their figure rather than baby, they think that it will destroy their figure, how absurd.It is also mention in the Holy Quran that mother should feed their own milk for at least two years but these modern mothers, ahhh alas!!!

gudkizzer said...

hi i like your post... it is good.coz everybody know that breastfeed is important it is related to Elizabeth Wilcox
i like it....

Elizabeth Wilcox

BGR said...

Benefits of breastfeeding:

1. Helps the womb contract.
2. Help cleans you out.
3. Helps you lose weight.

The only part of breastfeeding being exhausting is waking up in the night and early hrs to nurse. Other than that, breastfeeding is a rewarding and pleasant feeding, if of course you don't have sore or cracked nipples. Once the milk is flowing nicely, the baby do not have to 'chomp' down.

Sarah said...

Wonderful step to generate awareness on breast feeding and breast health