Modern Medicine

There may be politics but there is no debate: Breastfeeding is the best health option

Key Points
  • The Trump administration is in a political battle over breastfeeding guidance from the World Health Organization.
  • The medical science is clear, and many studies and organizations support it: Breastfeeding offers health benefits to infants that last throughout childhood.
  • Formula is a viable alternative that provides all the critical nutrients, but it cannot match some of the health properties found in mother's milk.

President Donald Trump and his administration can make politics out of the World Health Organization's breastfeeding guidance, but when it comes to medical science, they won't win a debate. There is an abundance of medical research showing the benefits breast milk plays in infancy that carry over in later life. Research consistently supports that breast milk is the safest and most nutritious feeding method for babies — and the most inexpensive.

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It is clear from recent government data that women have sided with science. The 2016 breastfeeding report from the Centers for Disease Control and Prevention revealed that breastfeeding rates are increasing. Four out of five infants start feeding on breast milk after birth, according to the report, and more than half are still breastfeeding at six months.

A number of health organizations, including WHO, the American Academy of Pediatrics and the American Medical Association, endorse breastfeeding as the best choice for babies.

But the WHO found itself in a surprising political battle with the U.S. government over its planned nursing guidance, according to a New York Times report from this past weekend. The Times reported that the Trump administration threatened trade retaliation and military withdrawal against WHO member countries, including Ecuador, for its support of breastfeeding guidance. The New York Times noted that baby formula manufacturers were at the WHO meeting in Geneva where the tensions erupted, but health advocates told the Times there were no indications of a direct effort by formula makers to influence policy.

Benefits of breastfeeding for mother and child

Often called the “perfect food” for a baby’s digestive system, breast milk contains nutrients such as lactose, protein and fat that are easily digested by a newborn, according to Nemours, a U.S. pediatric health system. This leads to babies having fewer bouts of diarrhea or constipation.

The Mayo Clinic states that breast milk is “the gold standard,” citing its balance of nutrients and ability to boost the baby’s immune system. It naturally contains antibodies that aren’t found in formula, which helps prevent ear infections, asthma, respiratory infections and other illnesses, the American Academy of Pediatrics states. It also contains leptin and ghrelin, hormones that control appetite in a child, according to a research paper published in the U.S. National Library of Medicine.

The main antibody found in breast milk, called IgA, boosts immunity by blocking pathogens from attaching to the gastrointestinal tract. The rate of sudden infant death syndrome is also reduced by more than a third in breastfed babies, according to the AAP.

Infants who exclusively consume breast milk for the first six months are also less prone to obesity, according to WHO. In a study solely focused on the relationship between obesity and breastfeeding, the AAP found that high-risk infants who were breastfed for less than two months were more likely to be on an overweight track as opposed to a stable-weight track. There is a 15 percent to 30 percent reduction in adolescent and adult obesity in breastfed versus non-breastfed infants, according to the AAP.

Commercial formulas can't completely match breast milk's exact composition. Why? Because milk is a living substance made by each mother for her individual infant, a process that can't be duplicated in a factory.
pediatric health system

A study published in the leading British medical journal The Lancet, conducted by multiple researchers, including those from the Bill and Melinda Gates Foundation and the Royal Children’s Hospital in England, reported that children who were breastfed had higher intelligence test results. For mothers, breastfeeding may help reduce the risk of breast and ovarian cancers, along with diabetes, the Lancet study found.

Nursing can also help mothers by burning calories and shrinking the uterus, allowing nursing moms to return to their pre-pregnancy shape and weight faster, Nemours found. It also reduces the risk of breast cancer, high blood pressure, diabetes and cardiovascular disease in moms. Based on research presented by the American College of Cardiology in February, it was found that women with normal blood pressure during pregnancy and who breastfed their babies for at least six months following birth had better markers of cardiovascular health years later compared to women who never breastfed. That's because they had higher levels of the "good" HDL cholesterol, along with lower triglycerides and healthier carotid artery thickness.

Nemours also found an added personal finance benefit: Breastfed babies have fewer overall infections and hospitalizations than formula-fed infants, allowing parents to save on money from prescriptions and over-the-counter medicines.

One study published in The Lancet in 2016 estimated that universal breastfeeding would prevent 800,00 child deaths a year globally, and save $300 billion between health-care costs and improved economic outlook for nursed children.

Of course, many women cannot nurse for various medical reasons and formula remains a completely viable alternative — and a huge business for health and nutrition companies, especially in the high population growth developing economies.

Nestle leads the infant nutrition market, but competition with rivals Abbott — which owns the Similac brand, Danone and Reckitt Benckiser — which bought Enfamil infant formula maker Mead Johnson, has intensified in recent years. While sales of infant formula in the U.S. and Europe have declined in recent years, infant nutrition is still considered a growth market globally and the major players are making aggressive moves to increase market share. Nestle reorganized its business in 2017. The market in Asia has been booming, particularly in China. Sales of infant nutrition climbed almost 10 percent last year at Danone, which boosted its earnings. The company said growth came from China and the rest of Asia.

Abbott declined to comment for the Times report, while Nestle tried to distance itself from the political furor and said it continues to support international code on marketing of breast milk substitutes.

President Trump denied the Times account in a tweet on Monday, writing that "The U.S. strongly supports breastfeeding but we don’t believe women should be denied access to formula. Many women need this option because of malnutrition and poverty."

“The U.S. Food and Drug Administration (FDA) regulates formula companies to ensure they provide all the necessary nutrients (including vitamin D) in their formulas,” Nemours states on a website devoted to children's health. “Still, commercial formulas can't completely match breast milk's exact composition. Why? Because milk is a living substance made by each mother for her individual infant, a process that can't be duplicated in a factory.”