Increased breastfeeding could save lives — if governments step up their game
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One of the most powerful lifesavers for babies doesn’t come from a pharmaceutical company. Instead, it comes from a mother’s breasts.

That’s the takeaway from two papers published Thursday in the Lancet, in which researchers from around the world teamed up to analyze the scientific literature about breastfeeding.

They found that increased breastfeeding worldwide could save over 800,000 children’s lives each year. And it could prevent 20,000 mothers from dying of breast and ovarian cancers, too.

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“Breastfeeding is an exquisite personalized medicine,” said Dr. Cesar Victora, an epidemiologist at the Federal University of Pelotas, in Brazil, and a lead author of the papers. “There is a biological dialogue between mother and child. The breast milk may change according to the child’s need.”

Victora’s comprehensive reviews come just days after the American Congress of Obstetricians and Gynecologists (ACOG) released a new set of guidelines urging physicians to support new mothers whether or not they choose to breastfeed.

These are just the most recent contributions to a long-standing debate as to whether breastfeeding is promoted too aggressively.

The World Health Organization recommends that babies be fed nothing but breast milk for the first six months of life, and those guidelines have been taken up by many other organizations, including ACOG.

But the US advisory group now wants to make sure that doctors are also taking patients’ choices into account.

To Courtney Jung, a political scientist at the University of Toronto, that change is huge. She had been researching questions of race and indigenous identity, but she took a detour into the politics of breastfeeding when she became pregnant herself and realized what a hot-button issue it was. Last month, she published a book called “Lactivism.”

“Right now, most of the initiatives that are advanced to promote breastfeeding are about putting more pressure on mothers to breastfeed,” she told STAT. “They’re not about supporting women’s own choices, and making it easier for them to choose to breastfeed.”

Victora and his team are explicit: They don’t want to lay the blame on mothers for not respecting guidelines to the T. 

“We want to change the perspective from pointing the finger at women who don’t breast feed to pointing the finger at governments,” said Victora. And he singled out the American government as one of the worst.

The United States is the only highly developed country that doesn’t give paid maternity leave, making it hard for American mothers to breastfeed their kids, Victora noted. He called on the US government and others to introduce more family-friendly leave policies, and to put limits on the advertising of formula.

Those measures could go a long way to promoting breastfeeding, which is thought to save lives for a wide range of reasons. Breastfeeding can release hormones that decrease the mother’s risk of breast cancer, and at the same time allows her to pass on her defenses against microbes to her offspring. She also doesn’t have to worry about whether the water she is using to dilute formula is clean, which is of particular concern in the developing world.

The papers also chronicle other benefits to breastfeeding, which include everything from slightly higher IQ levels to a richer gut microbiome.

“The cognitive side of it is tremendously important,” said Susan Horton, an economist at the University of Waterloo, in Canada, and one of the authors of the papers.

But the mechanisms that explain why breastfeeding can be so protective are still poorly understood. As Victora put it, “We’re still scratching the surface regarding the components that are present in breast milk.”

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