From August 1 to 7, World Breastfeeding Week is celebrated in more than 170 countries. Europe is an exception, since it is a typical holiday period on the continent, it was decided to move this celebration to the beginning of October, specifically to what would be the 41st week of the year. This date corresponds to the moment in which lactation would begin in a pregnancy started on January 1.
Why spend a week claiming the benefits of breastfeeding? According to the World Health Organization (WHO), less than half of children under 6 months are exclusively breastfed and only 20% of countries require employers to offer paid breaks and facilities for employees. breastfeeding or expressing milk. This body also recalls that "more than five hundred million working women do not benefit from essential maternity protection measures in national legislation" and, therefore, calls for a series of measures to guarantee the right of babies to receive Breastfeeding.
“Breast milk is the most suitable for the baby. We could say that it is the norm, it is the diet proper to our species, the one we need, since without it the species would not have reached this point”, explains Inma Cosmo, pediatric nurse and IBLCL (International Board Certified Lactation Consultant) at Hospital Vall d'Hebron, in Barcelona. Cosmo points out that breast milk "not only contains all the nutrients that the baby needs to develop, but also defenses, which prevents many diseases and that we do not find in formula milk that is marketed."
According to the nurse, "there are numerous studies that link breastfeeding with lower infant mortality, lower morbidity (in the short and long term), less risk of sudden death, better results in intelligence tests and better brain function." Therefore, it is important to guarantee "the right of all women to receive the necessary information and help to establish successful breastfeeding: that they have all the tools at all levels to be able to decide the type of breastfeeding they want" . Once this decision has been made, "the work of health professionals must always be to support and facilitate the decision made, whatever it may be".
In order to have the tools that allow for successful breastfeeding to be available in a real and effective way, the WHO calls for a series of measures. On the one hand, paid maternity leave worldwide of at least 18 weeks (preferably six months or more), in addition to paid breaks for breastfeeding or milk expression after returning to work. Another of the axes of the World Breastfeeding Week campaign, whose motto this year is 'Breastfeed and work: let's make it possible!', is to guarantee that mothers have a strong support environment, in addition to that workplaces provide the necessary support both to express milk and to facilitate breastfeeding.
This body establishes that breastfeeding should be exclusive during the first six months of life. “From six months, the WHO advises starting to introduce complementary feeding and continue breastfeeding for at least two years. Bearing in mind that, at least during the first year, breastfeeding should be the main food, it is the other foods that should accompany breast milk, and not the other way around”, explains Cosmo. The nurse and lactation consultant regrets, however, that today's working hours and rhythms prevent many women from reaching the WHO recommendations. “When there are only sixteen weeks of maternity leave and most mothers have to return to their job, it is difficult to maintain breastfeeding. On many occasions, if women do not have adequate support in their workplaces and with good accompaniment from their environment and professionals, returning to work can mean cessation of breastfeeding", explains Cosmo.
The multiple benefits of breast milk have been well proven by numerous studies. A review of research published in the journal Nutrición Hospitalaria points out some of them: the significant reduction in gastrointestinal and respiratory infections (both by reducing the prevalence and by shortening hospitalization time), decreased morbidity in the case of asthma and allergies, development more favorable neurological and less likely to suffer from obesity and diabetes in the future. The review also points out that breast milk is a dynamic and changing fluid that adapts to the age and needs of the child. “The newborn has an immature immune system and is exposed to a large number of pathogenic microorganisms from the moment of birth. However, breast milk gives him active and passive immunity, until he acquires his own immunological competence”, points out this work.
For his part, Cosmo also points out the benefits of breastfeeding for the mother. “In the short term it helps the uterus to involute and decreases the risk of postpartum hemorrhage. In the long term it reduces the risk of cardiovascular disease, as well as breast cancer, ovarian cancer and diabetes. On the other hand, the benefits for the environment and society are also remarkable, according to Cosmo. “We are talking about a diet that does not generate waste or contaminants and that does not require transportation. It should not be forgotten that powdered milk is cow's milk and that it requires a lot of resources to be processed. For example: more than 4,000 liters of water are needed to produce 1 kilo of formula milk. On the other hand, children get sick less, so that breastfeeding translates into considerable economic savings for public health and less absenteeism from work by parents”, sums up the expert.
According to a study published in the Gaceta Médica Boliviana magazine, “despite the efforts made by the industry to obtain products similar to breast milk, artificial formulas are still far from resembling it. However, this does not imply abandoning the investigations in this regard, on the contrary, it promotes continuing to improve the quality of these formulas”.
In this sense, the prestigious scientific journal The Lancet published a series of devastating articles against formula milk earlier this year. They denounce the advertising strategies used by companies that manufacture infant formula, which they describe as "abusive." The authors call for "urgent measures to combat their political interference and the misleading information they disseminate." As concluded in these articles, companies try to exert influence so that vital measures to support breastfeeding are not applied, thus seriously affecting the health and rights of women and children. The WHO agrees, denouncing that "incorrect marketing of breastmilk substitutes continues to undermine efforts to improve breastfeeding rates and duration throughout the world."
Another study, in this case conducted by scientists from Imperial College London and published in the British Medical Journal, notes that "most claims about the health and nutritional properties of breast-milk substitutes appear to be based on little or no evidence ”. Cosmo recalls, for his part, that formula milk is treated cow's milk, which does not contain hormones, immunoglobulins, growth factors or antibodies, so it does not provide the help in the form of defenses necessary to protect the system immunity while it develops, no matter how hard they try to imitate it.
With these data in hand, it is clear that the optimal way to feed a baby in its early years of development is breast milk. However, less than half receive this type of food. According to data from the Spanish Society of Extrahospital Pediatrics and Primary Care (SEPEAP), globally between 56% and 98% of newborns started breastfeeding. At six months 25% received exclusive breastfeeding (between 13% and 39% depending on the country) and non-exclusive from 38% to 71%. The highest rates at 6 months were in Norway (71%), Sweden (61%) and Germany (57%).
These figures are due, according to Cosmo, to the fact that "when establishing lactation it is common to encounter difficulties that can be overcome with professional help. For this, there must be proper training on the part of health personnel: it is not enough to say that it is best to breastfeed. If women find the necessary support both from the professionals who care for them and from their environment and receive information from reliable sources, avoiding all the myths that exist around breastfeeding, there are more chances that it will take place successfully”. Cosmo denounces, in this sense, “that in-depth training on breastfeeding should be given already in the grades, since what is available is insufficient. It cannot be that the functioning of the mammary gland, and therefore lactation, are not studied in as much depth as other organs or glands in the body."
Some of the most widespread myths about breastfeeding is that you should breastfeed every three hours, just ten minutes on each breast. "This only causes milk production to decrease and breastfeeding ends up failing," says Cosmo, who recalls that "natural feeding is on demand both day and night, and the time and duration of feedings are determined by the baby ". Another of the most common is the belief that some women have little milk to feed their baby. “Although it is true that there are, there are few causes of hypogalactia or low production of breast milk. Most cases of low milk production are due to insufficient drainage, which can be corrected. Simply put: the more milk comes out, the more milk is produced and if the baby does not drain well, the production drops. It is something that can be traced with the appropriate accompaniment ”, concludes the lactation consultant.
Thus, for Cosmo, it is essential "that mothers have all the information and they are the ones who decide." The work of health professionals should always be to “support this decision and accompany the type of breastfeeding that the mother wishes. They should be given information in a neutral way, they should decide what they want to do and from there support them. If the option is feeding with formula milk, our job must be to respect the decision and also help make this breastfeeding satisfactory and rewarding ”, he concludes.
