Download Breastfeeding – Health Benefits for Mother and Child Promoting

FACTS
Breastfeeding – Health Benefits for Mother and Child
Promoting Sound Lactation Policies in the U.S.
OVERVIEW
BREASTFEEDING AND HEALTH
A wealth of evidence demonstrates that breastfeeding
provides numerous short- and long-term benefits for
both mother and child. These include a solid
foundation for lifetime cardiovascular health, greater
resistance to childhood infectious diseases, enhanced
immunity, reduced risk for other chronic diseases, such
as diabetes, improved cognitive functions, and better
1,2,3,4
maternal physical and mental health.
Furthermore,
breastfeeding is economically beneficial for families,
3
employers and our healthcare system as a whole.
Given its importance, both the American Academy of
Pediatrics and the World Health Organization
recommend breastfeeding until six months of age.
Unfortunately, as of 2005, only slightly more than one
of ten new mothers in the U.S. were meeting this
5,6
goal. The American Heart Association (AHA)
advocates exclusive breastfeeding for the first six
months of a child’s life and supports policies and
patient education initiatives that encourage women to
make the informed choice to breastfeed.
A healthy diet for infants and children is critical for
lifetime cardiovascular health and breastfeeding is a
7
cornerstone of that healthy foundation. Breastfeeding
also lowers the incidence of many infant and childhood
diseases, including ear and respiratory infections,
gastroenteritis, type 2 diabetes, and sudden infant death
8
syndrome. Breastfeeding may also reduce the risk of
9,10
obesity later in life. In addition, breastfeeding may
hold the promise of helping decrease hypertension and
high cholesterol as children mature. However, further
robust research is needed to evaluate these
associations, especially in at-risk populations across
11
different ethnic, cultural, and socioeconomic groups.
The potential health benefits of breastfeeding are not
limited to infants and children. Breastfeeding can help
mothers reduce their risk of cardiovascular disease,
breast and ovarian cancer, type 2 diabetes and
12
postpartum depression. Breastfeeding is a win-win for
mothers and children.
Percent of Children Ever Breastfed Among Children Born
In 2004 (by State)
CHALLENGES
Despite the benefits of breastfeeding, only four states
(Alaska, Montana, Oregon, and Washington) have met
8
all five Healthy People 2010 targets for breastfeeding.
Source: National Immunization Survey, Centers for Disease Control and
Prevention, Department of Health and Human Services
One significant issue is maternity practices in hospitals
and birth centers which have the potential to significantly
influence a mother’s choice to breastfeed during a period
that is critical to successful lactation. Best practices
include: ensuring mother-newborn skin-to-skin contact,
keeping mother and newborn together, and not giving
supplemental feedings to breastfed newborns unless
8
medically indicated. Unfortunately, a substantial
proportion of facilities use maternity practices that are
not evidence-based and are known to interfere with
breastfeeding. States in the southern U.S. have the
lowest scores on best practices for promoting lactation.
Clearly, U.S. hospitals and birth centers need to
implement changes in maternity practices that support
breastfeeding.
There are special challenges for certain parts of the
population. For example, rates of exclusive
American Heart Association Advocacy Department 1150 Connecticut Ave. NW Suite 300 Washington, DC 20036
Phone: (202) 785-7900 Fax: (202) 785-7950 www.heart.org/advocacy
FACT SHEET:
Breastfeeding: Promoting Sound Lactation Policies
breastfeeding are significantly lower for black infants
and for infants born to unmarried mothers. By contrast,
factors such as older age, urban residence, higher
education, and higher income of mothers all contribute
8
to exclusive breastfeeding. Additional funding is
needed to identify and conduct successful
breastfeeding programs and policies that support
breastfeeding, especially for at-risk groups where
current rates are low.
THE WORKPLACE
Whether or not a mother is employed and how many
hours she works during the postpartum period is
another significant factor that determines whether or
not a woman chooses to breastfeed and for how
17
long. Lack of time, lack of private space for lactation
and additional stress have all been identified as
18
barriers. It is critical that employers institute worksite
lactation policies that make it easy for women to
continue breastfeeding when they return to work.
Under the Affordable Care Act, employers are required
to provide a reasonable break time for employees to
express breast milk and provide a suitable, safe,
secure space for lactation. The Department of Labor
has developed comprehensive resources to support
implementation of this law.
(http://www.dol.gov/whd/regs/compliance/whdfs73.htm)
Hopefully, as employers implement the requirements,
breastfeeding rates will increase.
Breastfeeding can also benefit a business’ bottom line.
Lactation programs are cost-effective, showing a $3
return for every dollar invested and employers can
reduce turnover, lower recruitment and training costs,
cut rates of absenteeism, boost morale and
13
productivity, and reduce health care costs.
THE AHA ADVOCATES FOR
•
•
•
•
•
Additional research on the link between
breastfeeding and improved cardiovascular health.
References:
1
Schack-Nielsen L, Michaelsen KF. Breast feeding and future health.
Curr Opin Clin Nutr Metab Care 2006;9(3):289-96.
2
Goldman AS, Hopkinson JM, Rassin DK. Benefits and risks of
breastfeeding. Adv Pediatr 2007;54:275-304.
3
Benefits of breastfeeding. Nutr Clin Care 2003;6(3):125-31.
4
Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, et al.
Breastfeeding and maternal and infant health outcomes in developed
countries. Evid Rep Technol Assess (Full Rep) 2007(153):1-186.
5
Bartick M, Reinhold A. The burden of suboptimal breastfeeding in
the United States: a pediatric cost analysis. Pediatrics;125(5):e104856.
6
Wolf JH. Low breastfeeding rates and public health in the United
States. Am J Public Health 2003;93(12):2000-10.
7
Singhal, A. The early origins of atherosclerosis. Adv. Exp. Med Bio.
2009; 646:51-58.
8
CDC. Breastfeeding Trends and Updated National Health
Objectives for Exclusive Breastfeeding --- United States, Birth Years
2000—2004. MMWR. August 3, 2007; 56(30);760-763.
9
Grummer-Strawn LM, Mei Z. Does breastfeeding protect against
pediatric overweight? Analysis of longitudinal data from the Centers
for Disease Control and Prevention Pediatric Nutrition Surveillance
System. Pediatrics 2004;113(2):e81-6.
10
Gillman MW, Rifas-Shiman SL, Camargo CA, Jr., Berkey CS,
Frazier AL, Rockett HR, et al. Risk of overweight among adolescents
who were breastfed as infants. JAMA 2001;285(19):2461-7.
11
Leon DA. Ronalds G. Breast-feeding influences on later life-cardiovascular disease. Adv Exp Med Biol. 2009;639:153-66.
12
Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB,
Freiberg MS, Cauley JA. Duration of lactation and risk factors for
maternal cardiovascular disease. Obstet Gynecol. 2009;113(5):972973.
13
United States Breastfeeding Committee. Workplace
accommodations to support and protect breastfeeding. 2010.
Accessible at:
http://www.usbreastfeeding.org/Portals/0/Publications/HC-ReformBackground-2010-05-USBC.pdf
Increased patient education by health
professionals regarding the short- and long-term
benefits of breastfeeding for both mother and child.
Increased support for women who choose to
breastfeed in the workplace. Excellent resources to
promote lactation policy in the workplace may be
found at
http://www.usbreastfeeding.org/Portals/0/Publicatio
ns/HC-Reform-Background-2010-05-USBC.pdf).
Adequate funding for ongoing systematic data
collection and continued assessment of nationwide
breastfeeding-related maternity care practices,
breastfeeding duration and prevalence, and
barriers to lactation.
U.S. hospitals and birth centers adopting best
maternity practices to support and promote
breastfeeding.
AHA/HPFS 1/2012