From the Journals

How infants and young children are nourished will have a profound impact on their health and development over their lifetime. It is now more clearly recognized that when infants and young children are not breastfed or receive insufficient breastmilk, there can be consequences that are long term and affect an individual’s health over a lifetime. Breastfeeding protects against the double burden of malnutrition and under-fives mortality in poor countries and the consequences of inappropriate nutrition of obesity, diabetes and chronic diseases in industrialized countries. Here’s a brief literature review:

Gillman M W et al. Breastfeeding and overweight in adolescence. Epidemiology 17: 112-114, 2006

To eliminate the social impact factor on breastfeeding and obesity, this  US based study of 5,614 children looked at siblings between the ages of 9 and14 to compare duration of breastfeeding and weight outcomes within families. The findings showed that siblings breastfed for a longer period of time were less likely to become overweight. This confirms previous findings that longer breastfeeding lowers the risk of obesity in later life; hence the association appears not to be related to social and cultural factors. Overall, longer breastfeeding for each increment of 3.7 months showed a 6 per cent reduction in the risk of becoming overweight by adolescence.

Weyerman M et al. Duration of breastfeeding and risk of overweight in childhood: a prospective birth cohort study from Germany. Int J Obes advance online publication February 28, 2006.

Active follow-up was used to determine the relationship between breastfeeding and reduction of overweight and obesity. For 12 months all mother and baby pairs were recruited after delivery at the University of Ulm Dept of Obs and Gyn. Of the 1066 recruited, 855 were available for a two year follow-up. Of these 8.4 per cent were overweight and 2.8 per cent severely overweight and 8.9 per cent were never breastfed, while 62.3 per cent were breastfed for at least six months.

Children who were exclusively breastfed more than three months and less than six months had a 20 per cent reduction risk and those who had breastfed exclusively for at least six months had a 60 per cent risk reduction for becoming overweight.

Sadauskaite-Kuehne V et al. Longer breastfeeding is an independent protective factor against development of type 1 diabetes mellitus in childhood. Diabet Metab Res Rev 20: 150-157, 2004

This Lithuanian study set out to determine the early nutritional influences on the development of type 1 diabetes later in life. To confirm previous research that early introduction of complementary foods, early  introduction of infant formulas and cow’s milks increases the risk of type 1 diabetes, the authors compared a Swedish and a Lithuanian cohort between the ages of one to 15 years with newly diagnosed type 1 diabetes. Questionnaires were administered to determine infant feeding histories. The Swedish cohort confirmed that the longer exclusive breastfeeding, the greater protection against the development of type 1 diabetes (exclusive breastfeeding longer than five  months OR of 0.54) and the longer the breastfeeding the greater the protection. For Lithuanian children, exclusive breastfeeding for longer than two months was found to be protective (OR of 0.58).

Malcove H et al. Absence of breast-feeding is associated with the risk of type 1 diabetes: a case-control study in a population with rapidly increasing incidence. Eur J Pediatr 165: 114-119, 2005

Data was collected via questionnaires in this case-controlled study consisting of 868 diabetic Czech children and 1,466 controls. This study too confirms that the risk for type 1 diabetes decreases with increased duration of breastfeeding. No breastfeeding was associated with an increased risk – OR of 1.93, while breastfeeding for 12 months or longer reduced the risk significantly – OR of 0.42

Martin RM et al. Breast-feeding and childhood cancer: A systematic review with meta-analysis. Int J Cancer 117:  1020-1031, 2005

The authors estimate that by increasing breastfeeding from 50 to 100 per cent would prevent at least 5 per cent of cases of childhood acute leukemia or lymphoma.

Guise JM et al. Review of case-controlled studies related to  breastfeeding and reduced risk of childhood leukemia. Pediatrics 116: 724-731, 2005

This systematic review to look at the evidence for the effect of breastfeeding on the risk of developing childhood leukemia, looked at 111 studies from which they identified 32 eligible articles. Of these they reviewed 10 and found that only four had quality evidence  regarding the association between breastfeeding and leukemia. In the two largest and highest-quality studies breastfeeding was associated with a significant risk reduction and  in one of these studies, the duration reflected greater protection. They note that in  the US approximately 1.4 billion dollars are spent annually to treat childhood leukemia.

And in poor countries

More than 10 million children die every year in low and middle-income countries before they reach the age of five. It is estimated that 2/3 of these deaths are  related to inadequate nutrition and are preventable. Each of these numbers represents an infant or a child, with a mother and father full of hope and expectation, yet ending in tragedy. This is a global crisis of obscene proportions in a world where trillions of dollars are spent on war and destruction, while the causes of poverty and disparity are not addressed.

The 5-part Lancet Child Survival Series: The Lancet 361: 2003 documents  he need to make child health an international health priority and to fight for the resources needed to give all children the right to food, health and life itself.

In the context of extreme poverty for so many, the promotion and support of breastfeeding not only prevents illness, but also is vital to the protection of life itself.