Skip to main content
Log in

Breast feeding: A time to craft new policies

  • Original Article
  • Published:
Journal of Public Health Policy Aims and scope Submit manuscript

Abstract

New studies of breastfeeding have discovered or confirmed the benefits to mother and child. They reinforce an emphasis on exclusive breastfeeding – no other food or fluids – during the first 6 months. Studies include findings from across the world, in well-resourced and poorly resourced settings. They also emphasize longer duration of breastfeeding, into the second year of life, and gradual rather than abrupt weaning. For HIV-infected mothers, the dangers of non-exclusive feeding in the first half year of life have been well documented in recent publications. Other studies open up the possibilities for antiretroviral treatment to accompany breastfeeding, whether given to the mother, or child, or both. To be effective, implementation of any recommendations must consider individual, family, and community resources.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Coovadia, H.M. and Bland, R.M. (2007) Preserving breastfeeding practice through the HIV pandemic. Tropical Medicine & International Health 12 (September): 1116–1133.

    Article  Google Scholar 

  • WHO Multicentre Growth Reference Study Group. (2006) Breastfeeding in the WHO multicentre growth reference study. Acta Paediatrica Supplement 450: 16–26.

  • Quigley, M.A., Kelly, Y.J. and Sacker, A. (2007) Breastfeeding and hospitalization for diarrheal and respiratory infection in the United Kingdom millennium cohort study. Pediatrics 119: e837–e842.

    Article  Google Scholar 

  • WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. (2000) Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: A pooled analysis. Lancet 355 (February): 451–455.

  • Bahl, R. et al (2005) Infant feeding patterns and risks of death and hospitalization in the first half of infancy: Multicentre cohort study. Bull WHO 83: 418–426.

    Google Scholar 

  • Mortensen, E.L., Michaelsen, K.F., Sanders, S.A. and Reinisch, J.M. (2007) The association between duration of breastfeeding and adult intelligence. Journal of the American Medical Association 18: 2365–2371.

    Google Scholar 

  • Kramer, M.S. et al (2008) Breastfeeding and child cognitive development: New evidence from a large randomized trial. Archives of General Psychiatry 65: 578–584.

    Article  Google Scholar 

  • Caspi, A. et al (2007) Moderation of breastfeeding effects on the IQ by genetic variation in fatty acid metabolism. Proceedings of the National Academy of Sciences 104: 18860–18865.

    Article  Google Scholar 

  • Hummel, S., Pfluger, M., Kreichauf, S., Hummel, M. and Ziegler, A.G. (2009) Predictors of overweight during childhood in offspring of parents with type 1 diabetes. Diabetes Care 19 February 2009, doi: 10.2337/dc 08–1943.

  • Koletzko, B. et al (2009) Can infant feeding choices modulate later obesity risk? American Journal of Clinical Nutrition 25 March 2009, doi: 10.3945/ajcn.2009.271130.

  • Owen, C.G. (2005) The effect of breastfeeding on mean body mass index throughout life: A quantitative review of published and unpublished observational evidence. American Journal of Clinical Nutrition 82 (December): 1298–1307.

    Google Scholar 

  • Owen, C.G. et al (2008) Does initial breastfeeding lead to lower blood cholesterol in adult life? A quantitative review of the evidence. American Journal of Clinical Nutrition 88 (August): 305–314.

    Google Scholar 

  • Ravelli, G.P., Stein, Z.A. and Susser, M.W. (1976) Obesity in young men after famine exposure in utero and early infancy. New England Journal of Medicine 295 (August): 349–353.

    Article  Google Scholar 

  • Short, R.V., Lewis, P.R., Renfree, M.B. and Shaw, G. (1991) Contraceptive effects of extended lactational amenorrhoea: Beyond the bellagio consensus. Lancet 337 (March): 715–717.

    Article  Google Scholar 

  • Lawrence, R. and Lawrence, R. (1999) Breastfeeding: A Guide for the Medical Professional. St Louis, MO: Mosby.

    Google Scholar 

  • Collaborative Group on Hormonal Factors in Breast Cancer. (2002) Breast cancer and breastfeeding: Collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet 360 (July): 187–195.

  • Rebuffe-Scrive, M. et al (1985) Fat cell metabolism in different regions in women: Effect of menstrual cycle, pregnancy and lactation. Journal of Clinical Investigation 75: 1973–1976.

    Article  Google Scholar 

  • Lawrence, R.A. (2007) The eradication of poverty one child at a time through breastfeeding: A contribution to the global theme issue on poverty and human development. Breastfeeding Medicine 2 (October): 1–2.

    Article  Google Scholar 

  • Shantakumar, S. et al (2007) Reproductive factors and breast cancer risk among older women. Breast Cancer Research and Treatment 102: 365–374.

    Article  Google Scholar 

  • Gwinn, M.L., Lee, N.C., Rhodes, P.H., Layde, P.M. and Rubin, G.L. (1990) Pregnancy, breast feeding, and oral contraceptives and the risk of epithelial ovarian cancer. Journal of Clinical Epidemiology 43 (6): 559–568.

    Article  Google Scholar 

  • Kramer, M.S. et al (2001) Promotion of breastfeeding intervention trial (PROBIT) A randomized trial in the republic of Belarus. Journal of the American Medical Association 285: 413–420.

    Article  Google Scholar 

  • Jones, G., Steketee, R.W., Black, R.E., Bhutta, Z.A. and Morris, S.S. (2003) The Bellagio child survival study. How many child deaths can we prevent this year? Lancet 362: 65–71.

    Article  Google Scholar 

  • Victora, C.G. et al (1987) Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil. Lancet 2: 319–322.

    Article  Google Scholar 

  • Popkin, B.M. (1990) Breast feeding and diarrheal morbidity. Pediatrics 86: 874–879.

    Google Scholar 

  • Arifeen, S. (2001) Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics 108 (October): E67.

    Article  Google Scholar 

  • Creek, T. et al. (2007) Role of infant feeding and HIV in a severe outbreak of diarrhea and malnutrition among young children, Botswana, 2006. 14th Conference on Retroviruses and Opportunistic Infections; 25–28 February, Los Angeles, CA.

  • Coutsoudis, A. (2001) Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: prospective cohort study from Durban, South Africa. AIDS 15: 379–387.

    Article  Google Scholar 

  • Coovadia, H.M. et al (2007) Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study. Lancet 369: 1107–1116.

    Article  Google Scholar 

  • Iliff, P. et al (2005) Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS 19: 699–708.

    Article  Google Scholar 

  • Kuhn, L. et al (2007) High uptake of exclusive breastfeeding and reduced early post-natal HIV transmission. PLoS ONE 2 (12): e1363.

    Article  Google Scholar 

  • Thior, I. et al (2006) Breastfeeding plus infant zidovudine prophylaxis for 6 months vs. formula feeding plus infant zidovudine for 1 month to reduce mother-to-child HIV transmission in Botswana: A randomized trial: the Mashi study. Journal of the American Medical Association 296 (Aug): 794–805.

    Article  Google Scholar 

  • Kuhn, L. et al (2008) Effects of early, abrupt cessation of breastfeeding on HIV-free survival of children in Zambia. New England Journal of Medicine 359: 130–141.

    Article  Google Scholar 

  • Smith, M.M. and Kuhn, L. (2000) Exclusive breast-feeding: Does it have the potential to reduce breast-feeding transmission of HIV-1? Nutrition Reviews 58: 333–340.

    Article  Google Scholar 

  • Coutsoudis, A., Goga, A.E., Rollins, N. and Coovadia, H.M. (2002) Free formula milk for infants of HIV-infected women: Blessing or curse? Health Policy and Planning 17: 154–160.

    Article  Google Scholar 

  • Piwoz, E.G. and Ross, J.S. (2005) Use of population-specific infant mortality rates to inform policy decisions regarding HIV and infant feeding. Journal of Nutrition 135 (May): 1113–1119.

    Google Scholar 

  • Kuhn, L., Stein, Z. and Susser, M. (2004) Preventing mother-to-child HIV transmission in the new millennium: The challenge of breast feeding. Paediatr Perinat Epidemiol 18: 10–16.

    Article  Google Scholar 

  • Chung, M., Raman, G., Trikalinos, T., Lau, J. and Ip, S. (2008) Interventions in primary care to promote breastfeeding: An evidence review for the U.S. Preventive Services Task Force. Annals of Internal Medicine 149: 565–582.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zena Stein.

Additional information

The authors review recent studies and reinforce an emphasis on exclusive breastfeeding–no other food or fluids–during the first 6 months.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stein, Z., Kuhn, L. Breast feeding: A time to craft new policies. J Public Health Pol 30, 300–310 (2009). https://doi.org/10.1057/jphp.2009.23

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/jphp.2009.23

Keywords

Navigation