Tuesday, March 30, 2010

Public Health and Breastfeeding

Breastfeeding is a Public Health Issue.

 

Less than one-third of infants are exclusively breastfeeding at 3 months of age, and almost 80% of infants in the United States stop breastfeeding before the recommended minimum of one year.

"Breastfeeding is the optimal form of infant nutrition. As public health leaders, it is our responsibility to protect, promote, and support breastfeeding mothers and babies. I urge you to consider ways you can be active in promoting and supporting breastfeeding in your environment, including your workplace and your community. These efforts will support a public health movement that not only provides optimal nutrition to infants, but also lessens the occurrence of infectious and chronic diseases, thereby improving the health of our nation."                  - United States Surgeon General

 

Societal Benefits of Breastfeeding

  • Total medical care costs for the nation are lower for fully breastfed infants than never-breastfed infants. This is because breastfed infants typically need fewer sick care visits, prescriptions, and hospitalizations.
  • Employers benefit because breastfeeding mothers do not miss as much work time caring for sick babies. Employer medical costs are also lower and employee productivity is higher.
  • Breastfeeding is better for our environment because there is less waste compared to that produced by formula cans and bottle supplies.


Breastfeeding and Public Health

Shortened or absent breastfeeding has enormous public health implications for all segments of society: children and adults, male and female. Below are some statistics:
  • Women who have never breastfed have 1.2-2.8 times the risk of pre-menopausal breast cancer.1 Breast cancer alone kills about 1,600 Massachusetts residents per year, striking about 4,400 people per year.2 About one-quarter of breast cancer deaths are in pre-menopausal women.3 (HIV, by comparison, killed 327 people in 2001).4
  • Two years of lifetime breastfeeding can dramatically lower the risk of pre-menopausal breast cancer. If a woman has two children, and breastfeeds each for a year (the recommended guideline), her risk of pre-menopausal breast cancer is lowered by 28-61%.1 Breastfeeding can lower the risk of any type of breast cancer by 4.3% for every 12 months of breastfeeding.
  • Women who have never breastfed have 1.25 times the rate of ovarian cancer,1,6 higher rates of endometrial cancer,6,7 as well as osteoporosis and hip fractures.1,8,9 Ovarian cancer kills about 400 people per year in this state.
  • Infants who were not breastfed have 7 times as much necrotizing enterocolitis (which has a 30% mortality rate);10 twice as many cases of otitis media, higher rates of hospitalization, higher rates of lower respiratory tract illness, gastrointestinal illness, meningitis; 15-18 Sudden Infant Death Syndrome (SIDS)14,19-20; and abandonment by their mothers.21 
  • Children who were not breastfed have higher rates of type 1 diabetes mellitus,11,14,22-2411,14,25 dental caries,26 dental malocclusion.27-28  leukemia and lymphoma,
  • Children and adults who were not breastfed as babies have higher rates of Crohn's disease and ulcerative colitis,11,14,29 and celiac disease.30
  • Massachusetts spends about $27 million/year to treat excessive cases of infant diarrhea, respiratory syncitial virus, and otitis media in formula fed infants.31 
  • It is estimated that an average of $331-475 in extra health care costs are incurred per child in the first year of life to treat excessive cases of lower respiratory tract infection, gastrointestinal disease, and otitis media in formula fed infants, compared to infants breastfed for as little as three months.32 
  • Nursing mothers miss less work because their children are healthier.33 
  • Maternal pre-menopausal breast cancer rates1 and rates of childhood otitis media,17,18 leukemia,25 and type 1 diabetes mellitus 22,23 all go down more with increasing duration of breastfeeding. 
  • Although the links between breastfeeding and asthma have been controversial, there remains considerable evidence that children who were not exclusively breastfed have 1.4-2.4 times the odds of having asthma.34-37 The prevalence of asthma is 10-30% among children and adolescents.39-43 Further, many children with asthma go on to have adult asthma as well. 

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