2 physiology and benefits of bf, risk of artificial feeding230113
1. Physiology and Benefits of
Breastfeeding and the Risks
of Artificial feeding
Dr. Varsha Atul Shah
2. Play movie
INDICATORS OF ADEQUATE
BREASTMILK INTAKE
•Breasts full before feeding and softer
afterwards
•Let-Down sensation in mother’s
breast
•Wet nappies/diapers (6x or more/24h)
•Bowel movements (several times/day)
•Contented baby between feeds
•Audible swallowing during feeding
•Average weight gain
• 18-30 g/day
• 125-210 g/week
3. Summary of Differences between Milk
Human milk Animal
milks
Infant
formula
Protein correct amount,
easy
to digest
too much,
difficult to
digest
partly
corrected
Fat enough
essential fatty
acids, lipase to
digest
lacks
essential fatty
acids, no
lipase
no lipase
Water enough extra needed may need
extra
Anti-
infective
properties
present absent absent
Adapted from: Breastfeeding counselling:A training course.Geneva, World Health Organization, 1993 (WHO/ CDR/93.6).
4. What makes Breastmilk different?
HUMAN
Fat
Protein
Lactose
COW
Fat
Protein
Lactose
GOAT
Fat
Protein
Lactose
Too much
protein for
muscle building
5. Differences in the Quality of the Proteins
HUMAN
Presence of
Anti-
infective
proteins
35%
Casein
COW’S
80%
Casein
Whey
proteins
Curds
Easy to digest
Harder to digest
7. Iron
HUMAN
50 - 70 g/100ml
COW’S
50 - 70 g/100ml
absorbed
10
50
%
Better absorption of breastmilk iron by
the baby
8. Breast Milk Composition Differences
(dynamic)
• Gestational age at birth (preterm and full term)
• Stage of lactation (colostrum and mature milk)
• During a feed (foremilk and hindmilk)
9. COLOSTRUM
Property
• Antibody-rich
• Many white cells
• Laxative
• Growth factors
• Vitamin-A rich
Importance
• Protects against infection and
allergy
• Protects against infection
• Clears meconium; helps prevent
jaundice
• Helps intestine mature; prevents
allergy, intolerance
• Reduces severity of some
infection (such as measles and
diarrhoea); prevents vitamin A
10. Breast milk in 2nd year of life
0
0
0
0
0
1
1
1
1
1
1
ENERGY PROTEIN VITAMIN A VITAMIN C
%DAILYNEEDSPROVIDEDBY500MLBREAST
MILK
31 38% 45%
95
%
From: Breastfeeding counselling: A training course. Geneva, World Health Organization ,1993(WHO/CDR/93.6).
11. Why should I breastfeed?
- the natural choice for BABIES
- the natural choice of MOTHERS
- the natural choice for the
ENVIRONMENT
13. • Nursing uses up extra calories,
making it easier to lose pounds of
pregnancy
• Breastfeeding lowers the risk of
breast and ovarian cancers
• Breastfeeding can help you bond
with your baby
• Save more money, easy,
convenient and more portable
• Breastfeeding has contraceptive
effect
15. • Breast milk is the most complete
form of nutrition for infants
• Breastfed babies score higher on
IQ tests
• Ensuring your baby has only
breastmilk for at least 6 months
may help minimize allergy
problems
• Babies breastfeed for comfort
and closeness as well as to
satisfy their hunger and thirst
16. % of Babies Bottledfed and Breastfed for
the 1st 13 weeks that had diarrhoea illness
at various weeks of age during the 1st year,
Scotland
19.5 19.1
22.3 22.4
3.6
7.1
12.9 11.9
0
5
10
15
20
25
0-13 14-26 27-39 40-52
Incidence of diarrhoea illness by age in weeks
%withdiarrhoea
bottle-fed Breast fed
Adapted from: Popkin BM, Adair L, Akin JS ,Black R et al.Breastfeeding and diarrheoa morbidity.Pediatric,
1990,86(6):874-882.
17. • A study in Dundee, Scotland found that
breastfed infants had much less diarrhoea.
• In babies 0 and 13 weeks of age, almost 20%
of bottle-fed infants had diarrhea compared with
only 3.6% of the breastfed infants
- Howie, et al
18. % of Babies Bottlefed and Breastfed for the
1st 13 weeks that had respiratory illness at
various weeks of age during the 1st year,
Scotland
40
54.1
45.547.1
38.9 42.4
36.2
23.1
0
10
20
30
40
50
60
0-13 14-26 27-39 40-52
Incidenceof respiratory illness by age in weeks
%withrespiratoryillness
Bottle-fed Breastfed
Adapted from:Howie PW,Forsyth JS,Ogston SA,Clarke A Florey CV.Protective effect of breastfeeding against
infection.BR Med J,1990,300:11-15.
19. • Another study in Dundee, Scotland found that
breastfed infants had much less respiratory
illness.
• In babies 0 and 13 weeks of age, almost 39% of
the bottle-fed infants had respiratory illness
compared to only 23% of the breastfed infants
Howie et al
20. Breastfeeding Decreases the Prevalence
of Obesity in childhood at age 5 & 6 years
Germany4.5
3.8
2.3
1.7
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
Prevalence
(%)
Months Breastfeeding
0 months
2 months
3-5 months
6-12 months
Adapted from: Von Kries R, Koletzko B, Sauerwald T et al. Breast feeding and obesity: cross sextional study
.BMJ, 1999,319:147-150.
21. Lower risk of obesity.
• A study in Germany found that among 9357
children aged 5 and 6 there was an over 5 times
difference in the prevalence of obesity among
those children never breastfed compared to
those breastfed for over one year
• The length of time an infant was breastfed was
inversely proportional to the prevalence of
childhood obesity
von Kries et al
23. • The production and feeding of breastmilk have a
far lower impact on our environment and the
world resources than ANY alternative feeding
method
• Breastfeeding saves food resources, fuel and
energy
• No packaging is required and NO CHEMICALS
are needed for preparation and disinfection
24. Benefits for the Hospital
• Warmer and calmer emotional environment
• No nurseries, more hospital space
• Fewer neonatal infections
• Less staff time needed
• Improved hospital image and prestige
• Fewer abandoned children
• Safer in emergencies
27. RISK OF ARTIFICIAL FEEDING
Baby
• More likely to fall sick
• Increase risk of obesity
• More diarrhoea and
respiratory infections
• More allergy and milk
intolerance
• Increased risk of chronic
diseases
• Risk of otitis media
• Risk of NEC in preterm
Mother
• Pregnant sooner
• Increased risk of ovarian
and breast cancer
• Interferes with bonding
• Hip fractures in older age
28. Dangers from the Use of Breast-milk
Substitutes
• Powdered Infant formula is not sterile and during
manufacture may be contaminated with bacteria
such as Enterobacteria Sakazakii & Salmonella
enterica.
• WHO has developed guidelines for careful
formula preparation in order to minimize the risk
to infants
Adapted from:16 guidelines for the safe preparation, Storage and Handling of powdered Infant
Formula, Food Safety, WHO(2007)
29. Impact on Society
• Possible increase in use of health care
services, and increase health care costs, both
as infants and later.
31. Scenario
• You are speaking to 22 years, Jessica,
beautician, who has delivered healthy 2.7
kg baby girl 24 hours ago. Jessica intent to
exclusively breastfeed.
Jessica was concerned about her daughter,
since she has not passed BO since birth and
is passing pink colour urine. She had only
changed diaper 2 times since birth.
32. Your role is to:
• Ask open-ended questions to find out her thoughts and
feelings about her anxiety
• Use probes to better understand what she means.
• Affirm her feelings and release her anxiety
• Your role is to communicate about her concerns and
discuss your action plan.
33. TRUE OR FALSE
1. Giving mothers’ information on risks and benefits of various feeding
options will minimize likelihood of breastfeeding mothers influenced
to use formula True/ False
2. Breast-milk substitutes include formula, teas, and juices (and other
products) True / False
3. Giving supplements increase protective benefits of breastfeeding
True/ False
4. Some of the risks from using breast milk substitutes could be
reduced by attention to process of preparation and hygienic
elements but the differences in the constituents of breast milk and
infant formula remain True/ False
5. Prospective study done on infants of atopic parents found that there
is no difference in the prevalence of atopic disease between
breastfed and artificially fed children True/ False
34. 6. Artificially-fed babies are at greater risk of
the developing the following EXCEPT:
a. Gastro-intestinal infections
b. Respiratory infections
c. Necrotising enterocolitis
d. Urinary tract infections
e. Tonsillitis
35. 7. Women who choose artificial feeding are
at a higher risk of the having the following
EXCEPT:
a. Breast cancer
b. Ovarian cancer
c. Hip fractures and bone density
d. Anaemia
e. Infertility
36. 8. Numerous studies have shown that artificial feeding
places a higher financial burden on the family due to the
following EXCEPT:
a. Cost of buying infant formula and other necessary
supplies
b. Increased medical bills due to frequent illnesses in
children
c. Higher cost to feed a lactating mother
d. Loss of income through a parent’s absence from work
to care for an ill child.
37. 9. Breastfeeding benefits for the hospital
include all of the following EXCEPT:
a. Warmer and calmer emotional environment
b. No nurseries, more hospital space
c. Fewer neonatal infections
d. Less staff time needed
e. Improved hospital image and prestige
f. No free sponsorship from pharma, samples
of formula and less earnings for hospital
38. 10. Breastfeeding benefits to family,
EXCEPT:
a. Better health, nutrition, and well-being of
mother and child
b. Costs less than artificial feeding
c. Results in lower medical care costs
d. Mother can do house works, can take
care of sibling and save money
39. Benefits of Colostrum, EXCEPT
a. Antibody-rich and has many white cells
b. Has laxative effects
c. Causes high incidence of jaundice
d. Has growth factors
e. Is vitamin-A rich
40. 12. Which of the following is TRUE for a
Mom who uses milk formula…
a. Does not get pregnant sooner
b. Increased risk of ovarian and breast
cancer
c. Interferes with bonding
d. Has higher hip fractures in older age
e. All of the above
f. None of the above
41. 13. AAP guidelines for breastfeeding
advocates
a. Exclusive breast feeding till 6 month
b. Weaning after 4 months in exclusive
breastfed infants
c. Can feed water and juices after 4 months
d. Use pacifier if breast milk is not enough
and baby is hungry
42. 14. Harmful effects of breastfeeding are:
a. Loss of mum’s figure
b. High risk of post natal depression
c. Low self-esteem in mother
d. Baby gets too attached to mum
e. Causes Iron deficiency anaemia in
mother
f. None of the above
43. 15. According to studies, breastfed babies
are at lower risk of the following conditions
EXCEPT:
a. Respiratory and diarrhoea diseases
b. Allergy disorder
c. Obesity
d. Schizophrenia
44. 16. Formula fed babies are constipated
because
a. Formula is low in thyroxin
b. Cow’s milk iron do not absorb well in
baby therefore more iron have been added
into infant formula which increased the risk
of baby having constipation.
c. Formula increases water absorption in
colon
d. Formula has less fibre
45. 17. Which of the following is not an effect of
breastfeeding?
a. Provides superior nutrition for optimum
growth.
b. Protects against infection and allergies.
c. Promotes bonding and development
d. Incur more cost for the family
46. 18. All are true, EXCEPT:
a. Iron is higher in breast milk
b. Iron is better absorbed in breastfed
infants
c. Iron supplements are needed in all
exclusively breastfed full term infants
d. Iron in formula causes constipation
47. 19. TRUE of NEC, except:
a. Exclusively formula fed infants were 6 to 10
times more likely to develop NEC than those who
received breast milk.
b. Although NEC is rare in babies over 30 week’s
gestation, it was 20 times more common if the
baby had received no breast milk.
c. Infection from mothers milk cause NEC in
preterm infection
d. Breast milk is easy to digest and less osmolar
52. References:
• Breastfeeding counselling: A training course. Geneva, World Health Organization,
1993(WHO/CDR/93.6).
• Breastfeeding and the use of water and teas. Division of Child Health and
Development UPDATE No.9, Geneva, World Health Organization, November 1997.
(http://www.who.int/child-adolescenthealth/New_Publications/
NUTRITION/Water_Teas.pdf).
• Popkin BM, Adair L, Akin JS, Black R, et al. Breastfeeding and diarrheal morbidity.
Pediatrics, 1990,86(6): 874-882.
• Scariati PD, Grummer-Strawn LM, Fein SB. A longitudinal analysis of infant morbidity
and the extent of breastfeeding in the United States. Pediatrics, 1997, 99(6).von Kries
R, Koletzko B, Sauerwald T et al. Breast feeding and obesity: cross sectional study.
BMJ, 1999, 319:147-150.
• Saarinen / Kajosaari M: Breastfeeding as prophylaxis against atopic disease
:Prospective Follow up study until 17 years old:Lancet 346: 1065 – 9 , 1995
53. References:
• Aniansson G,Alm B. Anderson B,Hakansson A, Larsson P.Nylen O,Peterson H,Rigner P.Svanborg M,Sabharnal Het al.A
prospective study on breastfeeding and otitis media in Swedish infants:Pediatr.Infect Dis J,1994 Mar 13(3)183-8
• Lucas A & Cole TJ (1990). Breast milk and neonatal necrotising enterocolitis. Lancet 336: 1519-1522
• Rosenblatt KA, Thomas DB, and the WHO collaborative study of neoplasia and steroid contraceptives. Lactation and the risk
of epithelial ovarian cancer. International J Epidemiol 1993;22:192-7..
• Cumming RG, Klineberg RJ. Breastfeeding and other reproductive factors and the risk of hip fractures in elderly
women.Int J Epidemiol. 1993 Aug;22(4):684-91. Erratum in: Int J Epidemiol 1993 Oct;22(5):962. PMID: 8225744 [PubMed -
indexed for MEDLINE]
• Ravelli ACJ, van der Meulen JH, Osmond C, et al. Infant feeding and adult glucose tolerance, lipid profile, blood pressure,
and obesity. Arch Dis Child 2000;82:248–52.
• Newcomb, P.A. et al. 1994. "Lactation and a reduced risk of premenopausal breast cancer." The New England Journal of
Medicine 330(2):81-87.
• Ball TM, Wright AL. Health care costs of formula-feeding in the first year of life.
• Pediatrics. 1999 Apr;103(4 Pt 2):870-6.PMID: 10103324 [PubMed - indexed for MEDLINE]
54. References:
• Breastfeeding counselling: A training course. Geneva, World Health Organization, 1993(WHO/CDR/93.6).
• Breastfeeding and the use of water and teas. Division of Child Health and Development UPDATE No.9, Geneva,
World Health Organization, November 1997. (http://www.who.int/child-adolescenthealth/New_Publications/
NUTRITION/Water_Teas.pdf).
• Fergusson DM, Beautrais AL, Silva PA. Breastfeeding and cognitive development in the first
seven years of life. Social Science and Medicine, 1982, 16:1705-1708. Howie PW, Forsyth JS,
Ogston SA,Clark A, Florey CV. Protective effect of breastfeeding against infection. BMJ, 1990,
300:11-15.
• Popkin BM, Adair L, Akin JS, Black R, et al. Breastfeeding and diarrheal morbidity. Pediatrics, 1990,86(6): 874-
882.
• Scariati PD, Grummer-Strawn LM, Fein SB. A longitudinal analysis of infant morbidity and the
extent of breastfeeding in the United States. Pediatrics, 1997, 99(6).von Kries R, Koletzko B,
Sauerwald T et al. Breast feeding and obesity: cross sectional study. BMJ, 1999, 319:147-150.
55. Breast cancer and breastfeeding:
Analysis of data from 47 epidemiological studies
in 30 countries (Beral V et al Lancet 2002)
Longer you breastfeed-relative risk of breast
cancer decreases
Adapted from: Beral V et al. (Collaborative group on hormonal factors in breast cancer). Breast cancer and breastfeeding:
collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries. Lancet 2002; 360: 187-95.
56. Risk of Ovarian cancer
• This multinational study showed a 20-25%
decrease in the risk of ovarian cancer among
women who lactated for at least 2 months per
pregnancy, compared to those who had not.
Rosenblatt KA et al. (1993). Lactation and the risk of epithelial ovarian cancer - The WHO Collaborative Study of
Neoplasia and Steroid Contraceptives. Int J Epidemiol 22: 499-503
57.
58.
59. Breastfeeding Savings per year (2012)
• For first 3 months of life baby needs average 2
tins of I kg powdered milk per month
– Each tin costs $44.60
– 24 tins will cost $1070.40
• Savings for each year by
breastfeeding is $1070.40
per year
60.
61.
62. Intelligence Quotient by Type of Feeding
BF 2POINTS
Higher than FF
Study in 3-7
Years old
1982
BF 2.1 points
higher than FF
Study in 6 months
to 2 years old,
1988
BF 12.9 points
higher than FF
Study in 9.5 year-olds
1996
BF 8.3 points
higher than FF –
Study in 7.5-8 year
-olds 1992
BM 7.5 points
higher than no BM
Study in 7.5-8 years-old
1992
References:
•Fergusson DM et al. Soc SciMed 1982
•Morrow-Tlucak M et al. SocSciMed,1988
• Lucas A et al. Lancet 1992
•Riva Eet al. Acta Paediatr 1996
Atleast 35 studies in the world show
BF babies score 3 to 9 IQ points higher than FF babies
63. Duration of breastfeeding associated with
higher IQ scores in young adults, Denmark
Adapted from: Mortensen EL, Michaelsen KF, Sanders SA, Reinisch JM. The association between
duration of breastfeeding and adult intelligence. JAMA, 2002, 287: 2365-2371.
99.4
101.7
102.3
106
104
96
97
98
99
100
101
102
103
104
105
106
Duration of breastfeeding in
months
<1 month
2-3 months
4-6 months
7-9 months
>9 months
LONGER U FEED = MORE BENEFIT
64. Breastfeeding Decreases the Risk of Allergic
disorders - A Prospective Birth Cohort
Study
Type of
feeding
Asthma Atopic
dermatitis
Allergic
rhinitis
Children
exclusively
breastfed 4
months or more
7.7% 24% 6.5%
Children
breastfed for a
shorter period
12% 27% 9%
Adapted from Kull I. et al. Breastfeeding and allergic diseases in infants - a prospective birth
cohort study. Archives of Disease in Childhood 2002: 87:478-481.
65. Lower risk of allergies.
• It is generally agreed that allergies are less
common in completely breastfed babies. A recent
study in Sweden in which a birth cohort of 4089
infants was followed prospectively found that
exclusive and partial breastfeeding reduced the
risk of allergic disorders
• Children exclusively breastfed during four months
or more exhibited less asthma (7.7% vs. 12%),
less atopic dermatitis (24% vs. 27%) and less
allergic rhinitis (6.5% vs. 9%)
Kull et al.
66. Risk of Allergy and Milk intolerance
• Artificial milk has different proteins from human
milk – slow and difficult to digest
• Some babies develop intolerance to proteins in
formula and develop rashes, diarrhea and other
symptoms
67. Artificial Feeding and Risk of Allergy
• Prospective study on Finnish infants of atopic
parents for 17 years found that the prevalence of
atopy was highest in the group of children not
breastfed at all or were breastfed less than a
month
Saarinen UM,Kajosaeri M(1995)
Breastfeeding as a prophylaxis against atopic disease: propsective follow up study until 17
years of age, Lancet 346:1065-1069
68. Increased Risk of Chronic Diseases
• Study done in Amsterdam on 625 adults aged 48-53
years
• Those who are bottle fed at hospital discharge had
greater risk factors for cardiovascular disease than
those who were exclusively breastfed
Adapted from Ravelli AC et al(2000)infant feeding and adult glucose tolerance, lipid profile,
blood pressure and obesity. Arch Dis Child 82:248-52
69. Risk of Otitis Media
• A study in Sweden found that breastfed infants
had less otitis media than artificially fed infants
• At one to three months of age, 6 % of the weaned
infants had otitis media, compared to only 1% of
the breastfed infants
Anaiansson et al
70. Necrotizing Enteritis in preterm infants
• 926 preterm infants were studied, 51 of whom
developed NEC.
• Exclusively formula fed infants were 6 to 10
times more likely to develop NEC than those
who received breast milk.
• Although NEC is rare in babies over 30 weeks
gestation, it was 20 times more common if the
baby had received no breast milk.
Adapted from Lucas A & Cole TJ (1990). Breast milk and neonatal necrotising
enterocolitis,Lancet 336:1519-1522
71. Risk of Breast cancer
• This multi-centre trial in the USA included more
than 14000 pre- and post-menopausal women. It
concluded that breast cancer risk was 22%
lower among pre-menopausal women who have
breastfed than among those who have never
breastfed.
Newcomb PA et al. (1994). Lactation and a reduced risk of premenopausal breast
cancer. New Engl J Med 330: 81-87
72. Risk of hip fractures in elderly women
• In one study of 311 cases of hip fractures in
women over 65 years of age, it was found that
parous women who had not breastfed had twice
the risk of hip fractures as nulliparous women
and those who did not breastfed
Adapted from Cumming RG & Klineberg RJ(1993)Breastfeeding and other reproductive
factors & the risk of hip fractures in elderly women.Int Epidermiol:022:684-691
Hinweis der Redaktion
A study to compare the prevalence of obesity in breastfed children at age five to six in Germany.
Infants cry less, are calmer; mothers can more easily respond to their babies’ needs. No need for nurseries when there is rooming-in, which means more space for patients and hospital staff. Rooming-in reduces neonatal infections. Exclusively breastfed infants have fewer infections. Less staff time is needed. Mothers are directly responsible for the care of their babies. Rooming-in and breastfeeding support increases hospital prestige and creates animage of a facility doing its best for mothers and babies. Mothers who breastfeed are less likely to abuse or abandon their babies. Breastfeeding is the safest feeding method during emergencies.
There are risks for baby and risks for mother. Lets look at the risks for the baby. Not breastfeeding means lack of the protective elements of breast milk, resulting in a higher illness rate. Babies not breastfed are at higher risk of becoming obese and having more prone to diarrheoa and respiratory infections. Babies not breastfed also have a higher incidence of allergy such as eczema or asthma. Studies have also shown that breastfeeding also decrease the risk of chronic diseases in adulthood such as Diabetes Mellitus and Hypertension. Exclusive breastfeeding also reduces the risk of otitis media in babies. Studies have shown preterm babies not given breast milk are at higher risk of contracting necrotising enterocolitis(NEC) . The risks also extend to mothers if baby is on artificial feeding. As not breastfeeding means mothers need to rely on use of contraceptive devices and methods to delay any unplanned pregnancy. Mothers are also deprived of the bonding process during breastfeeding. Studies have shown mothers who do not breastfeed are at a higher risk of ovarian and breast cancers
As baby’s immune system is not yet well developed, breastfeeding provides antibodies that protect your baby from infection. Hence breastfed infants are less likely to suffer from diarrhea, acute respiratory infections and other serious illnesses. Thus infants on formula feeding will not have that protection due to the lack of antibodies or other anti infective factors
A study in Germany found that among 9357 children aged 5 and 6 there was an over 5 times difference in the
prevalence of obesity among those children never breastfed compared to those breastfed for over one year.
As one can see from the study above, the longer an infant had been breastfed the lower prevalence of obesity at the age of 5 and 6 (von Kries et al.).
A study in Dundee, Scotland found that breastfed infants had much less diarrhoea. For example, between 0 and
13 weeks of age, almost 20% of bottlefed infants had diarrhoea compared with only 3.6% of the breastfed infants
(Howie et al.).
Another study in Dundee, Scotland found that breastfed infants had much less respiratory illness. For example, between 0 and 13 weeks of age, almost 39% of the bottle-fed infants had respiratory illness compared to only 23% of the breastfed infants (Howie et al.).
Some of the risks for mothers who chose not to breastfeed their babies are listed here.
The impact of the risks of not breastfeeding will extends to the family as well. The lack of protection from breast milk means the child is at higher risk of falling sick more frequently . Parents may need to take leave from work to look after the child. A daily rated worker parent may lose his income by absence from work. In addition the family will need to spend more money and time.
One of the dangers of using powdered milk is the risk of contamination by bacteria such as Enterobacteria Sakazakii and Salmonella Enterica. To counteract tie risk WHO has drawn up a set of guidelines for preparation of formula
Research shows that babies who are nursed tend to have fewer incidents of illness (from common infant diseases) and less visits to the pediatrician as compared with formula fed babies
Artificial feeding also has impact on society. In a study done to assess the numbers of excess hospitliazation,clinic visits and prescriptions issued it was found that 2033 excess visits, 212 hospitalizations and 609 excess prescription given. All these cost an additional $331 to $475 per baby who was not breastfed during the first year of life.
This multinational study showed a 20-25% decrease in the risk of ovarian cancer among women who
lactated for at least 2 months per pregnancy, compared to those who had not. Little or no further
decrease in risk was seen with increasing duration of lactation.
This was a study done to capture the amount of money saved for first 3 months of life for 15410 babies who were breastfed in Singapore. This as based on the prices in 1990s
A recent study in Sweden in which a birth cohort of 4089 infants was followed prospectively found that exclusive and partial breastfeeding reduced the risk of allergic disorders.
Lack of breastfeeding also posed a higher risk of chronic diseases such cardiovascular diseases in adulthood as shown in the study. Of 625 subjects aged 48-53 years born around the time of a severe period of famine in Amsterdam (1944-45), those were bottle fed at hospital discharge had greater risk factors for cardiovascular
disease than those who were exclusively breast fed as shown in their oral glucose tolerance test, a higher plasma low density lipoprotein (LDL) cholesterol concentration, a lower high density lipoprotein (HDL) cholesterol
concentration, and a higher LDL/HDL ratio. However Systolic blood pressure and body mass index were not
affected by the method of infant feeding.
A study in Sweden found that breastfed infants had less otitis media than artificially fed infants. For example, at one to three months of age, 6% of the weaned infants had otitis media, compared to only 1% of the breastfed infants (Aniansson et al.).
This is a study done to compare effect of breast milk on the prevalence of necrotising Enterocolitis in preterm babies. 926 preterm infants were studied, 51 of whom developed NEC. Exclusively formula fed infants were 6
to 10 times more likely to develop NEC than those who received breast milk. Although NEC is rare in
babies over 30 weeks gestation, it was 20 times more common if the baby had received no breast
milk.
A reanalysis of data from 47 epidemiological studies in 30 countries found that the relative risk of breast cancer decreased by 4.3% for every year of breastfeeding (Beral). The longer women breastfeed the more they are protected against breast cancer. The lack of or short lifetime duration of breastfeeding typical of women in developed countries makes a major contribution to the high incidence of breast cancer in these countries
This is a study on the prevalence of hip fractures in women who had not breastfed at all. In a study on 311 women with hip fractures women who had not breastfed their babies had 2 times the risk of hip fractures in old age.