Breastfeeding: The Essential Principles

Abstract

1. Latha Chandran, MBBS, MPH* 2. Polina Gelfer, MD† 1. *Editorial Board 2. †Assistant Professor of Clinical Pediatrics, State University of New York at Stony Brook, Stony Brook, NY After completing this article, readers should be able to: 1. Understand the physiology of lactation. 2. Discuss the biologic specificity of human milk. 3. Delineate the benefits of breastfeeding for the infant, the mother, and the community. 4. Know relative and absolute contraindications to breastfeeding. 5. Describe current recommendations for breastfeeding. Breastfeeding practice is the biologic norm for Homo sapiens and dates back some 40,000 years. Until the last several decades, breastfeeding was the norm, and wet-nursing was the only alternative to allow infants to survive. Although pediatricians overwhelmingly agree that breastfeeding is best for babies, in the United States today, only 68% of all new mothers even attempt it, and at least 50% abandon it quickly. The United States Public Health Service Healthy People 2010 Initiative calls for an increase in the rate of breastfeeding to 75% at birth, 50% at age 6 months, and 25% at 1 year of age (Figure⇓). The presence or absence of breastfeeding affects the economics of the family and the community. Multiple studies confirm that the annual cost to the United States health care system from women not breastfeeding is several billion dollars. Promoting breastfeeding can decrease costs for public health programs such as The Special Supplemental Nutrition Program for Women, Infants, and Children, parental employee absenteeism as a result of decreased infant illness, environmental burden for disposal of formula cans and bottles, and energy demands for production and transport of artificial feeding products. Figure. Breastfeeding rates in 2003 and United States Healthy People 2010 breastfeeding objectives. From Centers for Disease Control and Prevention breastfeeding national immunization data. During pregnancy, the breast grows larger, the diameter of the areola increases, pigmentation increases, the nipples become more erect, and the veins become more prominent. Various hormones stimulate breast growth: prolactin and placental lactogen stimulate nipple and areolar growth; estrogen …