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Is Bottle Feeding Really That Bad for Baby 2019

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Abstruse

Infant feeding decisions affect maternal and child health outcomes, worldwide. Even in settings with make clean water and skillful sanitation, infants who are not breast-fed face up an increased gamble of infectious, as well as non-infectious morbidity and mortality. The decision not to breast-feed can also adversely touch mothers' health past increasing the risk of pre-menopausal breast cancer, ovarian cancer, type Two diabetes, hypertension, hyperlipidemia and cardiovascular affliction. Clinicians who counsel mothers about the wellness touch of infant feeding and provide prove-based intendance to maximize successful breast-feeding, can improve the short and long-term health of both mothers and infants.

Introduction

Health outcomes differ substantially for mothers and infants who formula-feed, compared with those who breast-feed, even in wealthy countries such as the United States. Unfortunately, rates of chest-feeding in the United states keep to fall short of the Earth Health Organization's recommendations that children are chest-fed for their first 2 years of life.i The American Academy of Pediatrics2 and the American Academy of Family Physicians3 recommend exclusive breast-feeding for the first 6 months of life, continuing at least through the infant'southward first birthday, and every bit long thereafter as is mutually desired. In the United States, in 2005, only 74% of the The states infants were chest-fed at to the lowest degree once after delivery, only 32% were exclusively breast-fed at iii months of age, and just 12% were exclusively chest-fed at 6 months of historic period.4 These rates vary considerably by region, with the highest rates in the Pacific Northwest and the everyman rates in the Southeast. Although some of this variation reflects cultural differences, contempo data suggest that variations in hospital practices account for a considerable proportion of disparities in breast-feeding.5 This suggests that improvements in the quality of antenatal and perinatal support for breast-feeding could accept a substantial impact on public health. For this reason, it is important for clinicians to have a clear understanding of the risks and benefits of infant feeding practices for women's and children's wellness.

The risks of formula-feeding

For many years, public wellness campaigns and the medical literature have described the 'benefits of breastfeeding,' comparing health outcomes amongst breast-fed infants against a reference group of formula-fed infants. Although statistically synonymous with reporting the 'adventure of not breastfeeding,' this approach implicitly defines baby formula as the normal mode to feed an infant. This subtle stardom substantially affects perceptions of infant feeding.half-dozen, 7, 8 If 'breast is best,' and so formula is implicitly 'adept' or 'normal.' This distinction was underscored by a national survey showing that, in 2003, while 74% of the United States residents disagreed with the statement, 'Infant formula is as practiced as breast milk,' but 24% agreed with the statement, 'Feeding a baby formula instead of chest milk increases the gamble the babe will get sick.'9

These distinctions appear to influence feeding decisions. In 2002, the Ad Council conducted focus groups to develop the National Breastfeeding Awareness Campaign, targeted at reproductive-aged women who would not normally breastfeed. They found that women who were advised near the 'benefits of breastfeeding' viewed lactation as optional, like a multivitamin, that was helpful but not essential for infant wellness. In contrast, when the same data were presented every bit the 'hazard of non breastfeeding,' women were far more than probable to say that they would breastfeed their infants. Given these findings, this review will describe the risks of formula-feeding when presenting differences in maternal and kid wellness outcomes.

In addition, this article reviews the clinician's part in counseling women regarding baby feeding and ensuring chances of breast-feeding success are maximized at birth.

Impact of baby feeding on maternal health

Premature weaning, or non breast-feeding, is associated with health risks for mothers also as for infants. Epidemiological data advise that women who do not chest-feed face higher risks of cancer and cardiovascular diseases. It should be noted that in many studies of maternal health outcomes, associations have been reported co-ordinate to lifetime elapsing beyond all pregnancies, rather than the duration of feeding for each pregnancy. In addition, most evidence arises from observational studies, which may exist subject field to confounding by other health behaviors.

Lactation and maternal malignancy

Lactation suppresses ovulation, leading to lactational amenorrhea. In addition, lactogenesis leads to terminal differentiation of the breast tissue, which may reduce cancerous transformation. These effects may mediate associations betwixt chest-feeding and chest and ovarian cancer.

Chest cancer

Multiple studies have now examined the relationship betwixt breast-feeding and breast cancer risk. A recent meta-assay of 47 studies found that each twelvemonth of breast-feeding was associated with a four.iii% reduction in risk of invasive chest cancer.x Women who had never breast-fed had a ane.4-fold increased take a chance of breast cancer, compared with women who had breast-fed for a lifetime total of ⩾55 months. This meta-assay was important considering longitudinal studies take produced conflicting resultseleven, 12, xiii, 14, 15 and observational studies relating lactation and breast cancer among post-menopausal women have largely failed to identify an association.13, 16 Although reports from instance-control studies take suggested a modest protective effect of chest-feeding on pre-menopausal breast cancer gamble, these studies may be limited by the potential for remember bias.17, eighteen

Ovarian cancer

Multiple case-control studies take found a college run a risk of ovarian cancer among parous women who take never breast-fed. In a meta-assay, women who had never breast-fed had a 1.three-fold higher adventure of ovarian cancer than parous women who had never chest-fed.nineteen Danforth et al. 20 prospectively examined the risk of ovarian cancer in the Nurses' Health Studies, and found that parous women who had never breast-fed faced a 1.5-fold risk of ovarian cancer, compared with women who breast-fed for ⩾18 months.

It is interesting to annotation that women who developed mastitis while breast-feeding had the lowest risk of ovarian cancer, those who breast-fed and did not develop mastitis had an intermediate risk of ovarian cancer, whereas those who never breast-fed had the highest rates of ovarian cancer.21 Researchers hypothesize that antibodies to MUC1, which develop during mastitis, may accept a office in reducing the risk of ovarian cancer. In a case-command study, Cramer et al. 21 found higher levels of MUC1 antibodies among women who had chest-fed and adult mastitis.

Lactation and the risk of maternal cardiovascular disease

Breast-feeding requires a substantial metabolic expenditure; an exclusively breast-fed infant requires that mothers should employ 500 kcal d−1 to produce milk. This metabolic load may help mobilize the weight gained during pregnancy. In improver, breast-feeding is associated with more favorable glucose levels, lipid metabolism and blood force per unit area. Epidemiological studies suggest that these differences may persist after weaning, with long-term benefits for mothers.22

Dewey et al. 23 compared weight loss during the outset twelvemonth postpartum between ii groups of women: those breast-feeding <3 months, and those continuing for ⩾1 yr. Women who were intentionally dieting to lose weight were excluded from the written report. Women in the prolonged breast-feeding group lost four.four lbs more than women who weaned at iii months. This difference in weight persisted for 2 years postpartum. Other studies have found mixed results,19 suggesting that differences in caloric intake and concrete activity have a role in postpartum weight change. Results from a randomized, controlled trial in Republic of honduras provide evidence that breast-feeding can mobilize calories for weight loss.24 Exclusively chest-feeding women were randomized at 4 months postpartum to innovate complementary foods for their infants or continue to breast-feed exclusively. At 6 months, exclusively chest-feeding mothers had lost 600 g more than those in the complementary feeding grouping. Based on measurements of milk volume, the exclusively breast-feeding mothers expended 5520 additional kcal over the ii-month catamenia. The authors noted that 600 g of mobilized fat would provide 5400 kcal. These results provide causal evidence that more intense lactation mobilizes additional adipose stores.

Lactation and maternal diabetes

Differences in metabolism between chest-feeding and formula-feeding women announced to persist into later life. Several authors have found a higher risk of diabetes and the metabolic syndrome among women who accept never breast-fed, compared with those who breast-fed for a prolonged period. In the Nurses' Health Studies, the risk of type II diabetes in the 15 years since their final birth was 1.seven-fold higher amidst parous women who never chest-fed, compared with those who breast-fed for a lifetime total of ⩾2 years. Villegas et al.,25 examined information from the Shanghai Women's Health Study and found that women who had breast-fed their children tended to take a 12% lower adventure of diabetes mellitus than those who had never chest-fed. Using information from the Women's Health Initiative, Schwarz et al. 26 constitute a pregnant dose-response effect when examining the elapsing of lactation and risk of Type 2 diabetes. After adjusting for socio-demographic, family unit history, lifestyle variables and body mass alphabetize they institute that the odds ratio of developing diabetes for women who had breast-fed for 1–6 months was 0.91(0.84–0.99); for women who had a lifetime history of chest-feeding for 13–23 months, they found an odds ratio for developing diabetes of 0.75(0.66–0.85).

Lactation and maternal hypertension

A Korean study constitute that lactation decreased mothers' risk of developing hypertension by 8%.27 Similarly, in the United States, using data from the Women's Health Initiative, authors estimated that for every 29 women who chest-fed for more than 1 yr, 1 case of post-menopausal hypertension would be prevented.26

Lactation and maternal hyperlipidemia

Data from the Women's Health Initiative also indicates that for every forty women who breast-fed more than than i year, one case of postal service-menopausal hyperlipidemia would be prevented.26 Ram et al. 28 assessed the prevalence of metabolic syndrome in a cohort of center-anile women and found that each year of lactation decreased run a risk of developing the metabolic syndrome past 12%. In the CARDIA cohort, women who breast-fed less than three months had less favorable lipid profiles than women who chest-fed for three months or more than.29

Lactation and maternal cardiovascular disease

In the Nurses' Health Study, never having breast-fed was linked with a 1.three-fold risk of myocardial infarction, compared with lifetime breast-feeding for ii years or more.30 Over an average of 7.nine years of post-menopausal participation in the Women's Health Initiative, women with a single live birth who never chest-fed were 28% more than likely to develop CVD than women who breast-fed for 7–12 months.26

Infant feeding and child health outcomes

Infectious morbidity

Compared with breast-fed infants, formula-fed infants are more likely to develop an infection in the start yr of life. This increased chance of infectious morbidity and mortality is explained, in part, by specific and innate immune factors present in human milk.31 Plasma cells in the bronchial tree and intestine migrate to the mammary epithelium and produce immunoglobulin A antibodies specific to antigens in the mother–infant dyad's immediate surroundings, providing specific protection against local pathogens. Oligosaccharides, glycoproteins and human milk lipids directly interfere with the activity of common pathogens, including Haemophilus influenzae, Streptococcus pneunoniae,Vibrio cholerae, Escherichia coli, Giardia lamblia, grouping B streptococci, Staphylococcus epidermidis, rotavirus, respiratory syncytial virus and herpes simplex virus-1.

Gastrointestinal infections

Multiple studies suggest that formula-fed infants face up an increased take chances of gastroenteritis and diarrhea. In a meta-analysis of accomplice studies, Chien et al. 32 constitute that infants who were formula-fed or fed a mixture of formula and human being milk were two.eight times equally likely to develop gastrointestinal infection than those who were exclusively breast-fed. Data from the Promotion of Breastfeeding Intervention Trial (PROBIT) study, a randomized and controlled trial of an intervention to increase the duration of breast-feeding, found that infants in the control group were 1.seven times more likely to develop gastrointestinal illness than those in the intervention group.33

Of particular relevance to perinatologists, among preterm infants, not receiving breast milk is associated with a 2.four-fold run a risk of necrotizing enterocolitis, with an accented take a chance difference of 5%.19 In other words, for every 20 preterm infants who are fed breast milk, 1 case of necrotizing enterocolitis is prevented. As the example-fatality rate for necrotizing enterocolitis is 15%,34 providing preterm infants with breast milk is of great clinical significance.

Otitis media

Approximately 44% of infants will have at least one episode of otitis media in their first yr of life. The risk of otitis media amongst formula-fed infants is twice that of infants who are exclusively breast-fed for more than than 3 months.19

Lower respiratory tract infection

In a meta-analysis, Bachrach et al. 35 found that infants in developed countries who were not breast-fed faced a iii.half-dozen-fold increased take chances of hospitalization for lower respiratory tract infection in the start year of life, compared with infants who were exclusively chest-fed for more than 4 months. Lipids in human milk appear to accept antiviral activity against respiratory syncytial virus, which causes the majority of respiratory hospitalizations for infants. In developing countries, these benign effects of breast milk are of fifty-fifty greater importance in preventing lower respiratory tract infection and mortality.

Infant bloodshed

One written report evaluated the association betwixt babe feeding and bloodshed in the start twelvemonth of life.36 Adjusting for maternal age, education and smoking status, as well as infant race, gender, birth weight, congenital malformation, birth order, parity, and women, infants and children (WIC) status, formula-feeding was associated with a 1.3-fold higher take chances of baby mortality compared with e'er chest-feeding.

Sudden infant death syndrome

Meta-analyses of example control studies suggest that formula-feeding is associated with a i.six–2.i-fold increased odds of sudden infant death syndrome, compared with breast-feeding.19, 37 A contempo German language case-control study found that non being exclusively breast-fed at i month of historic period was associated with a twofold risk of sudden infant death syndrome,38 adjusting for socioeconomic status, maternal smoking and other potential confounders.

Obesity and babyhood metabolic disease

Epidemiological studies suggest that children who are breast-fed in infancy are less likely to become obese19, 39, forty or develop type Ii diabetes.19, 39, 41 Some studies accept also suggested a reduction in risk for cardiovascular disease, including lower blood pressure39, 42, 43 and more favorable lipid profiles,39, 44 but this literature is mixed. Researchers have proposed several mechanisms to explain these associations, including differences in composition of human milk vs formula, feeding practices, associated lifestyle factors and self-regulation of intake by the infant.45 Moreover, homo milk contains adipokines, which may take a role in regulating energy intake and long-term obesity adventure.46 Several authors take postulated that long-chain polyunsaturated fatty acids in breast milk may affect claret pressure and insulin resistance in afterwards life.39 However, a recent randomized controlled trial found that a breast-feeding promotion intervention, which resulted in substantial increases in the duration and exclusivity of chest-feeding, did non reduce measures of adiposity at 6.5 years of age.47

Neurodevelopment

Studies examining babe feeding and cognitive evolution have found mixed results.48, 49, l Several authors reported modestly lower IQ scores in formula-fed children, compared with breast-fed children, whereas others reported no association between infant feeding and intelligence. Data from ii randomized, controlled trials provide prove of developmental differences with shorter durations of breast-feeding. Dewey et al. 24 randomized mothers in Republic of honduras to the introduction of complementary foods at four months vs connected exclusive chest-feeding until vi months of age. Infants in the complementary nutrient group crawled after, and were less likely to exist walking at 12 months than infants in the exclusively breast-fed grouping. Kramer et al. similarly found differences in neurodevelopment with shorter chest-feeding in the PROBIT study. At 6.5 years of age, exact IQ scores were 7.5 points lower among children in the usual care group than amidst children in the grouping that received hospital-based breast-feeding support. Kramer'southward results provide causal testify of hospital policies that support breast-feeding having an impact on neurodevelopment. Formula supplemented with long-chain polyunsaturated fat acids, has been promoted as improving neurocognitive outcomes. However, a recent Cochrane meta-analysis51 found no benefit of long-chain polyunsaturated fat acids on neurodevelopment among term infants in well-conducted trials.

Sectional breast-feeding and the immune system

Early feeding has a fundamental role in the development and maturation of the infant allowed system. Compared with human-milk fed infants, formula-fed infants have higher pH stools and greater colonization with pathogenic bacteria, including Escherichia coli, Clostridium difficile and Bacteroides fragilis.52 The more favorable colonization in breast-fed infants appears to exist facilitated past bioactive factors in human being milk. These oligosaccharides, cytokines and immunoglobulins regulate gut colonization and development of gut-associated lymphoid tissue, and govern the differentiation of T-cells that have a role in host defence and tolerance.53 Formula-fed infants also have a smaller thymus than chest-fed infants.54 These differences in allowed system differentiation may underlie the higher incidence of allergic disease in formula-fed children. Not chest-feeding may also increment illness risk through exposure to foreign antigens in the formula.

Babyhood autoimmune disease

Asthma

Multiple studies have examined the association between infant feeding and development of asthma. In a meta-analysis, Ip et al. 19 institute a 1.7-fold risk of developing asthma amongst formula-fed children with a positive family history of asthma or atopy and a 1.4-fold hazard amidst those without a family history, compared with those who were chest-fed for three months or more. Gdalevich et al. 55 compared less than iii months of sectional breast-feeding with ⩾ 3 months of exclusive breast-feeding, and found a 1.nine-fold run a risk amidst those with a family history of asthma or atopy.

Atopic dermatitis

In a meta-analysis, Gdalevich et al. constitute that infants with a family history of atopy who were formula-fed or exclusively breast-fed for <three months have a 1.7-fold higher chance of atopic dermatitis, compared with infants who are exclusively breast-fed.56 Like findings were reported in the PROBIT randomized trial of breast-feeding support; infants delivered in control hospitals were 1.nine times equally likely to develop atopic dermatitis as those delivered in hospitals that provided breast-feeding support.

Type I diabetes

Epidemiological studies accept reported an association between exposure to cow's milk antigen and development of type I diabetes, although results take been mixed.57 In meta-analyses, <3 months of breast-feeding has been associated with a 1.two–1.iv-fold increased take chances of developing blazon I diabetes58 compared with ⩾3 months of chest-feeding. There is some evidence that differential recall between cases and controls may have biased results.59 In a pilot study,threescore exposure to cow'southward milk-based formula was associated with higher prevalence of islet prison cell auto-antibodies, providing tentative bear witness for a causal association betwixt cow'south milk exposure and type I diabetes.

Babyhood cancer

Several studies have examined associations betwixt formula-feeding and childhood leukemia, based on the hypothesis that immunoactive factors in breast milk may prevent viral infections implicated in leukemia pathogenesis.61 Two meta-analyses19, 62 found a i.3-fold college hazard of acute lymphoblastic leukemia amongst formula-fed children, compared with children who were chest-fed for greater than 6 months. Kwan et al. found a i.2-fold higher risk of acute myeloid leukemia among formula-fed infants, compared with infants breast-fed ⩾6 months.

The clinician'southward role in supporting breast-feeding

There is compelling evidence that formula-feeding is associated with increased health risks, both for mothers and for their children. By supporting chest-feeding as the normative way to feed an infant, clinicians can accept a powerful office in improving health outcomes across ii generations (Figure 2).

Counseling during antenatal care

Most mothers make decisions about infant feeding early in pregnancy. Clinicians tin can play a crucial role in educating mothers about the health touch of baby feeding and addressing potential obstacles to chest-feeding. However, many obstetricians underestimate the importance of their advice. In a study of obstetricians and patients at a multispecialty group practice in Massachusetts, USA,63 just eight% of physicians felt their advice on whether and how long to breast-feed was important. In contrast, more than than 33% of mothers reported that their provider's advice on these topics was very of import. It is to be noted that in a study of breast-feeding prevalence at 6 weeks postpartum, DiGirolamo64 found that the female parent's perception of their physician'southward opinion directly influenced breast-feeding rates at vi weeks postpartum. Among mothers who thought their physician favored breast-feeding, 70% were withal breast-feeding, whereas amidst mothers who thought the doctor had no preference, only 54% were still breast-feeding.

When counseling patients about breast-feeding, it is helpful to ask open-ended questions, such as 'What have you heard virtually breast-feeding?' followed past acknowledging the female parent'due south concerns and targeting instruction to her specific needs. For the mother who is planning to bottle-feed, this discussion allows for an open give-and-take of risks and benefits, and ensures informed consent for the feeding decision. Such an arroyo is more than effective than asking a close-concluded question, such equally 'Are you going to breast- or canteen-feed?'65

Part practices such every bit distributing marketing packs provided by formula manufacturers are also a major predictor of chest-feeding outcomes. Howard et al. 66 conducted a randomized, controlled trial of promotional materials at the commencement prenatal visit. Mothers received either a formula company-sponsored information pack on babe feeding or a non-commercial pack of equal value. Among mothers who were uncertain about their plans to chest-feed, those who received the formula marketing packet were 1.7 times more likely to wean than those who received the non-commercial data. This randomized trial provides compelling testify that physician offices should not distribute materials provided by formula makers.

Hospital practices and breast-feeding success

Maternity-care practices have a substantial outcome on chest-feeding success. Equally the PROBIT trial demonstrated,33 do patterns supportive of breast-feeding can effect duration of exclusive and total breast-feed through the first twelvemonth of life, also as influence school-historic period health outcomes including verbal IQ.67 Intervention hospitals in the PROBIT study implemented the Baby Friendly Hospital Initiative, a set of evidence-based guidelines developed by the World Health Organization to ensure optimal care for breast-feeding mothers and infants.68 Currently, more than fifteen 000 maternity facilities in 134 countries have implemented the Baby Friendly Guidelines,69 but fewer than 100 United States hospitals participate. One contempo report estimated that only eight% of Usa mothers experience all six 'Infant-Friendly' practices.70 A recent Centers for Affliction Control and Prevention5 study, which measured hospital practices at Usa maternity hospitals and birth centers, found express compliance with prove-based guidelines for breast-feeding care; the 2687 maternity centers studied received just 63 of 100 possible points for high quality care. Practices associated with poor breast-feeding outcomes were common. For example, 65% of facilities routinely propose women to limit the duration of suckling at each feeding, and 45% routinely provide pacifiers for breast-feeding infants, despite the evidence that these practices subtract duration of breast-feeding.

Clinicians can abet for better care by supporting quality improvement efforts in hospitals to eliminate outdated birthing practices. For example, a Cochrane review of randomized trials has shown that infants placed pare-to-pare at delivery breast-feed 42 days longer than infants who are swaddled in the starting time hour of life.71 Despite this evidence, the Centers for Disease Control'south survey constitute that healthy mother–baby dyads experienced pare-to-skin intendance and initiated early breast-feeding relatively rarely.5 The obstetrician can straight bear upon this practice by placing the healthy baby on the mother's chest at delivery and encouraging hospital staff to carry out the initial assessment while the baby is with the mother, every bit recommended past the American Academy of Pediatrics (Figure ane).

Figure i
figure 1

The importance of skin-to-skin contact at delivery.2 Good for you infants should exist placed and remain in direct pare-to-skin contact with their mothers immediately after delivery until the first feeding is accomplished.

Full size image

Maternal medications and breast-feeding

During prenatal care clinicians tin support breast-feeding by reviewing the safety of continuing chronic maternal medications during lactation. Postpartum, it is of import to coordinate with the baby's intendance provider to ensure full support of breast-feeding, and close follow-upwards of the infant when side effects of maternal medication use is a concern. When counseling the mother, the risks of baby medication exposure must exist weighed against the risks to maternal and baby health of interrupting or discontinuing chest-feeding. Reliable data on the safety of medication utilise during lactation is available online, gratuitous, through LactMed, a National Library of Medicine database. Unfortunately, a recent study72 establish that the quality of information in other electronic databases is highly variable. LactMed includes a monograph on each medication that summarizes data on lactation safety and lists alternative medications from the aforementioned form that may be preferred during lactation.

Figure 2
figure 2

Supporting initiation and continuation of breast-feeding.

Full size paradigm

Facilitating lactation for mothers of preterm infants

Qualitative studies suggest that mothers of preterm infants respond well to counseling about the effect of chest milk on preterm infant health;73 even those who initially planned to formula-feed practise non written report feeling pressured or coerced to breast-feed. Rather, mothers of preterm infants felt their milk 'made the difference' for their infant, and they were empowered by the hazard to contribute to their infants' care.74 This work contradicts commonly-held behavior that mothers of preterm infants are too stressed or overwhelmed to breast-feed.75

Rather than asking, 'Are you going to breast-feed?' clinicians tin can ask, 'Would you be willing to provide milk while your babe is in the neonatal intensive-care unit?' To establish a sufficient milk supply, mothers of preterm infants should initiate expression of milk inside 6 h of delivery, using a double-sided, hospital grade electric pump 8–12 times a day.76, 77 Counsel the mother that she may produce only a few drops of colostrum in the first ii–3 days; however, trophic feeding with this immunoglobulin-rich fabric may improve gut function in the preterm neonate, and early use of expressed colostrum appears to increase maternal milk production.78 It is of import to advise mothers that pain, stress and anxiety interfere with release of oxytocin and reduce milk let downwards.79 If mothers experience nipple pain while pumping, they should reduce the suction on the pump, and a trained nurse or lactation consultant should ensure that the pump flange fits properly. Continued pumping despite pain can lead to nipple trauma and infection. Expressing milk at the baby's bedside, or while looking at pictures of the infant, improves allow down and milk production. Mothers should express milk for x–15 min per pumping session. Once milk supply is established, they should keep until 1–2 min afterward period stops, simply for no longer than xxx min. A contempo written report suggests that betamethasone may reduce milk product betwixt three and 9 days after administration.80 Mothers who received antenatal corticosteroids soon before delivery should be encouraged to continue to limited milk regularly to found a supply.

Conclusions

Formula-feeding places mothers and infants at increased risk of a wide spectrum of adverse wellness outcomes, ranging from infectious morbidity to chronic disease. Given compelling show for differences in health outcomes, breast-feeding should be acknowledged every bit the biological norm for infant feeding. Physician counseling, part and hospital practices should be aligned to ensure that the breast-feeding mother–infant dyad has the best chance for a successful breast-feeding experience throughout the infant'south first year of life, and as long thereafter as is mutually desired by mother and child.two

For further information

Academy of breastfeeding medicine protocols

http://www.bfmed.org/Resource/Protocols.aspx

The University of breastfeeding medicine (ABM) is an international organization of physicians interested in the promotion and management of chest-feeding. The web site includes Department of Wellness and Human Services (DHHS)-funded evidence-based clinical guidelines for management of lactation bug.

LactMed

http://lactmed.nlm.nih.gov/

A service of the National Library of Medicine's ToxNet, LactMed is a free online database of monographs on medication safety in lactation.

Nutritional support of the very low birth weight (VLBW) infant toolkit

http://www.cpqcc.org/quality_improvement/qi_toolkits/nutritional_support_of_the_vlbw_infant_rev_december_2008

This is a comprehensive guide to supporting chest-feeding for the preterm baby, which includes quality comeback steps, handouts for patients and staff, and references.

Infant friendly U.s.a.

http://world wide web.babyfriendlyusa.org/

Baby friendly USA is a non-turn a profit organization that implements the Baby Friendly Hospital Initiative in the United States. The web site includes information on how the United States maternity centers tin apply for Baby Friendly certification.

Conflict of interest

The authors declare no disharmonize of interest.

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Author data

Affiliations

  1. Segmentation of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Due north Carolina School of Medicine, Chapel Hill, NC, USA

    A M Stuebe

  2. Department of Medicine, Epidemiology, Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, Usa

    E B Schwarz

Corresponding author

Correspondence to A K Stuebe.

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Stuebe, A., Schwarz, E. The risks and benefits of infant feeding practices for women and their children. J Perinatol 30, 155–162 (2010). https://doi.org/x.1038/jp.2009.107

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Keywords

  • breast feeding
  • epidemiology
  • health promotion
  • quality of health care

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