Most mothers quit breastfeeding far too soon

Reproduced from The Globe and Mail 
Published: June 15, 2006 By ANDRE PICARD

The single most effective way of giving a baby a healthy start in life is breastfeeding.

As a public-health measure, breastfeeding is unparalleled. It is cheap, easy to understand, has no negative side effects and the method is tried and true -- as old as motherhood itself.

Yet, Canada fails abysmally when it comes to providing babies with mother’s milk.

Things look good at first: Eighty-five per cent of Canadian women breastfeed their newborn babies, according to Statistics Canada. However, in the weeks after birth, that rate falls off precipitously.

Every major health group, including the World Health Organization, the Canadian Paediatric Society and the Public Health Agency of Canada, recommends that babies be fed breast milk exclusively for the first six months of life, and that breastfeeding should continue as long as possible after the introduction of solid foods. The reasons for this are clear: Breast milk provides all the nutrients, growth factors and immunological factors a baby needs for optimal growth and development (physical and neurological).

Yet, 1.5 million children die every year because they are not breastfed, according to the WHO.

In Canada, children are not dying for lack of breastfeeding, but they are missing out on tremendous benefits.

Research has shown that children who are breastfed have lower rates of pneumonia, bronchitis, colds, meningitis, urinary-tract infections, asthma, ear infections and sudden infant death syndrome. They are less likely to become overweight or obese, to develop breast cancer, allergies, diabetes, Crohn’s disease and rheumatoid arthritis. Some studies even suggest breastfed babies even grow up to have higher IQs.

So, how do we explain that fewer than one in six new mothers (about 15 per cent) in Canada are meeting the minimum health standard of breastfeeding exclusively for six months?

The simple answer is that despite the seeming enthusiasm for the practice, health authorities do not promote breastfeeding, nor does our health system provide the necessary supports to moms and their newborns.

While breastfeeding is natural, it’s not always easy. Proper technique -- getting the baby to latch on to the breast and suckle -- often requires some expert advice. Older mothers used to provide that knowledge but the previous generation or two lost that ability. In the postwar years, breastfeeding was actively discouraged, and by 1965, only one in four babies ever tasted mother’s milk.

So the task of educating new mothers falls to health professionals. Yet, in hospitals (where, sadly, most births still occur), nurses and physicians are often too busy to help. Many hospitals have closed their breastfeeding clinics. Because modern medical training does not include education about breastfeeding, advice is often appallingly bad. Formula makers aggressively market their products and health professionals and many Canadian hospitals still provide free samples of formula -- in flagrant violation of the international code. And not everyone can afford the help of a lactation consultant, a service rarely paid by medicare, a short-sighted measure if there were ever was one. In addition to providing services, there needs to be more education about the benefits of breastfeeding as well as the downside of formula.

The United States has shown the way with a hard-hitting public health campaign. The bold awareness program has focused on the risks of not breastfeeding. One TV ad showed a pregnant woman clutching her belly as she was thrown off a mechanical bull, and it compared the behaviour to failing to breastfeed. "You wouldn't take risks before baby’s born," the ad states. "Why start after?"

The United States is also looking at labelling formula the way cigarettes are now labelled, with hard-hitting health warnings.

What public health leaders are saying is that the weight of the scientific evidence for breastfeeding is so overwhelming that it is appropriate to emphasize the risks associated with giving babies formula rather than mother’s milk.

If 85 per cent of Canadian women were taking up smoking within six months of giving birth, it would be a national scandal. No effort and no expense would be spared to address the issue.

That 85 per cent are giving up on breastfeeding at some point during the six months is equally scandalous.

It is time for public health officials in Canada to show some leadership on the issue.

There is little justification for stocking formula in Canadian hospitals, let alone distributing samples. More investments are required in breastfeeding clinics. Workplaces and public spaces need to facilitate rather than discourage breastfeeding. Education campaigns, for health professionals and the public alike, are long overdue.

"Breast is best" should not just be a catchphrase; breastfeeding should be a public health priority.