Nutrition and health of the breast-fed infant

Breast milk is the most complete single source of nutrition for the first 6 months of life. There is no formula that duplicates breast milk. Breast milk contains:

• Antibodies and living cells that help protect the infant from infections. They also promote healthy bacteria that help the intestines to digest nutrients properly.
• Essential vitamins and minerals for optimal growth and development.
• Proteins, fats, and other substances that are especially adapted for the needs of a growing baby.

Breast milk changes over time with a baby's nutritional needs. The first milk produced is colostrum, a sticky, yellowish liquid that contains protein, minerals, vitamins, and antibodies. Colostrum is produced during pregnancy and the first few days after delivery. The transitional milk comes in after the colostrum, followed by mature milk about 10 to 15 days after delivering your baby. The type and level of protein in breast milk changes to meet the processing abilities of a baby's developing kidneys.¹

Breast milk also changes during each feeding. The last milk in the breast, called hindmilk, is higher in calories, nutrients, and fat and helps satisfy your baby's appetite. To get to the hindmilk, breast-feeding (or pumping) should continue on one breast until it is emptied. This usually requires at least 10 to 20 minutes of feeding or pumping per breast.

Breast milk is easy to digest, so breast-fed babies are rarely constipated. Newborns younger than 2 weeks should have at least 1 or 2 bowel movements a day. Babies older than 2 weeks can go 2 days and sometimes longer between bowel movements. It’s usually okay if it takes longer than 2 days, especially if your baby is feeding well and seems comfortable.

Breast-feeding protects and helps your baby in ways that formula feeding does not. These benefits include:

• Fewer upper respiratory infections (such as colds), ear infections, and lower respiratory infections (such as pneumonia). Breast milk has more than 50 components that boost the immune system and help protect your baby. When illnesses occur, they tend to be shorter and less severe. Fresh breast milk offers the highest concentration of protective antibodies.²
• Fewer gastrointestinal illnesses (vomiting and diarrhea).
• Reduced risk for eczema.³
• Reduced risk for asthma.⁴
• Possibly, a lower risk of food allergies.
• Reduced risk for obesity. Breast-fed babies are less likely than formula-fed babies to be overweight later in infancy and during childhood and adolescence.^{5, 6, 7} Maintaining a healthy weight reduces the risk for certain conditions, such as diabetes.
• Reduced risk for high cholesterol later in life.⁸
• Fewer doctor visits and less chance of needing hospitalization because of infection.⁹

Breast-feeding for at least 1 year is recommended by the American Academy of Pediatrics, the American Association of Family Physicians, and the American College of Obstetrics and Gynecology.^{10, 11}

Citations

1. Lawrence RM, Lawrence RA (2004). The breast and physiology of lactation. In RK Creasy, R Resnik, eds., Maternal-Fetal Medicine, 5th ed., pp. 135–153. Philadelphia: Saunders.

2. Hanna N, et al. (2004). Effect of storage on breast milk antioxidant activity. Archives of Disease in Childhood: Fetal and Neonatal Edition, 89(6): F518–F520.

3. Gdalevich M, et al. (2001). Breast-feeding and the onset of atopic dermatitis in childhood: A systematic review and meta-analysis of prospective studies. Journal of the American Academy of Dermatology, 45(4): 520–527.

4. Dell S, To T (2001). Breastfeeding and asthma in young children. Archives of Pediatrics and Adolescent Medicine, 155(11): 1261–1265.

5. Hediger ML, et al. (2001). Association between infant breastfeeding and overweight in young children. JAMA, 285(19): 2453–2460.

6. Gillman MW, et al. (2001). Risk of overweight among adolescents who were breastfed as infants. JAMA, 285(19): 2461–2467.

7. Grummer-Strawn LM, Mei Z (2004). Does breastfeeding protect against pediatric overweight? Analysis of longitudinal data from the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System. Pediatrics, 113(2): e81–e86.

8. Singhal A, et al. (2004). Breastmilk feeding and lipoprotein profile in adolescents born preterm: Follow-up of a prospective randomised study. Lancet, 363(9421): 1571–1578.

9. Talayero JMP, et al. (2006). Full breastfeeding and hospitalization as a result of infections in the first year of life. Pediatrics, 118(1): 92–99.

10. American Academy of Pediatrics Work Group on Breastfeeding (2005). Breastfeeding and the use of human milk. Pediatrics, 115(2): 496–506.

11. American College of Obstetricians and Gynecologists (2000). Breastfeeding: Maternal and infant aspects. ACOG Educational Bulletin No. 258. Obstetrics and Gynecology, 96(1): 1–16.