Breastfeeding is the feeding of an infant

Infant

A newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...

 or young child

Child

Biologically, a child is generally a human between the stages of birth and puberty. Some vernacular definitions of a child include the fetus, as being an unborn child. The legal definition of "child" generally refers to a minor, otherwise known as a person younger than the age of majority...

 with breast milk

Breast milk

Breast milk, more specifically human milk, is the milk produced by the breasts of a human female for her infant offspring...

 directly from female human breast

Breast

The breast is the upper ventral region of the torso of a primate, in left and right sides, which in a female contains the mammary gland that secretes milk used to feed infants.Both men and women develop breasts from the same embryological tissues...

s (i.e., via lactation

Lactation

Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process occurs in all female mammals, however it predates mammals. In humans the process of feeding milk is called breastfeeding or nursing...

) rather than from a baby bottle

Baby bottle

A baby bottle is a bottle with a teat to drink directly from. It is typically used by infants and young children when a mother does not breastfeed, or if someone cannot drink from a cup, for feeding oneself or being fed.In particular it is used to feed infant formula, expressed breast milk or...

 or other container. Babies have a sucking reflex that enables them to suck and swallow milk. It is recommended that mothers breastfeed for six months or more, without the addition of infant formula

Infant formula

Infant formula is a manufactured food designed and marketed for feeding to babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder or liquid . The U.S...

 or solid food. After the addition of solid food, mothers are advised to continue breastfeeding for at least a year, and can continue for two years or more.

Human breast milk

Breast milk

Breast milk, more specifically human milk, is the milk produced by the breasts of a human female for her infant offspring...

 is the healthiest form of milk for babies. There are few exceptions, such as when the mother is taking certain drug

Drug

A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage.In pharmacology, a...

s or is infected with human T-lymphotropic virus

Human T-lymphotropic virus

Human T-cell Lymphotropic Virus Type 1 , also called the Adult T-cell lymphoma virus type 1, a virus that has been seriously implicated in several kinds of diseases including HTLV-I-associated myelopathy, Strongyloides stercoralis hyper-infection, and a virus cancer link for leukemia...

, HIV

HIV

Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

 if not taking ARVs, or has active untreated tuberculosis

Tuberculosis

Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

. Breastfeeding promotes health and helps to prevent disease. Artificial feeding is associated with more deaths from diarrhea

Diarrhea

Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

 in infants in both developing

Developing country

A developing country, also known as a less-developed country, is a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries...

 and developed countries

Developed country

A developed country is a country that has a high level of development according to some criteria. Which criteria, and which countries are classified as being developed, is a contentious issue...

. Experts agree that breastfeeding is beneficial, and have concerns about artificial formulas but there are conflicting views about how long exclusive breastfeeding remains beneficial.

The World Health Organization

World Health Organization

The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 (WHO) and the American Academy of Pediatrics

American Academy of Pediatrics

The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...

 (AAP) emphasize the value of breastfeeding for mothers as well as children. Both recommend exclusive breastfeeding for the first six months of life. The AAP recommends that this be followed by supplemented breastfeeding for at least one year, while WHO recommends that supplemented breastfeeding continue up to two years or more. While recognizing the superiority of breastfeeding, regulating authorities also work to minimize the risks of artificial feeding.

Breast milk

Not all the properties of breast milk

Breast milk

Breast milk, more specifically human milk, is the milk produced by the breasts of a human female for her infant offspring...

 are understood, but its nutrient

Nutrient

A nutrient is a chemical that an organism needs to live and grow or a substance used in an organism's metabolism which must be taken in from its environment. They are used to build and repair tissues, regulate body processes and are converted to and used as energy...

 content is relatively stable. Breast milk is made from nutrients in the mother's bloodstream and bodily stores. Breast milk has just the right amount of fat

Fat

Fats consist of a wide group of compounds that are generally soluble in organic solvents and generally insoluble in water. Chemically, fats are triglycerides, triesters of glycerol and any of several fatty acids. Fats may be either solid or liquid at room temperature, depending on their structure...

, sugar

Sugar

Sugar is a class of edible crystalline carbohydrates, mainly sucrose, lactose, and fructose, characterized by a sweet flavor.Sucrose in its refined form primarily comes from sugar cane and sugar beet...

, water

Water

Water is a chemical substance with the chemical formula H2O. A water molecule contains one oxygen and two hydrogen atoms connected by covalent bonds. Water is a liquid at ambient conditions, but it often co-exists on Earth with its solid state, ice, and gaseous state . Water also exists in a...

, and protein

Protein

Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...

 that is needed for a baby's growth and development. Because breastfeeding uses an average of 500 calories a day it helps the mother lose weight after giving birth. The composition of breast milk changes depending on how long the baby nurses at each session, as well as on the age of the child. The quality of a mother's breast milk may be compromised by smoking

Smoking

Smoking is a practice in which a substance, most commonly tobacco or cannabis, is burned and the smoke is tasted or inhaled. This is primarily practised as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them...

, alcoholic beverage

Alcoholic beverage

An alcoholic beverage is a drink containing ethanol, commonly known as alcohol. Alcoholic beverages are divided into three general classes: beers, wines, and spirits. They are legally consumed in most countries, and over 100 countries have laws regulating their production, sale, and consumption...

s, caffeinated drink

Caffeinated drink

A caffeinated drink or caffeinated beverage is a drink which contains caffeine, a stimulant which is legal and popular in most developed countries.Caffeinated drinks are primarily coffee, tea, soft drinks, and energy drinks...

s, marijuana, methamphetamine

Methamphetamine

Methamphetamine is a psychostimulant of the phenethylamine and amphetamine class of psychoactive drugs...

, heroin, and methadone

Methadone

Methadone is a synthetic opioid, used medically as an analgesic and a maintenance anti-addictive for use in patients with opioid dependency. It was developed in Germany in 1937...

. Nonetheless, concerns about milk quality must be balanced with concerns about artificial baby milk. The American Academy of Pediatrics states that "Tobacco smoking by mothers is not a contraindication to breastfeeding." In addition, the AAP states that, while breastfeeding mothers "should avoid the use of alcoholic beverages," an "occasional celebratory single, small alcoholic drink is acceptable, but breastfeeding should be avoided for 2 hours after the drink."

Benefits for the infant

Scientific research, such as the studies summarized in a 2007 review for the U.S. Agency for Healthcare Research and Quality

Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality is a part of the United States Department of Health and Human Services, which supports research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to effective...

 (AHRQ) and a 2007 review for the WHO, has found many benefits to breastfeeding for the infant.

Greater immune health

During breastfeeding, antibodies

Antibody

An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...

 pass to the baby. This is one of the most important features of colostrum

Colostrum

Colostrum is a form of milk produced by the mammary glands of mammals in late pregnancy. Most species will generate colostrum just prior to giving birth...

, the breast milk created for newborns. Breast milk contains several anti-infective

Infection

An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

 factors such as bile salt stimulated lipase

Bile salt dependent lipase

Bile salt-dependent lipase , also known as carboxyl ester lipase is an enzyme produced by the adult pancreas and aids in the digestion of fats. Bile salt-stimulated lipase is an equivalent enzyme found within breast milk. BSDL has been found in the pancreatic secretions of all species in which it...

 (protecting against amoebic

Amoeba

Amoeba is a genus of Protozoa.History=The amoeba was first discovered by August Johann Rösel von Rosenhof in 1757. Early naturalists referred to Amoeba as the Proteus animalcule after the Greek god Proteus, who could change his shape...

 infections), lactoferrin

Lactoferrin

Lactoferrin , also known as lactotransferrin , is a multifunctional protein of the transferrin family. Lactoferrin is a globular glycoprotein with a molecular mass of about 80 kDa that is widely represented in various secretory fluids, such as milk, saliva, tears, and nasal secretions...

 (which binds to iron and inhibits the growth of intestinal bacteria

Gut flora

Gut flora consists of microorganisms that live in the digestive tracts of animals and is the largest reservoir of human flora. In this context, gut is synonymous with intestinal, and flora with microbiota and microflora....

) and immunoglobulin A

Immunoglobulin A

Immunoglobulin A is an antibody that plays a critical role in mucosal immunity. More IgA is produced in mucosal linings than all other types of antibody combined; between three and five grams are secreted into the intestinal lumen each day....

 protecting against microorganism

Microorganism

A microorganism or microbe is a microscopic organism that comprises either a single cell , cell clusters, or no cell at all...

s.

Fewer infections

Among the studies showing that breastfed infants have a lower risk of infection than non-breastfed infants are:

• In a 1993 University of Texas Medical Branch
  University of Texas Medical Branch
  The University of Texas Medical Branch is a component of the University of Texas System located in Galveston, Texas, United States, about 50 miles southeast of Downtown Houston...
  
   study, a longer period of breastfeeding was associated with a shorter duration of some middle ear infections (otitis media with effusion) in the first two years of life.
• A 1995 study of 87 infants found that breastfed babies had half the incidence of diarrheal illness, 19% fewer cases of any otitis media
  Otitis media
  Otitis media is inflammation of the middle ear, or a middle ear infection.It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache,...
  
   infection, and 80% fewer prolonged cases of otitis media than formula fed babies in the first twelve months of life.
• Breastfeeding appeared to reduce symptoms of upper respiratory tract infection
  Upper respiratory tract infection
  Upper respiratory tract infections are the illnesses caused by an acute infection which involves the upper respiratory tract: nose, sinuses, pharynx or larynx...
  
  s in premature infants up to seven months after release from hospital in a 2002 study of 39 infants.
• A 2004 case-control study found that breastfeeding reduced the risk of acquiring urinary tract infection
  Urinary tract infection
  A urinary tract infection is a bacterial infection that affects any part of the urinary tract. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine. The main causal agent is Escherichia coli...
  
  s in infants up to seven months of age, with the protection strongest immediately after birth.
• The 2007 review for AHRQ found that breastfeeding reduced the risk of acute otitis media, non-specific gastroenteritis, and severe lower respiratory tract infections.

Reduced sudden infant death syndrome

Breastfed babies have better arousal from sleep at 2–3 months. This coincides with the peak incidence of sudden infant death syndrome

Sudden infant death syndrome

Sudden infant death syndrome is marked by the sudden death of an infant that is unexpected by medical history, and remains unexplained after a thorough forensic autopsy and a detailed death scene investigation. An infant is at the highest risk for SIDS during sleep, which is why it is sometimes...

.
A study conducted at the University of Münster

University of Münster

The University of Münster is a public university located in the city of Münster, North Rhine-Westphalia in Germany. The WWU is part of the Deutsche Forschungsgemeinschaft, a society of Germany's leading research universities...

 found that breastfeeding halved the risk of sudden infant death syndrome in children up to the age of 1.

Less diabetes

Infants exclusively breastfed have less chance of developing diabetes mellitus type 1

Diabetes mellitus type 1

Diabetes mellitus type 1 is a form of diabetes mellitus that results from autoimmune destruction of insulin-producing beta cells of the pancreas. The subsequent lack of insulin leads to increased blood and urine glucose...

 than peers with a shorter duration of breastfeeding and an earlier exposure to cow milk and solid foods. Breastfeeding also appears to protect against diabetes mellitus type 2

Diabetes mellitus type 2

Diabetes mellitus type 2formerly non-insulin-dependent diabetes mellitus or adult-onset diabetesis a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Diabetes is often initially managed by increasing exercise and...

, at least in part due to its effects on the child's weight.

Less childhood obesity

Breastfeeding appears to reduce the risk of extreme obesity

Obesity

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...

 in children The protective effect of breastfeeding against obesity is consistent, though small, across many studies, and appears to increase with the duration of breastfeeding.

A study has also shown that infants who are bottle-fed in early infancy are more likely to empty the bottle or cup in late infancy than those who are breastfed. "Bottle-feeding, regardless of the type of milk, is distinct from feeding at the breast in its effect on infants' self-regulation of milk intake." According to the study, this may be due to one of three possible factors, including that when bottle feeding, parents may encourage an infant to finish the contents of the bottle whereas when breastfeeding, an infant naturally develops self-regulation of milk intake. A study in Today's Pediatrics associates solid food given too early to Formula-fed babies before 4 months old will make them 6 times as likely to become obese by age 3. It does not happen if the babies were given solid foods with breast feeding.

Less tendency to develop allergic diseases (atopy)

In children who are at risk for developing allergic diseases (defined as at least one parent or sibling having atopy

Atopy

Atopy or atopic syndrome is a predisposition toward developing certain allergic hypersensitivity reactions.Atopy may have a hereditary component, although contact with the allergen must occur before the hypersensitivity reaction can develop ....

), atopic syndrome can be prevented or delayed through exclusive breastfeeding for four months, though these benefits may not be present after four months of age. However, the key factor may be the age at which non-breastmilk is introduced rather than duration of breastfeeding. Atopic dermatitis

Atopic dermatitis

Atopic dermatitis is an inflammatory, chronically relapsing, non-contagious and pruritic skin disorder...

, the most common form of eczema

Eczema

Eczema is a form of dermatitis, or inflammation of the epidermis . In England, an estimated 5.7 million or about one in every nine people have been diagnosed with the disease by a clinician at some point in their lives.The term eczema is broadly applied to a range of persistent skin conditions...

, can be reduced through exclusive breastfeeding beyond 12 weeks in individuals with a family history of atopy, but when breastfeeding beyond 12 weeks is combined with other foods incidents of eczema rise irrespective of family history.

Less necrotizing enterocolitis in premature infants

Necrotizing enterocolitis

Necrotizing enterocolitis

Necrotizing enterocolitis is a medical condition primarily seen in premature infants, where portions of the bowel undergo necrosis .-Signs and symptoms:...

 (NEC) is an acute inflammatory disease in the intestines of infants. Necrosis or death of intestinal tissue may follow. It is mainly found in premature birth

Premature birth

In humans preterm birth refers to the birth of a baby of less than 37 weeks gestational age. The cause for preterm birth is in many situations elusive and unknown; many factors appear to be associated with the development of preterm birth, making the reduction of preterm birth a challenging...

s. In one study of 926 preterm infants, NEC developed in 51 infants (5.5%). The death rate from necrotizing enterocolitis was 26%. NEC was found to be six to ten times more common in infants fed formula exclusively, and three times more common in infants fed a mixture of breast milk and formula, compared with exclusive breastfeeding. In infants born at more than 30 weeks, NEC was twenty times more common in infants fed exclusively on formula. A 2007 meta-analysis of four randomized controlled trials found "a marginally statistically significant association" between breastfeeding and a reduction in the risk of NEC.

Other long term health effects

In one study, breastfeeding did not appear to offer protection against allergies

Allergy

An Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid...

. However, another study showed breastfeeding to have lowered the risk of asthma

Asthma

Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...

, protect against allergies, and provide improved protection for babies against respiratory and intestinal infections.

A review of the association between breastfeeding and celiac disease (CD) concluded that breast feeding while introducing gluten

Gluten

Gluten is a protein composite found in foods processed from wheat and related grain species, including barley and rye...

 to the diet reduced the risk of CD. The study was unable to determine if breastfeeding merely delayed symptoms or offered life-long protection.

An initial study at the University of Wisconsin found that women who were breast fed in infancy may have a lower risk of developing breast cancer

Breast cancer

Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

 than those who were not breast fed.

Breastfeeding may decrease the risk of cardiovascular disease

Cardiovascular disease

Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels . While the term technically refers to any disease that affects the cardiovascular system , it is usually used to refer to those related to atherosclerosis...

 in later life, as indicated by lower cholesterol

Cholesterol

Cholesterol is a complex isoprenoid. Specifically, it is a waxy steroid of fat that is produced in the liver or intestines. It is used to produce hormones and cell membranes and is transported in the blood plasma of all mammals. It is an essential structural component of mammalian cell membranes...

 and C-reactive protein

C-reactive protein

C-reactive protein is a protein found in the blood, the levels of which rise in response to inflammation...

 levels in adult women who had been breastfed as infants. Although a 2001 study suggested that adults who had been breastfed as infants had lower arterial distensibility than adults who had not been breastfed as infants, the 2007 review for the WHO concluded that breastfed infants "experienced lower mean blood pressure" later in life. A 2007 review for the AHRQ found that "there is an association between a history of
breastfeeding during infancy and a small reduction in adult blood pressure, but the clinical or
public health implication of this finding is unclear". A 2006 study found that breastfed babies are better able to cope with stress later in life.

Intelligence

Studies have examined whether breastfeeding in infants is associated with higher intelligence

Intelligence

Intelligence has been defined in different ways, including the abilities for abstract thought, understanding, communication, reasoning, learning, planning, emotional intelligence and problem solving....

 later in life. Possible association between breastfeeding and intelligence is not clear. The 2007 review for the AHRQ found "no relationship between breastfeeding in term infants and cognitive performance." The 2007 review for the WHO "suggests that breastfeeding is associated with increased cognitive development in childhood." The review also states that "The issue remains of whether the association is related to the properties of breastmilk itself, or whether breastfeeding enhances the bonding between mother and child, and thus contributes to intellectual development."

Some who have found a connection:

• Horwood, Darlow and Mogridge (2001) tested the intelligence quotient
  Intelligence quotient
  An intelligence quotient, or IQ, is a score derived from one of several different standardized tests designed to assess intelligence. When modern IQ tests are constructed, the mean score within an age group is set to 100 and the standard deviation to 15...
  
   (IQ) scores of 280 low birthweight children at seven or eight years of age. Those who were breastfed for more than eight months had verbal IQ scores 6 points higher (which was significantly higher
  Statistical significance
  In statistics, a result is called statistically significant if it is unlikely to have occurred by chance. The phrase test of significance was coined by Ronald Fisher....
  
  ) than comparable children breastfed for less time. They concluded "These findings add to a growing body of evidence to suggest that breast milk feeding may have small long term benefits for child cognitive development."
• A 2005 study using data on 2,734 sibling pairs from the National Longitudinal Study of Adolescent Health
  National Longitudinal Study of Adolescent Health
  The National Longitudinal Study of Adolescent Health is the only nationally representative study of adolescent sexuality, which has spawned over one thousand peer-reviewed publications on many issues related to adolescent health and sexuality, and other adolescent health risk behaviors.The Add...
  
   "provide[d] persuasive evidence of a causal connection between breastfeeding and intelligence." The same data "also suggests that nonexperimental studies of breastfeeding overstate some of [breastfeeding's] other long-term benefits, even if controls are included for race, ethnicity, income, and education."
• Two initial cohort studies
  Cohort study
  A cohort study or panel study is a form of longitudinal study used in medicine, social science, actuarial science, and ecology. It is an analysis of risk factors and follows a group of people who do not have the disease, and uses correlations to determine the absolute risk of subject contraction...
  
   published in 2007 suggest babies with a specific version of the FADS2
  FADS2
  Fatty acid desaturase 2 also known as delta fatty acid desaturase is an enzyme that in humans is encoded by the FADS2 gene.- Function :Fatty acid desaturase 2 is a member of the fatty acid desaturase gene family...
  
   gene demonstrated an IQ averaging 7 points higher if breastfed, compared with babies with a less common version of the gene who showed no improvement when breastfed. FADS2 affects the metabolism of polyunsaturated fatty acids found in human breast milk, such as docosahexaenoic acid
  Docosahexaenoic acid
  Docosahexaenoic acid is an omega-3 fatty acid that is a primary structural component of the human brain and retina. In chemical structure, DHA is a carboxylic acid with a 22-carbon chain and six cis double bonds; the first double bond is located at the third carbon from the omega end...
  
   and arachidonic acid, which are known to be linked to early brain development. The researchers were quoted as saying "Our findings support the idea that the nutritional content of breast milk accounts for the differences seen in human IQ. But it's not a simple all-or-none connection: it depends to some extent on the genetic makeup of each infant." The researchers wrote "further investigation to replicate and explain this specific gene–environment interaction is warranted."
• In "the largest randomized trial ever conducted in the area of human lactation," between 1996 and 1997 maternity hospitals and polyclinic
  Polyclinic
  Polyclinics in England are intended to offer a far greater range of services than can be offered by current general practitioner practices and local health centres. In addition to traditional GP services they would offer extended urgent care, healthy living services, community mental health...
  
  s in Belarus
  Belarus
  Belarus , officially the Republic of Belarus, is a landlocked country in Eastern Europe, bordered clockwise by Russia to the northeast, Ukraine to the south, Poland to the west, and Lithuania and Latvia to the northwest. Its capital is Minsk; other major cities include Brest, Grodno , Gomel ,...
  
   were randomized to receive or not receive breastfeeding promotion modeled on the Baby Friendly Hospital Initiative
  Baby Friendly Hospital Initiative
  The Baby Friendly Hospital Initiative , also known as “Baby Friendly Initiative” , is a worldwide programme of the World Health Organization and UNICEF, launched in 1991 following the adoption of the Innocenti Declaration on breastfeeding promotion in 1990...
  
  . Of 13,889 infants born at these hospitals and polyclinics and followed up in 2002–2005, those who had been born in hospitals and polyclinics receiving breastfeeding promotion had IQs that were 2.9–7.5 points higher (which was significantly higher). Since (among other reasons) a randomized trial should control for maternal IQ, the authors concluded in a 2008 paper that the data "provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development."

Some who have not found a connection:

• In 2006, Der and colleagues, having performed a prospective cohort study
  Prospective cohort study
  A prospective cohort study is a cohort study that follows over time a group of similar individuals who differ with respect to certain factors under study, to determine how these factors affect rates of a certain outcome...
  
  , sibling pairs analysis, and meta-analysis
  Meta-analysis
  In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...
  
  , concluded that "Breast feeding has little or no effect on intelligence in children." The researchers found that "Most of the observed association between breast feeding and cognitive development is the result of confounding
  Confounding
  In statistics, a confounding variable is an extraneous variable in a statistical model that correlates with both the dependent variable and the independent variable...
  
   by maternal intelligence."
• An attempt to replicate the Caspi study in 5934 8 year old children failed: No relationship of the common C allele to negative effects of formula feeding was apparent, and contra to the original report, the rare GG homozygote children performed worse when formula fed than other children on formula milk.
• A study of over 700 families recently found no evidence for either main or moderating effects of the original SNP (rs174575), nor of two additional FADS2 polymorphisms (rs1535 and rs174583), nor any effect of maternal FADS2 status on offspring IQ.

Benefits for mothers

Breastfeeding is a cost effective way of feeding an infant, providing nourishment for a child at a small cost to the mother. Frequent and exclusive breastfeeding can delay the return of fertility through lactational amenorrhea

Lactational Amenorrhea Method

The lactational amenorrhea method is a method of avoiding pregnancies which is based on the natural postnatal infertility that occurs when a woman is amenorrheic and fully breastfeeding...

, though breastfeeding is an imperfect means of birth control

Birth control

Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include contraception , contragestion and abortion...

. During breastfeeding beneficial hormone

Hormone

A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...

s are released into the mother's body and the maternal bond can be strengthened. Breastfeeding is possible throughout pregnancy

Pregnancy

Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...

, but generally milk production will be reduced at some point.

Bonding

Hormones released during breastfeeding help to strengthen the maternal bond

Maternal bond

The maternal bond is typically the relationship between a mother and her child.While it typically occurs due to pregnancy and childbirth, it may also occur between a woman and an unrelated child, such as in adoption...

. Teaching partners how to manage common difficulties is associated with higher breastfeeding rates. Support for a mother while breastfeeding can assist in familial bonds

Human bonding

Human bonding is the process of development of a close, interpersonal relationship. It most commonly takes place between family members or friends, but can also develop among groups such as sporting teams and whenever people spend time together...

 and help build a paternal bond

Paternal bond

A paternal bond refers to the relationship between a father and his child. In the U.S., legal paternity is presumed for the husband of the mother unless a separate action is taken; an unmarried man may establish paternity by signing a voluntary recognition of paternity or by taking court action...

 between father and child.

If the mother is away, an alternative caregiver may be able to feed the baby with expressed breast milk. The various breast pump

Breast pump

A breast pump is a mechanical device that extracts milk from the breasts of a lactating woman. Breast pumps may be manual devices powered by hand or foot movements or electrical devices powered by mains electricity or batteries.- History :...

s available help working mothers to feed their babies breast milk for as long as they want. To be successful, the mother must produce and store enough milk to feed the child for the time she is away, and the feeding caregiver must be comfortable in handling breast milk.

Hormone release

Breastfeeding releases oxytocin

Oxytocin

Oxytocin is a mammalian hormone that acts primarily as a neuromodulator in the brain.Oxytocin is best known for its roles in sexual reproduction, in particular during and after childbirth...

 and prolactin

Prolactin

Prolactin also known as luteotropic hormone is a protein that in humans is encoded by the PRL gene.Prolactin is a peptide hormone discovered by Henry Friesen...

, hormones that relax the mother and make her feel more nurturing toward her baby. Breastfeeding soon after giving birth increases the mother's oxytocin levels, making her uterus contract more quickly and reducing bleeding. Pitocin, a synthetic hormone used to make the uterus contract during and after labour, is structurally modelled on oxytocin. Syntocinon, another synthetic oxytocic, is commonly used in Australia and the UK rather than Pitocin.

Weight loss

As the fat accumulated during pregnancy is used to produce milk, extended breastfeeding—at least 6 months—can help mothers lose weight. However, weight loss is highly variable among lactating women; monitoring the diet and increasing the amount/intensity of exercise are more reliable ways of losing weight. The 2007 review for the AHRQ found "The effect of breastfeeding in mothers on return-to-pre-pregnancy weight was negligible, and the effect of breastfeeding on postpartum weight loss was unclear."

Natural postpartum infertility

Breastfeeding may delay the return to fertility for some women by suppressing ovulation. A breastfeeding woman may not ovulate, or have regular periods, during the entire lactation period. The period in which ovulation is absent differs for each woman. This lactational amenorrhea has been used as an imperfect form of natural contraception, with greater than 98% effectiveness during the first six months after birth if specific nursing behaviors are followed. It is possible for women to ovulate within two months after birth while fully breastfeeding and get pregnant again.

Long-term health effects

For breastfeeding women, long-term health benefits include:

• Less risk of breast cancer
  Breast cancer
  Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
  
  , ovarian cancer
  Ovarian cancer
  Ovarian cancer is a cancerous growth arising from the ovary. Symptoms are frequently very subtle early on and may include: bloating, pelvic pain, difficulty eating and frequent urination, and are easily confused with other illnesses....
  
  , and endometrial cancer
  Endometrial cancer
  Endometrial cancer refers to several types of malignancies that arise from the endometrium, or lining, of the uterus. Endometrial cancers are the most common gynecologic cancers in the United States, with over 35,000 women diagnosed each year. The incidence is on a slow rise secondary to the...
  
  .
• A 2009 study indicated that lactation for at least 24 months is associated with a 23% lower risk of coronary heart disease.
• Although the 2007 review for the AHRQ found "no relationship between a history of lactation and the risk of osteoporosis
  Osteoporosis
  Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
  
  ", mothers who breastfeed longer than eight months benefit from bone re-mineralisation.
• Breastfeeding diabetic mothers require less insulin.
• Reduced risk of metabolic syndrome
  Metabolic syndrome
  Metabolic syndrome is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. It affects one in five people in the United States and prevalence increases with age...
  
  
• Reduced risk of post-partum bleeding
  Bleeding
  Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
  
  .
• According to a Malmö University study published in 2009, women who breast fed for a longer duration have a lower risk for contracting rheumatoid arthritis
  Rheumatoid arthritis
  Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...
  
   than women who breast fed for a shorter duration or who had never breast fed.

World Health Organization

The WHO recommends exclusive breastfeeding for the first six months of life, after which "infants should
receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond."

American Academy of Pediatrics

The AAP recommends exclusive breastfeeding for the first six months of life. Furthermore, "breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child."

Methods and considerations

There are many books and videos to advise mothers about breastfeeding. Lactation consultant

Lactation consultant

A lactation consultant is a healthcare provider recognized as an expert in the fields of human lactation and breastfeeding. The USLCA, United States Lactation Consultant Association, is the presiding organization in the United States of America and the International Lactation Consultant...

s in hospitals or private practice, and volunteer organisations of breastfeeding mothers such as La Leche League International

La Leche League International

La Leche League International is an international nonprofit organization that distributes information on and promotes breastfeeding...

 also provide advice and support.

Early breastfeeding

In the half hour after birth, the baby's suckling reflex is strongest, and the baby is more alert, so it is the ideal time to start breastfeeding. Breastfeeding also releases hormones that contract the uterus to reduce post-partum bleeding. Early breastfeeding is associated with fewer nighttime feeding problems.

Time and place for breastfeeding

Breastfeeding at least every two to three hours helps to maintain milk production. For most women, eight breastfeeding or pumping sessions every 24 hours keeps their milk production high. Newborn babies may feed more often than this: 10 to 12 breastfeeding sessions every 24 hours is common, and some may even feed 18 times a day. Feeding a baby "on demand" (sometimes referred to as "on cue"), means feeding when the baby shows signs of hunger

Hunger

Hunger is the most commonly used term to describe the social condition of people who frequently experience the physical sensation of desiring food.-Malnutrition, famine, starvation:...

; feeding this way rather than by the clock helps to maintain milk production and ensure the baby's needs for milk and comfort are being met. However, it may be important to recognize whether a baby is truly hungry, as breastfeeding too frequently may mean the child receives a disproportionately high amount of foremilk, and not enough hindmilk.

"Experienced breastfeeding mothers learn that the sucking patterns and needs of babies vary. While some infants' sucking needs are met primarily during feedings, other babies may need additional sucking at the breast soon after a feeding even though they are not really hungry. Babies may also nurse when they are lonely, frightened or in pain."

"Comforting and meeting sucking needs at the breast is nature's original design. Pacifiers (dummies, soothers) are a substitute for the mother when she cannot be available. Other reasons to pacify a baby primarily at the breast include superior oral-facial development, prolonged lactational amenorrhea, avoidance of nipple confusion, and stimulation of an adequate milk supply to ensure higher rates of breastfeeding success."

Most US states now have laws that allow a mother to breastfeed her baby anywhere she is allowed to be. In hospitals, rooming-in care permits the baby to stay with the mother and improves the ease of breastfeeding. Some commercial establishments provide breastfeeding rooms, although laws generally specify that mothers may breastfeed anywhere, without requiring them to go to a special area.

Latching on, feeding, and positioning

Correct positioning and technique for latching on can prevent nipple soreness and allow the baby to obtain enough milk. The "rooting reflex" is the baby's natural tendency to turn towards the breast with the mouth open wide; mothers sometimes make use of this by gently stroking the baby's cheek or lips with their nipple to induce the baby to move into position for a breastfeeding session, then quickly moving the baby onto the breast while its mouth is wide open. To prevent nipple soreness and allow the baby to get enough milk, a large part of the breast and areola need to enter the baby's mouth. To help the baby latch on well, tickle the baby's top lip with the nipple, wait until the baby's mouth opens wide, then bring the baby up towards the nipple quickly, so that the baby has a mouthful of nipple and areola

Areola

This article is about the breast tissue. For the entomology term, see the glossary of Lepidopteran terms. For an artistic cloud motif, see aureola. For the cactus feature, see Areole....

. The nipple should be at the back of the baby's throat, with the baby's tongue lying flat in its mouth. Inverted or flat nipples

Inverted nipple

An inverted nipple is a condition where the nipple, instead of pointing outward, is retracted into the breast. In some cases, the nipple will be temporarily protruded if stimulated, but in others, the inversion remains regardless of stimulus...

 can be massaged so that the baby will have more to latch onto. Resist the temptation to move towards the baby, as this can lead to poor attachment.

Pain in the nipple or breast is linked to incorrect breastfeeding techniques. Failure to latch on is one of the main reasons for ineffective feeding and can lead to infant health concerns. A 2006 study found that inadequate parental education, incorrect breastfeeding techniques, or both were associated with higher rates of preventable hospital admissions in newborns.

The baby may pull away from the nipple after a few minutes or after a much longer period of time. Normal feeds at the breast can last a few sucks (newborns), from 10 to 20 minutes or even longer (on demand). Sometimes, after the finishing of a breast, the mother may offer the other breast.

While most women breastfeed their child in the cradling position, there are many ways to hold the feeding baby. It depends on the mother and child's comfort and the feeding preference of the baby. Some babies prefer one breast to the other, but the mother should offer both breasts at every nursing with her newborn.

When tandem breastfeeding, the mother is unable to move the baby from one breast to another and comfort can be more of an issue. As tandem breastfeeding brings extra strain to the arms, especially as the babies grow, many mothers of twins recommend the use of more supporting pillows.

Exclusive breastfeeding

Exclusive breastfeeding is defined as "an infant's consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk, and no foods) except for vitamins, minerals, and medications." National and international guidelines recommend that all infants be breastfed exclusively for the first six months of life. Breastfeeding may continue with the addition of appropriate foods, for two years or more. Exclusive breastfeeding has dramatically reduced infant deaths in developing countries by reducing diarrhea

Diarrhea

Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

 and infectious disease

Infectious disease

Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...

s. It has also been shown to reduce HIV transmission from mother to child, compared to mixed feeding.

Exclusively breastfed infants feed anywhere from 6 to 14 times a day. Newborns consume from 30 to 90 ml (1 to 3 US fluid ounces) per feed. After the age of four weeks, babies consume about 120ml (4 US fluid ounces) per feed. Each baby is different, but as it grows the amount will increase. It is important to recognize the baby's hunger signs. It is assumed that the baby knows how much milk it needs and it is therefore advised that the baby should dictate the number, frequency, and length of each feed. The supply of milk from the breast is determined by the number and length of these feeds or the amount of milk expressed. The birth weight

Birth weight

Birth weight is the body weight of a baby at its birth.There have been numerous studies that have attempted, with varying degrees of success, to show links between birth weight and later-life conditions, including diabetes, obesity, tobacco smoking and intelligence.-Determinants:There are...

 of the baby may affect its feeding habits, and mothers may be influenced by what they perceive its requirements to be. For example, a baby born small for gestational age may lead a mother to believe that her child needs to feed more than if it is larger; they should, however, go by the demands of the baby rather than what they feel is necessary.

While it can be hard to measure how much food a breastfed baby consumes, babies normally feed to meet their own requirements. Babies that fail to eat enough may exhibit symptoms of failure to thrive

Failure to thrive

Failure to thrive is a medical term which is used in both pediatric and adult human medicine, as well as veterinary medicine ....

. If necessary, it is possible to estimate feeding from wet and soiled nappies (diapers): 8 wet cloth or 5–6 wet disposable, and 2–5 soiled per 24 hours suggests an acceptable amount of input for newborns older than 5–6 days old. After 2–3 months, stool frequency is a less accurate measure of adequate input as some normal infants may go up to 10 days between stools. Babies can also be weighed before and after feeds.

Expressing breast milk

When direct breastfeeding is not possible, a mother can express (artificially remove and store) her milk. With manual massage or using a breast pump

Breast pump

A breast pump is a mechanical device that extracts milk from the breasts of a lactating woman. Breast pumps may be manual devices powered by hand or foot movements or electrical devices powered by mains electricity or batteries.- History :...

, a woman can express her milk and keep it in freezer storage bags, a supplemental nursing system

Supplemental nursing system

-Description:The supplemental nursing system consists of a container and a capillary tube leading from the container to the mother's nipple....

, or a bottle

Baby bottle

A baby bottle is a bottle with a teat to drink directly from. It is typically used by infants and young children when a mother does not breastfeed, or if someone cannot drink from a cup, for feeding oneself or being fed.In particular it is used to feed infant formula, expressed breast milk or...

 ready for use. Breast milk may be kept at room temperature

Room temperature

-Comfort levels:The American Society of Heating, Refrigerating and Air-Conditioning Engineers has listings for suggested temperatures and air flow rates in different types of buildings and different environmental circumstances. For example, a single office in a building has an occupancy ratio per...

 for up to six hours , refrigerated for up to eight days or frozen for up to four to six months. Research suggests that the antioxidant activity in expressed breast milk decreases over time but it still remains at higher levels than in infant formula.

Expressing breast milk can maintain a mother's milk supply when she and her child are apart. If a sick baby is unable to feed, expressed milk can be fed through a nasogastric tube.

Expressed milk can also be used when a mother is having trouble breastfeeding.

"Exclusively expressing", "exclusively pumping", and "EPing" are terms for a mother who feeds her baby exclusively on her breastmilk while not physically breastfeeding. This may arise because her baby is unable or unwilling to latch on to the breast. With good pumping habits, particularly in the first 12 weeks when the milk supply is being established, it is possible to produce enough milk to feed the baby for as long as the mother wishes.

It is generally advised to delay using a bottle to feed expressed breast milk until the baby is 4–6 weeks old and is good at sucking directly from the breast. As sucking from a bottle takes less effort, babies can lose their desire to suck from the breast. This is called nursing strike or nipple confusion. To avoid this when feeding expressed breast milk (EBM) before 4–6 weeks of age, it is recommended that breast milk be given by other means such as feeding spoons or feeding cups. Also, EBM should be given by someone other than the breastfeeding mother (or wet nurse), so that the baby can learn to associate direct feeding with the mother (or wet nurse) and associate bottle feeding with other people.

Some women donate their expressed breast milk (EBM) to others, either directly or through a milk bank

Human Milk Banking In North America

A human milk bank is "a service which collects, screens, processes, and dispenses by prescription human milk donated by nursing mothers who are not biologically related to the recipient infant". There are currently eleven milk banks in North America. They are usually housed in hospitals, although...

. Though historically the use of wet nurse

Wet nurse

A wet nurse is a woman who is used to breast feed and care for another's child. Wet nurses are used when the mother is unable or chooses not to nurse the child herself. Wet-nursed children may be known as "milk-siblings", and in some cultures the families are linked by a special relationship of...

s was common, some women dislike the idea of feeding their own child with another woman's milk; others appreciate being able to give their baby the benefits of breast milk. Feeding expressed breast milk—either from donors or the baby's own mother—is the feeding method of choice for premature babies. The transmission of some viral diseases through breastfeeding can be prevented by expressing breast milk and subjecting it to Holder pasteurisation.

Mixed feeding

Predominant or mixed breastfeeding means feeding breast milk along with infant formula

Infant formula

Infant formula is a manufactured food designed and marketed for feeding to babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder or liquid . The U.S...

, baby food

Baby food

Baby food is any food, other than breastmilk or infant formula, that is made specifically for infants, roughly between the ages of four to six months to 2 years. The food comes in multiple varieties and tastes, can be produced by many manufacturers, or may be table food that the rest of the family...

 and even water, depending on the age of the child. Babies feed differently with artificial teats than from a breast. With the breast, the infant's tongue massages the milk out rather than sucking. With an artificial teat, an infant will suck as long as there is milk flowing and it is easy to overfeed with a bottle. Since the flow is constant, and the baby does not have to elicit a letdown, mixing breastfeeding and bottle-feeding (or using a pacifier

Pacifier

A pacifier is a rubber, plastic, or silicone nipple given to an infant or other young child to suck upon. In its standard appearance it has a teat, mouth shield, and handle...

) before the baby is used to feeding from its mother, can result in the infant preferring the bottle to the breast. Some mothers supplement feed with a small syringe or flexible cup to reduce the risk of artificial nipple preference. When using a bottle it is important to use the slowest flow the baby will accept (and not move up to a faster flow just because the baby is getting older) and feed in a paced manner. The baby should sit almost upright and the bottle should be only tipped slightly to allow for a little bit of milk to pass to the baby. Bottle feeding should take as long as breastfeeding does. Faster feeding can easily result in overfeeding.

Tandem nursing

Feeding two children at the same time who are not twins or multiples is called tandem nursing. As the appetite and feeding habits of each baby may not be the same, this could mean feeding each according to their own individual needs and can also include breastfeeding them together, one on each breast.

In cases of triplets or more

Multiple birth

A multiple birth occurs when more than one fetus is carried to term in a single pregnancy. Different names for multiple births are used, depending on the number of offspring. Common multiples are two and three, known as twins and triplets...

, it is a challenge for a mother to organize feeding around the appetites of all the babies. Breasts can respond to the demand and produce large quantities of milk; mothers have been able to breastfeed triplets successfully.

Tandem nursing occurs when a woman has a baby while breastfeeding an older child. During the late stages of pregnancy, the milk will change to colostrum

Colostrum

Colostrum is a form of milk produced by the mammary glands of mammals in late pregnancy. Most species will generate colostrum just prior to giving birth...

, and some older nurslings will continue to feed even with this change, while others may wean due to the change in taste or drop in supply. Breastfeeding a child while being pregnant with another can also be considered a form of tandem feeding for the nursing mother, as she also provides the nutrition for two.

Shared breastfeeding

It used to be common worldwide, and still is in some developing nations such as those in Africa

Africa

Africa is the world's second largest and second most populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area...

, for more than one woman to breastfeed a child. Shared breastfeeding has now been found to be a risk factor for HIV

HIV

Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

 infection in infants. A woman who is engaged to breastfeed another's baby is known as a wet nurse

Wet nurse

A wet nurse is a woman who is used to breast feed and care for another's child. Wet nurses are used when the mother is unable or chooses not to nurse the child herself. Wet-nursed children may be known as "milk-siblings", and in some cultures the families are linked by a special relationship of...

. Shared breastfeeding can sometimes incur negative reactions in the Anglosphere

Anglosphere

Anglosphere is a neologism which refers to those nations with English as the most common language. The term can be used more specifically to refer to those nations which share certain characteristics within their cultures based on a linguistic heritage, through being former British colonies...

; American feminist activist Jennifer Baumgardner

Jennifer Baumgardner

Jennifer Baumgardner is an author, filmmaker, and third-wave feminist activist.-Early and personal life:Baumgardner grew up in Fargo, North Dakota and attended Lawrence University in Appleton, Wisconsin, graduating in 1992...

 has written about her experiences in New York

New York

New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...

 with this issue.

Duration of breastfeeding

The World Health Organization

World Health Organization

The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 recommends exclusive breastfeeding for the baby's first 6 months of life, and continued breastfeeding complemented with appropriate foods up to two years old and beyond.

In many Western countries, however, breastfeeding beyond the age of 1 year old is considered "extended breastfeeding".

These movements in the West towards earlier weaning, however, are recent. Breastfeeding beyond the age of 1 year old was at one time a very common practice worldwide. Dr. Martin Stein wrote in Parental Concerns about Extended Breastfeeding in a Toddler that “The discussion about extended nursing is similar to that of co-sleeping. They are both characteristics of child rearing that are closely linked to time and place. In most cultures before the 20th century, both practices were the norm. Changes in social, economical, and sexual expectations altered our views of the meaning of breastfeeding and bed sharing.” Extended breastfeeding was encouraged in Ancient Greek, Hebrew, and Muslim cultures. The Koran, the Talmud, and the writings of Aristotle all recommend breastfeeding for 2 to 3 years. In Breastfeeding Beyond 6 Months: Mothers' Perceptions of the Negative and Positive Consequences, Dr. S. B. Reamer states that "Over the past 100 years of American history, the acceptance of unrestricted nursing decreased and the age acceptable for weaning dropped dramatically, until the average weaning age was 3 months in the 1970's."

In reaction to the move in the West towards earlier weaning, several organizations have been founded in Western countries to support mothers who practice extended breastfeeding. These organizations include the International Childbirth Education Association and La Leche League International

La Leche League International

La Leche League International is an international nonprofit organization that distributes information on and promotes breastfeeding...

.

North America

Elizabeth Baldwin says in Extended Breastfeeding and the Law, that “Because our culture tends to view the breast as sexual, it can be hard for people to realize that breastfeeding is the natural way to nurture children.” In Western countries such as The United States of America, Canada

Canada

Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

, and Great Britain

Great Britain

Great Britain or Britain is an island situated to the northwest of Continental Europe. It is the ninth largest island in the world, and the largest European island, as well as the largest of the British Isles...

, extended breastfeeding is a taboo act. It is difficult to obtain accurate information and statistics about extended breastfeeding in these countries because of the mother's embarrassment. Mothers who nurse longer than the social norm sometimes hide their practices from all but very close family members and friends. This is called “closet nursing”. In a study published by the Journal of Tropical Pediatrics, 24% of American and Canadian mothers nursing past 6 months felt social hostility towards them. This number grew to 42% when mothers were nursing after 1 year of age. Also, 10% of mothers claimed embarrassment when more mobile, verbal toddlers made known in public the fact that they were nursed.

In the United States

United States

The United States of America is a federal constitutional republic comprising fifty states and a federal district...

, breastfeeding beyond 1 year of age is considered extended breastfeeding, and in contrast to WHO recommendations, the American Academy of Pediatrics

American Academy of Pediatrics

The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...

 stated in 1997 that, “Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child”.

In the United States overall, 43% of babies are breastfed until 6 months and 22.4% are breastfed until 12 months, though breastfeeding rates varied among the states.

Breastfeeding rates in the U.S. at 6 months rose from 34.2% in 2000 to 43.5% in 2006 and the rates at 12 months rose from 15.7% in 2000 to 22.7% in 2006. The U.S. Healthy People 2010 goals were to have at least 60% of babies exclusively breastfed at 3 months and 25% of babies exclusively breastfed at 6 months so this goal has yet to be met.

In the United States a study published by the Centers for Disease Control and Prevention found that 75 percent of mothers began breastfeeding. However, by 6 months, the rate fell to 43% and was just 22% after a year. Breastfeeding rates vary across the country, from nearly 90 percent initiating breastfeeding in Utah to 52.5 percent in Mississippi. The health care law now requires large employers to provide breastfeeding mothers with breaks and a private space to feed their babies.

There have been several cases in the United States

United States

The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 where children have been taken away from their mother's care because American

United States

The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 courts or government agencies found the mother's extended breastfeeding to be inappropriate.
In 1992, a New York State mother lost custody of her child for a year. She was still breastfeeding the child at age 3 and had reported experiences of sexual arousal while breastfeeding the child. The authorities took the child from the home in the fear that the mother might sexually abuse the child. Later, the social service agency that took over the case said that there was more to the case than could be released to the press due to confidentiality laws.
In 2000, an Illinois

Illinois

Illinois is the fifth-most populous state of the United States of America, and is often noted for being a microcosm of the entire country. With Chicago in the northeast, small industrial cities and great agricultural productivity in central and northern Illinois, and natural resources like coal,...

 child was removed from the mother's care after a judge ruled that the child might suffer emotional damage because of not being weaned. The child was later returned to the mother and the judge vacated the finding of neglect.
A social service agency in Colorado

Colorado

Colorado is a U.S. state that encompasses much of the Rocky Mountains as well as the northeastern portion of the Colorado Plateau and the western edge of the Great Plains...

 removed a 5-year-old child from the mother because she was still breastfeeding, but the court ordered the child returned to its family immediately.

Guinea-Bissau

In Guinea-Bissau

Guinea-Bissau

The Republic of Guinea-Bissau is a country in West Africa. It is bordered by Senegal to the north, and Guinea to the south and east, with the Atlantic Ocean to its west....

, West Africa, the average length of breastfeeding is 22.6 months.

India

In India

India

India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...

, mothers commonly breastfeed their children until 3 to 4 years of age. Stein says that “In India, women often wean their 3 or 4-year-old by putting the juice of a bitter gourd or melon on their nipples.”

The Philippines

In the Philippines

Philippines

The Philippines , officially known as the Republic of the Philippines , is a country in Southeast Asia in the western Pacific Ocean. To its north across the Luzon Strait lies Taiwan. West across the South China Sea sits Vietnam...

, the Implementing Rules and Regulations of the Milk Code require that breastfeeding be encouraged for babies up to the age of 2 years old or beyond. Under the same code, it is prohibited to advertise infant formula or breastmilk substitutes intended for infants and young children 24 months old and below. In practice, however, a 2008 WHO survey found that on average, mothers in the Philippines breastfed their babies until 14 months of age, with breastfeeding extending up to 17 months on average in rural areas. Almost fifty-eight percent of mothers surveyed around the nation were still breastfeeding their babies when the babies were a year old, and 34.2% of mothers were still breastfeeding when their babies were 2 years old.

Health effects

Priscilla Colletto stated in Beyond Toddlerhood: The Breastfeeding Relationship Continues, “The adverse health effects of weaning a child before or during toddlerhood are well documented for Third World countries such as Guinea-Bissau, where children who were no longer breastfed at ages 12–35 months had a 3.5 times higher mortality rate than did their peers who continued to breastfeed.” Dr. Laurence Grummer-Strawn observed that breastfeeding is protective against diarrheal diseases and other infections, breastfed children aged 12 to 36 months in Indonesia

Indonesia

Indonesia , officially the Republic of Indonesia , is a country in Southeast Asia and Oceania. Indonesia is an archipelago comprising approximately 13,000 islands. It has 33 provinces with over 238 million people, and is the world's fourth most populous country. Indonesia is a republic, with an...

 have much greater mid-arm circumference than children who have been weaned, and the incidences of malnourishment in breastfed Indonesian children are 3–5% less common than generally encountered in Indonesian clinics. Studies suggest that extended breastfeeding may reduce the chances of otitis media

Otitis media

Otitis media is inflammation of the middle ear, or a middle ear infection.It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache,...

 allergies, leukemia

Leukemia

Leukemia or leukaemia is a type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells called "blasts". Leukemia is a broad term covering a spectrum of diseases...

, and lymphoma

Lymphoma

Lymphoma is a cancer in the lymphatic cells of the immune system. Typically, lymphomas present as a solid tumor of lymphoid cells. Treatment might involve chemotherapy and in some cases radiotherapy and/or bone marrow transplantation, and can be curable depending on the histology, type, and stage...

 for the toddler, and premenopausal breast cancer in the mother. This is attributed to the fact that the levels of lysozyme, lactoferrin, and secretory IgA are stable and even increase in the breast milk of mothers who are breastfeeding for over 1 year. (Stein 1507). In one study, artificially-fed infants had 2 to 3 times as many episodes of significant illnesses (defined as “otitis media, lower respiratory disease, significant vomiting or diarrhea, and any illness requiring hospital admission”). However, there are also some studied risks involved in extended breastfeeding. Breastfeeding could impair a child's growth if they are not taught to eat other foods as well. Breast milk alone is not enough for children over 6 months of age and some have observed that children that have been breastfed longer than the norm have less of an appetite for added foods. Stein says that “As long as a toddler is eating a variety of grains, vegetables, fruits, and foods or supplements that provide adequate iron and vitamin D, nutrition will be adequate and appropriate growth and development will be ensured.”

Psychological effects

In A Time to Wean by Katherine Dettwyler, it states that “Western, industrialized societies can compensate for some (but not all) of the immunological benefits of breastfeeding with antibiotics, vaccines and improved sanitation. But the physical, cognitive, and emotional needs of the young child persist.” Many children who are breast-fed into their toddler years use the milk as a comforting, bonding moment with their mothers. In a 1974 survey of 152 mothers, 17% said that the security their toddlers obtained through extended breastfeeding helped them become more independent, 14% said that extended breastfeeding created a strong mother-child bond, and 14.6% said that extended breastfeeding strengthened their abilities as a mother. Four mothers said that they felt their child was too dependent and one mother considered her child a poor eater. Dr. Stein said that “A mother in my practice who breastfed 2 children until 2 years of age explained that she would slowdown and give her undivided attention to her child several times each day when breastfeeding. Her children knew that she always had time for those moments each day. This time was also important to the mother for relaxing and unwinding....For many nursing toddlers, the breast comes to serve the same function as a favorite blanket or stuffed animal in providing comfort and a sense of security.” One issue with extended breastfeeding is the ability of the mother and the child to separate. Some say that the desire for extended breastfeeding comes from the mother's inability to let go of "her baby". Baldwin refutes this statement, saying that the child is the one who chooses when they are weaned, as it is very difficult to force a child to breastfeed.

Diet during breastfeeding

Women who are breastfeeding need to be careful about what they eat and drink, since things can be passed to the baby through the breast milk. Just like during pregnancy, breastfeeding women should avoid fish that are high in mercury, and limit lower mercury fish intake. If a woman has alcohol, a small amount can be passed to the baby through breast milk. She should wait to breastfeed at least 2 hours after a single alcoholic drink to avoid passing any alcohol to the baby. Caffeine intake should be kept to no more than 300 milligrams (about one to three cups of regular coffee) per day for breastfeeding women because it may cause problems such as restlessness and irritability in some babies. A diet coke has 46 mg per 12 oz can, and a can of pepsi has 40 mg. Most drinks post their caffeine content on the can or bottle near the nutrition label and ingredients. Some infants are sensitive enough to caffeine to have problems even with smaller amounts of caffeine.

Healthy infant growth

The average breastfed baby doubles its birth weight in 5–6 months. By one year, a typical breastfed baby will weigh about 2½ times its birth weight. At one year, breastfed babies tend to be leaner than formula fed babies, which is healthier, especially in the long-run. A general guide to the growth of breastfed babies is the following:

• Weight gain of 4–7 ounces (112–200 grams) a week during the first month
• An average of 1–2 pounds (1/2 to 1 kilogram) per month for the first six months
• An average of one pound (1/2 kilogram) per month from six months to one year
• Babies usually grow in length by about an inch a month (2.5c.m.) during the first six months, and around one-half inch a month from six months to one year.

Weaning

Weaning

Weaning

Weaning is the process of gradually introducing a mammal infant, either human or animal, to what will be its adult diet and withdrawing the supply of its mother's milk.The process takes place only in mammals, as only mammals produce milk...

 is the process of introducing the infant to other food and reducing the supply of breast milk. The infant is fully weaned when it no longer receives any breast milk. Most mammals stop producing the enzyme

Enzyme

Enzymes are proteins that catalyze chemical reactions. In enzymatic reactions, the molecules at the beginning of the process, called substrates, are converted into different molecules, called products. Almost all chemical reactions in a biological cell need enzymes in order to occur at rates...

 lactase

Lactase

Lactase , a part of the β-galactosidase family of enzymes, is a glycoside hydrolase involved in the hydrolysis of the disaccharide lactose into constituent galactose and glucose monomers...

 at the end of weaning, and become lactose intolerant. Humans often have a mutation, with frequency depending primarily on ethnic background, that allows the production of lactase throughout life so they can drink milk — usually cow or goat milk — well beyond infancy. In humans, the psychological factors involved in the weaning process are crucial for both mother and infant as issues of closeness and separation are very prominent during this stage.

In the past bromocriptine

Bromocriptine

Bromocriptine , an ergoline derivative, is a dopamine agonist that is used in the treatment of pituitary tumors, Parkinson's disease , hyperprolactinaemia, neuroleptic malignant syndrome, and type 2 diabetes.- Indications :Amenorrhea, female infertility, galactorrhea, hypogonadism, and acromegaly...

 was in some countries frequently used to reduce the engorgement

Breast engorgement

Breast engorgement occurs in the mammary glands due to expansion and pressure exerted by the synthesis and storage of breast milk.It can be a cause of mastodynia....

 experienced by many women during weaning. This is now done only in exceptional cases as it causes frequent side effects, offers very little advantage over non-medical management and the possibility of serious side effects can not be ruled out. Other medications such as cabergoline

Cabergoline

Cabergoline , an ergot derivative, is a potent dopamine receptor agonist on D2 receptors. In vitro, rat studies show cabergoline has a direct inhibitory effect on pituitary lactotroph cells...

, lisuride

Lisuride

Lisuride is an antiparkinson agent of the iso-ergoline class, chemically related to the dopaminergic ergoline Parkinson's drugs. Lisuride is described as free base and as hydrogen maleate salt.Lisuride is used to lower prolactin and, in low doses, to prevent migraine attacks...

 or birth control pills may occasionally be used as lactation suppressants.

Physiological constraints to breastfeeding

While breastfeeding is a natural human activity, difficulties and complications are not uncommon. Putting the baby to the breast as soon as possible after the birth helps to avoid many problems, including mastitis

Puerperal mastitis

Puerperal mastitis is the inflammation of breast in connection with pregnancy, breastfeeding or weaning. It is caused by blocked milk ducts or milk excess and is relatively common; estimates range depending on methodology between 5–33%. However only about 0.4–0.5% of breastfeeding mothers develop...

. The AAP breastfeeding policy says: "Delay weighing, measuring, bathing, needle-sticks, and eye prophylaxis until after the first feeding is completed." Many breastfeeding difficulties can be resolved with proper hospital procedures, properly trained midwives, doctors and hospital staff, and lactation consultants. There are some situations in which breastfeeding may be harmful to the infant, including infection with HIV

HIV

Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

 and acute poisoning by environmental contaminants such as lead. The Institute of Medicine has reported that breast surgery, including breast implants or breast reduction surgery, reduces the chances that a woman will have sufficient milk to breast feed. Rarely, a mother may not be able to produce breastmilk because of a prolactin deficiency. This may be caused by Sheehan's syndrome

Sheehan's syndrome

Sheehan syndrome, also known as Simmonds' syndrome or postpartum hypopituitarism or postpartum pituitary necrosis, is hypopituitarism , caused by necrosis due to blood loss and hypovolemic shock during and after childbirth...

, an uncommon result of a sudden drop in blood pressure during childbirth typically due to hemorrhaging.

Social-cultural constraints to breastfeeding

In developed countries, many working mothers do not breast feed their children due to work pressures and very short periods of maternity leave. For example, a mother may need to schedule for frequent pumping breaks, and find a clean, private and quiet place at work for pumping. These inconveniences may cause mothers to give up on breast feeding and use infantyeah yeah wotecve

Barriers to breastfeeding

The majority of mothers intend to breastfeed when their baby is born. There are many things that happen that disrupt or intervene in this plan. Here are just a few of the barriers that women face when attempting to breastfeed.

• Birth procedures – routine separation of the baby from the mother, delayed breastfeeding initiation, vigorous routine suctioning, medications and mode of delivery all interfere with breastfeeding. A “substantial” number of hospital and facilities implemented procedures and policies that were not evidenced based and that were known to interfere with lactation.
• Nursery policies – additional separation, rooming in policies, routine bottles and pacifiers can also prevent the baby from learning to latch and establishing a supply. About a quarter of all breastfeeding infants receive formula supplementation in the first two days of life.
• Ignorance
  • Personal – breastfeeding is the biologic norm but in absence of watching others nurse their babies, it is a lost art as well. Classes, books and personal counseling (professional or lay) can be beneficial.
  • Partner – Partners also lack basic breastfeeding knowledge and are typically unsure of their role in breastfeeding.
  • Practitioner – Physicians and nurses have surprisingly little training in lactation and lactation support. One of the main action items in the Surgeon General’s Call to Action for Breastfeeding is to help educate practitioners about breastfeeding and breastfeeding issues.
• Workforce – Returning to work is the most common cited reason for discontinuing breastfeeding. Maternity leave in the US varies widely despite the Family Medical Leave Act (FMLA), which provides most working mothers up to 12 weeks. Many mothers are forced to take unpaid time off from their job and the majority do not use FMLA for the full twelve weeks. Fathers are also allowed to use FLMA for the birth or adoption of the child. Maternity leave varies widely by state.
• Poor latch - Pain caused from mis-positioning the baby on the breast or a tongue-tie in the infant can cause great pain in the mother and therefore discourage her from breastfeeding. These problems are generally easy to correct (by re-positioning or clipping the tongue-tie).

Women whose pregnancies are unintended

Unintended pregnancy

Unintended pregnancies are those in which conception was not intended by the female sexual partner. Worldwide, 38% of pregnancies were unintended in 1999 . Unintended pregnancies are the primary cause of induced abortion, resulting in about 42 million induced abortions per year...

 are less likely to breast feed their babies.

HIV infection

As breastfeeding can transmit HIV

HIV

Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

 from mother to child, UNAIDS recommends avoidance of all breastfeeding for HIV positive mothers where formula feeding is acceptable, feasible, affordable and safe. The qualifications are important. Some constituents of breast milk may protect from infection. High levels of certain polyunsaturated fatty acid

Polyunsaturated fatty acid

Polyunsaturated fatty acids are fatty acids that contain more than one double bond in their backbone. This class includes many important compounds, such as essential fatty acids and those that give drying oils their characteristic property....

s in breast milk (including eicosadienoic, arachidonic

Arachidonic acid

Arachidonic acid is a polyunsaturated omega-6 fatty acid 20:4.It is the counterpart to the saturated arachidic acid found in peanut oil, Arachidonic acid (AA, sometimes ARA) is a polyunsaturated omega-6 fatty acid 20:4(ω-6).It is the counterpart to the saturated arachidic acid found in peanut oil,...

 and gamma-linolenic acid

Gamma-Linolenic acid

γ-Linolenic acid is a fatty acid found primarily in vegetable oils...

s) are associated with a reduced risk of child infection when nursed by HIV-positive mothers. Arachidonic acid and gamma-linolenic acid may also reduce viral shedding

Viral shedding

Viral shedding refers to the successful reproduction, expulsion, and host-cell infection caused by virus progeny. Once replication has been completed and the host cell is exhausted of all resources in making viral progeny, the viruses may begin to leave the cell by several methods.The term is used...

 of HIV in breast milk. Due to this, in underdeveloped nations infant mortality rates are lower when HIV-positive mothers breastfeed their newborns than when they use infant formula. However, differences in infant mortality rates have not been reported in better resourced areas. Treating infants prophylactically with lamivudine

Lamivudine

Lamivudine is a potent nucleoside analog reverse transcriptase inhibitor .It is marketed by GlaxoSmithKline with the brand names Zeffix, Heptovir, Epivir, and Epivir-HBV.Lamivudine has been used for treatment of chronic hepatitis B at a lower dose than for treatment of HIV...

 (3TC) can help to decrease the transmission of HIV from mother to child by breastfeeding. If free or subsidized formula is given to HIV-infected mothers, recommendations have been made to minimize the drawbacks such as possible disclosure of the mother's HIV status.

History

Before the 20th century, breastfeeding was the main way of feeding babies. If for any reason the natural mother was unable to breastfeed, a wet nurse

Wet nurse

A wet nurse is a woman who is used to breast feed and care for another's child. Wet nurses are used when the mother is unable or chooses not to nurse the child herself. Wet-nursed children may be known as "milk-siblings", and in some cultures the families are linked by a special relationship of...

 was used. Attempts were made in 15th century Europe to use cow or goat milk, but these attempts were not successful. In the 18th century, flour or cereal mixed with broth were introduced as substitutes for breastfeeding, but this did not have a favorable outcome either. True commercial infant formula

Infant formula

Infant formula is a manufactured food designed and marketed for feeding to babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder or liquid . The U.S...

s appeared on the market in the mid 19th century but their use did not become widespread until after World War II

World War II

World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

. As the superior qualities of breast milk became better-established in medical literature, breastfeeding rates have increased and countries have enacted measures to protect the rights of infants and mothers to breastfeed.

Sociological factors

Researchers have found several social factors that correlate with differences in initiation, frequency, and duration of breastfeeding practices of mothers. Race, ethnic differences and socioeconomic status and other factors have been shown to affect a mother's choice whether or not to breastfeed and how long she breastfeeds her child.

• Race and culture Singh et al. also found that African American women are less likely than white women of similar socioeconomic status to breastfeed and Hispanic women are more likely to breastfeed. The Center of Disease Control used information from the National Immunization Survey to determine the proportion of Caucasian and African American children that were ever breast fed. They found that 71.5% of Caucasians had breastfed their child while only 50.1% of African Americans had. At six months of age this fell to 53.9% of Caucasian mothers and 43.2% of African American mothers who were still breastfeeding.
• Income Deborah L. Dee's research found that women and children who qualify for WIC
  Special Supplemental Nutrition Program for Women, Infants and Children
  The Special Supplemental Nutrition Program for Women, Infants and Children is a Federal assistance program of the Food and Nutrition Service of the United States Department of Agriculture for healthcare and nutrition of low-income pregnant women, breastfeeding women, and infants and children...
  
  , Special Supplemental Nutrition Program for Women, Infants, and Children were among those who were least likely to initiate breastfeeding. Income level can also contribute to women discontinuing breastfeeding early. More highly educated women are more likely to have access to information regarding difficulties with breastfeeding, allowing them to continue breastfeeding through difficulty rather than weaning early. Women in higher status jobs are more likely to have access to a lactation room
  Lactation room
  Lactation room is an American term for a private room where a breastfeeding woman can use a breast pump in private one or more times a day.-Purpose:...
  
   and suffer less social stigma from having to breastfeed or express breastmilk at work. In addition, women who are unable to take an extended leave from work following the birth of their child are less likely to continue breastfeeding when they return to work. Low income women are more likely to have unintended pregnancies, and women who's pregnancies are unintended are less likely to breast feed their babies.
• Other factors Other factors they found to have an effect on breastfeeding are “household composition, metropolitan/non-metropolitan residence, parental education, household income or poverty status, neighborhood safety, familial support, maternal physical activity, and household smoking status.”

Role of marketing

Controversy has arisen over the marketing of breast milk

Breast milk

Breast milk, more specifically human milk, is the milk produced by the breasts of a human female for her infant offspring...

 vs. formula

Infant formula

Infant formula is a manufactured food designed and marketed for feeding to babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder or liquid . The U.S...

; particularly how it affects the education of mothers in third world countries

Third World

The term Third World arose during the Cold War to define countries that remained non-aligned with either capitalism and NATO , or communism and the Soviet Union...

 and their comprehension (or lack thereof) of the health benefits of breastfeeding. The most famous example being the Nestlé boycott

Nestlé boycott

The Nestlé boycott is a boycott launched on July 7, 1977, in the United States against the Swiss-based Nestlé corporation. It spread quickly throughout the United States, and expanded into Europe in the early 1980s. In Canada, the controversy lasted from 1978 to 1984...

, which arose in the 1970s and continues to be supported by high-profile stars and international groups to this day.

In 1981, the World Health Assembly

World Health Assembly

The World Health Assembly is the forum through which the World Health Organization is governed by its 194 member states. It is the world's highest health policy setting body and is composed of health ministers from member states....

 (WHA) adopted Resolution WHA34.22 which includes the International Code of Marketing of Breast-milk Substitutes

International Code of Marketing of Breast-milk Substitutes

The International Code of Marketing of Breastmilk Substitutes is an international health policy framework for breastfeeding promotion adopted by the World Health Assembly of the World Health Organization in 1981...

.

See also

• Baby Friendly Hospital Initiative
  Baby Friendly Hospital Initiative
  The Baby Friendly Hospital Initiative , also known as “Baby Friendly Initiative” , is a worldwide programme of the World Health Organization and UNICEF, launched in 1991 following the adoption of the Innocenti Declaration on breastfeeding promotion in 1990...
  
  
• Baby-led weaning
• Breastfeeding promotion
  Breastfeeding promotion
  Breastfeeding promotion refers to coordinated activities and policies to promote health among women, newborns and infants through breastfeeding....
  
  
• Breast shell
  Breast shell
  Breast shells are hollow plastic disks worn inside the brassiere to protect the nipple from becoming flattened. The disk has a hole in the middle worn toward the nipple side. It is slightly concave to conform to the shape of the breast, but can sometimes still be slightly visible under tight...
  
  
• Dairy allergy
• Erotic lactation
  Erotic lactation
  Erotic lactation refers to a person achieving sexual arousal by breastfeeding or sucking on a female's breast. Depending on the context, the practice can also be referred to as adult suckling, adult nursing, and adult breastfeeding. Practitioners sometimes refer to themselves as being in an adult...
  
  

• Human milk banking in North America
  Human Milk Banking In North America
  A human milk bank is "a service which collects, screens, processes, and dispenses by prescription human milk donated by nursing mothers who are not biologically related to the recipient infant". There are currently eleven milk banks in North America. They are usually housed in hospitals, although...
  
  
• Lactation
  Lactation
  Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process occurs in all female mammals, however it predates mammals. In humans the process of feeding milk is called breastfeeding or nursing...
  
  
• Lactation room
  Lactation room
  Lactation room is an American term for a private room where a breastfeeding woman can use a breast pump in private one or more times a day.-Purpose:...
  
  
• Milk line
  Milk line
  The milk lines are two parallel lines, formed by thickenings of the epidermis along the ventral surface of mammals of both sexes. They extend from the upper limbs to the lower limbs and are developed in the embryo...
  
  
• Nursing chair
  Nursing chair
  A nursing chair is a low seated partially upholstered chair used at least since Victorian times for a woman's use while nursing an infant. This chair form was particularly popular in England and found primarily in upper class homes. The types of wood most frequently used were oak, rosewood or walnut...
  
  

External links

• Human Milk Secretion: An Overview US National Institute of Health
• Breastfeeding Resources La Leche League International
• Breast-Feeding Past Infancy ABC News
• Breast-Feeding Content Resources WHO reports on Breast Feeding
• Health risks of not breastfeeding US Department of Health & Human Services
• The World Alliance for Breastfeeding Action (WABA) is a global network of individuals & organisations concerned with the protection, promotion & support of breastfeeding worldwide.
• Breastfeeding: NHS Choices
• Center for Disease Control and Prevention Breastfeeding CDC