Nidar, Joy H.

Journal Review on

“Breastfeeding patterns and exposure to suboptimal breastfeeding among children in developing countries: review and analysis of nationally representative surveys”
Jeremy A Lauer, Ana Pilar Betrán, Cesar G Victora3, Mercedes de Onís and
Aluísio JD Barros

The reach of the study extends to almost a hundred developing countries, reflecting the breadth of the issue. It aims to study, in –line with previously conducted surveys, the exposure of infants and children to breastfeeding.
As stated in the study, the data is from nationally representative surveys.

Quote:

Most surveys were undertaken by the Demographic and Health Surveys (DHS) programme of Macro International, Calverton, MD, USA [8], or by UNICEF under its initiative on Multiple Indicators Cluster Surveys (MICS) [9]. About a dozen surveys were undertaken by national institutions.

The study is consistent with others that dabbled with the same issue. Although a lot can be suggested to resolve the issue, it hardly made any suggestions regarding what is to be done with the problem.


It is common knowledge that breastmilk is the most nutritious, the best even, food substance a mother can give to her child. Optimal breastfeeding greatly increases a child's capacity to survive from sickness and it decreases the rate of mortality.
But modern trend shows that less than half of children among developing countries receive breastmilk fully. And not all of them continued to be breastfed until 2 years of age. This certainly has an effect on the present and future health condition of the child which would ultimately affect his/her growth and development.
It is a sad fact that there are mothers that are more willing to spend money to buy breastmilk supplements that are incomparable to their own.
According to other studies, reasons cited are inadequacy of milk, socio-economic factors and family pressure among others.
Even if there is an advocacy on breastfeeding, modernity plays a large role on the start and continuing of breastfeeding.
Health professionals' role are still important to educate the public especially mothers but it seems it is still not enough.

What more can be done of the Filipino mentality of buying rather than giving a mother's breastmilk?

What is the trend presently with the new generation of mothers on breastfeeding?

Are there enough programs and political will by both the government and private organizations/institutions to advocate this cause?

childinfo.(2009).Overview of breastfeeding patterns. Retrieved June 21, 2009 from http://www.childinfo.org/

K KurzewskiI, J Meeks GardnerII. (2005). Breastfeeding patterns among six-week-old term infants at the University Hospital of the West Indies. West Indian Medical Journal. Retrieved June 21, 2009 from http://caribbean.scielo.org/

Teresa S. J. Abada, Frank Trovato and Nirannanilathu Lalu. (2000). Determinants of breastfeeding in the Philippines: a survival analysis. Elsevier Science Ltd. Retrieved June 21, 2009 from http://www.sciencedirect.com/

important components of breast milk.

1.Lysozyme, which is an antimicrobial enzyme, is found in mother’s milk, but not in formula. This substance has an important effect on which type of bacteria can survive in the intestinal tract. Interestingly, the level of lysozyme in the breast milk is not affected by what mom eats - probably because it is so important for the baby. There is no or very little Lysozyme in formula.

2.The bifidus factor in human milk supports the growth of Lactobacillaceae, which are beneficial bacteria that protects the baby against harmful bacteria and parasites. In fact, there is a huge difference between the bacteria found in the guts of breast- and formula-fed infants. Breast-fed babies have a level of lactobacillus that is as much as ten times greater than that of formula-fed infants.

3.Omega 3 fats such as DHA and AA. These fats are there to help the baby’s brain work, ensure that his immune system is functioning, and helps him take in fat-soluble vitamins. The fats that are found in formula are not digested completely by the infant, and formulas also don’t contain DHA.

4.immunoglobulins-Breast milk is also rich in immunoglobins, and while formula does contain these, it’s not the same kinds which are found in human milk.One important type of immoglubin is called secretory immunoglobulin A and has the ability to bind to foreign substances so they can be eliminated from the body. sIgA particularly protects the throat, nose and ears as well as the gastrointestinal tract.

5.Leukocytes are the white blood cells that are only found in breast milk. They help fight infection. It is the antibodies, enzymes, and hormones that make breastmilk ideal. These cannot be added to formula.

The abovementioned components of breast milk is important for the development of immune system in an infant, studied showed that there is a 21% reduction in infant death for having ever breastfed. bottle fed infants were at almost twice the risk for having respiratory illness and cognitive development is better in breastfed infants.

Leaders of developing nations should take this matter seriously, they should promote and launch campaigns that would boost the awareness of its population in the importance of breastfeeding.

references

http://www.easybabylife.com/breast-milk.html

http://www.breastfeedingonline.com/importanceofhumanmilk.html

http://www.rehydrate.org/breastfeed/index.html

Breasts- are an astounding and fascinating body part because of what they produce and the nursing process they are involved in! Compared to infant formula, breast milk is so much better that there is no comparison!

Quote:

“God knew what He was doing when He ordained our bodies to produce this amazing substance that makes babies thrive.”

Breast milk- is the perfect source of nutrition for infants. It contains appropriate amounts of carbohydrate, protein, and fat. It also provides the digestive proteins, minerals, vitamins, and hormones that infants need. Additionally, the immunity cells found in breast milk have been found to survive baby’s digestive process and could possibly use to provide a method of developing targets to conquer certain bacteria and viruses.

Breast milk- contains valuable antibodies from the mother that may help the baby resist infections. The antibodies found in breast milk, however, can never be added to formulas.

Formula-fed babies- are sicker, sick more often, and are more likely to die in infancy or childhood. Compared to exclusive/extended breastfed babies, formula-fed babies have a doubled overall infant death risk, and 4-fold risk of Sudden Infant Death Syndrome (SIDS).

In reality we should think breast milk as THE NORM and understand that infant formula is an inferior artificial baby feed. Formula is static, is often not tolerated well, and does not contain live white cells and antibodies to fight diseases like breast milk does.

Breast milk- is species-specific for humans and changes according to the infant's needs. For example, if the baby is born pre-term, breasts produce milk that has a different composition, especially suited for a premature infant. In fact, for premature babies, breast milk can make the difference in life and death. Also, the newborn's first milk, colostrum, is in many ways different from the mature milk. It contains lots of antibodies, and acts as a laxative to purge the newborn's bowels from waste accumulated during the time in utero. Man simply CANNOT duplicate this wonder substance! In one 2007 study from the University of Bristol3, researchers found that breastfed children are more likely to climb the social ladder than those who are bottle-fed. The researchers said one possible reason for the findings could be that breastfeeding improves health, stature, and IQ.

Adequate breast milk depends upon adequately nourished mothers. Also important is the proper use of breast milk substitutes—mixing formula with unclean water and/or diluting formula for cost-savings reasons, both known to occur in developing countries, have negative affects on the health of infants. The promotion by multinational corporations of breast milk substitutes to women in poorer countries has been one of the travesties of our times; it is estimated that 1.5 million deaths a year could be prevented by breast-feeding.

1. Jelliffe, Derrick B., and E. F. Patrice Jelliffe. Human Milk in the Modern World. Oxford and New York: Oxford University Press, 1978.
2. PETA.org: The Breast Is Best! PETA Asks Ben & Jerry's to Dump Dairy and Go With Human Milk Instead http://www.peta.org/mc/NewsItem.asp?id=11993
3. Newsvine.com. The Milk Of Human Kindness: Uses For Human Breast Milk http://daniel-slack.newsvine.com/_news/2009/04/26/2733785-the-milk-of-human-kindness-uses-for-human-breast-milk

Breastfeeding promotion is a key to infant survival strategy. It promotes wellbeing, helps avoid disease and reduces health care and feeding costs. In all countries, artificial feeding is associated with high mortality from diarrhea in infants. Although there is a broad scientific basis for its impact on post neonatal death, evidence is sparse for its impact on neonatal mortality.

There are some exceptions, such as when the mother is taking certain drugs or is infected with tuberculosis or HIV. Experts agree that breastfeeding is beneficial, but may disagree about the length of breastfeeding that is most beneficial, and about the risks of using artificial formulas. Interventions to improve early infant feeding practices can result in considerable reductions in neonatal mortality.

All-cause neonatal mortality could be reduced by 16.3% if all infants initiated breastfeeding on day 1 of life and by 22.3% if initiation took place within the first hour. The risk of neonatal death is increased approximately fourfold if milk-based fluids or solids are provided to breastfed neonates.

REFERENCES:

Lawn J, Cousens S, Zupan J. 4 million neonatal deaths: When? Where? Why? Lancet. 2005;365 :891 –900[CrossRef][ISI][Medline]

WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet. 2000;355 :451 –455

Riordan JM (1997). "The cost of not breastfeeding: a commentary". J Hum Lact 13 (2): 93–97

Horton S, Sanghvi T, Phillips M, et al. (1996). "Breastfeeding promotion and priority setting in health". Health Policy Plan 11 (2): 156–68

quote: The need for special attention and follow-up of mother-infant pairs at risk for breastfeeding difficulties during the first week postpartum. High-risk groups include primiparas (particularly those delivering large infants), mothers who have a long labor or deliver by cesarean section (particularly an urgent cesarean section), multiparas who receive labor medications, overweight mothers, women with flat or inverted nipples, and infants with SIBB during the first 24 hours. These findings imply that modifications of the labor and delivery experience that reduce the duration of labor (both total and stage II) and increase the likelihood of a spontaneous, unmedicated vaginal delivery should improve early lactation success.


PEDIATRICS Vol. 112 No. 3 September 2003, pp. 607-619
Kathryn G. Dewey, PhD, Laurie A. Nommsen-Rivers, MS, RD, IBCLC, M. Jane Heinig, PhD, IBCLC and Roberta J. Cohen, PhD . From the Department of Nutrition, University of California, Davis, Davis, California.

I have read a study which confirmed 'Positive Association between Duration of Breastfeeding and Adult Intelligence'
It stated that, in Journal of the American Medical Association (JAMA), researchers found that infants breastfed for seven to nine months had higher IQs as adults than those breastfed for less than seven months.

Using two types of intelligence tests, researchers compared IQ scores for young adults who had been breastfed for various lengths of time. While the study showed an increase in intelligence at all duration levels of breastfeeding, participants who had been breastfed for seven to nine months showed the largest increase of IQ points at 6, compared to those breastfed for one month or less.

The scientists concluded that duration of breastfeeding may have long-term positive effects on cognitive and intellectual development.


While previous studies have demonstrated a positive relationship between breastfeeding and psychomotor and mental development in children, most of them stressed the significant difference between those infants who had been breastfed versus those who were fed artificial baby milk. This study is unique in that it demonstrates the positive, life-long effects of breastfeeding by testing young adults in relationship to the duration of their breastfeeding experience as infants and because it is the first to track IQ into maturity. Scientists believe that the nutrients in human milk, maternal behavior, and factors associated with the choice of feeding method all play a part in the positive correlation between duration of breastfeeding and increased IQ.
Previous research has well documented additional long-term positive effects of breastfeeding both for the baby and the mother. For the infant, long-term effects of breastfeeding include reduced risk of celiac disease, diabetes, obesity, some childhood cancers, Crohn's disease, urinary tract infections, atopic disease, and reduced endometriosis in women in later life. For the breastfeeding mother, there is reduced risk of breast cancer, ovarian cancer and osteoporosis. (2002)

Quote:

What more can be done of the Filipino mentality of buying rather than giving a mother's breastmilk? What is the trend presently with the new generation of mothers on breastfeeding? Are there enough programs and political will by both the government and private organizations/institutions to advocate this cause?

In my perception, it all falls down to polishing the laws with regards to implementing the breast-feeding act . Trends may come and go, but there are lots of tools to be used by the government and private institutions to advocate this cause. One is through the use of media. Strict implementations of the law should be executed as well.

True enough, long term beneficial effects will be acquired by both mothers and infants in holistic entities as proved by the study above.

Reference:

Journal of the American Medical Association (JAMA),(2002), Positive Association between Duration of Breastfeeding and Adult Intelligence, http://www.llli.org/

Breastfeeding is definitely the most advisable for babies because of its many health benefits. Primarily, it promotes bonding to both the baby and the mother. It is readily available anytime it is needed and the temperature is just right for the infant. The antibodies in the breast milk increases the immunity of the infant, protecting the baby from a number of childhood diseases. Since it is the only source of food of the baby, the breast milk is nutritious and energy giving. It can also be easily digested.

Here is a list of health benefits to breastfed babies.
1. Babies until 2 years and older receive the complete and optimal mix of nutrients & antibodies needed.
2. The composition of breast milk is suitable for the infant's individual growth and nutritional needs.
3. Breast milk decreases the chance of dehydration caused by vomiting and diarrhea.
4. It is good for the stomach because it prevents gastroenteritis and enterocolitis and reduces risk of chronic constipation, colic, and other stomach upsets.
5. There is a reduced risk of childhood diabetes for babies who are exclusively breastfed.
6. It provides protection against ear infections, respiratory illnesses, pneumonia, bronchitis, kidney infections, septicemia.
7. There is also increased protection against allergies, asthma, eczema, and severity of allergic disease
8. It reduces risk of SIDS (sudden infant death syndrome) based on statistics..
9. It gives protection against meningitis, botulism, childhood lymphoma, crohn's disease and ulcerative entercolits
10. There is a decreased risk of tooth decay or cavities
11. The bond which is a part of breastfeeding may result to facial structure development, enhanced speech, straighter teeth and enhanced vision.
12. Breastfed infants develop higher IQ's, and have improved brain and nervous system development.
13. It can reduce the risk of heart disease later in life.
14. Breast milk increases bone density.
15. Breastfeeding plays an important role in developing the emotional and spiritual status of babies.
16. Breastfed babies enjoy a special bond and emotional relationship with their mothers.
17. Antibody response to vaccines are higher.
18. Breastfed babies are less hospitalized than formula fed infants.
19. The colostrum coats the GI tract, preventing harmful bacteria to cross the baby's blood.
20. Breastfed babies have lesser risk of childhood obesity.

These are just some of the benefits that breast milk can give to babies. Unfortunately, in our society today, breastfeeding is seldom practiced. Young mothers have the wrong belief of using formula milk as replacement for breast milk. Little do they know that no matter how many vitamins, minerals and supplements are added to the formula milk, it cannot replace the composition and benefits of breast milk.

*http://www.motheringfromtheheart.com/Benefits.htm

Only 16% of mothers in the Philippines breastfeed their babies, despite the health benefits of doing so. Why is this and will it change? (Walsh, 2007)

It is for the reason that our country and we are television ads-driven people. We tend to believe and follow what’s going on in the media. And with the vast majority of promotion of powdered milk is through TV commercials. We must face the fact that not every one of us is educated to understand what is best and righteous to do. If a not-so-assertive mother watched a very attractive, catchy and entertaining commercial about a powdered milk product, she would be lured to buy it for her infant not paying much attention on the end note: “breastfeeding is still best for babies”. Now is that 16% changeable? Yes, it is. We can change it through us of course. As nurses, we are health educators, and as teachers, we can simply teach them. We can achieve great percentage of mothers breastfeeding their babies and having infants fully breastfed, through reaching out in our primary heath setting, in our communities. In the community, we are clinicians, when they are sick; we give them health teaching and prescribed medications. Teaching and promoting breastfeeding in the community is not different from this and expect, they would follow us as well. And with perseverance and determination, we can be successful at this in due time.

REFERENCE:
Walsh J, (2007) Breastfeeding in the Philippines “The Struggle against Milk Powder Companies”

I may say that lot of health organizations has been very much concious of how the campaign of breastfeeding is being brought up as one way of preventions of some diseases that may arise. It also gives the idea that this is one way of showing a natural way of preventing a high cost area of expensenses when nurturing their newly born child. This is as much as a concern not only in our country but as well as to the developing countries that was mention in this study all because these said countries tends to have more developed technologies which looses the essence of having a natural way of nurturing the baby.

[quote]The Department of Health (DOH), World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) released a joint advisory to inform the public on the true state of breastfeeding practices in the country today. “We are appalled by the persistent distortion of data by the Pharmaceutical Healthcare Association of the Philippines (PHAP)”, DOH Undersecretary Alexander Padilla said. “They propagate misleading information that seriously undermines breastfeeding in the country.” The group cited in particular the press releases and paid advertisements that appeared in newspapers during the commemoration of World Breastfeeding Week. The worldwide event is the widest and largest annual celebration of breastfeeding by advocates held every first week of August. “The timing and nature of the materials are clearly unethical and is the very reason why the new implementing rules and regulations of Executive Order 51, or the Milk Code, is all the more imperative,” added Undersecretary Padilla.[quote]

This has been one issue that people must be aware of and that how we would still strengthen the bond of pursuing the benefits of breastfeeding among mothers all over the world. Not to mention the mothers who is also had problems in giving breastmilk considering their illnesses.

Reference:
Dennis,(2007) DOH, WHO, UNICEF Cautions public vs PHAP's Misleading Information About Breastfeeding: http://www.doh.gov.ph/node/1528

In a recent report by the Environmental Working Group , a consumer health advocacy group, tests performed on liquid baby formulas found that they all contained bisphenol A . This leaching, hormone-mimicking chemical is used by all major baby formula manufacturers in the linings of the metal cans in which baby formula is sold.

BPA has been found to cause hyperactivity, reproductive abnormalities and pediatric brain cancer in lab animals. Increasingly, scientists suspect that BPA might be linked to several medical problems in humans, including breast and testicular cancer.

other concerns in formula is the ingredient manganese, a neurotoxic chemical found in much higher concentrations in baby formula, particularly soy-based formulas, than in breast milk. According to the EWG, soy-based formulas contain about 80 times as much manganese as mother's milk, while animal-based formulas contain about 30 times more. Elevated manganese levels have been linked to behavioral problems, such as Attention Deficit Hyperactivity Disorder (ADHD) later in life. Babies are not able to absorb and excrete excess manganese during the first year of life, according to the EWG.

Some formulas may contain excessive levels of metals like aluminum, cadmium, lead or worse ,The fungal toxin aflatoxin has also been detected in some commercial formulas. Although detected levels were very low, this toxin is known to cause cancer and is not present in breast milk."


even unicef renewed calls for donors to refrain from sending formula milk as humanitarian assistance. saying it could even cause more death. they said that there was a strong correlation between formula consumption and deaths due to diarrhea in yogyakarta in the after math of 2006 earthquake. donations of powdered milk in an emergency situation can literally increase the rate of death for young babies.

these are the few reasons why i disagree in the consumption of formula milk, "human milk is designed for human babies" and "cows milk are designed for calf"

references

Annie Bond (2007 july) "Baby formula contains dangerous chemical"
http://www.care2.com/greenliving/baby-formula-alert.html#

Alexis Black(2006 april) "The poisoning of infants with formula products, and why breastfeeding is best" from http://www.naturalnews.com/019338.html

Prodita Sabarini (2009 june) THE JAKARTA POST "Formula milk 'dangerous' as humanitarian aid" from http://www.thejakartapost.com/news/2008/07/07/formula-milk-039dangerous039-humanitarian-aid.html

Breastfeeding indeed is a very ginuine way for mothers to show their love to their newborns. The colostrum of the breastmilk is very essential for every baby to have, for it contains most of the nutrients and the newborn will definitely benefit a lot from it. since milk is the only food that the newborn can take, there is no other better substitute to breastmilk that is why it should never be taken for granted. as ms. iza enumerated all of the advantages of giving breastmilk to the babies.
But many mothers nowadays do not continue breatfeeding for a longer time since most of them are working mothers. It is not as what i expected sine most of them are economically unstable so thinking that breastfeeding would be economical still does not apply.

References:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2148035&tool=pmcentrez

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2692345&tool=pmcentrez