- The Washington Times - Tuesday, July 31, 2018

An estimated 78 million babies are not breastfed within the first hour of life, increasing their chances of early death or disease by 33 percent, according to a new study by the World Health Organization.

Breast milk is essential because it gives babies colostrum, an antibody-rich nutrient, and provides critical first contact with the mother, WHO said.

The report follows news this month that the United States had tried to block a resolution at the World Health Assembly that supported breastfeeding over formula. The WHA is the decision-making body of WHO.

In the latest report, published Monday, WHO and the U.N. Children’s Fund (UNICEF) recommend that children initiate breastfeeding within the first hour of birth. They also recommend that children be exclusively breastfed for the first six months — meaning no other foods or liquids, including water.

WHO spokesman Tarik Jasarevic said that the recommendations are based on what is best for the health of mothers and babies and that pushing such an agenda doesn’t detract from acknowledging obstacles to breastfeeding.

“WHO is working with governments and NGOs to make breastfeeding easier for all women,” Mr. Jasarevic said in an email to The Washington Times. “With improved skills of health care providers, adequate opportunities for counseling, maternity leave and accommodations at the workplace, women are able to breast feed exclusively.”

Further, in a number of countries, more than 70 percent of infants younger than 6 months are exclusively breastfed, he said.

The report covers 76 countries but has no data on North America and Western Europe, primarily because global standards for data collection were not observed and could not be compared, the authors wrote. They called this a “concerning data-gap in high income countries.”

The focus on the first hour after birth as being critical to a baby’s health was supported by previous research that found children fed between two and 23 hours after birth had a 33 percent increase in early death or disease.

Globally, only 2-out-of-5 infants are put to the breast within that time period, the authors found. In Eastern Europe and Central Asia, 56 percent of newborns are fed their mother’s milk in the first hour, compared to 35 percent of newborns in the Middle East and North Africa. East Asia and the Pacific also had low percentages of immediate breast feeding, only 32 percent of newborns.

Eastern and South Africa had some of the highest rates, with 65 percent of newborns fed in the first hour.

“Breastfeeding gives children the best possible start in life,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus in written statement. “We must urgently scale up support to mothers — be it from family members, health care workers, employers and governments, so they can give their children the start they deserve.”

Evidence abounds on the importance of breastfeeding for both baby and mother.

“I think there’s no doubt that there is some medical and psychological benefits,” Dr. Richard J. Beckerman, chairman of the Department of Obstetrics and Gynecology at Sibley Memorial Hospital in Washington, D.C., told The Times. “Breastfeeding and that skin to skin contact in that first hour, there’s certainly nothing wrong with that, but certainly I think there’s some big positives to that.”

Colostrum is the first breast milk produced by mothers when their babies start feeding. It is extremely rich in nutrients and antibodies, and acts as a child’s first “vaccine,” the WHO report says.

Immediately placing the baby on its mother for skin-to-skin contact also promotes transfer of important, protective bacteria; regulates the child’s body temperature; and promotes the flow of the hormone oxytocin.

Dr. Beckerman said this hormone also known is to contract the uterus and help stymie afterbirth bleeding: “Oxytocin the elixir of life — breastfeeding and the release of oxytocin gives the woman a sense of well being and increases the bond between mother and child.”

Despite not having data on breastfeeding mothers in the U.S. and Europe, WHO researchers estimated that 2.6 million children, or 21 percent, in these high-income countries are not breast fed.

What’s more, an estimated 71 percent of women gave birth in medical institutions in 2017, an increase from 53 percent in 2005. But only 51 percent of them breastfed within the first hour in 2017, compared to 45 percent in 2005.

An increase in caesarean sections also is having a negative effect on breastfeeding, the report found. Among 51 countries, early initiation of breastfeeding is significantly lower among newborns delivered by C-section.

In Egypt, for example, breastfeeding decreased from 40 percent in 2005 to 27 percent in 2014. At the same time, C-section rates increased from 20 percent to 52 percent.

But this could also be due to complications following the procedure.

“Whatever might separate that mother and child in that first hour, usually if the mother or child are ill … that first hour might be a time where they won’t be able to breastfeed,” Dr. Beckerman said. “For those people who can’t breastfeed because of either surgical reasons, post-surgical … or for whatever reason they can’t, luckily these formulas are generally well prepared and healthy, but certainly do not take the place of breastmilk.”

Across the world, the report cites that early initiation to breastfeeding varies widely, but that newborn babies are most at risk in low- and middle-income nations for delayed initiation of their mothers’ milk.

The authors said that despite large gaps based on geography, other differences — such as sex of baby, rural verse urban or household wealth — didn’t account for when a baby first initiated breastfeeding.

Increasing awareness of the importance of breastfeeding and making it more accessible for women is key in promoting such policies, said Sascha Mayer, co-founder of Mamava, which provides portable lactation suites for a number of facilities, including airports, translations, sports stadiums and other locations.

“It’s great to have these recommendations, but if there isn’t the infrastructure and policy to support it, then all it does is make moms feel worse,” she said. “That is exactly where the inspiration for the company came from — trying to make breastfeeding more of an authentic choice for moms.”

Ms. Mayer said millennial moms are the ones really driving the change in how breastfeeding is being accepted in the mainstream, falling into line with other women’s rights movements like “Times Up” and the “Me Too” movement — protecting women against sexual assault.

“My co-founder, Christine Dodson and I are Gen-X moms, sort of disgruntedly accepting what’s being put forth by society. But the millennial mom is a way different mind set, asserting her expectations to be treated fairly,” Ms. Mayer said.

• Laura Kelly can be reached at lkelly@washingtontimes.com.

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