Shifting Perceptions of Breastfeeding

“Exclusive breastfeeding for about 6 months” reaffirms AAP 

Breastfeeding has long been regarded as a personal choice, but the American Academy of Pediatrics (AAP) is urging a shift in perspective. The AAP has recommended all full-term and preterm infants receive human milk, as manufacturers of cow's milk-based formulas continue to face litigation for their potential role in contributing to conditions like necrotizing enterocolitis (NEC) in preemies.

The American Academy of Pediatrics has urged infant nutrition to be considered a public health issue, rather than a lifestyle choice. While breastfeeding is a very personal choice, it is important to consider the numerous health benefits it provides for both mother and baby. 

In general, there is less consensus about the importance of breastfeeding in high-income countries including the United States, than there is in low-income and middle-income countries. 

However, the AAP’s 2022 report, Breastfeeding and the Use of Human Milk summarizes the relationship between the duration of breastfeeding and its protective effect for infants, for conditions including diabetes, SIDS, asthma, obesity, and more.  

In this report, the AAP “reaffirms its recommendation of exclusive breastfeeding for about 6 months” and recommends that all preterm infants receive human milk. Mother’s own milk (MOM) should be the primary diet, and if unavailable, pasteurized donor milk should be used.  

Benefits for Baby and Mother

A 2010 study, cited in the AAP’s report, found that “preterm infants fed an exclusive human milk diet compared with those fed human milk supplemented with cow milk-based infant formula products noted a 77% reduction in NEC.”

In addition, infants who received human milk in the NICU enjoyed several short- and long-term beneficial effects. 

These include, but are not limited to:

• Lower rates of sepsis 
• Fewer hospital readmissions in the year following NICU discharge 
• Higher intelligence test results, white matter, and total brain volume 
• Lower rates of severe retinopathy of prematurity

Mothers who breastfeed also enjoy several short and long-term beneficial effects. 

These include, but are not limited to the decreased risk of:

• Type 2 diabetes
• Breast cancer
• Ovarian cancer
• Rheumatoid arthritis

(findings based on cumulative duration of breastfeeding)

When Breastfeeding Isn't Possible

When infants arrive preterm, mothers may experience a slow start in milk production. This is typically considered normal. Skin-to-skin contact and pumping at your baby’s bedside in the NICU can both be very helpful in increasing supply.

When a mother's own milk is not available, pasteurized human donor milk is considered the next best option. The NEC Society has compiled a map of children's hospitals that provide their most fragile infants with pasteurized donor milk when mother’s milk is unavailable.

While human donor milk and human milk-based formula and fortifiers like Prolacta have been proven to be more viable alternatives, hospitals often face shortages in neonatal intensive care units.

Awareness of the need for breast milk donations is critical to help ensure premature infants have the best nutrition available in their time of need. 

Donors can find a milk bank through the Human Milk Banking Association of North America. Many of these milk banks offer the options for hospitals, as well as families, to order donor milk for premature and full-term babies across the country. 

These organizations also often accept monetary donations.

Saving Lives and Improving Public Health

The American Academy of Pediatrics (AAP) emphasizes the protective effects of breastfeeding and human milk on various health conditions, with implications for both baby and mother. 

“The scaling up of breastfeeding to a near universal level [worldwide] could prevent 823,000 annual deaths in children younger than 5 years and 20,000 annual deaths from breast cancer,” claims a study on breastfeeding in the 21st century.

Moreover, if 90% of U.S. mothers exclusively breastfed for 6 months, this could result in $13 billion in health-related savings per year, says the AAP.

By addressing the potential link between Enfamil, Similac, and NEC through legal action, these lawsuits play a crucial role in saving innocent lives and improving overall public health. Raising awareness about the risks cow’s milk formula poses to premature infants, as well as sharing research on breastfeeding and human milk has the potential to make a significant difference in the lives of children in the U.S. and across the world.