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Paediatrician call to step up breast-feeding

Monday February 1st, 2016

A senior paediatrician has urged the UK to step up breast-feeding levels after a global study found levels lower in rich countries than in poor ones.

Increasing breastfeeding to near-universal levels could save more than 800,000 children’s lives every year – equivalent to preventing 13% of all deaths among children under the age of two, a report in The Lancet claimed.

The largest and most detailed analysis to date that quantify levels, trends, and benefits of breastfeeding around the world, also found that if there was a significant increase in the number of women breastfeeding, it would prevent a further 20,000 breast cancer deaths every year.

Professor Russell Viner, of the Royal College of Paediatrics and Child Health, said: “Britain has one of the lowest levels of breastfeeding compared to other rich countries - we worry that things will get much worse with Government’s proposed budget cuts.”

He added: “The benefits of breastfeeding have been widely publicised yet with today’s paper showing that just 1 in 5 children are breastfed in high income countries and 1 in 3 in low and middle income countries, it’s clear that efforts are still falling far too short and the grave reality is that this is costing children’s lives.

“At home in the UK we know that babies born to mothers living in poverty are less likely to be breastfed. We also know these families are at higher risk of mortality, are more likely to be admitted to hospital and have higher incidences of mental health problems.”

The two-part series, which analysed data from 28 systematic reviews and meta-analyses – 22 of which were commissioned specifically, found that one in five children in high-income countries is breastfed to 12 months of age, while one in three children in low and middle-income countries is exclusively breastfed for the first six months.

It means, say the authors, that millions of children are failing to receive the full benefits provided by breastfeeding, which is one of the most effective preventive health measures for children and mothers but it is still overlooked as a critical need for population health.

Series author Professor Cesar Victora, from the Federal University of Pelotas in Brazil, said: “There is a widespread misconception that the benefits of breastfeeding only relate to poor countries. Nothing could be further from the truth.

“Our work for this Series clearly shows that breastfeeding saves lives and money in all countries, rich and poor alike. Therefore, the importance of tackling the issue globally is greater than ever.”

According to the study, breastfeeding reduces the risk of sudden infant deaths (SIDS) by more than one third in high income countries, while in low-and middle-income countries it can help to prevent about half of all diarrhoea episodes and one third of respiratory infections.

The investigation also revealed a strong economic case for investment in promoting breastfeeding.

Boosting breastfeeding rates for babies under six months to 90% in the USA, China, and Brazil, and to 45% in the UK, would cut treatment costs of common childhood illnesses. The authors estimate that it would save healthcare systems at least $2.45 US billion in the USA, $29.5 US million in the UK, $223.6 US million in China, and $6.0 US million in Brazil.

“Breastfeeding is one of the few positive health behaviours that is more common in poor than richer countries, and within poor countries, is more frequent among poor mothers,” said Prof Victora.

“The stark reality is that in the absence of breastfeeding, the rich-poor gap in child survival would be even wider. Our findings should reassure policymakers that a rapid return on investment is realistic and feasible, and won’t need a generation to be realised.”

The authors call for political commitment and financial investment to protect, promote, and support breastfeeding at all levels, while more needs to be done to regulate the breastmilk-substitute industry.

“There is a widespread misconception that breastmilk can be replaced with artificial products without detrimental consequences,” said Prof Victora.

“The evidence outlined in the Series, contributed by some of the leading experts in the field, leaves no doubt that the decision not to breastfeed has major long-term negative effects on the health, nutrition and development of children and on women’s health.”

Victora C, Bahl R, Barros A et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016; 387: 475–90.

Rollins N, Bhandari N, Hajeebhoy N et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016; 387: 491–504.

Tags: Child Health | Childbirth and Pregnancy | Nursing & Midwifery | UK News | Women's Health & Gynaecology

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