There have been a few articles in the press recently suggesting that the recommendation of 6 months exclusive breastfeeding is too long for women in New Zealand and is only appropriate in countries where sanitation and water quality are poor. The World Health Organisation (WHO) recommends that babies are breastfed exclusively for the first 6 months of life at which time complementary foods may be introduced, with breastfeeding continuing for 2 years or beyond.
These recommenations aren’t based on poor water quality or inadequate sanitation. Breastfeeding is the normal way of providing the exact food required for the healthy growth and development of a human baby. Breastfeeding is also part of the reproductive cycle of the mother, and has important implications on her health. Human breastmilk is designed for human babies and provides everything the baby needs for the first 6 months of life – all the energy and nutrients, as well as promoting sensory, cognitive and emotional development. Breastmilk continues to provide at least half of the baby’s nutritional needs in the second 6 months of life, and up to one third during the second year of life.
Breastfeeding protects the baby against many illnesses, including diarrhoea and pneumonia. Whilst in many western countries these are not so often life threatening illnesses, a breastfed baby will still suffer less severely and recover more quickly. The breastfeeding mother has a lower risk of ovarian and breast cancer, periods return later in the breastfed mother helping space children naturally.
The impact of breastfeeding continues into adulthood too: studies show that adults who were breastfed as babies often have lower blood pressure and lower cholesterol, as well as lower rates of overweight, obesity and type-2 diabetes.
Although the risks of feeding infant formula are reduced in modern countries where we we have clean water and can sterilise baby equipment adequately, baby formula still doesn’t contain the antibodies found in breastmilk and therefore doesn’t provide the same protection as breastmilk, and there have been many instances of bacteria or foreign bodies being found in infant formula.
In New Zealand, the majority of women start off breastfeeding their baby, but many women have stopped breastfeeding or no longer exclusively breastfeed by the time their baby is 6 months old. One of the reasons is that nearly 19% of women are back at work by the time their baby is 20 weeks old.
Breastfeeding is a learned behaviour and many women do not grow up seeing other women breastfeeding. This means that modern women do not have the knowledge or experience of the normal course of breastfeeding. This is demonstrated by the fact that nearly 45% of women in New Zealand stop breastfeeding because they believe they don’t have enough milk. This is rarely the case, but the lack of support from knowledgeable family members/community and not growing up seeing women breastfeeding means that there is not the understanding of how breastfeeding works or what is “normal” behaviour for a breastfed baby.
So many women want to breastfeed their baby and stop before they want to due to lack of support when it is needed, or having to go back to a work environment that doesn’t allow for continued breastfeeding, expressing at work, breastfeeding breaks, adequate maternity pay, or working at home.
Are these good reasons to consider changing the recommendation that exclusive breastfeeding continues for the first 6 months of a baby’s life? Personally, I don’t think so, but that also means that women need the suport, knowledge and working environment or maternity pay to allow them to have the opportunity to exclusively breastfeed for 6 months – IF they want to.
Whilst I believe in the WHO recommendations, I also believe that women should have the choice about whether, and for how long, they choose to breastfeed. The way things stand at the moment, many women feel they have NO CHOICE but to stop breastfeeding.