EXCERPT FROM THE WHITE HOUSE TASK FORCE CHILD OBESITY REPORT TO THE PRESIDENT (FOOTNOTES OMITTED):

Breastfeeding
Children who are breastfed are at reduced risk of obesity.  Studies have found that the likelihood of obesity is 22% lower among children who were breastfed. The strongest effects were observed among adolescents, meaning that the obesity-reducing benefits of breastfeeding extend many years into a child’s life Another study determined that the risk of becoming overweight was reduced by 4% for each month of breastfeeding. This effect plateaued after nine months of breastfeeding.The protective effect of breastfeeding likely results from a combination of factors.

  • First, infant formula contains nearly twice as much protein per serving as breast milk. This excess protein may stimulate insulin secretion in an unhealthy way.
  • Second, the biological response to breast milk differs from that of formula. When feeding a baby, the mother’s milk prompts the baby’s liver to release a protein that helps regulate metabolism.  Feeding formula instead of breast milk increases the baby’s concentrations of insulin in his or her blood, prolongs insulin response,  and, even into childhood, is associated with unfavorable concentrations of leptin, a hormone that inhibits appetite and controls body fatness.

Barriers to Breastfeeding

Despite the well-known health benefits of breastfeeding and the preference of most pregnant women to breastfeed,  numerous barriers make breastfeeding difficult. For first-time mothers, breastfeeding can be challenging, even for those who intend to breastfeed. For those who have less clear intent to breastfeed, cultural, social, or structural challenges can prevent breastfeeding initiation or continuation. For example, immediately after birth, many babies are unnecessarily given formula and separated from their mothers, making it harder to start and practice breastfeeding. Also, hospital staff are often insufficiently trained in breastfeeding support.

Hospitals are changing their ways

Hospitals that meet specific criteria for optimal breastfeeding-related maternity care are designated as “Baby Friendly” by Baby-Friendly U S A. This non-governmental organization has been named by the US Committee for UNICEF as the designating authority for UNICEF/WHO standards in the United States. Currently only 3% of births in America occur in Baby-Friendly facilities.

Workplace and Child Care Accommodations

Research has demonstrated that support is essential for helping mothers establish and continue breastfeeding as they return to work or school and make use of child care services.  Many women return to work soon after their baby’s birth, yet 75% of employers do not offer accommodations for them to breastfeed or express milk at work.

Changes are under way, however. Following the lead of states whose laws requiring employers to make accommodations, the recently-enacted Affordable Care Act requires employers to provide a reasonable break time and a place for breastfeeding mothers to express milk for one year after their child’s birth. ….The return on investment of companies that assist breastfeeding employees through appropriate support and accommodations is well-documented. Companies benefit through better employee retention, lower health care costs, and better work attendance.

Support for breastfeeding in child care settings is important as well. Among women whose infants are cared for outside the home, irrespective of their intent to breastfeed, those who report better support for breastfeeding from early learning settings (such as refrigerated storage for breast milk, a commitment to feed it to the child, or private space for on-site breastfeeding) are more likely to breastfeed longer.

Support Programs

In many communities, role models for breastfeeding are rare, and new mothers do not know where to turn for breastfeeding assistance Volunteer networks of experienced breastfeeding mothers such as the La Leche League provide help for some mothers, but networks like this are not available in many communities According to the CDC’s annual State Breastfeeding Report Card, there were 34 breastfeeding support groups per 100,000 live births in 2009, which means about one support group for every 3000 new babies Peer support programs, such as the Peer Counselor program delivered as part of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), provide counseling skills, training, and support to experienced breastfeeding mothers so they can effectively support new mothers. Recently, federal funds were provided to further expand the availability of peer counseling in local WIC clinics. Prenatal counseling on breast feeding can also have positive impacts on breastfeeding rates,94 and pre- and postnatal intervention together with peer counseling is most effective.  [Editor’s note: some hospitals have created Milk Cafes in or near the maternity area where mothers can bring their babies, meet with other mothers and lactation specialists, ask questions and get help with nursing problems.  Look for one in your community.]

SOLVING THE PROBLEM OF CHILDHOOD OBESITY

Recommendations

Hospitals and health care providers should use maternity care practices that empower new mothers to breastfeed, such as the Baby-Friendly hospital standards. 

[Editor’s note: the ACA now requires many health insurers to provide breast pumps and lactation counseling to insured mothers.  Ask your health insurer whether your policy covers this benefit.]

Health care providers and insurance companies should provide information to pregnant women and new mothers on breastfeeding, including the availability of educational classes, and connect pregnant women and new mothers to breastfeeding support programs to help them make an informed infant feeding decision.

Local health departments and community-based organizations, working with health care providers, insurance companies, and others should develop peer support programs that empower pregnant women and mothers to get the help and support they need from other mothers who have breastfed. 

Early childhood settings should support breastfeeding.