BREASTFEEDING BUILDS BRIGHTER BRAINS

We can't promise that breastfeeding will make your child a Nobel Prize winner, but research shows that babies who are breastfed are smarter when they get older.

• Children who were breastfed have I.Q. scores averaging seven to ten points higher than formula-fed infants. It's important to remember that these numbers represent averages for hundreds of children, not the effect of breastfeeding on a specific individual. So, if you want to raise the intelligence level of an entire generation of children, breastfeeding would be a simple and cost-effective way to do it.
• Studies have shown that children who are breastfed get higher grades in school, even after other influences on school performance are taken into account.
• The intellectual advantage gained from breastfeeding is greater the longer the baby is breastfed.

Although intellectual differences between breastfed and formula-fed children used to be attributed to the increased holding and interaction associated with breastfeeding and to the fact that mothers who breastfed were better educated and/or more child-centered, new evidence shows that there are nutrients in breastmilk that enhance brain growth.

Smarter fats. One key ingredient in breastmilk is a brain-boosting fat called DHA (docasahexaenoic acid), an omega-3 fatty acid. DHA is a vital nutrient for growth, development, and maintenance of brain tissue. Autopsy analysis of brain tissue from breastfed and formula-fed infants shows that the brains of breastfed babies have a higher concentration of DHA, and DHA levels are highest in babies who are breastfed the longest. Infant formulas made in the United States do not contain DHA.

Nutritip. To insure that babies get enough nutrients for their growing brains, it's important that breastfeeding mothers get enough DHA in their diets. Rich sources of DHA are fish (particularly salmon and tuna). Increases DHA will will benefit mom's health, too. Remember the nutritional rule of F's: four ounces of fish a day keeps central nervous system degeneration at bay.

Cholesterol. Another fat needed for optimal brain development. Breastmilk contains a lot of cholesterol, while infant formulas currently contain none. "Low in cholesterol" may be good news for adult diets, but not for babies--cholesterol provides basic components for manufacturing nerve tissue in the growing brain.

DHA, cholesterol, and other breastmilk fats provide the right substances for manufacturing myelin, the fatty sheath that surrounds nerve fibers. Myelin acts as insulation, making it possible for nerves to carry information from one part of the brain or body to another. So important are these brain-building fats, that if mother's diet doesn't provide enough of them for her milk, the breasts can make them on the spot.

Smarter sugars. Lactose is the main sugar in breastmilk. The body breaks it down into two simpler sugars - glucose and galactose. Galactose is a valuable nutrient for brain tissue development. Anthropologists have demonstrated that the more intelligent species of mammals have greater amounts of lactose in their milk, and human milk contains one of the highest concentrations of lactose of any mammal milk. Cow milk and some cow milk formulas contain lactose, but not as much as human milk. Soy-based and other lactose-free formulas contain no lactose at all, only table sugar and corn syrup.

Smarter connections. During the first two years of your baby's life, the brain grows rapidly, and baby's everyday experiences shapes brain growth. Brains cells, called neurons, multiply and connect with each other until the brain circuitry resembles miles of tangled electrical wires. Every time a baby interacts with her environment, her brain makes a new connection. Because breastmilk is digested faster, breastfed babies feed more often and therefore probably interact with their caregivers more often. Breastfeeding itself, with its skin-to-skin contact, the variations in milk flow, and the closeness between mother and baby, is usually a more interesting, more interactive experience than bottle-feeding. This is nature's way of insuring that babies get the stimulation they need for optimal brain development.

HOW HUMAN MILK PROTECTS FROM ILLNESS

Human milk is more than food. It's a complex living substance, like blood, with a long list of active germ-fighting and health-promoting ingredients. These help protect babies against all kinds of infections, common and not-so-common.

A drop of breastmilk contains around one million white blood cells. These cells, called macrophages ("big eaters"), gobble up germs. Breastmilk is also power-packed with immunoglobulin A (IgA), which coats the lining of babies' immature intestines, preventing germs from leaking through. Secretory IgA also works to prevent food allergies. By coating the intestinal lining like a protective paint, it prevents molecules of foreign foods from getting into the bloodstream to set up an allergic reaction.

Colostrum, the milk mothers produce in the first few days after birth, is especially rich in IgA, just at the time when the newborn is first exposed to the outside world and needs protection from germs and foreign substances entering his body. Colostrum also contains higher amounts of white blood cells and infection-fighting substances than mature milk. Think of colostrum as your baby's first important immunization.

As babies grow, mother's milk continues to provide important protection against infection and disease. Human infants receive antibodies through the placenta, but these are gradually used up during the first six months. Human milk fills in the immunity gap until baby's own immune system matures and kicks in. Even babies who continue to nurse into toddlerhood benefit from the many immune factors in their mother's milk.

Immunities made-to-order. Each mother provides custom-designed milk to protect her infant. When a baby is exposed to a new germ, mother's body manufactures antibodies to that germ. These antibodies show up in her milk and are passed along to her baby. Many a nursing mother can tell the story of the entire family--dad, mom, siblings--coming down with the flu and the nursing baby having the mildest case, or not getting sick at all. When mother comes down with a bug, the best thing she can do for her baby is to keep breastfeeding.

BREASTFED BABIES ARE HEALTHIER

Derrick and Patrice Jelliffe, pioneers in breastfeeding research, stated that breastfed infants are "biochemically different." This difference in body chemistry may be the reason they are healthier. While babies are breastfeeding, they have fewer and less serious respiratory infections, less diarrhea, and less vomiting. When breastfed babies do become ill, they are less likely to become dehydrated and need hospitalization.

Here are some specific ways in which breastfeeding protects babies from illness:

• Friendly to little ears. Ear infections are a childhood nuisance, often following on the heels of stuffy noses and colds. The middle ear fills with fluid, and eventually that fluid becomes infected, causing pain, especially in the middle of the night. Repeated ear infections, or those that go untreated, can lead to hearing loss. This is an important concern in young children, since hearing difficulties can interfere with language, and language problems can later affect reading skills.

  Breastfeeding protects against ear infections in four possible ways:

  1. The many germ-fighting ingredients in human milk keep harmful bacteria from bothering baby, so that stuffed-up noses and ears are less likely to become infected middle ears.
  2. Because breastfed babies are fed in a more upright position, they're less likely to experience milk backing up through the eustachian tube into their ears; if this does happen during a breastfeeding session, human milk is less irritating to the tissues of the middle ear than infant formula.
  3. Breastfed babies have fewer, or at least less severe, colds than formula-fed babies. Fewer colds means fewer ear infections.
  4. Breastfed babies have fewer respiratory allergies, another cause of fluid building up in the middle ear, which setts the stage for bacteria to grow.
• Protects tiny tummies. Human milk excels at protecting babies from diarrhea and tummy upsets. This is important not only for individual babies but also on a global scale. Diarrhea is a leading cause of infant mortality worldwide, and breastfeeding is the simplest, most cost- effective way to protect babies from repeated bouts of gastrointestinal illness.

  Another way in which breastfeeding protects tiny tummies is by promoting the growth of healthful bacteria in the intestines. Intestines are healthiest when you can keep the right "bugs" in the bowels. The healthful bacteria, known as bifidus bacteria, do good things for the body in return for a warm place to live. They manufacture vitamins and nutrients and keep the harmful bacteria in check. The high levels of lactose in breastmilk particularly encourage the growth of the healthful resident bacteria Lactobacillus bifidus.

• Protects against other infection. Studies have found that breastfeeding protects against a wide variety of other diseases. Here's a partial list:
  • Haemophilus influenzae type B
  • Pneumonia caused by Streptococcus pneumoniae
  • Meningitis
  • Infant botulism
  • Urinary tract infections
  • Cholera
  • Salmonella
  • E. coli infections
  • Respiratory syncytial virus
• Reduces risk of SIDS. Many parents are relieved to learn that breastfed babies are less likely to become victims of SIDS. There are many ways in which breastfeeding could influence the incidence of SIDS. One recent theory suggests that infants who die of SIDS may sleep too deeply and fail to awaken if they stop breathing for a moment or two, as babies often do when they're sleeping. Breastfed babies sleep less deeply and thus may be more likely to wake up if there is a problem with their breathing. Breastfeeding's protection against infection may also help to lower the SIDS risk. (See Breastfeeding and SIDS)
• Fewer problems with reflux. While all babies spit up a bit, some regurgitate excessive amounts of milk, because of a condition called gastroesophageal reflux (GER). Normally, the circular band of muscle where the esophagus joins the stomach acts like a one-way valve, keeping milk, food, and stomach acids from backing up into the esophagus when the stomach contracts. When it doesn't do its job and these acids enter the esophagus, the result is an irritation that adults would call heartburn. In many infants, it takes six months to a year for this muscle to mature enough to prevent this regurgitation or reflux. GER is less of a problem in breastfed infants because breastmilk is emptied twice as fast from the stomach. It's less likely to be regurgitated than slow-to-digest formula with its tough casein curds.

HOW THE BREASTS MAKE AND DELIVER MILK

• The lactation system inside your breasts resemble a tree. The milk glands (the leaves) are grapelike clusters of cells high up in the breast that make milk. Milk travels from these glands down through the milk ducts (the branches). These ducts then widen beneath the areola (the dark area surrounding the nipple), forming milk sinuses (the tree trunk), which then empties into the approximately twenty openings in your nipple (like the channels going down to the roots of the tree). These milk sinuses are located beneath your areola.
• To empty these milk sinuses effectively, your baby's gums must be positioned over them so that baby's jaws compress the sinuses where the milk is pooled. If baby sucks only on your nipple, only a little milk will be drawn out, and your nipple will be irritated unnecessarily. Remember the golden rule of effective latch-on: Babies suck on areolas, not nipples. Baby must have enough of your areolas in her mouth to get the milk out.
• Your baby's sucking stimulates nerves in your nipple that send messages to the pituitary gland in you brain to secrete the hormone prolactin. Prolactin surges encourage continued milk production, which goes on around the clock. As your baby continues sucking, the sensors in your nipple signal the pituitary gland to secrete another hormone, oxytocin. This hormone causes the elastic tissue around each of the many milk glands to contract, squeezing a large supply of milk through the milk ducts into the sinuses and out the nipple. This is called the milk ejection reflux , or MER. The milk may come out so fast that it leaks out the side of your baby's mouth. If you were pumping or expressing by hand, you would see the milk spray out in every direction.
• The first milk your baby receives at each feeding is the foremilk, which is thin like skim milk because of low fat content. As baby continues to suck, more oxytocin brings on phase two, squeezing out the later milk (called hindmilk), which is much higher in fat and slightly higher in protein and, therefore, helps baby gain weight and helps baby's tummy feel full. Consider this creamier hindmilk "grow milk."
• The more milk that is removed from your breasts, the more milk your body makes to replace it. Frequent removal of milk from your breasts by your baby or by a pump will sti9mulate your body to produce more milk. When your baby breastfeeds less, the body responds by cutting back on milk production. This supply and demand system is how mothers produce enough milk for twins or even triplets.

MOTHER'S MILK: IDEAL NUTRITION FOR HUMAN BABIES

Milk is milk, right? Mammals make it (humans are mammals) and babies drink it. There's more to the story than that. Each species of mammal makes a unique kind of milk, which meets all the nutritional requirements of its offspring at the beginning of life. Each species' milk has specific qualities that insure the survival of the young in a particular environment. This principle is known as the biological specificity of milk. Mother seals, for example, make a high-fat milk because baby seals need lots of body fat to survive in cold water. Since brain development is crucial to the survival of humans, human milk provides nutrients for rapid brain growth.

No matter what animal it comes from, milk contains the basic nutritional elements of fats, proteins, carbohydrates, vitamins, and minerals. Let's look at each one of these nutrients in human milk, comparing them to the same nutrients in formula or cow milk, so you can further appreciate how your milk is custom-made to meet the needs of your baby.

Unique nutrition for unique humans. As hormones levels change in the days after birth, the mother's body starts to make more plentiful amounts of milk. Colostrum gradually changes into mature milk--the stuff babies have been thriving on for thousands of years. Milk's basic ingredients are fat, proteins, lactose, vitamins, minerals, and water. This is true of milk from all kinds of mammals. Yet, the proportions of these ingredients differ, as do the kinds of protein and fat. This is what makes each species' milk uniquely suited to its young. It's also why cow's milk and cow's milk-based formulas are not the ideal food for human infants.

HIGH QUALITY PROTEIN

Protein is a prime example of how human milk is unique nutrition for human babies. Human milk is low in protein, at least when compared with the milk of other species, especially cow's milk. This isn't a nutritional deficiency; there are good reasons for this. Human infants are designed to grow slowly. While it's important for humans to develop strong bodies, even more important is brain development and the learning of social skills. The experiences that shape the brain come from close contact between mother and baby when baby is held and carried. If human infants doubled their birthweight in less than 50 days the way baby calves do, and then continued growing, how could their mothers carry them and talk to them and keep them close? Baby cows need to learn where to find the best grass in the meadow; baby humans need to learn how to work with others so that everyone's needs get met.

Though the protein content of human milk is generally low, the types of amino acids that make up these proteins are important. One particular amino acid, taurine, is found in large amounts in human milk. Studies show that taurine has an important role in the development of the brain and the eyes. The body can't convert other kinds of amino acids into taurine, so its presence in human milk is significant--so significant that some formula manufacturers have begun adding it to artificial baby milks.

If you let milk stand out of the refrigerator and sour, you will see that milk proteins fall into two categories, curds and whey. (Remember Miss Muffet?) The curd portion, the casein proteins, are the white clots; the liquid is the whey. Cow's milk is mostly casein protein, which forms a rubbery, hard-to-digest curd in babies' tummies. Human milk has more whey than curd, and the curds that are formed are softer and more quickly digested. Breastfed babies get hungry sooner than babies who are formula-fed because human milk proteins are digested so efficiently. It doesn't take as much energy to digest human milk as it does to digest formula. Frequent feedings also ensure that human babies get lots of attention from their mothers.

SELF-DIGESTING FATS

There's another reason why babies digest human milk so quickly: the fat in human milk comes with an enzyme, lipase, that breaks the fat down into smaller globules so this important nutrient can be better absorbed into the bloodstream. Fat is a valuable source of energy for babies, so the presence of lipase makes the fat in human milk more available. This is one of the reasons human milk is so good for premature babies, who need lots of energy to grow but whose digestive systems are very immature.

A changing nutrient for changing needs. The fat content of human milk changes constantly. Typically, fat levels are low at the beginning of a feeding and high at the end. Babies nurse eagerly to get the low-fat, thirst-quenching foremilk, then slow down and linger over the high-fat dessert at the end of their meal. Babies who nurse again soon after the end of the last feeding get more high-fat milk, so babies who breastfeed more frequently during a growth spurt get more calories. Longer intervals between feedings bring down the fat content of the milk stored in the breast. This nutritional fact of human milk is one of the many reasons why the rigid 3 to 4 hour scheduled style of feeding is biologically incorrect.

Smarter fats. The special kind of fat in human milk is important to brain development. As newborn babies grow, the nerves are covered with a substance called myelin which helps the nerves transmit messages to other nerves throughout the brain and body. To develop high-quality myelin, the body needs certain types of fatty acids--linoleic and linolenic--which are found in large amounts in human milk.

VITAMINS AND MINERALS

The vitamins and minerals listed on the formula can are no match for those in the milk made by mom, even if milligram by milligram comparisions suggest otherwise. When formula researchers want to know how much of a particular vitamin or mineral babies need each day, they look first at how much of that nutrient is present in human milk and how much milk a baby of a given age takes in a day. But just doing the math doesn't tell the whole story. More important than the amounts of nutrients in the milk is the amount that is available for the infant to use, a nutrient principle called bioavailability. The bioavailability of a nutrient is influenced by many factors, including its chemical form and the presence of other substances.

The three important minerals calcium, phosphorus, and iron are present in breastmilk at lower levels than in formula, but in breastmilk these minerals are present in forms that have high bioavailability. For example, 50 to 75 percent of the iron in breastmilk is absorbed by the baby. With formula, as little as four percent of the iron is absorbed into baby's bloodstream. To make up for the low bioavailability of factory-added vitamins and minerals, formula manufactures raise the concentrations. Sounds reasonable, right? If only half gets absorbed by the body, put twice as much into the can. Yet, this nutrient manipulation may have a metabolic price.

Baby's immature intestines are required to dispose of the excess. Meanwhile, the excess unabsorbed minerals (especially iron) can upset the "ecology of the gut," interfering with the growth of healthful bacteria and allowing harmful bacteria to flourish. This is another reason formula-fed infants have harder, more unpleasant smelling stools.

To enhance the bioavailability of nutrients, breastmilk contains facilitators - substances that enhance the absorption of other nutrients. For example, vitamin C in human milk increases the absorption of iron. Zinc absorption is also enhanced by other factors in human milk. In an interesting experiment, researchers added equal amounts of iron and zinc to samples of human milk, formula, and cow'd milk, and fed them to adult volunteers. More of the nutrients in the human-milk sample got into the bloodstream compared to the formula and cow's milk. In essence, breastmilk puts nutrients where they belong - in baby's blood, not in baby's bowels.

HORMONES AND ENZYMES

Every year medical journal articles describe more valuable substances discovered in human milk. Scientists are only beginning to write the story on other factors in human milk that may be important to baby's growth and development. For example, other enzymes besides lipase are available to aid infant digestion. Epidermal growth factor, present in human milk in significant amounts, may promote the development of tissues in the digestive tract and elsewhere. Other hormones in milk may influence a baby's metabolism, growth, and physiology. The effects may be subtle, but they may also have far-reaching implications. Being breastfed has advantages that reach into adulthood. Science is only beginning to learn what these benefits are.

COMPARISON OF HUMAN MILK AND FORMULA

NUTRIENT FACTOR	BREAST MILK CONTAINS	FORMULA CONTAINS	COMMENT
Fats	Rich in brain-building omega 3s, namely DHA and AA -Automatically adjusts to infant's needs; levels decline as baby gets older -Rich in cholesterol -Nearly completely absorbed -Contains fat-digesting enzyme, lipase	-No DHA -Doesn't adjust to infant's needs -No cholesterol -Not completely absorbed -No lipase	Fat is the most important nutrient in breastmilk; the absence of cholesterol and DHA, vital nutrients for growing brains and bodies, may predispose a child to adult heart and central nervous system diseases. Leftover, unabsorbed fat accounts for unpleasant smelling stools in formula-fed babies.
Protein	-Soft, easily-digestible whey -More completely absorbed; higher in the milk of mothers who deliver preterm -Lactoferrin for intestinal health -Lysozyme, an antimicrobial -Rich in brain-and-body- building protein components -Rich in growth factors -Contains sleep-inducing proteins	-Harder-to-digest casein curds -Not completely absorbed, more waste, harder on kidneys -No lactoferrin, or only a trace -No lysozyme -Deficient or low in some brain-and body-building proteins -Deficient in growth factors -Does not contain as many sleep-inducing proteins.	Infants aren't allergic to human milk protein.
Carbohdrates	-Rich in lactose -Rich in oligosaccharides, which promote intestinal health	-No lactose in some formulas -Deficient in oligosaccharides	Lactose is considered an important carbohydrate for brain development. Studies show the level of lactose in the milk of a species correlates with the size of the brain of that species.
Immune Boosters	-Rich in living white blood cells, millions per feeding -Rich in immunoglobulins	-No live white blood cells-or any other cells. Dead food has less immunological benefit. -Few immunoglobulins and most are the wrong kind	When mother is exposed to a germ, she makes antibodies to that germ and gives these antibodies to her infant via her milk.
Vitamins and Minerals	-Better absorbed, especially iron, zinc, and calcium -Iron is 50 to 75 percent absorbed. -Contains more selenium (an antioxidant)	-Not absorbed as well -Iron is 5 to 10 percent absorbed -Contains less selenium (an antioxidant)	Vitamins and minerals in breast milk enjoy a higher bioavailability-that is, a greater percentage is absorbed. To compensate, more is added to formula, which makes it harder to digest.
Enzymes and Hormones	-Rich in digestive enzymes, such as lipase and amylase -Rich in many hormones: thyroid, prolactin, oxytocin, and more than fifteen others -Varies with mother's diet	-Processing kills digestive enzymes -Processing kills hormones, which are not human to begin with -Always tastes the same	Digestive enzymes promote intestinal health. Hormones contribute to the overall biochemical balance and well- being of baby. By taking on the flavor of mother's diet, breastmilk shapes the tastes of the child to family foods.
Cost	-Around $600 a year in extra food for mother	-Around $1,200 a year -Up to $2,500 a year for hypoallergenic formulas -Cost for bottles and other supplies -Lost income when baby is ill

7 WAYS BREASTFEEDING BENEFITS MOTHERS

What's good for baby is also good for mother. When mothers follow nature's lead and breastfeed their babies, their own bodies benefit--so do their budgets!

1. Reduces the risk of breast cancer. Women who breastfeed reduce their risk of developing breast cancer by as much as 25 percent. The reduction in cancer risk comes in proportion to the cumulative lifetime duration of breastfeeding. That is, the more months or years a mother breastfeeds, the lower her risk of breast cancer.
2. Reduces the risk of uterine and ovarian cancer. One of the reasons for the cancer-fighting effects of breastfeeding is that estrogen levels are lower during lactation. It is thought that the less estrogen available to stimulate the lining of the uterus and perhaps breast tissue also, the less the risk of these tissues becoming cancerous.
3. Lessens osteoporosis. Non-breastfeeding women have a four times greater chance of developing osteoporosis than breastfeeding women and are more likely to suffer from hip fractures in the post-menopausal years.
4. Benefits child spacing. Since breastfeeding delays ovulation, the longer a mother breastfeeds the more she is able to practice natural childspacing, if she desires. How long a woman remains infertile depends on her baby's nursing pattern and her own individual baby.
5. Promotes emotional health. Not only is breastfeeding good for mother's body, it's good for her mind. Studies show that breastfeeding mothers show less postpartum anxiety and depression than do formula-feeding mothers.
6. Promotes postpartum weight loss. Breastfeeding mothers showed significantly larger reductions in hip circumference and more fat loss by one month postpartum when compared with formula-feeding moms. Breastfeeding mothers tend to have an earlier return to their pre-pregnant weight.
7. Costs less to breastfeed. It costs around $1,200 a year to formula-feed your baby. Even taking into consideration the slight increase in food costs to a breastfeeding mother, the American Academy of Pediatrics estimates that a breastfeeding mother will save around $400 during the first year of breastfeeding.