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Context: According to some studies, the tendency of mothers to breastfeed has declined in recent years. Due to numerous benefits of breastfeeding which had been reported, this problem may put children's health and overall health of society at risk. In this study, we reviewed previous studies, emphasizing importance and necessity and enumerating benefits of breast-feeding. Evidence Acquisition: Websites including PubMed, Science Direct, Biomed, Medline, Cochrane Library, EMBASE, SID, and magazines related to the topic were searched using keywords. Articles that examined various aspects of breastfeeding were analyzed as well. Results: The most perfect food for babies during the first two years of their lives is breast milk. It has so many health benefits for both
J Compr Ped. 2014 May; 4(2): e14028.
Published online 2014 May 1. Review Article
An Overview of Importance of Breastfeeding
Foad Alimoradi 1; Maryam Javadi 1; Ameneh Barikani 2,*; Naser Kalantari 3; Mohamad
Ahmadi 1
1Department of Nutrition, Faculty of Health, Qazvin University of Medical Sciences, Qazvin, IR Iran
2Department of Social Medicine, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, IR Iran
3Department of Community Nutrition, National Nutrition and Food Technology Research institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medi-
cal Sciences, Tehran, IR Iran
*Corresponding author: Ameneh Barikani, Department of Social Medicine, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, IR Iran. Tel/Fax: +98-2813341934, E-mail:
Received: August 4, 2013; Revised: February 17, 2014; Accepted: April 11, 2014
Context: According to some studies, the tendency of mothers to breastfeed has declined in recent years. Due to numerous benefits of
breastfeeding which had been reported, this problem may put children’s health and overall health of society at risk. In this study, we
reviewed previous studies, emphasizing importance and necessity and enumerating benefits of breast-feeding.
Evidence Acquisition: Websites including PubMed, Science Direct, Biomed, Medline, Cochrane Library, EMBASE, SID, and magazines
related to the topic were searched using keywords. Articles that examined various aspects of breastfeeding were analyzed as well.
Results: The most perfect food for babies during the first two years of their lives is breast milk. It has so many health benefits for both
mother and baby. Breastfeeding was studied from various aspects. There was significant correlation between the examined factors in vast
majority of papers. However, some factors that researchers considered important did not give definitive results; therefore more extensive
research is needed in this area.
Conclusions: Breast milk is the most perfect food for babies during the first two years and no replacement is recommended during this
time. Breastfeeding has so many health benefits for both mother and baby during the breastfeeding period as well as in the future.
Keywords: Breastfeeding; Nutrition; Pediatrics
Implication for health policy/practice/research/medical education:
Decreased tendency of mothers to breastfeed in recent years may put children’s health and overall society health at risk. In this study, we reviewed previ-
ous studies to emphasize importance, necessity and enumerate benefits of breast-feeding.
Copyright © 2014, Iranian Society of Pediatrics; Published by Safnek. This is an open-access article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Context
Breast milk is a unique source of food for babies (1, 2)
which contains all necessary nutrients that will ensures
the infant's health, growth and development (2). This
source of food cannot be replaced with any other diet, as
breast milk contains numerous antioxidants, protecting
babies against harm caused by pathogens (3, 4). Breast-
feeding is also an important source of antioxidants, such
as vitamin C and vitamin E, that prevent or reduce oxida-
tive damages to various body tissues (5). Many anti-in-
flammatory agents were also found in breast milk which
protects child from inflammatory damage (6).
The breastfeeding period is the most critical period of
each individual’s life in terms of his growth and devel-
opment and an infant’s nutrition is highly important at
this stage. Secretary IgA of breast milk protects the ears,
nose, throat and digestive tract, also reduces intensity of
diseases such as diarrhea, respiratory tract infections (7,
8), otitis media, bacterial meningitis and urinary tract in-
fection (9). The carnitine level in infants fed with breast
milk is higher than infants fed with milk powder. Note
that carnitine is required for utilization of fatty acids as
an energy source (9). Exclusive breast feeding up to the
first 6 months of an infant’s life reduces the risk of devel-
oping gastrointestinal infections (10), asthma (10, 11) and
increases prevention on development of childhood obe-
sity (12-15) and diabetes in later years of children’s lives
(16, 17) and may be associated with decreased cholesterol
concentrations (16). Also breast-fed children have higher
scores of mental-cognitive capability than children who
were not breast fed (18).
Breastfeeding significantly reduced the risk of sudden
death syndrome in children under one year old (19-23)
and in early birth has a tremendous positive effect on
children's health (24). On the other hand mothers who
had breastfed their babies are less likely to suffer from
hypertension (25) and with increased breastfeeding du-
ration decreased the risk of developing cardiovascular
disease in 50 year old mothers (26). Also were less prone
to develop breast cancer (27-29) and recurrence rate of
postpartum migraine (30, 31).
Alimoradi F et al.
J Compr Ped. 2014;4(2):e140282
2. Evidence Acquisition
In examining factors associated with breast milk, due to
extensive articles and topics related to this area of inter-
est, papers which stressed on the importance and ben-
efits of breastfeeding were reviewed. The following key-
words were mostly looked up in articles: Breast Feeding,
Milk, Exclusive Breast Feeding, Women Milk, and Human
Milk. Sites that were used in this paper are as followed:
PubMed, ScienceDierect, Biomed, Medline, Cochrane Li-
brary, EMBASE, SID. Articles whose topics contradict this
article’s topic were considered as well.
Numerous studies have examined various aspects of
breastfeeding and breast milk feeding. There was a sig-
nificant relationship between breastfeeding and critical
factors of human health in many of these studies. Given
the breadth of material in this field of study, a summary
of examined reviewed studies are described individually
with respect to their topics in the rest of this paper.
2.1. Examining Relationship Between Breastfeeding
and Prevention of Diseases
Breastfeeding protects babies from many diseases and
reduces the severity of their symptoms. Among these dis-
eases we can mention respiratory infections, gastrointes-
tinal infections and diarrhea. Lower incidences of these
diseases were reported in infants fed with breast milk
(32-36). Salehi Abarghooyi et al. (37) showed that breast-
feeding longer than 12 months is effective in reducing the
risk of myopia in six to seven years old children. A review
of several studies showed that breast milk contains bac-
teria that are disinfectants and strengthen the immune
systems of the infants’ bodies (38). Cornall (39) supported
the high impact of breastfeeding on growth and health
of skeletal system of children, compared to other nutri-
tional methods of breast feeding.
2.2. Examining the Relationship Between
Overweight and Obesity and Breastfeeding
Ibrahimzadekar et al. (40) showed that exclusive breast
feeding up to six months and its continuation until 18
months is effective in reducing the risk of childhood
obesity. Some studies have shown that breastfeeding and
increased breastfeeding duration is an important factor
in reducing obesity and overweight in children (14, 41-
46). But, Shields et al. (47) and Nelson et al. (48) did not
find an independent relationship between decreased
overweight and obesity and breastfeeding. Instead, they
found that other factors, including genetic and environ-
mental factors are involved in this relationship. How-
ever, in another study, Kramer et al. (11, 49) showed that
breastfeeding had no effect on reducing obesity and over-
weight. Ijarotimi (50) study of 200 breastfeeding moth-
ers concluded that there was no significant relationship
between breastfeeding mothers and their BMI. Burke et
al. (45) suggested in a study that children that are breast-
fed for less than four months are more likely to develop
obesity and overweight, or had increased obesity and
overweight, compared to children who had been breast
fed more than 4 months.
2.3. Examining the Relationship between
Breastfeeding and Incidence of Diabetes and
Several studies also supported the protective effect of
breastfeeding against the development of type I diabetes
(17, 51). Meyer et al. (52) showed in their study of 167 ado-
lescents that breastfeeding is a protective factor against
type II diabetes in adolescents. In some studies linking
breastfeeding with reduced risk of type II diabetes has
been emphasized (53, 54). According to Villegas et al.
(53) and Stuebe et al. (55) studies, breastfeeding protects
both mother and child from type II diabetes. Stuebe et al.
(56) have also shown that breastfeeding protects mother
from hypertension; however other studies did not report
such an association (11, 57). Stuebe et al. (58) found that
the risk of developing type II diabetes in mothers who
tend to breastfeed their babies less than a month is more
than mothers who do not.
2.4. Examining the Relationship Between
Breastfeeding and Incidence of Asthma and
In a case-control study of 400 cases and controls con-
ducted by Schnooyi et al. (59) it was shown that breast-
feeding up to six months is associated with a reduced risk
of asthma in 2-8 year-old children. Another study showed
that vitamin C found in breast milk reduces allergy in
children (6). Kramer et al. (60) study of 17046 children
did not confirm the effects of long-term breast-feeding
in reducing asthma and allergy. On the other hand, Sil-
vers et al. (61) reported a significant relationship between
breastfeeding and lower respiratory disorders, especially
wheezing. Silvers et al. (62) showed that exclusive breast-
feeding may reduce asthma and allergies at age six years
2.5. Examining the Relationship Between
Breastfeeding and Development and Function of
Nervous System
In a study of 69750 children conducted by Sun et al.
(63), it was demonstrated that persistent and long-term
breastfeeding is a protective factor against the develop-
ment of epilepsy in children. Several studies showed
that breastfeeding is effective in increasing children's
cognitive understanding (18, 62, 64-66), in addition these
studies emphasized on long-term breast milk consump-
tion (62). Several studies also implied the positive role
of breastfeeding on increased IQ and mental abilities,
especially in language learning (67-69). This criterion is
Alimoradi F et al.
J Compr Ped. 2014;4(2):e14028
probably due to the presence of unsaturated fatty acids,
especially DHA, in breast milk (65, 70). Based on a case-
control study conducted by Al-Farsi et al. (71), breast milk
prevents the occurrence of autism in children. Another
study (72) also showed that the lack of breastfeeding or
early weaning of infants can make children vulnerable
to ADHA (Attention-deficit/hyperactivity disorder). Nish-
ioka et al. (73) concluded in a study of 405 mothers that
mothers who breastfed their children for six months
were less prone to postpartum depression.
2.6. Examining the Relationship Between
Breastfeeding and Other Factors
The positive effect of breastfeeding on the decreasing
risk of breast cancer was seen in mothers who had breast-
fed (27, 29, 58, 74). In two studies by Ram et al. (75) and
Gunderson et al. (76), it was shown that an increased
breastfeeding duration by mothers protects them
against metabolic syndrome in the following years after
weaning. Stuebe et al. (77) stated in a study of 89326 that
prolonged breastfeeding protects mothers from cardio-
vascular diseases. Schwarz et al. (78) found that increased
breastfeeding duration decreases the incidence of hyper-
tension, diabetes, cardiovascular diseases and Hyperlip-
idemia in mothers.
3. Results
This paper showed that breastfeeding is the most criti-
cal solution which helps both an individual [the baby]
and society because both mother and child benefits from
the advantages of breastfeeding. The impact of breast-
feeding on reducing obesity and overweight were greatly
proven in children and adolescents. This issue can solve
many problems and diseases that society faces in the fu-
ture. The findings in the mentioned studies show that
breastfeeding reduces the risk of developing so many dis-
eases including diarrhea, respiratory infections, diges-
tive disorders, asthma, allergies and some neurological
disorders. Besides, breastfeeding can reduce obesity and
overweight in youths and adolescents. Other benefits
of breast milk are its protective effect in reduced risk of
developing diabetes, hypertension, metabolic syndrome
and breast cancer in mothers and children. Breastfeed-
ing prevents the risk of developing cardiovascular dis-
eases as well. The high concentration of anti-oxidant in
breast milk, leads to the conclusion that breast milk is a
protective factor against several numbers of cancers. So
far, no replacement has been proposed for breast milk.
4. Conclusions
Breast milk is the perfect food source - without any
other replacement - in children’s diet during the first two
years of their lives. Further studies are still needed to ex-
amine the relationship between breastfeeding and other
health factors.
4.1. Recommendations
1) Child should be exclusively fed with breast milk in the
first six months of his life.
2) Child determines breastfeeding time and any time
the child demands breast milk, he should be breastfed.
3) Breastfeeding should start from early hours after
4) Breastfeeding should continue after six months
along with complementary food for the child.
5) Mothers who cannot be near their children at all
times - for any reason - can freeze their milk, so that other
family members can feed the child with this milk when-
ever the child needs to be fed.
6) Do not deprive your children from breast milk as
long as it is possible.
Sincere thanks to Social Determinants of Health Re-
search Center, Qazvin University of Medical Sciences, Qaz-
vin, Iran for their helps.
Authors’ Contributions
Alimoradi 30%, Javadi 30%, Barikani 25%, Kalantari 10%,
Ahmadi 5%.
Financial Disclosure
This article did not use any financial support and there
is no conflict of interests for authors.
This research was supported by Qazvin University in
Medical Sciences, Qazvin Research Center for Social De-
terminants of Health, Qazvin, Iran.
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Colostrum is well known for helping to fight infection and promote the growth and development of the infant. The acceptance of colostrum and the frequency of colostrum feeding vary between cultures in Pakistan. Objective: To determine whether females are aware of the value of breastfeeding and colostrum feeding. Methods: Data collection was done through females attending Sheikh Zaid hospital, Rahim Yar Khan. In this cross-sectional study, non-probability convenient sampling was employed with a sample size of 100. Results: Among the women, 79 were knowledgeable about breastfeeding, whereas 21 were not. Also, 33 women started nursing right away after delivery compared to 67 who didn't. Lastly, the findings showed that just 10 women thought of colostrum as a complete source of nutrition, whereas 90 women did not have any idea. Conclusion: The findings suggests that further efforts are needed to enhance the knowledge, attitude, and practice of colostrum feeding since many mothers were unaware of the significance of colostrum and initiation of breastfeeding soon after delivery.
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In this review, we describe the patterns of known immunological components in breast milk and examine the relationship between breastfeeding and reduced risk of breast cancer. The top risk factors for breast cancer are a woman's age and family history, specifically having a first-degree relative with breast cancer. Women that have a history of breastfeeding have been shown to have reduced rates of breast cancer. Although the specific cause has not been elucidated, previous studies have suggested that breastfeeding reduces the risk of breast cancer primarily through two mechanisms: the differentiation of breast tissue and reduction in the lifetime number of ovulatory cycles. In this context, one of the primary components of human milk that is postulated to affect cancer risk is alpha-lactalbumin. Tumour cell death can be induced by HAMLET (a human milk complex of alpha-lactalbumin and oleic acid). HAMLET induces apoptosis only in tumour cells, while normal differentiated cells are resistant to its effects. Therefore, HAMLET may provide safe and effective protection against the development of breast cancer. Mothers should be encouraged to breastfeed their babies because the complex components of human milk secretion make it an ideal food source for babies and clinical evidence has shown that there is a lower risk of breast cancer in women who breastfed their babies.
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Attention-deficit/hyperactivity disorder (ADHD), one of the most common neuropsychiatric disorders that present at young age, may occasionally be associated with physical problems and disorders. Among them exists a group of oral-pharyngeal conditions with considerable clinical morbidity. Previous research that identified absence or short duration of breastfeeding in ADHD children has been reviewed. Essential nutritional factors in breast milk can affect brain development and regulate the manifestation of ADHD symptoms. Low ferritin levels caused by insufficient breastfeeding may contribute to ADHD susceptibility because of the role of iron in dopaminergic activity. Insufficient breast feeding and subsequently excessive bottle-feeding may lead to increased rates of non-nutritive sucking habits, such as pacifier use and thumb-sucking, all of which are associated with the risk of development of malocclusions. Malocclusion refers to an unacceptable deviation from the ideal relationship of the upper and lower teeth and necessitates orthodontic treatment. Sleep-disordered breathing in children may present with neurocognitive symptoms that resemble ADHD and abnormal craniofacial developments, as well as malocclusions, have been cited as part of the syndrome. Obesity, which is an outcome of insufficient breastfeeding, is a shared comorbidity of ADHD and sleep-disordered breathing. The risk of traumatic dental injury is higher in children with ADHD and presence of malocclusions further increases the likelihood of dental injuries. In this review, certain oral-pharyngeal conditions relating to ADHD have been reviewed and links among them have been highlighted in a tentative explanatory model. More research that will provide increased awareness and clinical implications is needed.
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Aim: Breast cancer is one of the most common cancers of women in India with high fatality rate. Over a 1 year study period 105 consecutive biopsy or fine needle aspiration cytology confirmed breast cancer patients were interviewed by direct questionnaire method regarding risk factors attending Surgery and Radiotherapy OPD of Medical College Kolkata, West Bengal while taking other 105 patients attending Surgery Department for some other disease as controls. The data were compiled in MS Excel 2007 and analyzed by Epi info 3.5.1 software. Among the cases, rural residence, illiteracy and low socio-economic status was significantly higher than controls. Late onset of menarche, late onset of menopause, ever OCP usage, breast feeding for 1-2 years and age of 1st childbirth between 20-30 years were found to be significant protective factors. People should be made aware regarding the modifiable risk factors to prevent breast cancer.
Background: Findings from observational studies suggest an inverse association between lactation and premenopausal breast cancer risk, but results are inconsistent, and data from large prospective cohort studies are lacking. Methods: We used information from 60 075 parous women participating in the prospective cohort study of the Nurses' Health Study 11 from 1997 to 2005. Our primary outcome was incident premenopausal breast cancer. Results: We ascertained 608 incident cases of premenopausal breast cancer during 357 556 person-years of follow-up. Women who had ever breastfed had a covariate-adjusted hazard ratio (HR) of 0.75 (95% confidence interval [CI], 0.56-1.00) for premenopausal breast cancer compared with women who had never breastfed. No linear trend was found with duration of total lactation (P=.95), exclusive lactation (P=.74), or lactation amenorrhea (P=.88). The association between lactation and premenopausal breast cancer was modified by family history of breast cancer (P value for interaction =.03). Among women with a first-degree relative with breast cancer, those who had ever breastfed had a covariate-adjusted HR of 0.41 (95% CI, 0.22-0.75) for premenopausal breast cancer compared with women who had never breastfed, whereas no association was observed among women without a family history of breast cancer. Conclusion: In this large, prospective cohort study of parous premenopausal women, having ever breastfed was inversely associated with incidence of breast cancer among women with a family history of breast cancer.
Background: A review of the breastfeeding related literature was undertaken to provide background for a qualitative study that explores how osteopaths promote effective breastfeeding. Topics considered relevant to osteopathic practice are presented with the aim of informing and stimulating discussion and further inquiry. Data Sources and Selection: Information is drawn together from the following databases: Lactation Resource Centre of Australian Breastfeeding Association, Cinahl, Cochrane Library, and Medline. Qualitative and quantitative studies of all designs, government and professional association websites, and conference presentations are included as the aim is to generate a broad background on the biological and psychosocial aspects of breastfeeding that could impact on osteopathic practise. The theoretical literature is included in areas where little research is available. Conclusions: A strong evidence base promotes breastfeeding as important health behaviour for a mother and baby; influenced by many complex and sensitive biopsychosocial factors. The theoretical literature and studies that have investigated the biomechanics of breastfeeding provide a rationale for osteopathic treatment to facilitate effective breastfeeding; however little supportive research has been undertaken. Further well designed studies are needed to determine the role that osteopaths might play in supporting a mother-baby dyad to successfully breastfeed.
Objective: The objective of this study was to determine how parity and breastfeeding were associated with maternal high blood pressure, and how age modifies this association. Study design: Baseline data for 74,785 women were sourced from the 45 and Up Study, Australia. These women were 45 years of age or older, had an intact uterus, and had not been diagnosed with high blood pressure before pregnancy. Odds ratios (ORs) and 99% confidence intervals (CIs) for the association between giving birth, breastfeeding, lifetime breastfeeding duration, and average breastfeeding per child with high blood pressure were estimated using logistic regression. Results: The combination of parity and breastfeeding was associated with lower odds of having high blood pressure (adjusted OR, 0.89; 99% CI, 0.82-0.97; P < .001), compared with nulliparous women, whereas there was no significant difference between mothers who did not breastfeed and nulliparous women (adjusted OR, 1.06; 99% CI, 0.95-1.18; P = .20). Women who breastfed for longer than 6 months in their lifetime, or greater than 3 months per child, on average, had significantly lower odds of having high blood pressure when compared with parous women who never breastfed. The odds were lower with longer breastfeeding durations and were no longer significant in the majority of women over the age of 64 years. Conclusion: Women should be encouraged to breastfeed for as long as possible and a woman's breastfeeding history should be taken into account when assessing her likelihood of high blood pressure in later life.
Lactation places a considerable metabolic burden on mothers through increasing energy requirements, but there are reports that lactation may lower the risk that type 2 diabetes will develop in the future. The authors report a prospective observational cohort study examining the association between type 2 diabetes and the history of lactation in 83,585 parous women enrolled in the Nurses' Health Study (NHS). In addition, a retrospective observational cohort study was undertaken in 73,418 parous women taking part in the Nurses' Health Study II (NHS II). A history of breast feeding was obtained from 64% of women in the NHS cohort and 85% of those in the NHS II cohort. In both groups, the lifetime duration of breast feeding increased with parity. Women who breastfed for longer times were relatively less likely to have a family history of diabetes. In the NHS cohort, there were 5145 cases of type 2 diabetes during 1,239,709 person-years of follow up in the years 1986-2002. The NHS II cohort included 1132 women diagnosed as having type 2 diabetes during 778,876 person-years of follow up in 1989-2001. An increased duration of lactation was associated with a lower risk of type 2 diabetes. Women in the NHS group who gave birth in the past 15 years had a 15% reduction in the risk of diabetes for each additional year of lactation. The corresponding risk reduction in the NHS II cohort was 14%. These estimates were made while controlling for current body mass index and other risk factors relevant to type 2 diabetes. Women in the NHS II cohort who had a history of gestational diabetes were at markedly increased risk of developing type 2 diabetes, but lactation had no influence on the risk of diabetes in these women. In these large cohorts of parous women, those reporting an increased duration of breast feeding were at reduced risk of developing type 2 diabetes. Along with clinical reports of improved glucose metabolism in lactating women, these findings suggest that lactation may lower the risk of type 2 diabetes in young and middle-aged women. The physiological factors underlying this association require further study.