II. Epidemiology

  1. U.S. Prevalence of Breast Feeding (AAP recommends Breast Feeding for at least 1 year, exclusively for first 6 months)
    1. Initial: 83%
    2. Exclusively through 3 months: 47%
    3. At 6 months: 58% (25% exclusively)
    4. At 1 year: 36%
    5. CDC Breastfeeding Facts
      1. https://www.cdc.gov/breastfeeding/data/facts.html
  2. Highest Breast Feeding rates:
    1. White
    2. Primipara
    3. Over age 30 years
    4. College educated
    5. Employed
    6. Higher socioeconomic status
    7. Western states
  3. Lowest rates among:
    1. Under age 20 years
    2. Unemployed
    3. Unmarried
    4. Lower socioeconomic class
    5. Poor social support

III. Advantages: Breast Feeding

  1. Lower Incidence of Infantile Colic
  2. Most important method of maternal-infant bonding
  3. Easier to digest than formula (related to Protein)
    1. Human milk is digested in 1.5 hours
    2. Formula is digested in 4 hours
  4. Does not induce allergic response (contrast to formula)
    1. Diarrhea
    2. Gastrointestinal Tract bleeding
    3. Atopic Dermatitis
  5. IQ higher for Breastfed infants
    1. Kramer (2008) Arch Gen Psychiatry 65(5): 578-84 [PubMed]
    2. Horta (2015) Acta Paediatr 104(467): 14-9 [PubMed]
  6. Lower Incidence of feeding problems
    1. Gastroesophageal Reflux (Regurgitation)
    2. Constipation
  7. Colostrum contains multiple immune factors
    1. Macrophages
      1. Complement
      2. Lysozyme
      3. Lactoferrin
    2. Secretory IgA antibodies
      1. Infant receives 0.5 to 1g Secretory IgA per day
      2. Bacterial, Viral, and protozoal protection
  8. Lower Incidence of infection
    1. Bacteremia
    2. Meningitis
    3. Botulism
    4. Gastrointestinal infection
    5. Lower respiratory infection
    6. Otitis Media
    7. Urinary Tract Infection
  9. Advantages to mother
    1. Faster return to pre-pregnancy weight
    2. Decreased postpartum bleeding
    3. Decreased Postpartum Depression risk
    4. Increased Bone Mineral Density
    5. Lower Incidence of Ovarian Cancer
    6. Lower Incidence of premenopausal Breast Cancer
    7. Lower risk of Type II Diabetes, Cardiovascular Disease and Hypertension

IV. Efficacy: Breast Feeding is not guaranteed Contraception

  1. Bottle Feeding
    1. Postpartum 12 weeks: 100% of women ovulating
  2. Breast Feeding
    1. Postpartum 12 weeks: 20% ovulating
    2. Postpartum 20 weeks: 50% ovulating
    3. Postpartum 30 weeks: 75% ovulating
    4. Postpartum 40 weeks: 85% ovulating
    5. Postpartum 50 weeks: 95% ovulating
    6. Postpartum 60 weeks: 100% ovulating

V. Contraindications: Absolute

  1. Maternal HIV Infection
  2. Untreated Active Tuberculosis
  3. Herpes Simplex Virus (HSV) lesions on Breast
  4. Chemical Dependency
  5. Important medication use that contraindicates Lactation
    1. See Contraindicated Drugs in Lactation

VI. Contraindications: Relative

  1. Tobacco Smoking in Lactation
    1. Significant nicotine exposure via Breast Milk
    2. 10x greater exposure than in bottle fed infants
    3. Mascola (1998) Am J Public Health 88:893-6 [PubMed]

VII. Advantages: Higher risk infants could benefit most from Lactation

  1. Respond positively to prenatal education
  2. Physician counseling and support

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Breast Feeding (C0006147)

Definition (MSH) The nursing of an infant at the breast.
Definition (MEDLINEPLUS)

Breastfeeding offers many benefits to your baby. Breast milk contains the right balance of nutrients to help your infant grow into a strong and healthy toddler. Some of the nutrients in breast milk also help protect your infant against some common childhood illnesses and infections. It may also help your health. Certain types of cancer may occur less often in mothers who have breastfed their babies.

Women who don't have health problems should try to give their babies breast milk for at least the first six months of life. There are some cases when it's better not to breastfeed. If you have HIV or active tuberculosis, you should not breastfeed because you could give the infection to your baby. Certain medicines, illegal drugs, and alcohol can also pass through the breast milk and cause harm to your baby.

If you are having problems with breastfeeding, contact a lactation consultant.

NIH: National Institute of Child Health and Human Development

Definition (NCI) The nursing of an infant at the mother's breast.
Definition (CSP) nursing of an infant at the mother's breast.
Concepts Organism Function (T040)
MSH D001942
SnomedCT 12434007, 146973009, 169741004
English Breastfeeding, Feeding, Breast, Breast feeding, Infant breast fed, BF - Breast fed, BF - Breast-feeding, breast fed, breastfeed, breast feedings, breast fed infants, breastfeedings, breasting feeding, breast fed infant, breast feeding, breast feed, Lactation, Breast feeding, function (observable entity), Breast fed, Breast fed (finding), Breast feeding, NOS, Breast feeding (function), Breast Feeding, Nursing, breastfeeding, Infant breastfed, BF - Breastfed, BF - Breastfeeding
Spanish amamantado, lactancia, lactancia materna, lactancia materna (entidad observable), amamantamiento, Amamantamiento, lactancia materna (función), Lactancia materna, lactancia (hallazgo), alimentado a pecho (hallazgo), alimentado a pecho, Lactancia Materna
Swedish Amning
Japanese ボニュウエイヨウホウ, 母乳栄養法, 母乳栄養
Czech kojení, Kojení
Finnish Imetys
French Allaitement, Allaitement maternel, Allaitement au sein
Croatian DOJENJE
Polish Karmienie piersią, Żywienie niemowląt naturalne
Hungarian Emlő táplálás
Norwegian Amming
Portuguese Amamentação, Aleitamento Materno
Dutch borstvoeding, Borstvoeding, Voeding, borst-
German Stillen
Italian Allattamento al seno

Ontology: Lactation Disorders (C0022927)

Definition (NCI_CTCAE) A disorder characterized by disturbances of milk secretion. It is not necessarily related to pregnancy that is observed in females and can be observed in males.
Definition (NCI) A disorder not necessarily related to pregnancy that is observed in females and males. It is characterized by disturbances of milk secretion. Causes include damage to the breast parenchyma due to inflammation, medications, pituitary tumors, and hypothyroidism.
Definition (MSH) Disturbances of MILK secretion in either SEX, not necessarily related to PREGNANCY.
Concepts Disease or Syndrome (T047)
MSH D007775
ICD9 676.90, 676.9
ICD10 O92.70
SnomedCT 200460006, 200459001, 200465001, 35046003
English LACTATION DISORDER, Disorders, Lactation, Lactation Disorders, Unspecified disorder of lactation, Unspecified disorder of lactation, unspecified as to episode of care, Disorder, Lactation, Lactation disorders, Disorders of lactation NOS, Disorder of lactation NOS, Disorder of lactation NOS, unspecified, Lactation disorder NOS unspec, LACTATION DIS, lactation disorder (diagnosis), lactation disorder, Lactation disorder NOS, Lactation Disorder, Lactation dis NOS-unspec, Unspecified disorders of lactation, Lactation Disorders [Disease/Finding], Disorder;lactation, Unspecified disorder of lactation, unspecified as to episode of care or not applicable, Disorders of lactation NOS (disorder), Disorder of lactation NOS, unspecified (disorder), Disorder of lactation NOS (disorder), Lactation disorder, Disorder of lactation (disorder), Disorder of lactation, disorder; lactation, lactation; disorder, Disorder of lactation, NOS, disorder of lactation
Italian Disturbo della lattazione, Disturbo della lattazione non specificato, Disturbo della lattazione NAS, Disturbo della lattazione non specificato, episodio di cura non specificato, Disturbi della lattazione
Dutch niet-gespecificeerde aandoening van lactatie, niet-gespecificeerd naar behandelperiode, borstvoedingsstoornis NAO, niet-gespecificeerde aandoening van lactatie, lactatie; stoornis, stoornis; lactatie, borstvoedingsstoornis, lactatiestoornissen, Lactatiestoornis, Lactatiestoornissen, Stoornis, lactatie-, Stoornissen, lactatie-
French Trouble de l'allaitement SAI, Trouble de la lactation non précisé, Trouble de la lactation non précisé, épisode de soins non précisé, Trouble de l'allaitement, Troubles de la lactation
German unspezifische Laktationsstoerung, Laktationsstoerung NNB, unspezifische Laktationsstoerung, ohne Angabe der Behandlungsepisode, Laktationsstoerungen, Laktationsstoerung, Laktationsstörungen
Portuguese Perturbação da lactação NE, episódio de cuidados NE, Alteração da lactação NE, Perturbação da lactação NE, Alteração da lactação, Alterações da lactação, Transtornos da Lactação
Spanish Trastorno no especificado de la lactación, Trastorno no especificado de la lactancia, sin especificación del episodio de asistencia, Trastorno de la lactación NEOM, trastornos de la lactancia, SAI (trastorno), trastornos de la lactancia, SAI, trastorno de la lactancia, SAI, trastornos de la lactancia, SAI, no especificados (trastorno), trastorno de la lactancia, SAI (trastorno), trastornos de la lactancia, SAI, no especificados, trastorno de la lactancia (trastorno), trastorno de la lactancia, Trastorno de la lactancia, Trastornos de la lactación, Trastornos de la Lactancia
Japanese 乳汁分泌障害, 乳汁分泌障害NOS, 詳細不明の乳汁分泌障害, ニュウジュウブンピツショウガイ, ニュウジュウブンピショウガイNOS, ニュウジュウブンピツショウガイNOS, ショウサイフメイノニュウジュウブンピショウガイ, ショウサイフメイノニュウジュウブンピツショウガイ, ニュウジュウブンピショウガイ
Swedish Amningssvårigheter
Finnish Laktaatiohäiriöt
Czech Porucha laktace, Blíže neurčená porucha laktace, Poruchy laktace, Porucha laktace NOS, Blíže neurčená porucha laktace, bez určení vztahu k péči, laktace - poruchy, poruchy laktace
Polish Laktacja niedostateczna, Zaburzenia laktacji
Hungarian Tejelválasztási zavar, Tejelválasztás nem meghatározott betegsége, Lactatio betegségei, Tejelválasztási zavar k.m.n., Tejelválasztás terhesegondozás időpontja alapján nem meghatározható, nem meghatározott betegségei
Norwegian Ammeproblemer, Diegiingsforstyrrelser, Ammingsforstyrrelser, Diegivingsforstyrrelser, Diegivningsforstyrrelser, Laktasjonsforstyrrelser

Ontology: Milk, Human (C0026140)

Definition (CSP) white liquid secreted by the human mammary glands; it contains proteins, sugar, lipids, vitamins, and minerals.
Concepts Body Substance (T031)
MSH D008895
SnomedCT 226789007, 87640006
LNC LA16914-6
English Human Milk, Breast Milk, Breast Milks, Mother's milk, human milk (medication), foods milk human, human milk, mother's milk, breasts milk, breast milk, Mother's milk (substance), Breast milk, Human milk, BM - Breast milk, Breast milk (substance), Milk, Human, Milk, Breast
French Lait de femme, Lait humain, Lait maternel
Swedish Bröstmjölk
Spanish leche materna, leche materna (sustancia), Leche Materna, leche humana (sustancia), leche humana, Leche de la Madre, Leche Humana
Finnish Äidinmaito
Italian Latte materno, Latte umano
Polish Mleko kobiece
Japanese 母乳, 人乳
Czech mléko mateřské, mateřské mléko
German Brustmilch, Frauenmilch, Muttermilch, menschliche
Dutch Melk, moeder-, Moedermelk
Portuguese Leite Humano, Leite Materno