Nature's milk…

Breast is best, as the saying goes. Yet a majority of Irish mothers still choose to feed their newborns with manufactured products that have to be prepared, rather than with the milk their own body produces. Time and again, it has been demonstrated that breast milk gives newborn babies the best possible start in life. Why then, are Irish mothers continuing to reach for the bottle?

Despite all kinds of evidence that proves breastfeeding is better not only for the child but also the mother, breastfeeding is still only pursued by a minority of mothers, many of whom cease as soon as they return home from maternity hospital.

Promotion programmes designed to increase awareness of the benefits of breastfeeding continue to fall on largely deaf ears. One of the difficulties is that mothers, when they return home with their new baby, may get limited or no support to continue with breastfeeding, if they encounter problems. The demands of the 'real' world take over.

Formula milk

Breastfeeding is much more common in developing countries than it is in parts of Europe. Access to expensive formula milk is probably the deciding factor for mothers in the developing world, but the fact remains that they gain vital health benefits for themselves and their children that infants in Europe are not receiving.

While the World Health Organisation (WHO) estimates that 35% of all children worldwide are being breastfed at the age of four months, in Ireland, less than that number are even receiving breast milk at birth. Only 12% of children in Ireland will be breastfed at four months old, according to research conducted by the Midland Health Board last year.

The majority of Irish mothers do not breastfeed.

Because they are not being breastfed, the majority of Irish children are missing out on a tremendous head start in life. Breast milk is 'designed' for each child by its own mother and contains immunoglobins and antibodies for a wide range of infections and diseases. Studies have consistently shown that breastmilk offers babies phenomenal health benefits that formula milks cannot dream of providing.

Immune factors

Breastfeeding allows infants to feel secure and loved at their mother's breast, while also receiving vital immune factors and antibodies that protect their health. As they grow, breastfed children have been proven to suffer less respiratory illness, fewer colds and significantly less bronchitis and pneumonia. They have less allergies, including less eczema, asthma and hay fever.

Breastfeeding is uniquely suited to meet the physical and emotional needs of babies.

Breastmilk contains special cells that counteract the effects of bacteria in the child's stomach, meaning that they experience less gastroenteritis than other infants. That means that they vomit less often, have fewer infections and are admitted to hospital much less often than bottle-fed children.

Formula milk cannot compare to breastmilk because, while it offers children a balanced form of nutrition, it does not respond to a child's health needs. Mother's milk varies from woman to woman and from birth to birth. A lactating woman produces slightly different milk at different times throughout the day, instantly responding to the needs of her child.

Promoting a new culture

In the latest attempt to change mothers' minds about the importance of breastfeeding, the government has appointed a National Breastfeeding co-ordinator. Formerly the assistant director of midwifery at the National Maternity Hospital in Dublin's Holles Street, Maureen Fallon took up her new position in June. She sees her job as promoting a culture of breastfeeding in Ireland such as exists in Scandinavia or the developing world.

"Obviously, breastfeeding is the normal, natural way for babies to be fed and Irish women breastfed like everyone else", she explains. "I think breastfeeding is a skill that we lost around two generations ago. There are complex reasons for that, including the introduction of women to the workplace and a past association of breastfeeding with poverty. But now the message needs to be that breastfeeding is the best start any mother can give her child, and women need to be supported in breastfeeding".

The problems for Irish women often begin with receiving mixed signals about whether to breastfeed or use formula milk, she said.

Up to 1998, the formula manufacturers had to comply with a code of conduct in how they advertised their products - overseen by a Code Monitoring Committee set up in 1982. The Committee was set up after Ireland voted in favour of the WHO Code on the marketing of breast milk substitutes.

Now, enforcement responsibility for this area rests with the Food Safety Authority of Ireland and it is underpinned by a Statutory Instrument (SI 243 of 1998).

Research by the lobby group Lionra On-line suggested that the International Code of Marketing of Breastmilk Substitutes, which was adopted by Ireland over 20 years ago, was breached in 90% of Ireland's maternity units. The code stipulated that marketing material for artificial milks should not be advertised in maternity units or ante-natal classes.

"There is a monitoring system that functions from within the Food Safety Authority. However, there have yet to be any prosecutions", says Maureen Fallon. "It has to be admitted that there have been problems with formula manufacturers. What is needed is a level of diligence among health professionals who deal with pregnant women".

However, the Advisory Committee on the Marketing of Infant Formula rejects these claims and told that the complaints under the original code of marketing were not numerous and it added that since the enforcement responsibility was given to the FSAI three years ago, 'there have been few complaints'.

Breaking barriers

Maureen Fallon believes that breastfeeding, while normal and natural, is a learned skill and both mother and child need support from the wider family while the mother learns how to place the child at her breast and the baby learns how to suckle. Society also has a role to play in lowering the barriers it has erected against the breastfeeding mother.

"I would like to see it written into law that a woman is allowed to breastfeed her baby whenever and wherever she pleases, as long as it is discreet", says Maureen Fallon. "If you go out to a hotel or restaurant and try to breastfeed your child, you will often encounter a barrier. Someone might complain to the manager or ask you to leave".

She praises La Leche League and Ciudiu for their peer promotion of breastfeeding among new mothers and believes that health service professionals themselves are good models for the pregnant women they deal with. A large majority of health workers choose to breastfeed their children, thus endorsing breastfeeding in the best way possible - by doing it themselves.

"As consumers, we are not used to a superior product being available for free", Ms Fallon says. "The benefits of breastmilk don't just last while feeding or during childhood, but throughout life. The miracle of nature is that breastmilk 'knows' what each child needs. Bottlefed babies are not just being fed artificial and inferior food, but they are getting it in an abnormal way. Babies require low volumes of food regularly".

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