This version is aimed at parents and those with a general interest. For those involved in the field of lactation. such as counsellors and midwives (or if you just generally prefer a more hardcore scientific explanation) please see the long version.

Exclusive Breastfeeding and Why…

by Charlotte Young, iwantmymum.com

Many of the health reasons cited for breastfeeding require exclusive breastfeeding, which means solely breastmilk. No water, solids or formula. Current guidelines by the UK Government, the World Health Organisation (WHO) and UNICEF are to breastfeed exclusively for 6 months – why?

A newborn’s gastrointestinal tract (the tube that extends from the mouth to the anus) is sterile. If born normally, a baby is exposed to his mother’s bacteria first and he has received protection from this before birth from the placenta. As baby breastfeeds, he receives additional antibodies from colostrum and breastmilk.

If babies are born by caesarean section however, they are likely to be initially exposed to hospital air and the staff. As mum may not carry antibodies to germs found in this environment, baby is more vulnerable to infection. Other babies at greater risk are preterm infants, and full term infants with any condition that requires separation from their mother or the giving of a breastmilk substitute.

The immune system of a baby is very different from that of an older child or adult. Before birth, baby only receives some immunity to specific viral infections. His own immature immune system takes several years to produce adult levels of some antibodies, and up to six years for others.

What makes babies even more vulnerable still is that until around six months of age, they have what is often referred to as an “open gut”. This means large molecules can pass directly into their bloodstream. For these reasons, babies demonstrate a marked susceptibility to infections, and minor infections have the potential to become generalised very easily.

Human infants are meant to drink human milk; there are very good reasons for this. Firstly it is rich in the antibodies baby lacks, providing the infant with passive immunity until his own system is mature enough to take over. Mum also creates specific antibodies whenever she and her baby come in contact with harmful germs. When her baby breastfeeds, he passes any germs he has picked up into mother’s body via saliva on her nipple. This signals her immune system to provide or produce the antibodies locally within her breast, which are passed back at subsequent feedings.

If breastmilk is all that has ever entered baby’s gut, it is often referred to as a “virgin gut”. This is because it is a unique environment only found in an exclusively breastfed baby. Different things within breastmilk create amazing conditions, where good bacteria thrive; this aids digestion and interferes with the growth of harmful bacteria. What’s more, the antibodies mum passes can survive in this environment. They then coat the surface of the gastrointestinal tract, acting as a seal for the “open gut” and prevent germs being absorbed into baby’s bloodstream.

These antibodies “ignore” good bacteria, but cling to and destroy harmful germs. Other antibodies enter the bloodstream and move throughout the body, searching for any foreign substances that may cause harm. This serves as a first line of defence for the immature immune system.

Although the “open gut” benefits the breastfed baby by allowing antibodies to slip easily into the bloodstream, in the artificially fed infant it only serves to allow less desirable germs, or potentially harmful food proteins to enter directly into baby’s body.

Only small amounts of formula or solid foods cause a shift that destroys this “virgin gut” environment; removing the coating and killing good bacteria. Just one formula supplement per day will result in an almost immediate shift in which good bacteria are no longer dominant. Even if breastmilk was given exclusively again thereafter, it would take two to four weeks to return again to a state favouring good bacteria. (Brown & Bosworth, 1922; Gerstley, Howell, Nagel, 1932). If breastmilk subsitutes are used in the first few days, the gut flora may never reach normal levels.

The introduction of solid food also causes a major change in the gut flora, with a rapid rise in the number of bacteria. These can cause various infections which can cause for example Salmonella and E-Coli. Numbers also increase of other extremely antibiotic-resistant germs responsible for a variety of infections throughout the body, including ear infections, diarrhoea and even meningitis.

Around the middle of the first year, in readiness for the introduction of solids, the gut closes, preventing large food proteins entering the bloodstream. Introducing foods (alongside breastmilk) that are sources of “good bacteria”, or encourage them to thrive, is important to continued health.

Breastmilk contains many active constituents that actively assist in fighting disease; early breastmilk contains as many white cells as blood! Some aggressively target disease-causing pathogens, whilst others prevent bacteria multiplying and carry them from the body. Some damage bacteria so they are unable to replicate and cause further damage, and others bind to the organisms bacteria could feed on. Some are really clever and send out signals which mobilise other parts of the immune system, whilst others then direct the immune cells to where they are needed. Some cells within breastmilk have the ability to turn into other types of cells, serving as a sort of internal repair system! Others show the infant’s immune system how to respond, helping to prevent an over-reaction, and another very special constituent has been shown to kill forty different types of cancer.

We now understand that breastfeeding is the cornerstone of infant health, with an impact on lifelong outcome. Artificial formula has none of the above attributes; it is a static product that actively destroys protection provided by human milk. As a result rates of sickness, disease and even mortality rates are higher in infants not exclusively breastfed - with a knock-on effect lasting right into adulthood.

Scientists are researching the potential of various breastmilk constituents in the longer term for treating conditions such as:
Spinal injuries
Diabetes
Dementia and stroke recovery.
Parkinson’s disease
Rheumatoid arthritis
Multiple sclerosis
Septic shock.
Acne

Today, some patients suffering from immunological diseases - such as HIV, leukaemia or hepatitis - or those receiving therapy that reduces the immune system, such as chemotherapy, are drinking breast milk in the hope that it can help adults, just as it helps sick babies. It has also been taken by cancer patients who claim it slows the progression of the disease and in the USA, some milk banks provide it to adults with a prescription from their doctor.

Supplementation of the Breastfed Baby: “Just One Bottle Won’t Hurt”—or Will It? by Marsha Walker, RN, IBCLC

WHO: The Optimal Duration of Exclusive Breastfeeding: A Systematic Review WHO/NHD/01.08 (2002)

http://en.wikipedia.org/wiki/Gut_flora

http://www.gentlebirth.org