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 is sterile – there are no bacteria or other microbes. If born vaginally, they are exposed to their mother’s bacteria first - to which they already have some immunological protection from antibodies via the placenta. Baby then receives additional antibodies via colostrum and breastmilk, adding further protection to this expected exposure.

If babies are born by caesarean however, initial exposure is more likely to be environmental microbes from the air or staff caring for the baby. As mum may not carry antibodies to these foreign microbes, baby is more vulnerable to infection - even more so if they do not receive colostrum or breastmilk. Other babies at greater risk are preterm infants, and full term infants with any condition that requires separation from their mother.

All babies have what is often referred to as an “open gut”, which means the spaces between the cells of the small intestines will allow large molecules to pass directly into the baby’s bloodstream. If only breastmilk has entered this gut, it is referred to as a “virgin gut”.

As an infant’s immune system is not fully developed until 5-7 years of age, babies are not well equipped to handle harmful pathogens and bacteria. Instead the breastfeeding mother produces antibodies for her infant, and they can slip easily through the open gut into the baby’s bloodstream. What’s more, mum creates antibodies specifically tailored to protect against pathogens acquired from the baby’s immediate surroundings.

New antibodies are produced whenever she comes in contact with harmful microbes, ensuring updated protection is constantly passed to the nursling. As my co-founder put it, “it’s rather like having Boots the Chemist strapped to your chest!”

The gut of an exclusively breastfed baby and a formula fed infant are therefore very different. The acidity levels differ dramatically and so does the profile of bacteria present. If babies are exclusively breastfed and maintain their virgin gut, they develop natural healthy gut flora full of good bacteria which aid digestion. This serves as a line of defence, assisting the immature immune system.

The antibodies (particularly SIg A , the antibody type naturally produced by the body to protect mucosal surfaces against infectious organisms and toxins) from colostrum and breast milk coat the gut, thus preventing anything harmful being absorbed into baby’s bloodstream. These antibodies “ignore” good bacteria, but cling to and destroy harmful pathogens (disease causing microbes).

The downside to the “open gut” in the artificially fed baby is that other less desirable microbes such as pathogens or potentially harmful food proteins can also enter directly into baby’s bloodstream. They also lack maternal antibodies to fight infection.

Very small amounts of formula or solid foods destroy this protective coating. Just one formula supplement per 24 hours will result in an almost immediate shift from breastfed to formula-fed gut flora - in which good bacteria (Bifidobacteria) are no longer dominant. (Mackie, Sghir, Gaskins, 1999. Bullen, Tearle, Stewart, 1977)

If breast milk were again given exclusively, it would take 2-4 weeks for the intestinal environment to return again to a state favouring Grampositive Flora .(Brown & Bosworth, 1922; Gerstley, Howell, Nagel, 1932)

The introduction of solid food also causes a major shift in the gut ecosystem, with a rapid rise in the number of Enterobacteria (which can cause for example Salmonella and E-Coli) and Enterococci (an extremely antibioticresistant germ responsible for infections including urinary tract infections and meningitis). This is followed by progressive colonisation of Bacteroides ,(extremely antibiotic resistant, generally opportunistic germs which can cause a variety of infections throughout the body), Clostridia (which cause for example tetanus, botulism, diarrhoea and colitis and Clostridium difficile (c.dif) which can cause infection and diarrhea.

Around the middle of the first year, a baby begins producing enough IgA antibodies to cope with the changing environment, and in readiness for the introduction of solids the spaces between the cells of the small intestines are reduced (making a “closed gut”), thus preventing large food proteins entering the bloodstream.

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