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I write, occasionally, about breastfeeding and bottlefeeding. I try, when I do, to present a balanced approach. It is challenging at times - to reconcile the choices I've made personally with my own children, with evidence-based studies and information that seems to come out regularly pointing to the overwhelming health benefits of exclusive breastfeeding; with the anger and frustration some women share over their own guilt about not breastfeeding their children; or the frustration they feel that they are made to feel guilty about the choices they've made. It's a fine line one walks between presenting the information and making mothers feel guilty for the loving and thoughtful choices we make on behalf of our children. At the very least, it's hard to deny that regardless of whether new mothers chose, in this country at least, to breastfeed or formula feed or do a combination of both, or if the choice is made for us because of HIV status, or because of low milk-supply for example, we will be judged in some way. It is, on the other hand, possibly helpful to suggest that women can be stronger than we sometimes give ourselves credit for (barring postpartum mood disorders which can leave women without the full ability to control one's reaction to situations and experiences); that we can learn to stand up to judgment, to speak up against criticism, bias and outright prejudice from those who disagree with our choices (or lack thereof).

I begin this post with this sort of olive branch to all new mothers because, while I formula fed one of my children from the time he was a newborn, and breastfed my other until she was three years old (and would have gone longer had she not fallen quite ill), I want to continue to share positive, solid evidence that supports how important - and truly amazing -  breastfeeding can be to a healthy start in life, if it's a feasible option for you and your baby.

With that in mind, I offer up the results of a study completed by Dutch researchers and released last month, published in the journal Pediatrics, of the American Academy of Pediatrics, on the importance of exclusive breastfeeding for babies up to 6 months old and partially for babies up to twelve months old.

The study, undertaken in the Netherlands, showed that babies who were partially breastfed for at least four months had markedly lower incidents of upper and lower respiratory infections as well as severe gastrointestinal issues as well. Breastfeeding had such a significant impact, in fact, that the researchers found that:

Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants.

In other words, it is literally saving babies' lives in some instances. Please understand that, as a first time mother who did not breastfed her baby, this information is not meant to scare new mothers - though I realize it might do that for some. It's meant to help us all understand how important it is to persuade our health providers, policymakers and business owners that we must implement mother-and-baby friendly policies in order to protect the health and lives of our newborns.

Miriam Labbock, MD, MPH, a professor at the University of North Carolina, Chapel Hill and the Director of the Carolina Global Breastfeeding Institute told me that the results of this new study were not surprising to her. Earlier studies have shown the same thing.

In 2006, the journal Pediatrics published a study which found that exclusive breastfeeding for at least six months or more place a baby at a signicantly decreased risk for pneumonia, than those babies who were exclusively breastfed for four to six months.

In 1987, Lancet published a study out of Brazil which found similar marked impacts of breastfeeding on gastrointestinal and respiratory infections, resulting in death in some instances:

In a population-based case-control study of infant mortality in two urban areas of southern Brazil, the type of milk in an infant's diet was found to be an important risk factor for deaths from diarrhoeal and respiratory infections. Compared with infants who were breast-fed with no milk supplements, and after adjusting for confounding variables, those completely weaned had 14.2 and 3.6 times the risk of death from diarrhoea and respiratory infections, respectively.

Labbok told me, in an email:

"Ever since we started studying the difference between exclusive and partial breastfeeding, we have seen this unexpected slight increase in lung issues with early partial breastfeeding. Why, you might ask? I could postulate that even some formula use ends up with increased microbuli to the lungs, promoting infection. This is compounded by the fact that we see that partially breastfed infants are more likely to be in day care where they are exposed to more infections and we might guess that the anti-inflammatory impact of breastfeeding is muted, so that we see the symptoms more.

All in all, it just keeps showing up - not for diarrhea, where any  intensity of breastfeeding helps, but for lung issues.

Since pneumonia is the major cause for hospitalization in the the first year of life in North Carolina, this is yet another reason that we must work for exclusive breastfeeding, not partial, not expressed milk feeding, but exclusive breastfeeding for at least the early weeks and months."

These are studies that, taken together over years and years, make you wonder why we are not, as a nation, prioritizing hospital and workplace policies, and laws that make breastfeeding as normal, and relatively easy to continue for an extended period of time, as possible. If the health benefits of breastfeeding are so acute, so great, why wouldn't those extremely vocal, angry anti-choice organizaions which work so long and hard to wrest rights away from women and physicians in the name of "life", work equally as hard to ensure a healthy life for babies and mothers? Universal health care for all - let no newborn go without health care. Ensure all pregnant women and new mothers have access to high quality health care including postpartum care, lactation services and more. Maternity leave, for all jobs, should be a national priority. Why don't all working women, who are new mothers, automatically have nursing breaks as part of their back-to-work schedule? Why aren't all hospitals baby-friendly hospitals, focusing first and foremost on providing all the information, resources and support a woman needs to exculsively breastfeed for the first few months?

Information on the health benefits of breastfeeding is important to highlight in order to help pregnant women come to a thoughtful decision about how they are going to feed their babies but for too many new mothers, it's the lack of societal support and an absence of prioritization on the national level which is the real decision-maker.

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