The exclusive breastfeeding of babies -- giving them nothing, including water, but breast milk -- for at least the first six months of their lives is a better guard against future obesity than living healthy lifestyles as adults. That is according to international breastfeeding expert Jeanne Stolzer, of the University Nebraska Kearny in the United States.
"The longer and more frequently a baby is solely breastfed, the less likely that infant is to be overweight or obese throughout his or her life," she said.
Stolzer recently published in the Open Journal of Preventive Medicine an analysis of more than 40 studies that have found breastfed babies to be significantly less likely than bottle-fed infants to be fat, or to suffer from overweight-related conditions such as diabetes, heart diseases and high blood pressure, throughout their lives. "People tend to think that babies are only protected while they're being breastfed. That's simply not true. Research clearly shows that the protective effects continue throughout a human being's life," Stolzer said.
One study compared the body mass index (BMI -- a measure of body fat) of breastfed and bottle-fed babies at three months, and at the ages of four, five and six years. It found that the obesity rate among formula-fed children had tripled by the age of six.
Six-year-olds are considered obese when their BMI is about 20. Further research revealed that the greatest protection against obesity was seen when infants were breastfed exclusively for more than three months.
According to the United States Centres for Disease Control in Atlanta, up to 20% of obesity could be prevented by breastfeeding and the US surgeon-general, Regina Benjamin, recently announced that the government could save up to $3.5-billion annually if exclusive breastfeeding rates were increased from current levels, as breastfed babies were significantly less likely to suffer from a range of conditions, including obesity.
South Africa has one of the lowest exclusive breastfeeding rates in the world -- much lower than those of the US, where only about one out of 10 babies are solely breastfed at six months.
According to the latest South African demographic and health survey, only 1.5% of infants between four and six months are solely breastfed.
The World Health Organisation recommends exclusive breastfeeding for a minimum of six months and that breastfeeding, combined with solids, should continue until a child is two years old.
Stolzer said that one of the reasons researchers believed breastfed babies were thinner was because they could be better at self-regulating their food intake. "Formula feeding comes with recommended dosages, which often leads to overeating and the inability of infants to determine when they've had enough to drink. In contrast, breastfed babies have no predetermined amounts they're supposed to drink at each feeding and the infant therefore learns appetite regulation beginning immediately after birth."
Study finds evidence that exclusively breastfed babies are likely to avoid obesity
A study published in the British Medical Journal, which surveyed 9 300 children, found evidence that babies who were exclusively breastfed for three to five months were a third less likely to be obese by the age of six than those who were bottle-fed. The longer the period in which babies received breast milk, the greater the benefits were, with those who were breastfed for a year or longer being five times less likely to become obese. Researchers took into account factors such as eating habits, socioeconomic class, birth weight, parents' and siblings' ages, amount of outdoor activity, and whether or not the child had their own bedroom.
Stolzer said that it was important for babies to receive breast milk directly from the breast to enjoy the optimal protective effects from obesity. "When a nanny feeds an infant expressed breast milk from a bottle, that baby does not learn appetite regulation as it doesn't learn to stop drinking when it's full. The nanny will, in all likelihood, try to give the baby all that's in the bottle."
But the contents of breast milk also seem to play a role in preventing babies from becoming obese. Researchers have established higher concentrations of insulin in bottle-fed babies' blood, which are often associated with the accumulation of fatty tissue. Stolzer said that human milk also contained significantly less fat and proteins than formula milk, and the proteins in human milk seemed to be easier to metabolise than those in artificial infant milk and were therefore less likely to be stored -- later to become fat.
"Exclusive breastfeeding strongly protects against obesity," Stolzer said. "Just imagine how much less obesity there would be if we increased breastfeeding rates and also had wholesome eating and exercise habits?"
Push for changes to help working mothers
Health Minister Aaron Motsoaledi announced a six-months exclusive breastfeeding policy in September last year, compelling women who give birth in state hospitals to breastfeed their infants unless a health practitioner prescribes otherwise.
But employers are legally required to provide women with only four months' maternity leave, making it almost impossible for many to follow this policy.
Motsoaledi said he would lobby for maternity leave to be increased to six months and for women to be allowed to breastfeed their babies at work. But nothing has been said about it since then.
"We either need enough maternity leave, be allowed to take our babies to the office, or work from home," breastfeeding expert Jeanne Stolzer from the University of Nebraska Kearny said.
Obesity is a growing health concern in South Africa. According to a 2010 survey by GlaxoSmithKline, at least six out of 10 South Africans are overweight or obese, and nearly two out of 10 children between one and nine are obese.
Although breastfeeding research has shown that exclusive breastfeeding for six months strongly guards babies against obesity, dietician Nathalie Mat from MME Dieticians in Johannesburg said that it was equally important for parents to exhibit healthy eating habits for their children. "Children learn by copying their parents' behaviour. If they grow up with an inactive mommy and daddy who eat few vegetables and fruit, they'll do it themselves.
By the age of five it becomes extremely difficult to change a child's eating habits." -- Mia Malan
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