This is great news for the health of our nation because babies who are breastfed have lower risks of ear and gastrointestinal infections, diabetes and obesity and mothers who breastfeed have lower risks of breast and ovarian cancers. Also, breastfeeding lowers health care costs. —CDC director Dr. Tom Frieden
New research shows breastfeeding has long-term benefits for a baby's developing intelligence. The longer nursing occurs, the greater the enhancement on vocabulary and IQ.
Meanwhile, a major new report shows more mothers are trying to breastfeed and more are breastfeeding their babies longer.
In a study published in JAMA Pediatrics, one of the American Medical Association's journals, researchers from Boston Children's Hospital and Harvard showed that verbal scores were higher at age 3 and IQ scores at age 7 if the child had breastfed for the first year.
The researchers looked at data from more than 1,300 babies whose moms breastfed them for at least six months. In later intelligence testing of those babies, they found verbal scores were .2 higher at age 3 for each month the baby was breastfed, while at age 7, they demonstrated IQ score increase equivalent to one-third of a point for each month of breastfeeding. That benefit was for both verbal and nonverbal intelligence. At both ages, the measure of intellectual improvement was statistically significant.
Benefits of breastfeeding have long been touted within the medical community.
American Academy of Pediatrics guidelines note that "Breastfeeding provides a protective effect against respiratory illnesses, ear infections, gastrointestinal diseases and allergies including asthma, eczema and atopic dermatitis. The rate of sudden infant death syndrome (SIDS) is reduced by over a third in breastfed babies, and there is a 15 percent to 30 percent reduction in adolescent and adult obesity in breastfed vs. non-breastfed infants."
Previous studies have also found intellectual benefits, but the new one controlled for other issues that could account for the benefit, including a mother's intelligence, education, or economic background. The findings bring the research a step closer to showing causation, rather than just association, said lead author Dr. Mandy Belfort of Boston Children's Hospital.
More breastfeeding moms
Meanwhile, the Centers for Disease Control and Prevention this week heralded numbers showing an increase in how many women at least try to breastfeed, from 71 percent in 2000 to 77 percent in 2009. While that's good news for babies and families, experts said, many women stop breastfeeding by about six months, the minimum duration recommended by national and international health organizations. At six months of age, only 47 percent are breastfed, and it falls to 26 percent at 12 months, CDC figures show.
The new findings point out that even when breastfeeding is difficult, perseverance is worth it. The AAP and the World Health Organization are among groups that herald significant benefits to breastfeeding exclusively for six months and continuing to augment feedings with breast milk at least to baby's first birthday.
"This is great news for the health of our nation because babies who are breastfed have lower risks of ear and gastrointestinal infections, diabetes and obesity and mothers who breastfeed have lower risks of breast and ovarian cancers," said CDC director Dr. Tom Frieden. "Also, breastfeeding lowers health care costs."
He said researchers believe if women met breastfeeding recommendations, Americans would save $2.2 billion a year in health care costs.
Illinois-based La Leche League International has chapters in every state and around the world. They find great consistency in what women ask and what they need as they approach breastfeeding, said spokeswoman Diana West.
Most women want to breastfeed, she said, and are well aware of the benefits, which go even beyond the positives on both mom's and baby's health. Besides building baby's immune system, it promotes intimacy and bonding, for example.
While they are still pregnant, women worry about whether breastfeeding will cause pain — there should not be any, West said — and whether they will produce enough milk. Some need reassurance they can do it or crave tips that will help them. They wonder what it is supposed to be like.
After the birth, many women need advice to optimize production. "There are a lot of ways to increase milk production," said West, who said that's important to know because many women for different reasons struggle to produce enough. It helps to be able to consult lactation experts.
In an editorial in the same issue of JAMA Pediatrics as the study, Dr. Dimitri A. Christakis of Seattle Children's Research Institute questioned whether news that breastfeeding boosts intellect would provide an impetus for American moms to work harder to breastfeed successfully. Many have not responded to health benefits like fewer ear infections, which are not seen as life threatening. Intellect, though, is a long-term issue that could resonate more.
"It is possible that cognitive ability (and what it might lead to, namely, educational achievement, higher lifetime income, etc.) might be more powerful motivators for breastfeeding than reduced risk for otitis media and diarrhea and eczema," he wrote, noting it could kick off a positive cycle of lifelong benefits to both baby and society. Or the opposite could happen.
“It is clear that a vicious cycle can be created wherein lack of breast-feeding begets lower IQ, which begets lower socioeconomic status and thereby decreases the probability of breast-feeding the next generation and so on,” he wrote.
Christakis called for policy changes that would include insurance coverage of public health nurse visits and breast pumps, creation by employers of private places for women to pump milk when they are not with their babies and targeted efforts to destigmatize breastfeeding in public.
He ended with a plea: “Let’s allow our children’s cognitive function to be the force that tilts the scale, and let’s get on with it.”
The CDC said efforts to increase breastfeeding rates have been helped by an increase in hospitals that room mothers and babies together during maternity stays. Rooming in and skin-to-skin contact are important steps to helping mother and newborn get a good start on breastfeeding.
The World Health Organization feels so strongly about breastfeeding that it created recommendations called an "International Code of Marketing of Breast Milk Substitutes." This week, WHO announced that 37 countries, or about one-fifth of those that report to it, have passed laws that reflect the guidelines, which include banning advertising for breast-milk substitutes, not allowing free formula samples to be distributed through health services, andtio promon of advertising on the superiority of breastfeeding over substitutes.
The national Breastfeeding Report Card for 2013 said that among the states, Idaho leads the way, with 91.8 percent of new moms breastfeeding, followed by California, Oregon, Colorado and New Hampshire. At six months, the top three are the same, but Hawaii and New Hampshire round out the top five. At a year, Utah has crept ahead of Idaho, with 52.3 percent of mothers nursing, compared to Idaho's 45.5 percent. California, Hawaii and Vermont are the other leaders.
On the bottom, in Mississippi, only 50.5 percent of new moms nurse their babies for any length of time and less than 1 in 10 nurse for a full year. The report card said Alabama, Arkansas, Kentucky and Louisiana round out the worst five states for breastfeeding.
Not everyone can nurse successfully, including moms who adopted babies or those with certain medical challenges. Belfort and other experts say those moms can still enhance intellectual development in important ways like talking to, reading to and playing with baby.
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