The benefits of exclusively breastfeeding for 6 months - Evidence Based Babies
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The benefits of exclusive breastfeeding for 6 months

The benefits of exclusively breastfeeding for 6 months

You’ve heard of all the recommendations on how long you should exclusively breastfeed your baby, whether it was from national and/or international organizations, healthcare professionals, or even from fellow moms, they may have all been telling you the same thing, that you should exclusively breastfeed your baby for the first 6 months of their life.

Why 6 months though? Why not 4 months as so many people recommend? Why not rather 8 months instead? What makes 6 months the lucky number? Is it really that beneficial and important to exclusively breastfeed for the first 6 months of your baby’s life? Do some babies need to start solids earlier than others for some reason? What are the benefits of exclusive breastfeeding for 6 months?

The recommendations

The American Academy of Pediatrics (AAP)

“Breastfeeding and human milk are the normative standards for infant feeding and nutrition. The short- and long-term medical and neurodevelopmental advantages of breastfeeding make breastfeeding, or the provision of human milk, a public health imperative. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond.” – The American Academy of Pediatrics (AAP) publications 2022

UNICEF and The World Health Organization (WHO)

“WHO and UNICEF recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life – meaning no other foods or liquids are provided, including water.

Infants should be breastfed on demand – that is as often as the child wants, day and night. No bottles, teats or pacifiers should be used.

From the age of 6 months, children should begin eating safe and adequate complementary foods while continuing to breastfeed for up to two years of age or beyond.” – The World Health Organization (WHO)

What does exclusive breastfeeding mean?

Exclusive breastfeeding is when your baby only receives breastmilk for the first 6 months of their life. No other foods or liquids, including both infant formula milk and water.

It still counts as exclusive breastfeeding if your baby needs certain vitamins or medications for health reasons.

The benefits of breastfeeding

We all know breastfeeding offers many benefits to both the child’s health and even to maternal health.

Even small amounts of breastmilk will offer a child many benefits such as meeting some of their nutritional needs, offering protection against different infections such as respiratory infections, chronic diseases, childhood cancer and many other illnesses.

The benefits for any amount of breastfeeding

The benefits for the mother

Better sleep

Breastfeeding is associated with changes in the sleep and wake cycles for both the mother and the child.

Studies have shown that breastfed mother gets more sleep and better-quality sleep compared to formula feeding mothers.

Reduced anxiety and postpartum depression

Breastfeeding provides a psychoneuroimmunological benefit to mothers that reduces anxiety.

Studies have shown that breastfeeding directly decreases the symptoms of depression. Early weaning not only eliminates this benefit, but it can even increase the risk of developing depression.

Postpartum weight loss

We all know that breastfeeding burns 300-700 additional calories per day, per child and that pregnancy is associated with long-term weight gain. Breastfeeding on the other hand is associated with postpartum weight loss due to the additional energy needed by the body to produce breastmilk.

Mother-infant bonding

There is evidence of a biologic link between breastfeeding and bonding emerging as breastfeeding mothers had higher brain responses to their own infants’ cry and exhibited more sensitive behavior than formula-feeding mothers.

Protection against Rheumatoid Arthritis

One study found that compared with those who had never breastfed, breastfeeding was associated with half the risk of Rheumatoid Arthritis.

Reduced metabolic risks

Breastfeeding is associated with positive metabolic changes.

Reduces the risk of breast cancer, uterine and ovarian cancer

A decrease in risk for reproductive cancers has been observed among women who have breastfed, possibly reducing their reduced lifetime exposure to hormones such as estrogen.

The benefits for the child

Optimal nutrition

It’s no secret that breastmilk is the best choice for infants as it offers them optimal nutrition and can sustain infants for the first 6 months of life and sometimes even longer than that.

Improved social, physical and cognitive development

A couple of studies have shown a positive relationship between breastfeeding duration and physical, social and cognitive development.

Immunity by means of maternal antibodies

The predominant antibody in breastmilk secretory IgA (sIgA), penetrates the gastrointestinal (GI) tract and promotes integrity of the intestinal barrier and competitively inhibits pathogen binding, thereby preventing inflammatory responses.

Protection against infections and illnesses

Breastfeeding helps protect children against respiratory infections and illnesses.

Reduced risk of childhood cancer

There is some evidence that breastfeeding may reduce the risk of acute lymphoblastic leukemia in children.

Reduced risk of childhood obesity

The two ways in which breastfeeding may protect against obesity in the child are through the components/composition of human milk and behaviors related to infant feeding such as being able to pace their own feed and feeding as needed.

Reduced risk of diabetes mellitus

In a meta-analysis of 7 studies, breastfeeding decreased the risk of type 2 diabetes by nearly 40% compared to formula-feeding.

Reduced risk of cardiovascular disease, heart disease (high blood pressure) and metabolic disease

Breastfeeding may also decrease the risk of developing type 1 diabetes and high blood pressure later in adulthood. So, there’s not only short-term benefits to breastfeeding, but some of the benefits will also last well into adulthood.

The benefits of exclusive breastfeeding for the first 6 months of life

Protection against infections

The introduction of foods other than breastmilk before the age of six months is associated with an increased risk of gastrointestinal infections.

One systemic review article concluded that infants who have been exclusively breastfed for six months are better protected against gastrointestinal infections than infants who are provided with other foods in addition to breastmilk from the age of 3–4 months.

Reduced risk of middle ear infections

Breastfeeding, particularly exclusively and for as long as possible, may protect against middle ear (otitis media) throat, and sinus infections well beyond infancy.

Respiratory tract infections

Breastfeeding can protect against multiple respiratory and gastrointestinal acute illnesses.

Colds and infections

Babies exclusively breastfed for 6 months may have a lower risk of getting serious colds and ear or throat infections.

Gut infections

Breastfeeding is linked with a reduction in gut infections.

One study of infants exclusively breastfeeding for 6 months vs infants who were exclusively breastfed for at least 3 months, found a difference between the two groups and the incidence of gastrointestinal infections. Infants who were exclusively breastfed for 6 months had a much lower incidence of gastrointestinal infections.

Global benefits

An 8% global increase in exclusive breastfeeding to six months is estimated to have reduced infant mortality by 1,000,000, decreased fertility by 600,000, and saved countries billions of dollars in breastmilk substitutes.

Reduced risk Sudden infant death syndrome (SIDS)

Breastfeeding is linked to a reduced risk of SIDS, especially when breastfeeding exclusively.

Allergic diseases

It was previously believed that high allergen foods need to be introduced in infants’ diets to reduce the risk of developing allergies. However, there is no evidence to recommend the introduction of potentially allergenic foods at an age of less than six months. In fact, breastfeeding may actually help protect babies from allergies.

Bowel diseases

Babies who are breastfed may be less likely to develop Crohn’s disease and ulcerative colitis.

Diabetes

Breastfeeding is linked to a reduced risk of developing type 1 diabetes and non-insulin-dependent (type 2) diabetes.

Childhood leukemia

Breastfeeding for 6 months or longer compared with a shorter duration or not breastfeeding at all is associated with a 20% lower risk for childhood leukemia

Postpartum weightloss

Breastfeeding is associated with postpartum weight loss. In one prospective cohort study, it showed that greater exclusivity and duration of breastfeeding was associated with greater weight loss at 6 and 18 months postpartum in women of all BMI categories.

Lactational amenorrhea

Breastfeeding exclusively has the natural effect of suppressing ovulation, which then acts as a natural birth control for up to 6 months (or as long as the woman is exclusively breastfeeding and her menses have not returned).

Exclusive breastfeeding can save lives

It is well-known that breastfeeding saves and improves the quality of lives even in relatively clean, industrialized contexts. In one analysis of data, researchers calculated that if 90% of infants were exclusively breastfed for 6 months, 911 deaths would be prevented. In an earlier analysis of the costs of formula-feeding, other researchers found that, compared to 1,000 infants exclusively breastfed for 3 months, 1,000 infants never breastfed required 2,033 more office visits, 212 more days in the hospital, and 609 more prescriptions in the first year.

Why babies don’t need solid foods before 6 months of age

– There is no proof of benefits in starting solids early.

– There has been no quality research that has found any benefits from starting solid food before the age of six months.

– Breastmilk is enough to sustain babies for the first 6 months of life, or even longer. It provides the necessary amounts of calories and nutrients that a baby needs to grow, develop and thrive.

– Infants salivary amylase production only reaches near adult levels around 6 months of age. Salivary amylase is the enzyme responsible for breaking down carbohydrates. In infants, these levels are only near adult levels around the age of 6 months.

– Most babies are not developmentally ready for solids before 6 months of age.

– Most babies will only have signs of developmental readiness around 6-8 months of age. Most babies have no interest in solid foods before then, other than normal baby curiosity which should not be mistaken for readiness for solid foods.

Signs of readiness for solid foods

– At least 6 months of age

-Good head and neck control

– Can sit with very minimal support but preferably unsupported

– Lost the tongue thrust reflex

– Baby is ready and willing to chew

– Baby can pick up food and bring it to their mouth

What are not signs of readiness for solid foods

– Under 6 months of age

– Reaching a certain height or weight

– Being a small or big baby

– Frequent night wakings

– Frequent feeding

– Cluster feeding

– Watching their parents eat

– The curiosity of food

Important notes on exclusive breastfeeding for 6 months

From around 6 months of age, most babies do need solids, but they’ll only need a very small amount of food. Eating solids is necessary as breastmilk may no longer be able to provide all of the calories and nutrients such as Iron and Zinc that a baby needs and chewing solids is good for their oral and facial development.

Babies need very little food in the first year, even in the first few years. Studies have shown that most babies are only up to a diet of 80% solids by 2 years of age. Trust your baby, they know their body and their needs, follow their lead.

Breastmilk is still the main source of nutrition until 1 year of age. Breastmilk is still much more important than solids at this stage and it will continue to be a very important part of their diet for at least another year or two.

It’s clear, exclusive breastfeeding for the first 6 months of life not only offers breastfed infants optimal nutrition, but it also offers them many health benefits such physical, emotional and developmental benefits, and it’s beneficial for both their short-term health and for their long-term health.

Exclusive breastfeeding for 6 moths also greatly benefits the mother.

If you’re ever worried about your baby and their wellbeing, do not hesitate to contact a healthcare provider who specializes in the care of breastfed babies.

If you have any concerns regarding your baby’s diet or their nutritional intake or needs, a consultation with a dietician who’s also educated in breastfeeding can also be a really good idea to help answer your questions and to help put your mind at ease.

If you have any concerns regarding breastfeeding, contact an International Board Certified Lactation Consultant (IBCLC) to assess and support you and your baby.

Additional information and resources:

The optimal duration of exclusive breastfeeding: a systematic review

American Academy Of Pediatrics (AAP) policy statement breastfeeding recommendations

The World Health Organization (WHO) breastfeeding recommendations

Impact of exclusive breastfeeding until six months of age on common illnesses: A prospective observational study

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