Breastfeeding and Breast Milk – from Biochemistry to Impact, (Ed, Family Larson- Rosenquist Foundation) Georg Thieme Verlag KG

Nature has empowered mothers with control over the production and distribution of an extraordinarily protective substance for the health and development of their babies — breast milk. This evolutionary innovation provides all of the nutrition an infant needs for the first six months of life and affords protection from infectious diseases, reduces the risk of sickness and death, and contributes to healthy digestive and brain development well into early childhood. Unlike the vast majority of health interventions, breast milk is wholly owned and operated by mothers who function as “doctors” administering their “medicine”. To unleash the protective powers of breast milk, mothers must not only be knowledgeable about the benefits of breast milk. They must also be freely able to exercise their choice to breastfeed, unfettered by external barriers. If mothers cannot breastfeed due to sickness or absence, they should be able to ensure that their babies have access to their own breast milk and, where that is not possible, to donor breast milk from the newborn period onwards. It is critical that development actors confront the reality that for almost all mothers — an estimated 140 million women give birth every year — breastfeeding is not always a choice. Depending on the severity of the barriers, a mother may be so constrained by forces beyond her control (e.g., lack of education, lack of family support, the need to earn an income) that she cannot exercise a preference to breastfeed. For many tens of millions of mothers, breastfeeding is not possible in the environments in which they live. For these women, reducing or removing the external constraints is what will ultimately lead to sustained increases in breastfeeding. Women facing the most significant barriers to breastfeeding are also most likely to live in communities where the costs of not breastfeeding fall most heavily on children. These are the populations where very low breastfeeding rates coexist with very high rates of newborn and child sickness and death. Empowering mothers in these high-risk environments to exercise a real choice to breastfeed in supportive homes, workplaces, and public spaces should be the primary focus of development efforts to increase breastfeeding rates.