What makes breast milk so important?

Breast milk is said to be the best nutrition for babies, but unlike some countries, Israel still does not have a breast-milk bank.

By ILAN SAMISH
November 17, 2016 17:40
breast milk

A nurse examines bottles of breast milk donated by nursing mothers at the human-milk bank at the San Juan de Dios hospital in Guatemala in August. (photo credit: REUTERS)

 
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Breast milk is known to be the best diet for babies. In many cases, such as nutrition for premature babies, it is a life-saving treatment.

The World Health Organization recommends exclusive breast-feeding for babies until the age of six months, with the integration of extras later on. Yet according to the organization, only 38% of babies receive breast milk for their first six months of life. The organization claims that not enough has been done to encourage breast-feeding, and has set a target of an increase to 50% for the number of breast-fed infants within a decade.

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The recommendation is designed to save lives, and protect against infectious diseases, gastrointestinal diseases, respiratory diseases (asthma) and metabolic diseases (such as obesity). According to statistics, over 20 million babies are born each year at a low weight (below 2.5 kg) and these are at higher risk for developmental delays and diseases. In these cases, the organization recommends that if the mother cannot breast-fed, the optimal nutrition is breast milk from a donor, provided that a milk bank service is available and safe. At a very low birth weight (less than 1.5 kg), the recommendation is a base of breast milk supplemented by minerals and vitamins.

The medical journal The Lancet recently published a series of articles and recommendations on breast-feeding.

Prof. Cesar Victora, an office holder at the universities of Oxford, Harvard and Johns Hopkins, led an international team of 50 scientists for a comparative analysis (meta-analysis) of all the studies in the field. The team found that if a baby is not exclusively fed on breast milk in the first six months of life, the risk of death in childhood increases significantly.

But apparently, the benefit of breast-feeding is not only medical.

Comparative analysis concluded that breastfeeding reduces hospitalization during childhood, increases intelligence, and increases productivity and income throughout the baby’s adult life. Therefore, according to the articles, the transfer of babies to full breast-feeding for the first six months of life is expected to add more than $300 billion to world revenue.



In an interview with Victora regarding the series of articles, he notes that it is the Western world where fewer mothers are breast-feeding due to the labor market requirements. Therefore, the onus to breast-feed is not only on the mother but rather by the society, which needs to extend maternity leave, provide a nursery at the workplace, limit the aggressive marketing of infant formula and provide lactation consultation.

Breast-feeding also has many advantages for the mother. For example, according to studies, for every additional year of breast-feeding, there is a 6% decrease in the chance of the mother developing breast cancer. Some epidemiologists calculated that an increase in breast-feeding will reduce breast cancer mortality rates, saving approximately 20,000 women’s lives per year.

PROF. (EMERITUS) Arthur Eidelman, one of the founders of neonatology in Israel, led a team from the American Academy of Pediatrics to publish a policy paper in the field of breast-feeding confirming the findings of previous reports on the subject. According to the paper, breast-feeding reduces the incidence of diabetes, obesity, ear infections, respiratory infections, asthma, digestive tract diseases, neural-developmental delay, cardiovascular disease, retinal disease (retinopathy), hospitalizations, leukemia and more.

The academy recommends that the diet for premature babies be based exclusively on breast milk. Such a diet heavily reduces the risk of necrotizing enterocolitis, which appears in a tenth of premature babies (especially those born weighing less than 1.5 kg) and can result in lifelong ailments. The policy paper emphasizes that if there is a reason a premature baby cannot receive its mother's milk, a donor can supply the required breast milk but it is important for it to undergo pasteurization and testing through a breast-milk bank. The European Society of Pediatrics and Nutrition issued similar recommendations.


The situation in

Israel Following the unequivocal medical recommendations, there currently exist over 500 breast-milk banks worldwide that receive donor milk that undergoes pasteurization and testing. In Israel each year more than 12,000 premature babies are born with approximately 1,600 weighing less than 1.5 kg.

In light of the clear advantages, the Health Ministry issued extensive guidelines earlier this year toward establishing a human-milk bank. Moreover, the guidelines emphasize that the construction cost of a human-milk bank is significantly lower than the cost of the direct treatment for symptoms of lack of breast milk nutrition.

The Health Ministry stresses that a human breast-milk bank will primarily be designed for small premature infants and babies with birth defects or deficiencies in the digestive tract and other health problems. A second priority will be given to larger premature infants, orphaned babies, adopted babies or those born via the surrogacy process, and every baby whose mother's milk is not available.

For the bank, an association for donations of breast milk has been established.

Association members include Eidelman and Dr. Sharron Bransburg-Zabari, a scientist specializing in breast milk and the development of the immune system of newborns.

Bransburg-Zabari cited the report on the state of premature babies in Israel, jointly published by the Israeli Neonatology Association, the Association for Premature Babies in Israel and the Israel Forum for Premature Babies. According to the report, the mortality rate of premature babies (weighing less than 1.5 kg) is significantly higher in Israel compared to developed countries where breast-milk banks exist and premature babies are solely fed on breast milk. This is due to many factors including manpower, space, hygiene and overall budget for neonatal units. For example, if premature mortality rates in Israel were the same as Japan, every year lives of 138 premature babies would have been saved, and the percentage of morbidity rates would be lower.

In light of the ongoing bureaucratic procedures of government offices, a human- milk bank is yet to be open in Israel, and there is no guarantee of a budget.

Yesterday we marked World Prematurity Day, highlighting the unique needs of pre-term babies. With very low funding, which actually will save medical costs, Israel can establish a human breast-milk bank and do so much more for one of the weakest links in our society.

The writer holds a PhD in biochemistry, he is an academic adviser at the Weizmann Institute, and a writer for the Davidson Institute of Science Education.

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