1/29/2013

Breastfeeding in the world today


It is the first child of Louise and Peter. Finally the longed day came and the little Damian is healthy and strong. His parents did their part to make a quiet delivery, but mostly without intervention, to allow nature to fulfill his part. They had read that if you put sera, epidural anesthesia and stuff, your project could go to ruin and the risk of ending in cesarean was higher. Then, breastfeeding may be difficult, it could be more difficult for the child to attach to the breast and milk production would be lower. But this time they were lucky and this did not happen.


In recent decades, the modern vision of a world with incredible technological advances has been minimizing the traditional concept of a natural diet as the basis for maintaining good health. In our environment, some have called for a return to the Mediterranean diet, for some now in decline.

With regard to infant feeding, we often hear that breastfeeding is best, regardless that this statement implies the tacit acceptance that the other option or artificial feeding, is worse. Medical societies have kept ambiguous positions on the matter. Forums are full of complaints from parents by the contradictions in which we doctors incur and the ease with which we prescribe infant formula at the slightest difficulty when it comes to breastfeeding. In our defense we say that we passed through the halls of medicine reiving no training at all on breastfeeding.

This situation, however, may change after the publication by the American Academy of Pediatrics, something like the summit of pediatric knowledge and respected by pediatricians all over the world, a declaration which recognizes breastfeeding as the gold standard child nutrition. This statement marks a milestone, because for the first time is the result of consensus of all the committees of specialties dependent on the Academy and recognizes the importance of breastfeeding from the point of view of public health for the bad consequences for child health in developed and developing countries when children are fed with infant formula.


This initiative was the result of a comprehensive assessment of the available scientific evidence. The Spanish Mediterranean region of Marina Alta is honored to have contributed to a study published in the journal Pediatrics in 2006, conducted by Dr. Paricio Talayero of Pediatrics Service from the old hospital of La Pedrera, which showed among other things, that the risk of hospitalization due to infection was 7 times higher among non-breastfed children compared with those who were breastfed for 1 year.

Why then do we often opt for the worst? The current recommendation is exclusive breastfeeding for the first 6 months and then continue it with complementary foods until the child is weaned itself. In practice we see that most children start weaning early, many receive aid from maternity milks and more than 70% longer breastfed at 4 months of life. Multiple causes affect this result, but by far the most important is the absence of a value system in society that foster and provide support to the mother who wants to breastfeed. There are many missed opportunities both in health and social fields, in which breastfeeding is lost for the lack of support or adequate advice.

Aware of these shortcomings, there are groups of professionals interested in remedying this situation. The LM Committee of the Spanish Association of Pediatrics, support groups led by midwives, nurses and related professionals working to promote breastfeeding. A few months ago APILAM was created by a group of professionals from various disciplines, as a non-profit association for the support, promotion and research of breastfeeding. It is responsible for managing the page on medications and breastfeeding www.e-lactancia.org,  highly valued for years by providing free information on breastfeeding support over 1,600 pharmaceuticals, natural and diseases and will provide training courses for professionals and support groups on breastfeeding.

A few weeks ago in Madrid delegations from several countries met to discuss the issue of early abandonment of breastfeeding to develop an agenda with strategies for each country. In the case of Spain was reflected in several surveys the little information of the population and lack of commitment of the professionals. The result was the commitment request to the Ministry of Health, Social Services and Equality for the creation of a National Breastfeeding Committee to coordinate in the Autonomous Community the training and promotion, granting of benefits to companies that create spaces and facilities for working mothers who want to breastfeed their children and include in their advertising messages to improve the image of breastfeeding in public places and, of course, the inclusion of theoretical an practical contents about breastfeeding in the training of medical and health professionals.

Returning to the story of the son of Louise and Peter, their fate was huge because they found a support group in their community run by a very enterprising midwife who led them and knew to remove the doubts that were appearing in the course of the breastfeeding of little Damian.

Author: Leonardo Landa Rivera - Pediatrician. APILAM member. Member of Breastfeeding Committee of the Spanish Association of Pediatrics.

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