“How many of you recall your mother at the first instance you are in distress and/or suffering? 

The answer is “most of us”, at least in Indian context we can say that. 

This bond of love, affection, care giving develops in the early motherhood and get strengthen during breast feeding period and therafter.

Breastfeeding is the effective keystone to ensure the health of infant and young child as well as the mother.It provides a complete package of nourishment to the developing baby for first six months; more than half and one third of nutritional needs thereafterup to first and second year of life, respectively. Therefore, the World Health Organization endorses exclusive breastfeeding for the first 6 months, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. Breastfeeding significantly improve neonatal survival and reduce morbidity due to sudden infant death syndrome (SIDS).

Why do we breastfeed our child?

Breastmilk is the ideal food for infants. It is of two types: first milk and mature milk. In fact, the first milk “colostrum” also called “yellow gold” is a priceless nourishment for a newborn.  It is of yellowish colour thick liquid produced by the mammary glands in late pregnancy and few days after giving birth. Colostrum is packed with carbohydrates, proteins, antibodies, and other nutrients like vitamins, minerals, digestive hormones and growth hormones whereas fat content is low as it is difficult for newborn to digest the fat.

A major portion of colostrum is made up of white blood cells (two-thirds of thetotal cells in colostrum)which are the major life guards and prepare the child’s immune system to start fight against infections.Immunoglobulins commonly known as antibodies are the major immune protective component in human breast milk. Secretory immunoglobulin A (sIgA) is present >90% of the Ig fraction in colostrum, IgM is the next most abundant while IgGis present in small proportion in colostrum and transitional milk, and in greater proportion in mature milk. 

sIgAlines the gastrointestinal tract simply binds to pathogens and blocks the pathogens contact with the intestinal epithelial layer by trapping the pathogens within the mucin layers. It neutralizes viruses and bacteria within epithelial cells through broad spectrum binding of bacteria and virus particle to the glycan sugar component of sIgA which is resistance to proteolysis in the intestine. Various studies have reported the broad spectrum activity of sIgA antibodies against bacteria, viruses, parasites and fungi [Bacteria:E. coli, Shigella, Salmonella, Campylobacter pylori, V. cholerae, Haemophilus influenzae, Streptococcus pneumoniae, streptococcus group B, type III, Staphylococcus aureus, Clostridium difficile, Clostridium botulinum, Klebsiella pneumonia, and Listeria monocytogenes. Parasites:Entamoebahistolytica, Giardia, Strongyloidesstercoralis,

 Fingus:Candida albicans;

Viruses: poliovirus, coxsackie, and echovirus), cytomegalovirus (CMV), herpes simplex virus, human immunodeficiency virus (HIV), Semliki Forest virus, respiratory syncytial virus (RSV), rubella, reovirus type 3, rotavirus, measles, norovirus, and porcine coronavirus.

IgM kills therecognized pathogens by agglutination (clumping of antigens by antibodies) and complement activation as well as innate immune-like activities. Immunoglobulin G (IgG) activates phagocytosis with antigen transport to the lamina propria for B-cell activation affecting the infant’s adaptive response. Thus immunoglobulinshelp to promote the gut health of the infant.

Human milk oligosaccharides (HMOs) and human milk glycoproteins (HMGPs) function by binding pathogens without stimulating an inflammatory response and fight against infection by binding to specific pathogens including HIV, rotavirus, Escherichia coli, Salmonella. H. influenzae, Streptococci, Helicobacter pylori, Reovirus, and Burkholderiacepacia.

Colostrum acts as laxative for the newborn and help to protect from jaundice by flushing out the bilirubin produced by the liver.

It’s not like that the breastfeeding only favours the child, it is equallyimportant for the mothers too. Nursing Mothers who breastfed their child experience an increase in fat burning after 3 months of lactation thus help to regain their original weight before pregnancy. Breastfeeding reinforce the production of oxytocin hormone, which reduce bleeding and helps in uterine contraction to return the uterus to its actual size and shape. Breastfeeding mothers are less likely to develop postpartum depression due to increased production of oxytocin in their body, which encourages caregiving, relaxation and bonding between mother and child. Apart from that nursing mothers have lower risk of breast and ovarian cancer, high blood pressure, arthritis, high blood fats, heart disease and type 2 diabetes.

Breastfeeding is completely hassle-free and save time and money. It is ecological friendly way to feed your child rather than choosing costly formula milk which needs proper sterilization of milk bottles every time, warm water to mixing and calculating needs as per the age of the child. Above all the facts, breastfeeding gives the mother a valid reason to sit and relax while feeding to strengthen the bond with your child.

Breastfeeding: a challenge especially for working mothers.

Working mothers face a great challenge of breastfeeding their child as they are out for work. In that case these mothers can pump their milk and store it at an optimum temperature for further use to meet the nutritional need of their child. According to the American Academy of Pediatrics (AAP) Pediatric Nutrition Handbook (2014); Academy of Breastfeeding Medicine (ABM) Clinical Protocol #8 Human Milk Storage Information for Home Use for Full-Term Infants(link is external) (2017); CDC Human Milk Storage Guidelines (2018) breast milk can be stored at room temperature for 4-hours for immediate use by the infants, at 4-6℃ for 4 days while it can be kept at freezing temperature (-18℃) for six months but avoid the repeated freeze thaw cycles as it impact the quality of milk. So, the working mothers can give their best by feeding their growing child through breast milk to boost the immunity by improving gut health rather than formula milk.

Breastfeeding for healthier planet: Breastfeeding and Covid-19

Healthier planetcan be defined by the health and wellbeing of its main civilization “the Humans” which in terms is the interconnected framework of humans with its surrounding nature to ease sustainable development for both.

Covid-19 outbreak took a great toll on human health and lives worldwide and immunocompromised and individuals with low immunity are more prone to acquire infection and leading cause of mortality and morbidity. 

Innate immunity, i.e. immunity transferred from mother to child through placenta during third trimester onwards and afterwards through breastfeeding is the first line of host defence in the child. Human milk is a dynamic living fluid containing 90% of viable cells including neutrophils, macrophages, lymphocytes, stem cells, epithelial cells, and microbe which impart infant health and long term immunity to fight infections. So, it is important tocreate an environment to support improve breastfeeding practices at structural, settings and individual levels. Breastfeeding is crucial for saving infant lives to improving socio-economic development of individuals and nations. sIgA antibodies present in human milk lined the mucosal layers in gastrointestinal and respiratory tract and neutralizes the pathogenic bacteria and viruses. So, it is imperative that coronavirus infection can be controlled to a great extent in breastfeeding children. 

According to a recent report of WHO, 115 mother-child pairs from 17 articles where the mother is confirmed COVID-19 positive, 13 children had COVID-19 (4 breastfed, 5 formula-fed, 2 mix-fed, 2 unreported feeding practice). The breastmilk samples of twenty mothers tested for the presence of SARS-CoV-2 RNA particles by RT-PCR among which 18 had negative results and 2 had positive results. 7 of them had children with COVID-19 (2 breastfed,1 formula fed, 2 mix-fed, 2 unreported). So it isconcluding from this report that the covid-19 positive mothers might not transfer the disease through breastmilk. So, WHO recommend to initiate and continue breastfeeding in case of suspected or confirmed COVID-19 positive mothers. However, mothers should be taken great care while doing so to outweigh the potential risks of transmission.

“Encourage breastfeeding for the stronger nation and healthier planet”

By
Dr. Meenakshi Choudhary
Center for Biomedical Engineering
Indian Institute of Technology (IIT) Delhi