BREASTFEEDING

BREAST MILK

Rich in brain-building omega-3s, namely,

DHA and AA. Automatically adjusts to

infant’s needs; levels decline as baby

gets older. Rich in cholesterol; nearly

completely absorbed.

Contains the fat-digesting enzyme lipase

FORMULA

FATS

No DHA

Doesn’t adjust to infant’s needs

No cholesterol

Not completely absorbed

No lipase

PROTEIN

Soft, easily digestible whey. More

completely absorbed; higher in the milk of

mothers who deliver preterm. Lactoferrin

for intestinal health. Lysozyme, an

antimicrobial. Rich in brain- and body

building protein components. Rich in

growth factors. Contains sleep-inducing

proteins

Harder-to-digest casein curds

Not completely absorbed, so more waste,

harder on kidneys

Little or no lactoferrin

No lysozyme. Defi cient or low in some brain

and body-building proteins

Defi cient in growth factors

Contains fewer sleep-inducing proteins

CARBOHYDRATES

Rich in oligosaccharides, which promote

intestinal health

No lactose in some formulas

Defi cient in oligosaccharides

IMMUNE-BOOSTERS

Millions of living white blood cells, in

every feeding

Rich in immunoglobulins

No live white blood cells or any other cells.

Has no immune benefi t

Better absorbed

Iron is 50–75 per cent absorbed

Contains more selenium (an antioxidant)

Rich in digestive enzymes such as lipase

and amylase. Rich in many hormones such

as thyroid, prolactin and oxytocin. Taste

varies with mother’s diet, thus helping the

child acclimatise to the cultural diet

VITAMINS & MINERALS

Not absorbed as well

Iron is 5–10 per cent absorbed

Contains less selenium (an antioxidant)

ENZYMES & HORMONES

Processing kills digestive enzymes

Processing kills hormones, which are not

human to begin with

Always tastes the same

COST

COMMENTS

The most important nutrient in

breastmilk; the absence of cholesterol and

DHA may predispose a child to adult heart

and CNS diseases. Leftover, unabsorbed fat

accounts for unpleasant smelling stools in

formula-fed babies

Infants aren’t allergic to human milk

proteins

Lactose is important for brain

development

Breastfeeding provides active and dynamic

protection from infections of all kinds

Breastmilk can be used to alleviate a

range of external health problems such as

nappy rash and conjunctivitis

Nutrients in formula are poorly absorbed.

To compensate, more nutrients are added

to formula, making it harder to digest

Digestive enzymes promote intestinal

health; hormones contribute to the

biochemical balance and wellbeing of

the baby

Around £350/year in extra food for mother

if she was on a very poor diet to begin

with

Around £650/ year. Up to £1300/year for

hypoallergenic formulas. Cost for bottles and

other supplies. Lost income when parents

must stay home to care for a sick baby

In the UK, the NHS spends £35 million

each year just treating gastroenteritis

in bottlefed babies. In the US, insurance

companies pay out $3.6 billion for treating

diseases in bottlefed babies

THE ECOLOGIST 025
BREASTFEEDING

Compared to Breastfed babies, BOTTLEFED BABIES ARE... TWICE as likely to die from any cause in

the fi rst six weeks of life

TWO TO FIVE TIMES more likely to

die from SIDS (sudden infant death

syndrome)

FIVE times more likely to be

admitted to hospital suffering from

gastroenteritis

TWICE as likely to suffer from diarrhoea

TWICE as likely to suffer from otitis

media (inner-ear infection)

TWICE as likely to develop eczema or

a wheeze if there is a family history of

atopic disease

FIVE times more likely to develop

urinary tract infections

SIX to TEN times more likely to develop

necrotising enterocolitis – a serious

infection of the intestine, in the fi rst six

months of life.

TWICE as likely to develop juvenile

onset insulin-dependent (type 1)

diabetes

FIVE to EIGHT times more likely to

develop lymphomas before the age of

In later life, studies have shown

that bottlefed babies have a greater

tendency towards developing:

childhood infl ammatory bowel disease,

multiple sclerosis, dental malocclusion,

coronary heart disease, diabetes,

hyperactivity, autoimmune thyroid

disease and coeliac disease.

026 THE ECOLOGIST

Bottlefed babies are twice as likely to die from any cause in the fi rst six weeks of life. In particular, bottlefeeding raises the risk of SIDS (sudden infant death syndrome) by two to fi ve times. Bottlefed babies are also at a signifi cantly higher risk of ending up in hospital with a range of infections. They are, for instance, fi ve times more likely to be admitted to hospital suffering from gastroenteritis. Even in developed countries, bottlefed babies have rates of diarrhoea twice as high as breastfed ones. They are twice as likely (20 per cent vs 10 per cent) to suffer from otitis media (inner-ear infection), twice as likely to develop eczema or a wheeze if there is a family history of atopic disease, and fi ve times more likely to develop urinary tract infections. In the fi rst six months of life, bottlefed babies are six to 10 times more likely to develop necrotising enterocolitis – a serious infection of the intestine, with intestinal tissue death – a fi gure that increases to 30 times the risk after that time. Even more serious diseases are also linked with bottlefeeding. Compared with infants who are fully breastfed even for only three to four months, a baby drinking artifi cial milk is twice as likely to develop juvenile-onset insulin-dependent (type 1) diabetes. There is also a fi ve- to eightfold risk of developing lymphomas in children under 15 who were formulafed, or breastfed for less than six months. In later life, studies have shown that bottlefed babies have a greater tendency towards developing conditions such as childhood infl ammatory bowel disease, multiple sclerosis, dental malocclusion, coronary heart disease, diabetes, hyperactivity, autoimmune thyroid disease and coeliac disease. For all of these reasons, formula cannot be considered even ‘second best’ compared with breastmilk. Offi cially, the World Health Organization (WHO) designates formula milk as the last choice in infant-feeding: Its fi rst choice is breastmilk from the mother; second choice is the mother’s own milk given via cup or bottle; third choice is breastmilk from a milk bank or wet nurse and, fi nally, in fourth place, formula milk. And yet, breastfed babies are becoming an endangered species. In the UK, rates are catastrophically low and have been

that way for decades. Current fi gures suggest that only 62 per cent of women in Britain even attempt to breastfeed (usually while in hospital). At six weeks, just 42 per cent are breastfeeding. By four months, only 29 per cent are still breastfeeding and, by six months, this fi gure drops to 22 per cent. These fi gures could come from almost any developed country in the world and, it should be noted, do not necessarily refl ect the ideal of ‘exclusive’ breastfeeding. Instead, many modern mothers practice mixed feeding – combining breastfeeding with artifi cial baby milks and infant foods. Worldwide, the WHO estimates that only 35 per cent of infants are getting any breastmilk at all by age four months and, although no one can say for sure because research into exclusive breastfeeding is both scarce and incomplete, it is estimated that only 1 per cent are exclusively breastfed at six months. Younger women in particular are the least likely to breastfeed, with over 40 per cent of mothers under 24 never even trying. The biggest gap, however, is a socioeconomic one. Women who live in low-income households or who are poorly educated are many times less likely to breastfeed, even though it can make an enormous difference to a child’s health. In children from socially disadvantaged families, exclusive breastfeeding in the fi rst six months of life can go a long way towards cancelling out the health inequalities between being born into poverty and being born into affl uence. In essence, breastfeeding takes the infant out of poverty for those fi rst crucial months and gives it a decent start in life.

So why aren’t women breastfeeding? Before bottles became the norm, breastfeeding was an activity of daily living based on mimicry, and learning within the family and community. Women became their own experts through the trial and error of the experience itself. But today, what should come more or less naturally has become extraordinarily complicated – the focus of global marketing strategies and politics, lawmaking, lobbying support groups, activists and the interference of a wellintentioned, but occasionally ineffective,