Risks of NOT Breastfeeding

Human breast milk is specifically produced by human mothers to be fed to their human babies. Accordingly, the greatest risk of not breastfeeding is rooted in this basic fact. While baby may receive adequate nutrition from other supplements like infant formula, human breast milk is the best milk for human babies. Human breast milk is dynamic, with nutritional and hormonal content varying according to the time of day, conformed to baby’s needs, changes as baby grows, allows for proliferation of healthy gut flora that help protect baby from infection, and decreases risks of chronic illnesses. There is NO perfect substitute for human breast milk!

The benefits of exclusive breastfeeding cannot be overstated. Even if mother exclusively breastfeeds for only baby’s first six months, the incomparable nutrition received from breast milk impacts baby’s immune system and health for the rest of his life. Feeding breast milk to baby is one of the best lifetime gifts, a mother may give her child. The longer mother breastfeeds, the lower the risks of health problems throughout the child’s life.

A woman’s body is wonderfully created to make milk for her baby. Every mother is different, along with her breastfeeding journey, and milk production may also be individually different. However, every mother may choose to feed breast milk, even if not putting baby to breast. Pumping breast milk or donor breast milk are certainly options to feeding breast milk to baby. The earlier mother starts breastfeeding or pumping after delivery, her body’s milk production establishes and milk volume increases.

Here are major reasons for exclusive breast milk feeding and starting early after birth:

  • Helps mom after delivery by reducing bleeding and shrinking the uterus
  • Burns about 600 calories per day for mom to return to pre-pregnancy weight
  • Establishes and increases mom’s milk supply quickly
  • Colostrum is high in protein, concentrated in volume, and easily digestible for newborn
  • Decreases illness due to natural protective ingredients in breast milk
  • Breast milk micronutrients, especially pyroxidol (vitamin B-6), beta-carotene, and lycopene are crucial in baby’s neurodevelopment
  • Reduces baby’s risk of Sudden Infant Death Syndrome (SIDS), developing allergies, asthma, juvenile diabetes, childhood obesity, and certain cancers

Per Texas Health & Human Resources, “The Texas Ten Step (TTS) program is a designation provided by Health and Human Services that recognizes birthing facilities that implement policies and practices aligned with the World Health Organization and UNICEF’s Ten Steps to Successful Breastfeeding. Established in 1999, the TTS program aims to help create environments where policies and practices support mothers’ informed infant feeding decisions, and where evidence-based maternity and newborn health care practices are part of everyday patient care. TTS requires that all designated facilities ensure that their healthcare team is trained to provide breastfeeding education, resources and continued support throughout a patient’s stay.”

For more information about Texas Ten Step or to find a TTS designated hospital near you, check out the Texas Ten Step website: Texas Ten Step | TexasTenStep.org or link: Texas Ten Step Fact Sheet.
For more information about The Baby-Friendly Hospital Initiative in the United States, which is the gold standard designation for care of lactating mothers and babies, or to find a B-F designated hospital near you, check out the Baby-Friendly USA website: Baby-Friendly USA ~ Upholding the Highest Standards of Infant Feeding Care (babyfriendlyusa.org)

Because of the Texas Ten Step program, Baby-Friendly Hospital initiative, and numerous designated birthing facilities across the state, mom may be given an opportunity to learn and practice with nurses and lactation consultants to gain confidence before hospital discharge, to continue breastfeeding at home. Ask for lactation help while at the hospital, and secure support from a Lactation Consultant (IBCLC) as soon as you are home. Having assistance and support from the start of your breastfeeding journey will greatly influence success in reaching your feeding goals!

The American Academy of Pediatrics, The Academy of Breastfeeding Medicine, The World Health Organization, and UNICEF, do not recommend the use of infant formula or nipples unless there is a medical indication. Your doctor or health care professional will advise and instruct you about supplementation if medically necessary. If short term supplementation is required, it is strongly recommended to use an alternative feeding method such as a spoon, cup, syringe, or supplemental nursing system. It may not seem like offering baby a bottle of infant formula has any consequences, but feeding just one or many bottles of infant formula increases the risks of not breast milk feeding baby. Additionally, it is encouraged to limit supplementation amounts per feeding (8-12 feedings daily) depending on infant’s day of life. Baby’s stomach is small after birth, and only small amounts of milk, whether breast or formula are needed per feeding: Day 1: 5-7 mL, Day 3: 25-50 mL, Day 7: 45-70 mL.

These are potential complications associated with formula supplementation, soon after birth:

  • Delay in milk production or reduced milk supply
  • Reduce baby’s desire to breastfeed because milk flow from bottle is faster and continuous for baby
  • Baby may have difficulty latching after bottle feedings, especially if breastfeeding is not yet established
  • Mom’s nipples may become sore due to improper latch learned when baby is fed with artificial nipple

    Potential Increased Health Risks for Formula-fed Baby:
  • Risk of possible contaminated formula or improper preparation
    of ingredients
  • Infections (lung and GI tract)
  • Necrotizing Enterocolitis in premature babies
  • Sudden infant death syndrome
  • Childhood obesity
  • Type 1 and type 2 diabetes
  • Childhood cancer
  • Otitis media (ear infections)
  • Lower respiratory tract infections
  • Asthma
  • Atopic dermatitis (skin allergies)
  • Heart disease and high blood pressure
  • Diarrhea
  • Colic and stomach upset
  • Changes the digestive bacteria in your baby’s GI tract
  • Alterations in pH of the bowel causing diarrhea and bowel infection
  • Sensitivity to soy or cow’s milk protein
  • Dental malocclusion

    Potential Increased Health Risks for Mother Who Chooses to Not Breastfeed:
  • Premenopausal breast cancer
  • Ovarian cancer
  • Obesity
  • Retained pregnancy weight gain
  • Type 2 diabetes
  • Myocardial infarction (heart attack)
  • Metabolic syndrome
  • Osteoporosis
  • Rheumatoid arthritis

Substantial evidence has proven that feeding breast milk increases long-term healthy outcomes for mothers and babies. Per research article of M. Bartick etal., “Suboptimal Breastfeeding in the United States: Maternal and Pediatric Health Outcomes and Costs,” published in Maternal and Child Nutrition 2017: “If infants were breastfed optimally (6 months exclusively, continuing for a year or more), it would save 3,340 lives from only 3 diagnoses (breast cancer, hypertension, and myocardial infarction) annually. Moreover, if infants were breastfed optimally (6 months exclusively, continuing for a year or more), it would save 721 infant lives and $14 billion annually”. Per The Lancet Journal’s conclusions of their meta-analyses on breastfeeding, January 29, 2016: “Improving breastfeeding practices could save more than 820,000 lives a year. Globally, estimated costs associated with not breastfeeding amount to $300 billion annually. The effect of optimal breastfeeding at a near universal level: for children under five years, prevention of 823,000 annual deaths, and for women, prevention of 20,000 annual deaths from breast cancer. Every mother and child, no matter their location or circumstance, benefits from optimal breastfeeding.”
https://www.thelancet.com/series/breastfeeding

Check out the CDC Breastfeeding Report Card 2022 for the United States which reflects breastfeeding rates among babies born in 2019, with data collected across 2020-2021. CDC releases a Breastfeeding Report Card every two years. “Among infants born in 2019, most (83.2%) started out receiving some breast milk, and 78.6% were receiving any breast milk at 1 month. At 6 months, 55.8% of infants received any breast milk and 24.9% received exclusive breast milk.” https://www.cdc.gov/breastfeeding/data/reportcard.htm

Also check out the UNICEF Global Breastfeeding Report Card 2023. “Globally, exclusive breastfeeding rates have increased by 10 percentage points over the past decade reaching 48%. The world is poised to reach the World Health Assembly target of 50% by 2025.”
Global breastfeeding scorecard 2023.pdf (unicef.org)

The Centers for Disease Control, The American Academy of Pediatrics, the World Health Organization, and other professional groups involved in infant health, all recommend exclusive breastfeeding for the first 6 months, and then continuing for 1-2 years with the gradual introduction of solid foods.

Whether you choose to breastfeed, pump and feed breast milk, feed donor breast milk, or bottle-feed infant formula, the information and evidence provided here is worth considering to learn why breastfeeding is encouraged for all mothers and babies, and the risks of not breast milk feeding. Of course, each mom’s situation is different, and the decision of what is best for feeding baby is ultimately yours to make.

If you decide to exclusively breastfeed or pump, you do not have to take your breastfeeding journey alone! Assistance and support to succeed in your feeding goals are available to you at Momma & Babe Lactation Consulting, through in-person or home visits in the Waco-Central Texas area or telehealth visits wherever you live. Lactation consultant (IBCLC) support is covered by most health insurance providers.

Check your insurance policy for coverage of breastfeeding counseling, and schedule an initial visit to a lactation consultant (IBCLC) within 1-2 weeks after you and baby are discharged from the hospital, or sooner if you are having breastfeeding difficulties. Depending on your insurance policy, you may be allowed one to six lactation consultant visits. Schedule an appointment as soon as possible, especially if you are having problems.

For help, contact The Lactation Network (TLN), a national company who works to verify insurance benefits and connect families with International Board-Certified Lactation Consultants (IBCLC) across the United States. To verify insurance coverage, go to our TLN link: https://go.lactationnetwork.com/MommaAndBabeLactationConsulting

Happy World Breastfeeding Week (Aug. 1-7) and
National Breastfeeding Month!!!


REFERENCES:

Bartick M, Schwarz E, Green B, Jegier B, Reinhold A, Colaizy T, Bogen D, Schaefer A, Stuebe A. Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs. NLM; PubMed Central; Maternal & Child Nutrition 2017 Jan; 13(1): e12366.
Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs – PMC (nih.gov)

Lactation Education Resources
English Handouts – Lactation Education Resources (lactationtraining.com)
Spanish Handouts – Lactation Education Resources (lactationtraining.com)

Meek JY, Noble L. Policy Statement: Breastfeeding and the Use of Human Milk. AAP Section on Breastfeeding. Pediatrics. 2022;150(1):e2022057988. doi:10.1542/peds.2022-057988
Policy Statement: Breastfeeding and the Use of Human Milk | Pediatrics | American Academy of Pediatrics (aap.org)

Stuebe A. The Risks of Not Breastfeeding for Mothers and Infants. NLM; PubMed Central; Reviews in Obstetrics and Gynecology 2009 Fall; 2(4): 222–231.
The Risks of Not Breastfeeding for Mothers and Infants – PMC (nih.gov)

Spatz D.L., Lessen R. Risks of Not Breastfeeding. International Lactation Consultant Association 2011.
Copies of this paper may be purchased from the International Lactation Consultant Association. Email: info@ilca.org

Sulaski Wyckoff A. Updated AAP guidance recommends longer breastfeeding due to benefits. AAP Publications; AAP News July 2022.
Updated AAP guidance recommends longer breastfeeding due to benefits | AAP News | American Academy of Pediatric