Breastfeeding, also known as nursing, is the feeding of babies and young children with milk from a woman’s breast. Health professionals recommend that breastfeeding begin within the first hour of a baby’s life and continue as often and as much as the baby wants. During the first few weeks of life, babies may nurse roughly every two to three hours and the duration of a feeding is usually ten to fifteen minutes on each breast. Older children feed less often.

Babies who are breastfed show signs of early brain development, particularly in regions associated with language, emotional function, and cognition.

Studies have been carried out where researchers used specialized, baby-friendly magnetic resonance imaging (MRI) to look at the brain growth in a sample of children under the age of 4 years. By age 2, babies who had been breastfed exclusively for at least three months had enhanced development compared to children who were fed formula exclusively or who were fed a combination of formula and breast milk.

This isn’t the first study to suggest that breastfeeding aids babies’ brain development. Behavioral studies have previously associated breastfeeding with better cognitive outcomes in older adolescents and adults.

But this is the first imaging study that looked for differences associated with breastfeeding in the brains of very young and healthy children.

Investigating the makeup and composition of breast milk has been a critical part of understanding how newborn babies build their immune systems and ward off disease later in life. Initially it was thought that breast milk did not contain bacteria except when a mother had an infection. But more recent studies have shown that breast milk has millions of microbes (bacteria, viruses and fungi) that are critical to preventing babies from suffering diseases and other acute infections later in life. These include ear infections, meningitis, urinary tract infection, asthma, type 1 diabetes and obesity. To develop their immune systems, babies need an optimal slew of bacteria to colonize their gut.
Earlier research has shown that the bacterial makeup in breast milk is unique to every mother, like a fingerprint. Several factors affect the composition of this bacterial community. These include the mother’s diet and well-being (stress, for example, has a major impact), the age at which she has a baby, her geographic location, the mode of delivery of the baby, as well as her use of antibiotics or probiotics.

When it comes to the mode of delivery of the baby, a good diet and regular exercise (even before the mother falls pregnant), it was found that this had an impact and significant effect on the micro-biome in the mother’s milk. But this differed between countries.

This is important as it could identify additional benefits to breast feeding which in turn could help efforts to increase the number of women who breastfeed.

Global health bodies strongly recommend that babies be breastfed exclusively until they are six months old. This is based on research that shows that breast feeding is best for babies.

Yet only 38% of all babies in the world are fed for half a year. The effect on their health has been extensively studied. For example, research shows that in developing countries babies who are not breastfed are 14.4 times more likely to die in the first months of life from diseases such as diarrhea and pneumonia than babies who are breastfed.

Cultivating micro-biome
Bacteria start to be transferred from mother to baby in the womb. This continues during the actual birthing process and after birth, through breast milk, where millions of microbes are sent into the baby’s gut every day.

This is important because breast milk bacteria play several roles in the baby’s gut. They:

• Reduce the incidence and severity of infections;
• Improve the intestinal barrier function by increasing the amount of mucous that acts as a shield;
• “Teach” the immune system, showing it to differentiate good bacteria from the bad;
• Produce anti-inflammatory substances which keeps the gut alive and thriving; and
• Burn energy as this determines how much fat the baby stores and breaks down sugars and proteins.

Previously, it has been suggested that the hormones released during labor can influence the bacterial community in breast milk. Where elective cesarean section is the delivery mode (when a mother has a cesarean section before going into labor), these labor hormones are not released and therefore no alteration of the breast milk bacterial community is observed.

What next?
Breast feeding rates need to increase to meet the sustainable development goals which strive to reduce maternal and infant deaths.

Researches on the breast milk micro-biome and its core role in infant health is an attempt to improve infant health by providing additional information on these bacteria. Primary health caregivers, nurses and midwives, partners and mothers all need to be equipped with as much information as possible about its positive attributes so that the prolonged benefits of breast feeding can be shared with mothers, and the practice initiated immediately.