Abstract

PIP: The author discusses support for the benefits of breastfeeding during the 1st 3-6 months of an infant's life, raises the issues of potentially deleterious and detrimental maternal-infant exchange of infectious diseases and alcohol, and comments on demands faced by working mothers hoping to breastfeed. For developing countries, breastfeeding is an inexpensive, nutritious feeding method, which may be used instead of other potentially contaminated or inadequate substances. Rich in immune components, studies suggest that breast milk reduces infant morbidity and mortality from infectious diseases, and may increase the chances of survival of low-birth-weight infants in both developed and developing countries. Concerns over available feeding alternatives and sanitation being less important in the United States, most physicians still encourage mothers to breastfeed on the basis of its cost-effectiveness, the potential effects on the clinical severity of gastrointestinal infections, the presumed beneficial effects on maternal-infant interactions, the mother's perception of that interaction, and its contributions to the mother's confidence in her maternal capabilities. The author acknowledges the need for concern over HIV and alcohol transmission from mother to child through breast milk, and discusses the ongoing debate while pointing out caveats and qualifications to conclusions. Breastfeeding may be impossible for constrained by the obligations of work. Accordingly, physicians should recognize these limitations, and support political and legislative initiatives to make breastfeeding a practical possibility for all mothers.