The editor of Medscape's Women's Health Section, Ursula Snyder, PhD, wrote an editiorial in their WOMEN'S HEALTH AND SOCIOECONOMICS section titled:  Aug.2002:  What will it take to improve the health of mothers?  Not surprisingly, it said nothing about breastfeeding.  Here is my letter to her:

 Dear Dr. Snyder:
I read your web article on the status of women's health.  As someone who has been involved in her community for 20+ years working in perinatal populations, I couldn't agree more with your sense that this is a political issue, requiring policy as well as medical solutions. 

  However, I was surprised to find no mention of the impact of breastfeeding on maternal and child health.  The epidemiologic evidence is so strong in support of the fact that breastfeeding impacts both in major ways.  A recent collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50,302 women with breast cancer and 96,973 women without the disease (published inThe Lancet, Vol 320(9328) 20 July 2002: 187-195) provides strong evidence that breastfeeding reduces the risk of breast cancer.  New data (J Allergy Clin Immunol 2002; 110:65-67) state that independent of maternal asthma history, infants exclusively breastfeeding for 4 months are less likely to develop asthma than those not breastfed or breastfed for shorter durations.  Add these studies to the recent ones linking mode of early infant feeding (i.e. formula) to increased risk of development of obesity and of poorer cardiovascular health in late adolescence, and you have a compelling set of reasons for including breastfeeding in any policy push that is geared towards improving the health of mothers and babies.

This is an issue with major cost implications.  The US public health system is strained with caring for uninsured infants.  J. Weimer did a cost analysis study for the USDA (The Economic Benefits of Breastfeeding: A Review and Analysis, USDA, Food Assistance and Nutrition Research, Report No. 13, March 2001) that describes a potential of $3.6 billion savings if breastfeeding rates were increased to the Surgeon General's target goals.  The report describes this as an underrepresentation of the potential savings because it only describes the impact of three of the many illnesses breastfeeding protects against:  otitis media, NEC, and gastroenteritis.  The money saved by improving the health of infants would be very useful to put towards improving the health care delivery system in other areas.

We can no longer afford to describe breastfeeding as a lifestyle choice and to equate formula as an equivalent feeding choice.  This issue ressonates with the early days of the tobacco debate.  When smoking became identified as a significant health risk factor and that information was made available to the public, it was easier to promulgate programs that began to protect the public. Until physicians begin to include breastfeeding in their public health policy agendas, women and infants will continue to be denied a meaningful remedy for costly and stressful conditions.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com


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