Scaling up breastfeeding could prevent 820,000 child deaths a year
Breastfeeding delivers milk to a baby straight from the breast or through a pump. If poorer countries brought it close to universal coverage, one estimate says they could avert roughly 820,000 deaths of under-fives every year, while mothers gain protection against bleeding, depression and later breast cancer.
The WHO advises starting within the first hour after birth and giving nothing but breast milk for six months. Early feeds are slow, sometimes 30 to 60 minutes, while the baby masters the rhythm of sucking, swallowing and breathing; later a breast can be drained in five to ten minutes. Newborns typically feed eight to twelve times a day, and a nursing parent needs an estimated 300 or more extra calories daily to keep production going.
Preparation begins long before delivery. From around week 16 of pregnancy, oestrogen, progesterone and prolactin build the milk-making alveoli and start colostrum, which can already leak as a straw-coloured fluid. When the placenta is delivered, usually within half an hour of the baby, its hormones crash; the fall in progesterone frees prolactin to act, and over the following days the milk comes in. Breast size, set by fat cells, says nothing about how much milk a mother can make.
Once supply is established, control becomes local. Prolactin levels do not predict volume; what drives production is frequent drainage, so the breast essentially makes milk on demand. Leaving milk behind can lead to mastitis, yet the Academy of Breastfeeding Medicine warns against over-pumping to empty the breast, because that breeds oversupply. Lactation can even be induced without pregnancy through hormones and nipple stimulation.
The milk itself shifts over time. Colostrum, rich in protein and vitamins A, B12 and K, carries about 54 calories per 100 millilitres in volumes matched to a newborn's tiny stomach. Transitional milk follows, protein falls over several weeks, and within a single feed thin foremilk gives way to fattier hindmilk. For the baby, nursing lowers the risk of chest and ear infections, diarrhoea and sudden infant death.
Source: Breastfeeding
