Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Background
  • The World Health Organization (1998, 2002) has recommended that infants should be exclusively breastfed for the first six months of life. 
  • Breast-milk contains all the fluid and nutrients required for optimal growth (Heinig, Nommsen, & Peerson, 1993; Humenick, 1987; Tyson, Burchfield, & Sentence, 1992; Woolridge, Ingram, & Baum, 1990). 
  • Breast-milk contains the omega-3 fatty acids docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA), which are important for the development of the retina and brain in the last trimester of pregnancy and throughout the first year of life (Jorgensen, Holmer, Lund, Hernell & Michaelsen, 1998). 
  • Artificial milk available in Canada is not supplemented with omega-3 fatty acids, and infants receiving this food must synthesize their own DHA and ALA from precursors.
  • Randomized studies have demonstrated that healthy term infants fed breast-milk have better visual acuity than infants fed standard artificial milks at two and four months postpartum (Jorgensen et al., 1998; Makrides, Neumann, Simmer, Pater & Gibson, 1995).
  • In developed countries, studies have provided evidence that breastfeeding protects against gastrointestinal infections and otitis media (Beaudry, Dufour, Marcoux,1995; Howie et al., 1990).
  • For infants with a family history of allergies, exclusive breastfeeding for four months appears to have a protective effect (Burr et. al.1993; Chandra, 1997; Lucas, Brooke, Morley & Bamford, 1990; Saarinen & Kajosaari, 1995). Breastfeeding, however, does not appear to decrease incidence of allergies in infants who do not have a positive family history (Lucus, et al., 1990).
  • There are conflicting views about whether breastfeeding is protective of insulin-dependent diabetes mellitus, whether it is a delayed introduction of cows’ milk that may be protective, or whether the onset of insulin dependent diabetes mellitus results from unrelated environmental factors (see Ellis & Atkinson, 1996 and Heinig, 1997 for discussions of the evidence). 
  • Dentists note that breastfeeding is important for the proper development of the infant’s oral cavity (Palmer, 1998).
  • There is some suggestion in the literature that possible health benefits for mothers may include fewer hip fractures after menopause, less risk of ovarian cancer and less bleeding after delivery (Weimer, 2001).