Breastfeeding protects against illness and infection in infants and children: a review of the evidence.

Nutrition is essential to the health and development of infants and children. Breastfeeding is superior to infant formula feeding because in addition to breastmilk's nutritional advantages, it protects against infections through specific and non-specific immune factors and has long-term consequences for metabolism and disease later in life. The objectives of this paper are to summarise the epidemiological and other scientific evidence in support of breastfeeding, to clarify why breastmilk is a better food for infants than infant formula and to demonstrate support for further breastfeeding initiatives in Australia. There is much epidemiological evidence for the benefits of breastfeeding to the human infant against a wide range of illnesses and infections. Other scientific evidence for breastfeeding has demonstrated specific nutritional components that provide immunologic protection and beneficial effects on intestinal flora. Human milk enhances the immature immunologic system of the neonate and strengthens host defence mechanisms against infective and other foreign agents. Mechanisms to explain active stimulation of the infant's immune system by breastfeeding are through bioactive factors in human milk. Following breastfeeding termination there may be prolonged protection against infections due to influences on the infant immune system mediated via human milk. World-wide initiatives have been established to promote breastfeeding and curb the use of infant formula. Primarily the Baby Friendly Hospital Initiative promotes the Ten Steps to Successful Breastfeeding and should be implemented in all maternity services in Australia. There is enough evidence to support further breastfeeding health promotion initiatives in Australia to ensure that all hospitals become 'baby friendly', that all mothers are encouraged and supported to commence breastfeeding and that there is adequate community support for mothers to continue exclusive breastfeeding for at least the first six months of life.