Press Release

26 March 2006

Breastfeeding in the first hour of life could save almost one million babies’ lives each year

New research funded by the Department for International Development (DFID) has shown for the first time that starting to breastfeed immediately after birth significantly increases the chances of survival of babies.

4 million babies in the developing world die each year in the first month of life. If mothers start breastfeeding within one hour of birth, 22% of babies who die in the first 28 days, the equivalent to almost one million newborn children each year, could be saved. If breastfeeding starts on the first day then 16% of lives could be saved. The likelihood of death increases significantly each day the start of breastfeeding is further delayed.

The research is the first study to assess the effect on newborn survival rates of when mothers start to breastfeed. It was carried out by the Kintampo Health Research Centre in Ghana and the London School of Hygiene and Tropical Medicine and was funded by DFID. The analysis was based on 10,947 breastfeeding babies born between July 2003 and June 2004 in Ghana who survived to the second day.

Babies that were fed only breastmilk were four times less likely to die than those who were also fed other milk or solids, confirming the health benefits of exclusive breastfeeding in the first month.

Commenting Hilary Benn, Secretary of State for International Development, said:

    “This groundbreaking research could help save one million children’s lives every year. What’s so exciting about it is that the solution doesn’t need costly medicines. We just need to get across the simple message to women that, unless they have HIV, breastfeeding from the time they give birth is not only best – it will increase the chances of their baby surviving. We need to support Ministries of Health, UNICEF, WHO and other partners to educate midwives and community healthworkers so they can spread this message far and wide. We also need to tackle the underlying reasons why, in some cultures, breastfeeding in the first few days is discouraged.”

Reasons why early breastfeeding saves lives include:

  • Early human milk is rich in a variety of immune and non-immune components that are important for early gut growth and resistance to infection.
  • Lack of feeding in the first hours or days of life may disrupt metabolic functions and cause acid build-up (acidosis) and low glucose (hypoglycaemia).
  • Early feeding with non-human milk proteins (for example, animal milk) may severely disrupt normal gut function.
  • Promotion of warmth and protection when breastfeeding may reduce the risk of death from hypothermia.
  • Mothers who suckle their babies shortly after birth have a greater chance of successfully establishing and sustaining breastfeeding throughout infancy.

In countries including India and Bangladesh, many believe that colostrum, the first milk that is produced after childbirth, is ‘pollution’ and should not be used. In some traditional families the mother-in-law must give newborn sons the first feed, often from a local water source. Colostrum is easy to digest and high in nutrition and antibodies to keep the newborn baby healthy. When colostrum is discarded it is often replaced by feeds made with unclean water, from cereal, animal milk, herbal concoctions or other liquids which are lower in nutrients, may expose the baby to disease or damage the baby’s digestion.

The research was carried out in Ghana where the prevalence of HIV is low at around 4%. In countries where HIV infection is much higher breastfeeding cannot be promoted so easily. The risk of HIV transmission from mother to child through breastfeeding, which happens in about 15% of cases, should be taken into account. WHO recommends that, where possible, HIV positive mothers give their babies artificial milk. However, WHO recognises that exclusive breastfeeding, rather than mixed feeding, remains the best option for many poor women with HIV who don’t have access to clean water or cannot afford artificial milk. The reality is that until women are able to know their HIV status before giving birth and until they can afford to give artificial feeds if they have HIV, breastfeeding is the only option.

Notes to editors:

Summary of the research results

1. Breastfeeding was initiated within the first day of birth in 71% of infants.

2. 70% were exclusively (not mixed) breastfed during the neonatal period (first 28 days)

3. The risk of neonatal death was four times higher in children given milk-based fluids or solids in addition to breast milk.

4. Increased delay in initiation of breastfeeding from 1 hour to day 7 led to increasing risk of neonatal death. Starting breastfeeding after day 1 was associated with a 2.4 times greater risk of death.

5.external linkThe research results have been published in the American Journal Pediatrics

6. Current World Health Organisation (WHO) recommendations on breastfeeding in poor countries are as follows:

  • For HIV-negative women and women whose status is unknown it is recommended to breastfeed exclusively for 6 months (with early initiation) and to continue breastfeeding with adequate complementary feeding for 2 years of age or beyond.
  • The recommendation for HIV-positive mothers is: when replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended. Otherwise, exclusive breastfeeding is recommended during the first months of life and should then be discontinued as soon as feasible.
  • More information from the WHO

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For further information, contact Diana Murray on 020 7023 0233, e-mail d-murray@dfid.gov.uk  or call our Public Enquiries Point on 0845 300 4100.