The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend that babies start breastfeeding within the first hour of life, but a new joint report has found that this guideline is being largely ignored worldwide. According to the recent findings, most babies aren't breastfed immediately after birth, putting them at an increased risk of infection and even death, as reported by PBS NewsHour. That doesn't mean they're not breastfed at all, just that the crucial first feeding is being delayed for a variety of reasons.
Three out of five babies aren't breastfed in the first hour after birth, according to the new report by UNICEF and WHO, and the lack of early implementation isn't linked to socio-economic status or access to medical professionals, but rather local customs, underscoring the need for better global breastfeeding education. Research shows that only 42 percent of babies worldwide are receiving colostrum, the first form of breast milk, which is high in nutrients and antibodies.
Although WHO says that babies may display feeding cues as soon as 15 minutes after birth, medical professionals often separate them from their mothers during that time, particularly following a C-section. But UNICEF's Maaike Arts told PBS NewsHour that there are safe methods of breastfeeding even under those circumstances; doctors just need to be made aware of them, as do parents. For example, What To Expect recommends moms ask their partner or a nurse help position them in the OR, either propping them up for a football hold or shifting them onto their side, so they, if they choose to breastfeed, moms don't have to miss out on this important hour
Educating mothers and medical professionals makes a big difference, the report noted. For example, when Serbia's early breastfeeding rates dropped to just 8 percent in 2010, according to WHO, the government instituted policies to encourage hospitals to prioritize the first feeding, and in just four years, the rate rose to 51 percent.
Worldwide progress, however, is much slower; since 2005, early breastfeeding rates have risen only 5 percent in the 76 low and middle-income countries surveyed for the study. While breastfeeding during the first hour is common in East and Southern Africa, according to the report, countries in Europe and Asia have a lot of catching up to do. Delaying the first feeding between two and 23 hours increases an infant's risk of death by 33 percent, according to a 2017 study published in the journal PLoS ONE, and waiting 24 hours or more doubles that risk.
"When it comes to the start of breastfeeding, timing is everything. In many countries, it can even be a matter of life or death," UNICEF executive director Henrietta Fore told Al Jazeera. "Each year, millions of newborns miss out on the benefits of early breastfeeding and the reasons — all too often — are things we can change."
Fore continued, according to Al Jazeera, "Mothers simply don't receive enough support to breastfeed within those crucial minutes after birth, even from medical personnel at health facilities."
In addition to receiving colostrum, immediate skin-to-skin contact helps regulate newborns' body temperature and provides access to "good" bacteria from mothers' skin, which helps build babies' immune systems, the report noted. Early feeding also helps to stimulates mothers' milk production, according to the Mayo Clinic.
But about three in five babies are missing out on these benefits, not only from doctors' misplaced caution after C-sections, but due to some shockingly common practices of having the babies' first feeding administered by a medical professional or other family member, rather than the mother, according to the WHO and UNICEF. And it's not necessarily infant formula that they're giving them; as WHO and UNICEF's report found, in many countries, colostrum is deliberately thrown away in favor of plain water, sugar water, honey, or tea — none of which are medically advisable, according to the Mayo Clinic.
With this information, it seems obvious that better global education is in order. However, earlier this year, the Trump administration allegedly objected to a resolution backed by the United Nations aimed at promoting breastfeeding, according to the New York Times. Critics accused the delegates of allegedly promoting the agenda of infant formula manufacturers, but Trump tweeted a response to the Times article claiming that the administration "strongly supports breast feeding but we don't believe women should be denied access to formula." The resolution, which eventually passed with Russia's support, does not encourage denying access to formula, according to the New York Times.
Barring any serious medical complications, babies can and should be handed over to the mother for feeding immediately after birth, and doctors can even perform their Apgar assessments while they're still being held by mom. Expectant mothers should speak to their health care teams before the big day to make sure this practice — which is encouraged by the American Academy of Pediatrics — will be followed. Luckily, according to BabyCenter, it's pretty routine in U.S. hospitals, but the WHO and UNICEF hope to make it a global practice.