Case Studies

New research funded by the Central Research Department 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.

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

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.

Click on the "View PDF" icon to read the Policy Briefing Paper: "Impact of early initiation of breastfeeding on neonatal mortality: implications for meeting the millennium development goals for child survival". Or click here to view a PDF summary of the briefing paper (20 KB).

The research findings have been published in Pediatrics

On the 26 March 2006, DFID issued a press release related to this research.

For further information, please contact Dr Karen Edmond