The Essential Role of Breastfeeding in Infant Health and Development

Despite the numerous proven benefits of breastfeeding, more than 40% of infants worldwide are not breastfed. Between 2015 and 2021, fewer than 50% of newborns received breast milk within the first hour of life, well below the global target of 70%. This shortfall is significantly influenced by how healthcare providers promote breastfeeding during pregnancy, postpartum, and early childhood.

The first months of life represent a critical window for a child's development and long-term health. Human breast milk is a dynamic, living fluid that provides optimal nutrition and a wide range of bioactive components essential for growth, immune function, and the establishment of a healthy microbiome.

Nutritional and Bioactive Richness of Human Milk

Breast milk is uniquely suited to meet an infant’s changing nutritional needs. It contains complex proteins, lipids, and carbohydrates that adjust over a single feeding session and throughout the lactation period. Beyond basic nutrition, breast milk delivers a diverse array of bioactive molecules—such as immunoglobulins, hormones, and oligosaccharides—which support immune system maturation, organ development, and protection against infection and inflammation.

Among these, human milk oligosaccharides (HMOs) are especially critical. They are the third most abundant solid component in breast milk after lactose and lipids. Synthesized according to the maternal genotype, HMOs serve as prebiotics, nourishing beneficial gut bacteria like Bifidobacterium and Bacteroides. They also help prevent the adhesion of harmful pathogens to the infant’s intestinal lining and promote mucosal immune development.

Microbiome Transfer and Maternal Influence

Emerging evidence suggests that beneficial bacteria from the mother’s gut can translocate to her breast milk, dynamically influencing the infant's gut microbiota. This microbial transfer begins in utero, is reinforced during vaginal birth, and continues through breastfeeding. The maternal microbiome—shaped largely by diet, antibiotic exposure, and environmental factors—plays a foundational role in this process.

The increasing prevalence of ultra-processed foods, antibiotic use, and reduced exposure to natural environments is altering human microbial profiles, potentially disrupting this critical maternal-infant microbial inheritance.

Nutritional Considerations for Mothers

A mother’s diet, before conception and throughout pregnancy directly affects her microbiome and, consequently, her infant’s health. Diets rich in fiber, healthy lipids, and clean proteins support microbial diversity and resilience. Therefore, nutritional choices during this time should be prioritized:

  • Organic, whole foods

  • Minimally processed items

  • Foods free from additives, preservatives, and chemical contaminants

  • Microbiota-supporting ingredients like prebiotic fibers and fermented foods

Encouraging natural childbirth over cesarean delivery—when medically appropriate—also preserves the natural microbial transfer process disrupted by surgical birth and perioperative antibiotics.

Health Outcomes of Breastfeeding

A review of over 400 studies has established strong associations between breastfeeding and reduced risk of numerous conditions, including:

  • Acute ear infections

  • Gastrointestinal and respiratory infections

  • Asthma and atopic dermatitis

  • Obesity and metabolic diseases (type 1 and 2 diabetes)

  • Childhood leukemia

  • Sudden infant death syndrome (SIDS)

  • Necrotizing Enterocolitis (NEC) in preterm infants

Recommendations and the Way Forward

The World Health Organization (WHO) and American Academy of Pediatrics (AAP) recommend initiating breastfeeding within the first hour after birth and continuing exclusively for at least six months.

To achieve these goals and improve breastfeeding rates globally, comprehensive support is needed, especially in healthcare settings. This includes:

  • Prenatal education about breastfeeding benefits

  • Postpartum lactation support

  • Encouraging practices that promote natural microbiota transfer

  • Dietary counseling for mothers before and during pregnancy

Promoting breastfeeding is not just a personal choice, it is a public health priority that supports lifelong health for both infants and mothers.

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