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Deborah: You know, breast milk is a fascinating fluid with so many truly amazing properties. And today, we're going to explore some of the benefits you already know it can offer. And maybe some you didn't know about like how breast milk actually protects newborns. This is the podcast series from Deaconess The Women's Hospital, a place for all your life.

I’m Deborah Howell. And our guest today is Mary Roby, registered nurse and lactation consultant at The Women's Hospital. Welcome to you, Mary.

Mary Roby: Good morning, Deborah.

Deborah: Very happy to have you on today. Can you explain some of the benefits of breastfeeding?

Mary Roby: Well, Deborah, there are so many benefits. For the baby themselves, breast milk helps build a stronger immune system. That'll make them have so much less illness. For example, less GI illness, things like diarrhea and reflux. Breastfed babies tend to have fewer colds and respiratory illnesses, pneumonia, RSV, those kinds of breathing things.

They get fewer ear infections, have fewer allergies and it actually lowers their risk of other diseases like childhood cancers and diabetes. Also, equally important, there are lower rates of SIDS, sudden infant death syndrome with breastfed babies and just lower infant mortality rates in general. In fact, infant mortality rates in the United States are reduced by 21% in breastfed infants and that's really huge.

Parents, there's benefits to parents. They tend to miss less work because their children aren't ill as often. Moms benefit from breastfeeding. They recover from delivery much more quickly. They have less postpartum bleeding. They lose the baby weight quicker as a rule because there's a big calorie burn producing breast milk.

It even helps moms in the long run prevent certain kinds of cancers. It's preventative for things like breast and ovarian cancer. And interestingly, the effect is cumulative. The more months total that a woman breastfeeds her children, the better protective effect. Now, it doesn't mean that no one will get sick. It just really improves the chances of not getting sick if that makes sense.  

Deborah: That's a lot of benefits. Can you explain how breastmilk protects babies from illness?

Mary Roby: Sure. Doctors have really known for a long time that breastfed infants get fewer infections and illnesses than non-breastfed infants. And mother's milk helps babies avoid illnesses in a lot of ways. Especially in their first few months of life, a baby has a lot less ability to fight off infection. A newborn baby's immune system is really immature. In fact, a child's immune system doesn't really even fully develop until they're about five years old.

So babies get their initial immune coverage during pregnancy when the mother passes antibodies to her baby, by way of the placenta while she's pregnant. Antibodies are proteins that your body makes to help you find and disable germs that could maybe make you sick. So the mom's body passes these antibodies to the baby while she's pregnant, breast milk passes them to the baby after the baby's born.

Deborah: Okay. And can you explain how this happens?

Mary Roby: So breast milk is a living tissue. It's full of cells, nutrients and these antibodies. These enter the baby's body when they drink the milk and they coat the lining of the baby's GI tract. The antibodies and nutrients are really easily absorbed by the baby's body. That basically kind of make the stomach and intestines leak-proof. It's kind of like a suit of armor all the way down the GI tract, so germs and allergens can't get into the baby's body or at least they're a lot less likely to. I guess, to me, breastmilk cells are kind of like soldiers sent to protect and defend the baby until the baby's strong enough to do it by themselves.

Deborah: It's remarkable. Now, does breast milk work in any other way to protect babies from illness?

Mary Roby: It does. It actually contains immune cells, like for example, white blood cells, which are infection fighters. It stimulates other defenses in the infant's body to be activated. One of the really coolest things that it does, and this was coming out in a lot more recent research, it actually feeds the good bacteria in the baby's gut.

If you've heard of anything called the gut biome, that's the good microbes that set up shop inside the gut and they digest food, but they also protect the body. Breast milk not only feeds the baby, but it feeds the bacteria in the baby's gut, which helps with some of that long-term protection against illness.

Deborah: Just amazing process. I mean, there's so much to learn and it's just such a beautiful, beautiful system, if you will. And how long are these benefits of breast milk, I want to say, good for? And how many years of a child's life?

Mary Roby: Well, that's an excellent question. And there are real black and white answers, but we do know that if that gut microbiome is primed with not only the right bacteria, but the right arrangement of the bacteria, babies, children, adults, as a person grows, it can have effects well into adulthood.

The baby and the gut bacteria kind of develop together and it sort of sets the stage, in fact, so much that there's a lot of research going on right now just on the bacteria in the gut, like Duke University is doing research, trying to help formula companies actually make formula to better adapt to that gut biome similar to breast milk. That's not me plugging formula. That's me kind of being excited about research that can look at the feeding as more than just nutrition.

Deborah: Yeah. I was raised on formula because I was baby number three and I was kind of a mistake, came really late in the game. So can babies like me, can we do anything later in life to help boost our immune system or is it really just from the get-go?

Mary Roby: Well, obviously, as adults, we can do things with healthy diet and probiotics and things. I was also the fourth of five. So actually none of them were breastfed until the fifth one who ironically is the only one without allergies. And, you know, that's a great question, Deborah. I don't have all the answers to that one other than using a good holistic, balanced approach to your diet and nutritional substance and probiotics, and everybody has their philosophy on that. And that's something you kind of work with your physician on or do your research now that we have so many tools at our disposal.

Deborah: Now, can every mother breastfeed or are there some others who just cannot?

Mary Roby: That's really a great question. Some mothers and some babies really struggle to breastfeed. There's a really small percentage of women who don't actually make enough milk. You hear frequently of women saying, "I didn't make enough milk." But most of the time, that is not because of her body. The last statistic I read was maybe 1% to 3% of women don't actually have the capacity, their bodies won't make that milk.

Most of the time, women can make enough milk if they have the right education and support. Sometimes babies have issues that don't allow them to breastfeed, for example, a cleft palate. But that doesn't mean they couldn't have breast milk in a specialized bottle.

There are some disorders that would be contraindicated as far as breastfeeding. There's a rare genetic disorder called galactosemia where the baby can't metabolize sugars in the breast milk, and they have to have a special formula and they cannot breastfeed.

If a mom's on certain kind of chemotherapy or radioactive medications that she has, for example, thyroid cancer and has a radioactive iodine implant, she wouldn't breastfeed. Obviously, street drugs, you wouldn't want to breastfeed.

In the United States, an HIV positive woman, which shouldn't breastfeed, that's a little different recommendation in different areas of the world where there are less safe water and food sources that the current recommendation in our country is don't breastfeed if you're HIV positive. So things like that, but they're actually not common.

Deborah: Okay. And my last question to you is how long should a woman breastfeed?

Mary Roby: Well, I can tell you what the American Academy officially recommends. They recommend nothing in the baby's gut except breast milk for the first six months of life. And then after six months, start introducing baby foods or other foods, but still breast milk would be the primary source of nutrition. And then after the first year of life, for as long as mom and babies both want to continue.

Now, I believe the world health organization recommends a full two years because of less stable, safe, and clean food sources globally in some areas. I will tell you the human biologic norm is four plus years. I know that sounds like a lot to people, but breastmilk really never loses its beneficial nutritional punch and its immune protecting punch. It's still good viable, healthy living tissue even for a three or four-year-old, but not that many people do breastfeed that long. It's certainly okay to.

Deborah: Do you have a final quote for us today?

Mary Roby: I do. There's a wonderful pediatrician, Dr. Jack Newman, and he's a really noted breastfeeding expert. I'd call him a guru. And here's his quote that I love. He says, "All things considered, breast milk is truly a fascinating fluid that supplies infants with far more than nutrition. It protects them against infection until they can protect themselves."

Deborah: Beautiful and perfect. And thank you so much, Mary, for shedding some light on how to give our babies the very best care from the very start with good old-fashioned mother's milk. It's been so nice to have you on the podcast today.

Mary Roby: Thank you for having me. I've really enjoyed talking with you.

Deborah: You too. And that wraps up this episode of the podcast series from Deaconess The Women's Hospital, a place for all your life. For more information, head on over to deaconess.com/healthybaby. And for more health tips and updates, follow us on your social channels. I'm Deborah Howell. Thanks for listening and have yourself a great day.