World Breastfeeding Week: Studies find gut, ADHD & sleep benefits

For World Breastfeeding Week, Nutrition Insight explores some of the latest research on breastfeeding benefits. A review breaks down stigmatized myths in the medical sector, while other research papers reveal how the nutrition source makes infants’ gut bacteria resilient into adulthood, may prevent Attention Deficit Hyperactivity Disorder (ADHD) symptoms, and could improve sleep. 

Additionally, the WHO underscores that breastfeeding is one of the most cost-effective investments a country can make, yet governments and donors are not aware of the economic evidence. Thus, it will be launching an updated global investment case for breastfeeding with Nutrition International.

The Global Breastfeeding Collective has found slight improvements in breastfeeding rates last year. However, they state that enabling feeding environments “lags dangerously behind.” 

“Donor funding for breastfeeding programs remains far below needs, most countries fail to guarantee workplace protections, and three-quarters of countries lack comprehensive systems to protect breastfeeding during emergencies.”

Combating breastfeeding myths

A systematic review has found that misconceptions about early milk production, pacifiers, and breast pumps are widespread in the medical community. It adds that common clinical practices and beliefs are not supported by clinical evidence. 

Misinformed breastfeeding myths include early milk production being insufficient, restrictions on pacifier use, and the fast introduction of electric breast pumps.The Journal of Maternal-Fetal & Neonatal Medicine publication addresses three common misconceptions encountered in maternity wards during 48–72 hours after birth: the perception that early milk production is insufficient, leading to premature formula supplementation, routine restrictions on pacifier (dummy) use, and the early introduction of electric breast pumps.

Researchers at the Sapienza University of Rome, Italy, flagged meeting new mothers feeling overwhelmed by fear that they did not have enough milk. However, the review suggests that colostrum, which is highly concentrated milk produced after giving birth, is usually sufficient to meet a newborn’s nutritional needs. Its production is also physiologically matched to babies’ stomach capacity.

The researcher explains that myths about colostrum are causing early introduction of formula and stopping breastfeeding prematurely. Early formula supplementation is only required when there is a medical need, and if supplementing early, it lowers milk production and reinforces mothers’ fears of insufficiency.

They stress that pacifiers do not reduce breastfeeding duration or exclusivity, and breast pumps are not recommended for routine use in the first days after birth.

In some cases, mothers pumping early might worsen breastfeeding outcomes, as it reinforces anxieties about low milk supply. Hand expression is recommended as a first intervention when milk expression is needed.

The review examined 78 studies from various countries, which include randomized controlled trials, systematic reviews, meta-analyses, and observational cohort studies. 

Breast milk helps gut microbes survive

Sugars in breast milk have an important role in gut microbacteria development, giving infants a head start, finds recent research from the Technical University of Denmark and Rigshospitalet.

HMOs in breast milk help determine which bacteria survive into adulthood.The Nature Communications study reveals that breast milk shapes the gut bacteria longer than previously thought, as the nondigestible sugars — human milk oligosaccharides (HMOs) — influence which bacteria survive when infants transition to solid food.

The researchers reveal the previously unknown mechanism that enables specific gut bacteria to flourish in the gut during weaning to metabolize HMOs and fibers from plant-based foods. This period is essential to development as it shapes the microbiome that is carried on into adulthood. 

The findings suggest that it can help the development of better nutritional solutions for infants, promote breastfeeding, and deepen understanding of how early life nutrition impacts later life. The researchers urge mothers to breastfeed for as long as possible during the transition to solid foods.

The study examined changes in bacteria and their genes during weaning, while also culturing bacteria in the laboratory, mimicking human gut environments. This enabled the identification of fiber-utilizing bifidobacteria.

Impacts on ADHD symptoms 

Breastfeeding babies up to six months of age, which is WHO-recommended, has recently been linked to reduced risk of ADHD symptoms in children aged three to eight.

The researchers at the University of Bergen, Norway, point out that scientists are interested in understanding how breast milk and breastfeeding affect infants’ brain development and immune system.

Using data from 37,600 families in the Norwegian Mother, Father and Child Cohort Study, the Biological Psychiatry study found that the longer a child was exclusively breastfed, the lower the levels of ADHD symptoms at ages three, five, and eight years. This association was weakest at age eight and strongest at ages three and five for boys and girls. 

Exclusively breastfed babies were linked to lower levels of ADHD symptoms at ages three, five, and eight years.It is important to note that ADHD is partly explained by genetics. For instance, the researchers point to research suggesting that ADHD mothers tend to breastfeed less than neurotypical parents, plus they are more likely to have children with ADHD symptoms. These babies might be more difficult to breastfeed.

However, after adjusting for possible genetic factors, the researchers found moderate protective benefits of long-term exclusive breastfeeding and later ADHD symptoms.

Better and longer sleep 

A study from Japan has found that breastfed infants are less likely to have short sleep by age one. Researchers from the University of Toyama underscore that infants need sufficient sleep, as short sleep has been linked to obesity, behavioral problems, and poorer cognitive performance later in life.

They point out that parents and caregivers commonly believe that breastfed infants sleep less or require more feeding than formula-fed infants, however, this is a misperception.

The Toyama Regional Center for the Japan Environment and Children’s Study examined over 82,000 children from the Japan Environment and Children’s Study — one of the world’s largest birth cohort studies.

Infants who were breastfed have a lower chance of insufficient sleep compared to babies exclusively fed formula, finds the European Journal of Clinical Nutrition study. 

In detail, infants who were only fed formula for six months had a 12.2% chance of having short sleep, while the risk in infants breastfed for less than six months was 10.2%. Infants breastfed all six months and supplemented with formula had a lower risk at 9.7%. Whereas babies exclusively breastfed for the first six months had an 8.8% risk.

The researchers add that after adjusting for maternal, infant, and environmental factors, six-month-old breastfed-exclusive babies had a 23% lower chance of short sleep duration compared to babies only fed formula.