"Breast milk is the natural food for full-term infants during the first months of life." It is the most appropriate milk for infants because besides being "homemade", it is adapted to the infants needs.
Breast milk is free of contaminating bacteria, is readily available, does not need to be preparated and is always fresh. In lower socioeconomic groups, breast-fed infants are most likely to survive because of the lower risks of gastrointestinal disturbances, such as severe diarrhea. Breast-fed infants are at lower risk of having otitis media in the first year of life, pneumonia, bacteremia, meningitis and other diseases later in life.
Breast milk contains secretory IgA antibodies, bacterial and viral antibodies, which provide local gastrointestinal immunity by preventing microorganisms from adhering to the intestinal mucosa. Human milk also contains macrophages which produce complement, lysozyme and lactoferrin, an iron-binding protein which has an inhibitory affect on the growth of "Escherichia coli"; transfer of tuberculin responsiveness by breast milk suggests passive transfer of T-cell immunity.
The only nutrients which may need to be given to the infant are fluoride (0.25 mg daily if the water is inadequately fluoridated) and vitamin D (10 micrograms daily in case the mother's intake is inadequate and the baby isn't exposed frequently to sunlight). Administration of 1 mg of vitamin K parenterally at birth is recommended for all infants. By 4-6 months, iron-fortified cereals and baby food should supplememnt the diet.
Breast feeding also has psychologic advantages for both the mother and the infant which should not be forgotten. It is important to estabilish comfortable and pleasurable feeding practices and habits.
Most infants may start breast feeding shortly after birth, others within the first 4-6 hours of life. Variations in the time between feedings are to be expected, but by the end of the first month of life, 90% of infants will have estabilished a regular schedule.
Hemolytic disease of the newborn is not a contraindication for breast feeding unless the infant isn't in adequate conditions. Mothers who are HIV positive should not breast feed their infants because transmission of the virus by this route is well documented. According to the World Health Organization, in developing countries breast feeding should continue even in the setting of high HIV prevalence because the benefits are greater than the risks of bottle feeding (lack of higiene, risks of gastrointestinal disease).
Other viruses that can be transmitted by breast feeding include cytomegalovirus (greater risk of disease to preterm infants), hepatitis B (although the main route of transmission is at delivery, and active immunization and immune globulin reduce the risk to a minimum) and herpes simplex virus.
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