EAT FOR HEALTH – AusTRALiAn diETARy guidELinEs
88Guideline 4
4.1 Setting the scene
The World Health Organization (WHO) states that ‘breastfeeding is an unequalled way of providing ideal food
for the healthy growth and development of infants’.^871 Breastfeeding has short-term and long-term health and
other benefits for infants and mothers. Maximising the benefits of breastfeeding to the infant and mother
requires the support of the other family members and a supportive community environment.Australia has a long history of promoting and supporting breastfeeding in its public health policy. In 1981
Australia became a signatory to the WHO International code of marketing of breast-milk substitutes
(WHO Code),^872 the main aim of which was to protect and promote breastfeeding. The importance of
breastfeeding led to its inclusion in the first edition of the dietary guidelines endorsed by the NHMRC
in 1982.^750In Australia, the WHO code is implemented through the Marketing in Australia of Infant Formulas (MAIF)
Agreement, a voluntary agreement by infant formula manufacturers and importers. The Infant Feeding
Guidelines^351 provide more information on the WHO Code, the MAIF Agreement and the obligations of all
health workers. They also provide detailed information on the benefits of breastfeeding for the infant and
mother, and recommendations on appropriate foods for infants from birth to about 2 years of age. Other
Government initiatives and policies are outlined in the Australian national breastfeeding strategy 2010–2015
which aims to promote, protect, support and monitor breastfeeding.^873Breast milk is a living tissue that contains many unique compounds, including antibodies and immune cells.
In the first few days after giving birth a mother’s breasts produce colostrum, which provides all the nutrients
and water required by her newborn infant. Colostrum contains higher levels of protein, vitamin A and vitamin B 12
and less fat than breast milk. It also contains lactoferrin, immunoglobulin A, enzymes, maternal antibodies,
living cells (leukocytes, neutrophils and macrophages) and prebiotics, which limit the growth of pathogenic
bacteria and viruses, stimulate the growth of an appropriate human microbiome and protect against illness.657,874,875
Colostrum feeding is important for the infant and also stimulates the mother’s breast milk production. Skin-to-skin
contact and colostrum feeding should begin as soon as possible after birth, preferably within 30 to 60 minutes.
The composition of colostrum gradually changes as lactation is established and milk production begins
48–72 hours after birth.The nutrient composition of mature human milk varies between individuals and across the stages of lactation.
The energy content varies between 270 and 315 kilojoules per 100ml, largely due to variation in the fat
content.876,877 Fat content typically increases through each breastfeed. It provides energy and omega-3 and
omega-6 lCPuFAs, plus the fat-soluble vitamins A, D, E and K, as well as prostaglandins. The fat in breast milk
is typically better absorbed by an infant’s gastrointestinal tract than the fat in cow’s milk. Mature milk continues
to provide the infant with immune factors and enzymes.35,878Breast milk provides all the vitamins, major minerals and trace elements known to be essential for healthy
full-term infants for around the first 6 months of life.143,879 These nutrients are more bioavailable than those
found in infant formula. Because the composition of breast milk constantly changes throughout lactation and
during a single breastfeed, no infant formula can exactly mimic the composition of breast milk. Breast milk is
a convenient, hygienic and inexpensive food source with no environmental costs.^880Breast milk continues to be an important source of vitamins, minerals and trace elements when other foods
are introduced at around 6 months (complementary feeding).Consuming a variety of nutritious foods is particularly important for breastfeeding women.