ENCOuRAGE, SuPPORT AND PROMOTE BREASTFEEDING
89Guideline 4
4.2 The evidence for ‘encourage, support and promote breastfeeding’
There is considerable evidence to justify the recommendation to encourage, support and promote breastfeeding,
including:
• the many benefits of breastfeeding for both infants – in babyhood and later life – and mothers
• the effectiveness of antenatal and postnatal support in increasing the duration of breastfeeding.
Table 4.1: Evidence statements for ‘encouraging, supporting and promoting breastfeeding’
Evidence statement Grade
Compared to infants who are formula fed, being breastfed is associated with reduced risk of becoming obese in childhood,
adolescence, and early adulthood. A
Prenatal and perinatal support for breastfeeding can increase the proportion of women breastfeeding (both exclusive and
non-exclusive) up to age 6 months. A
Being breastfed in infancy is associated with lower systolic and diastolic blood pressure up to adolescence. B
Infants who are exclusively breastfed for 6 months experience less morbidity from gastrointestinal infection than those
who are mixed breastfed as of 3 or 4 months. B
Infants, from either developing or developed countries, who are exclusively breastfed for 6 months or longer do not have
deficits in growth compared to those who are not exclusively breastfed. B
There are no apparent risks in a general recommendation for exclusive breastfeeding for the first 6 months of life, in both
developing and developed countries. However, infants should still be managed individually in order to achieve sufficient
growth and minimise adverse outcomes.
B
Exclusive breastfeeding for 6 months or more prolongs lactational amenorrhea for mothers. B
Breastfeeding support (any type) increases duration of both exclusive and non-exclusive breastfeeding both in the
immediate postnatal period and at 6 months of age. B
Being breastfed initially, particularly exclusively breastfed, is associated with lower total and LDL cholesterol
concentrations in adult life.
C
Breastfeeding is associated with a reduced risk of asthma and atopic disease. C
Not breastfeeding is associated with an increased risk of sudden infant death syndrome. C
Maternal perceived insufficient milk supply is associated with increased risk of early cessation of lactation. C
Notes: Grades – A: convincing association, B: probable association, C: suggestive association
Includes evidence statements and gradings from the Evidence Report (literature from years 2002–2009). Does not include evidence from
other sources, such as the 2003 edition of the dietary guidelines (in which individual studies were classified according to their design as
level I, II or III but overall grades for relationships were not derived), although these sources have been used to inform these Guidelines.
Grade C evidence statements showing no association and all Grade D statements can be found in Appendix E.