All posts by bgazette

Issue 1, January 2019

Ancient cultures and the most current research provide an abundance of conclusive scientific evidence that mothers’ milk is the best source of nutrition for infants, and breastfeeding is the best feeding choice for both the mother and the baby.  In many cultures, to this day, if for any reason a mother cannot breastfeed her baby, the first and natural choice for the parents is to find another breast-feeding mother to breastfeed their baby (Fildes, 1988 & 1995). However, since the recent advent of artificial feeding, infant feeding has changed dramatically along racial and social dimensions, generating a conflictual situation for mothers who wish to breastfeed their babies (Hausman, 2003).  This statement argues for why we must acknowledge, inform, recommend, assist, endorse, support, encourage, advocate, and promote breastfeeding.

Human milk is the “optimal nutrition” for full term infants, as well as for promoting the health and survival of preterm babies (Wight 2001).   The Promotion Of  Breastfeeding Intervention Trial (PROBIT) randomized study demonstrates that breastfeeding supports both short and long-term health outcomes for child and mother, (Kramer, Chalmers & Hodnett, et  al., 2001).

Morbidity and mortality:

Infant feeding practices have been,  and continue to be, major determinants of infant morbidity and mortality around most of the world (World Health Organization, 2003).  Overwhelming research has shown that there is a far lower risk for mortality and morbidity among breastfed children in comparison to those children who were not.  

Health benefits of breastfeeding:

Physical-biological health and development: Mother’s milk is proven to promote physical health and growth, immune ontogeny, and prevent diseases for both the mother and the growing baby in both short and long term.

Mother’s milk is effective and useful forallergy prevention and digestive health, including compensating for and protecting the immune system, (Goldman, 2012; Kramer & Kakuma, 2004; &  Quigley, Kelly & Sacker, 2007), prevention of multiple illnesses such as diarrhea, and other digestive problems and infectious diseases (Chien & Howie, 2001; Quigley, Kelly, & Sacker, 2007).  For example, in their meta-analysis, Bachrach and colleagues (2003) found evidence of a positive impact of breastfeeding on lowering risk for hospitalization (72%)

for respiratory infections.

Breastfed babies’ have more stable and predicatable growth than formula fed babies. Mother’s milk is qualitatively superior to the artificial milk. Analyses show it is a stabilizing factor for weight gain (Beyerlein, Toschke, & von Kries, 2008; & Grummer-Strawn & Mei, 2004), as well as a preventive factor for obesity in childhood and later in life (Gillman, Rifas-Shiman, Camargo, et al., 2001; Rolland-Cachera, Deheeger, Akrout, et al., 1995; & Lucas, Sarson, Blackburn, et al., 1980), and type 2 diabetes (Savino, Bebetti, Lignori, et. al. (2013).  

Mother’s milk is also associated with better gastrointestinal health (Brandtzaeg, 2003; Chirico, Marzollo, Cortinovis, et al., 2008; and Newburg, & Walker, 2007).  Formula feeding has been shown to result in a higher incidence of feeding intolerance and gastrointestinal diseases such as necrotising enterocolitis, which, if  the infant survives, may adversely affect the baby’s growth and development. By contrast, mother’s milk is shown to prevent this devastating condition  (Lucas & Cole, 1990; McGuire & Anthony, 2003).

Nutrition: The lactose in mother’s milk helps with absorption of minerals and calcium. Lactose deficiency results in malabsorption and intolerance syndrome. Such diseases are rare among exclusively breastfed infants (Martin, Ling & Blackburn, 2016).

In regions where clean water is not available, making a safe formula is not possible.  It is also common practice in poor communities that formula is diluted to extend the supply, leaving babies malnourished, hungry and underdeveloped, and resulting in subsequent negative health outcomes with long-term consequences. Inadequate and inappropriate nutrition can lead to the diarrhea, and dehydration which is a primary cause of infant mortality worldwide. Even developed countries are affected: illness and death due to unsafe and non-sterile formula was reported by the U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition in 2002.

Whole brain development:  Breastfeeding has direct beneficial impact onself-regulation, socio-emotional, and cognitive domains for infants, with corresponding benefits for breastfeeding mothers including mood stabilizing, affect regulation, stress reduction, and more responsive and effective parenting (Krol and Grossman 2018).  

Social and relational health: Physical perception of the mother’s heart beat (hearing, feeling) while breastfeeding has a calming effect that a bottle does not provide. While breastfeeding, mother and child are connected physically, emotionally, and intellectually.  

Eye contact between the mother and the baby while in the position of breastfeeding provides a right brain to right brain conduit of communication that is critical to brain development. The experience of shared joy during these face to face close interactions, feeling each others’ body temperature, heart-beats, holding and touch, and the mother’s tone of voice are factors in regulating the baby neurologically and emotionally, supporting bonding and connections that set a template for his further growth and development for all other relationships over the lifetime of the child. Additionally, mother’s verbal expressions and reciprocal interactions with the baby’s responses  – movements and sound utterances  – provide critical mental stimulations known to facilitate language skills and learning in the infant. 

Cognitive development and learning: Findings of the PROBIT study were controlled for potential confounding factors such as parent’s education, social status, and the environmental variances. At 6 ½ year follow up breastfed children had higher IQ scores and teacher ratings than those in the alternative feeding group (Kramer, Aboud, Mironova, et al., 2008). In another study, Amin, et. al. (2000), reported that breastfed infants have faster brainstem maturation, which the researchers attributed to the constituent composition of breast milk compared with formula-fed infants. In another study, Lucas, et al. (2002) report lower IQ (8-15 points) for premature babies who were not breastfed.  In the largest ever randomized study of human lataction, Kramer, et al. (2008), concluded that “prolonged and exclusive breastfeeding improves children’s cognitive development.”

Maternal health outcomes for breastfeeding mothers:

Breastfeeding is a protective factor for mothers. They are likely to enjoy improved health, as well as reduced risk of developing diseases in the future (Godfrey & Lawrence, 2010).

Dieterich, Felice, O’Sullivan & Rasmussen, (2013), list immediate, short, and long-lasting positive outcomes for breastfeeding mothers, including:

Bonding is facilitated through breastfeeding between mother and the baby and is the primary reason for breastfeeding reported by breastfeeding mothers (Leung & Sauve, 2005). Breastfeeding mothers become more attuned to the cues of the baby, and consequently, more reciprocal and responsive to the needs of the baby. These linkages are less observed among formula-fed infants (Kim, Feldman, Mayes, et al., 2011).

Weight loss: Breastfeeding mothers arebetter able to lose weight gained during pregnancy.  This effect is associated with the duration of breastfeeding (Baker, Gamborg, Heitmann, et al., 2008; Dewey, Heinig, & Nommsen, 1993).

Lactational amenorrhea (Godfrey & Lawrence, 2010), is a natural effect of breastfeeding, typically lasting 6 months or more, reducing the likelihood of another pregnancy in the infant’s first formative months of life. This phenomenon is absent in formula feeding mothers.  

Diabetes, metabolic, reproductive cancer, and cardiovascular risk:

Breastfeeding is associated with positive metabolic changes resulting in reduced risk for chronic diseases which may persist after weaning. (Stuebe, & Rich-Edwards, 2009).  For example, during lactation insulin sensitivity increases, an enduring effect that reduces the risk that the mother will develop type 2 diabetes.

The medical community has long recognized that breastfeeding is associated with a reduced risk of both breast cancer and ovarian cancer (Collaborative Group on Hormonal Factors in Breast Cancer, 2002; Ip, Chung, Raman, et al., 2009).

Lactation is associated with better cardiovascular health (Natland, Nilsen, Midthjell, et al., 2012; Schwarz, Ray, Stuebe, et al., 2009).  Research findings show decreased risk for the breastfeeding mother for cardiovascular disease, hypertension, diabetes, and hyperlipidemia.

Cost: A cost benefits analysis (Kelly Bonyata Feb. 2, 2018) reports an average savings of $3000.0 per year for families that breastfeed vs. purchasing and using formula.    

Bartick & Reinhold (2010), estimate that if 80% of mothers breastfeed for six months, this would result in a savings of over $13 billion per year in healthcare costs and save more than 900 lives.

An earlier analysis of the costs of formula feeding vs. benefits of breastfeeding, (Ball & Wright, 1999), analyzed cost of three diseases for which infants were most frequently referred to the medical facilities in the first year of life: lower respiratory tract illnesses, otitis media, and gastrointestinal illness. They found that for every 1,000 infants exclusively breastfed for 3 months,1,000 infants never breastfed required 2,033 more office visits, 212 more days in the hospital, and 609 more prescriptions in the first year of life.


While breastfeeding rates are rising in the United States, 81% of mothers in 2016, up from 75% in 2011 (CDC), there are still many barriers to breastfeeding in the US including maternal education, beliefs about breastfeeding, her physical and emotional health, community support, and the health of the infant.

It is is not always possible for a mother to breastfeed her baby, and women should not be made to feel shame when they are unable to do so or choose not to breastfeed for their own personal reasons,  professionals and policy makers, however, have a clear and compelling duty to acknowledge, inform, recommend, assist, endorse, support, encourage, advocate, and promote breastfeeding for every mother who is able to feed her baby during the first year of life. The failure to do sobrings harm to infants, mothers, and society.


Amin, S.B., Merle, K. S., Orlando, M.S., Dalzell, L.E., & Guillet, R. (2000). Brainstem maturation in premature infants as a function of feeding type. Pediatrics, 106 (2 Pt 1), 318–322.

Bachrach, V. R., Schwarz, E., & Bachrach, L. R. (2003). Breastfeeding and the risk of hospitalization for respiratory disease in infancy: a meta-analysis. Arch Pediatric Adolescent Med., 157(3), 237–43. [PubMed: 12622672]

Baker, J. L., Gamborg, M., Heitmann, B.L., et al. (2008).  Breastfeeding reduces postpartum weight retention. American Journal of Clinical Nutrition, 88(6),1543–1551.

[PubMed: 19064514]

Ball, T.M., & Wright, .AL. (1999). Health care costs of formula-feeding in the first year of life. Pediatrics, 103(4), 870–876. [PubMed: 10103324]


Bartick, M., Reinhold, A. (2010). The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics, 125(5), e1048-56.

Beyerlein, A., Toschke, A. M. & von Kries, R. (2008). Breastfeeding and childhood obesity: shift of the entire BMI distribution or only the upper parts? Obesity (Silver Spring), 16, 2730–2033.

Kelly Bonyata (2018). Financial costs of not breastfeeding …or cost benefits of breastfeeding.

Brandtzaeg, P. (2003). Mucosal immunity: integration between mother and the breast-fed infant. Vaccine, 21(24), 3382–3388. [PubMed: 12850345]

Centers for Disease Control and Prevention. (2011). Breastfeeding Report Card –– United States. Atlanta, GA.  [cited July 10, 2018]; Available from:


Centers for Disease Control and Prevention. (2016). Breastfeeding Report Card –– United States. Atlanta, GA.  [cited July 10, 2018]; Available from:


Chien, P. F., & Howie, P. W. (2001). Breast milk and the risk of opportunistic infection in infancy in industrialized and non-industrialized settings. Advances in Nutritional Research, 10, 69–104. [PubMed: 11795054]

Chirico, G., Marzollo, R., Cortinovis, S., et al. (2008). Antiinfective properties of human milk. Journal of Nutrition, 138(9), 1801s–1806s. [PubMed: 18716190]

Collaborative Group on Hormonal Factors in Breast Cancer. (2002). Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50,302 women with breast cancer and 96,973 women without the disease. The Lancet, 360(9328):187–95.

Dewey, K. G., Heinig, M. J., Nommsen, L.A. (1993). Maternal weight-loss patterns during prolonged lactation. The American Journal of Clinical Nutrition, 58 (2),162–166.

[PubMed: 8338042

Dieterich, C. M., Felice, J. P., O’Sullivan, E., & Rasmussen, K.M. (2013). Breastfeeding and Health Outcomes for the Mother-Infant Dyad. Pediatric Clin North Am., 60(1), 31–48. doi:10.1016/j.pcl.2012.09.010.

Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. (2000). Lancet, 355, 451–455.

Fildes, V. (1988). Breasts, Bottles, and Babies: A History of Infant Feeding. Medical  Anthropology Quarterly, 2(3), 306-308.

Fildes, V. (1995). The culture and biology of breastfeeding: A historical review of Western Europe. In P. S.  Macadam & K. A. Dettwyler (Eds.), Breastfeeding: Biocultural Perspectives. Aldine De Gruyter, N.Y., Pp. 101- 126.

Gillman MW, Rifas-Shiman SL, & Camargo CA, Jr., et al. (2001). Risk of overweight among adolescents who were breastfed as infants. JAMA, 285, 2461–2467.

Godfrey, J. R., & Lawrence, R. A. (2010). Toward optimal health: the maternal benefits of breastfeeding. Journal of Women’s Health, 19(9), 1597–602.

Goldman, A.S. (2012). Evolution of immune functions of the mammary gland and protection of the infant. Breastfeeding Medicine. 7(3), 132–142. [PubMed: 22577734]

Grummer-Strawn, L. M., & Mei, Z. (2004). Does breastfeeding protect against pediatric overweight? Analysis of longitudinal data from the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System. Pediatrics, 113, e81–e86.

Hausman, B. L. (2003). Mother’s milk: Breastfeeding controversies in American culture. New York, Routledge.

Ip, S., Chung, M., Raman, G., et al. (2009). A summary of the agency for healthcare research and quality’s evidence report on breastfeeding in developed countries. Breastfeeding Medicine, 4(1), S17–S30. [PubMed: 19827919]

Kim, P., Feldman, R., Mayes, L.C., et al. (2011).Breastfeeding, brain activation to own infant cry, and maternal sensitivity. Journal of Child Psychology and Psychiatry, 52(8), 907–915. [PubMed: 21501165]

Kramer, M. S., Aboud, F., Mironova, E., et al. (2008). Breastfeeding and child cognitive development: new evidence from a large randomized trial. Arch Gen Psychiatry, 65(5), 578–584. [PubMed: 18458209]

Kramer, M. S., Chalmers, B., & Hodnett, E. D., et al. (2001). Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA, 285(4), 413–420. [PubMed: 11242425]

Kramer, M. S., & Kakuma, R. (2004). The optimal duration of exclusive breastfeeding: a systematic review. Adv. Exp Med Biol., 554, 63–77.

Krol and Grossman (2018). Psychological effects of breastfeeding on children and mothers. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz

DOI: 10.1007/s00103-018-2769-0

Leung, A.K., & Sauve, R.S. (2005). Breast is best for babies. Journal of the National Medical Association, 97(7), 1010–1019. [PubMed: 16080672]

Lucas, A. & Cole, T. J. (1990). Breast milk and neonatal necrotising enterocolitis. Lancet, 336,1519–23.

Lucas A, Sarson DL, Blackburn AM, et al. (1980). Breast vs bottle: endocrine responses are different with formula feeding. Lancet, 1, 1267–1269.

Martin, C. R., Ling, P-R., & Blackburn, G. L. (2016). Review of infant feeding: Key features of breast milk and infant formula.Nutrients, (8), 279, 1-11. Doi:10.3390/nu8050279

McGuire, W. & Anthony, M.Y. (2003). Donor human milk versus formula for preventing necrotising enterocolitis in preterm infants: systematic review. Arch Dis Child Fetal Neonatal Ed., 88,F11–14.

Natland, S.T., Nilsen, T.I.L., Midthjell, K., et al. (2012). Lactation and cardiovascular risk factors in mothers in a population-based study: the HUNT-study. International Breastfeeding Journal, 7(8) F1-12. Natland et al. International Breastfeeding Journal 2012, 7:8

Newburg, D. S., & Walker, W. A. (2007). Protection of the neonate by the innate immune system of developing gut and of human milk. Pediatric Research, 61(1):2–8. [PubMed: 17211132]

Quigley, M. A., Kelly, Y. J., & Sacker, A. (2007). A. Breastfeeding and hospitalization for diarrheal and respiratory infection in the United Kingdom Millennium Cohort Study. Pediatrics, 119, e837–42.

Quigley, M. A., Kelly, Y.J., Sacker, A. (2007). Breastfeeding and hospitalization for diarrheal and respiratory infection in the United Kingdom Millennium Cohort Study. Pediatrics, 119, e837–e842.

Rolland-Cachera, M. F., Deheeger, M., Akrout, M., et al. (1995). Influence of macronutrients on adiposity development: a follow up study of nutrition and growth from 10 months to 8 years of age. Int J Obes Relat Metab Disord., 19, 573–8.

Savino, F., Bebetti, S., Lignori, S.A., (2013). Advances on human milk hormones and protection against obesity. Cell. Mol. Biol., 59, 89–98. [PubMed]

Schwarz, E.B., Ray, R.M., Stuebe, A.M., et al. (2009). Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol. 113(5), 974–82. [PubMed: 19384111]

Stuebe, A.M., & Rich-Edwards, .JW. (2009). The reset hypothesis: Lactation and maternal metabolism. American Journal of Perinatology, 26(1), 81–8. [PubMed: 19031350].

United States Breastfeeding Committee. Economic benefits of breastfeeding [issue paper]. Raleigh, NC: United States Breastfeeding Committee; 2002.

U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, Office of Nutritional Products, Labeling and Dietary Supplements. (2002). Health professionals letter on Enterobacter sakazakii infections associated with use of powdered (dry) infant formulas in

neonatal intensive care units 2002 Apr 11. Available at: http://www.  Accessed May 19, 2017.

World Health Organization. (2003). Global Strategy for Infant and Young Child Feeding. Geneva, Switzerland: WHO and UNICEF.

Wight, N.E. (2001). Donor human milk for preterm infants.  Journal of Perinatology, 21(4), 249-254.

Issue 1, January 2014

Developmental Illiteracy of Young Children’s Caregivers Is a Risk Factor for Child Outcome

High quality caregiving is essential to support developmental processes and build school readiness skills for every young child. Developmental literacy of caregivers is a major contributing factor supporting young children’s development in physical/neurobiological, motor, regulatory, somato-sensory,  social/emotional, relational, verbal and nonverbal communication, and cognitive domains.

Child abuse and neglect, and multiple placements in foster care are among the risk factors curtailing young children’s development.  Developmental illiteracy of caregivers of young children in the child welfare system places them at additional developmental risks and poor educational outcomes.

Continue reading

Archived Issue 7

Welcome to Baby Gazette

We are delighted to see the increased interest in subscription to our Baby Gazette. In the last four months, the subscription rate has increased four fold. We owe this increased interest mostly to our subscribers who find Baby Gazette a useful mean of communication among like minded colleagues, and take an active role in introducing it to their colleagues and friends who may find the information interesting and useful. Future success of Baby Gazette depends on its subscribers’ interest, subscriptions, active contribution through “Brief Article”; “News Brief”; notes on “For Your Information”; and “Your Corner”; and participation in spreading the word. Continue reading

Archived Issue 6

ZZ’s Corner

In this issue, the second segment of “IMPACTS OF SEPARATION FROM PRIMARY CAREGIVER (S) DUE TO SOCIAL AND POLITICAL TURMOIL DURING EARLY CHILDHOOD; UNIVERSALITY VS. CULTURAL RELATIVISM“, developmental domains will be reviewed from a variety of perspectives as impacted by trauma and violence caused by separation from the primary caregiver(s) due to war and geopolitical turmoil. To cover such a significant and wide-range of domains of human development and giving it the attention and scope it deserves, this segment will be covered within two consecutive issues – this and the next month. Continue reading

Archived Issue 5

ZZ’s Corner

Following last issue’s note, I received some encouraging feedbacks from my colleagues regarding the state of our young children in our world around us. The invisible and the silent ones – the youngest and most vulnerable among us around the world – the young children affected by wars and geopolitical conflicts who need our voice to be heard and our efforts to heal. Continue reading

Archived Issue 4

ZZ’s Corner

It has been a while that “we are the world” was sung by children from around the world, it has been ringing in my ears and caused a lump in my throat. Plights of thousands of children orphaned and displaced because of the natural force of an earthquake in Bam last year, the recent earthquake and Tsunami, and on going wars in the continent of Asia, ravaging AIDS and on-going conflicts and wars in the African continent are major reasons for this melancholy. Reports from responsible journalists, human rights and non-for-profit service provider agencies give us a scan view of the enormity of pain and suffering of these children. In the face of the pain and suffering of all these children my contributions individually, or as an active member in coordination with some international agencies is minute. Continue reading

Archived Issue 3

ZZ’s Corner

Wishing you all peace, and a very healthy, safe, joyous and fulfilling 2005.

There are transitional points in everyone’s life. Zero To Three (ZTT) Mid Career Harris Fellowship is one of those in my life. It came as close as it could to “coming home” for me. It brought me closer to a family of minds and mentors I admire, and colleagues and friends I trust. This Fellowship is a lifetime commitment on both sides, the fellow and the ZTT family, in efforts to improve the lives of young children and their caregivers around the world. ZTT 2003-2004 fellows graduated on December 4, 2004 joining the other pioneer ZTT Graduate Fellows. Continue reading

Archived Issue 2


In the last issue, in the “Meet the Future” section, I introduced the Multi-System, Multi-Cultural, Trans-Disciplinary Intervention Program: A Community Care And Relationship Enrichment Services Center (MulTICARE) For Families With Children Birth to Five Years of Age, by providing a Brief Description of the Proposed Project.

In this issue, I am providing you information on the role of Baby Gazette in this process as follows. Continue reading

Archived Issue 1

Welcome to Baby Gazette

Baby Gazette was born as a mean of communication between the members of my Advisory Committee and I, when I was directing the Infancy, Childhood And Relationship Enrichment (ICARE) Program at the Los Angeles County Department of Mental Health (LACDMH) from 1998 to 2003. Together, in a short amount of time, with unsubstantial sum of $ grants, hard work, high energy and dedication of many professionals, ICARE Program grew from zero ground to over 30 active programs, providing preventive oriented support and health related interventions for the at high risk children birth to five years of age and their families in their communities. Continue reading