DRAFT Australian Dietary Guidelines - Eat For Health

5.1 Setting the scene
The World Health Organization states that “breastfeeding is an unequalled way of providing ideal
food for the healthy growth and development of infants”. Breastmilk is a living tissue that includes
many unique compounds. 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 WHO’s International Code of Marketing of Breast-milk
Substitutes [860], the stated aim of which was to protect and promote breastfeeding. The
importance of breastfeeding led to its inclusion in the Australian Dietary Guidelines endorsed by the
NHMRC in 1983 [568].
In Australia, part of the WHO code is implemented by the Marketing in Australia of Infant Formulas
(MAIF) Agreement, a voluntary agreement by infant formula manufacturers and importers. The
Infant Feeding Guidelines for Health Workers [133] provide more information on the WHO code,
the MAIF Agreement and the obligations of all health workers. They also provide
recommendations on the appropriate foods for infants from birth to about two years of age,
including detailed information on the benefits of breastfeeding for the infant and mother.
Breastmilk 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 their newborn infant. Colostrum contains higher levels of protein, vitamin
A and vitamin B 12 and less fat than breastmilk. 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 [483, 861, 862]. Colostrum feeding is
important for the infant and also stimulates the mother’s breastmilk production. 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 kJ per 100 mL, largely due to
variation in the fat content [863, 864]. Fat content typically increases through each breastfeed. It
provides much of the energy and omega-3 and omega-6 long-chain polyunsaturated fatty acids, plus
the fat-soluble vitamins A, D, E and K, as well as prostaglandins. The fat in breastmilk is typically
better absorbed by an infant’s gastrointestinal tract than the fat in cow’s milk. Mature milk
continues to provide immune factors and enzymes to the infant [36, 865].
Breastmilk provides all the vitamins, major minerals and trace elements known to be essential for
healthy full-term infants for around the first six months [731, 866]. These are more bioavailable
DRAFT Australian Dietary Guidelines- December 2011 133