Breastfeeding in the first hour of life protects against neonatal mortality.

More than four million babies die in the neonatal period every year, and most of these deaths occur in poorer countries. The longer the delay in breastfeeding initiation, the greater the chances of neonatal mortality caused by infections. Breastfeeding within the first hour of life has been shown to reduce high neonatal mortality by 22%. During this sensitive period, the protective effect of breastfeeding delivered by colostrum may be related to a range of mechanisms that include intestinal colonization by specific bacteria found in maternal milk, and the ability of breast milk to produce bioactive immune factors suitable for the newborn. The Baby-Friendly Initiative (BFI) of the World Health Organization (WHO) recommends placing babies in skin-to-skin contact with their mothers immediately after birth for at least one hour and helping mothers to recognize when their babies are ready to breastfeed. This aid to mothers in the initiation of breastfeeding corresponds to the step four of the BFI (Table 1). In this edition of the Jornal de Pediatria, Boccolini et al. report on an ecological study using data from 67 countries obtained from the Demographic and Health Surveys (DHS) up to 2008 to assess the correlation between breastfeeding in the first hour of life and rates of neonatal mortality.