Nutrition Committee of the Canadian Paediatric Society and the Committee on Nutrition of the American Academy of Pediatrics

Despite increasing evidence for the apparent s-upenionity of human milk, formula-feeding has progressively supplanted breast-feeding throughout much of the industrialized world, with the exception of the Soviet Union and Israel.’ The decline of breast-feeding in industrialized society began about 50 years ago, then spread to developing countries. This change in feeding patterns has had implications for infant morbidity and mortality and for the economy of those nations which can least afford to waste their resources.’ The need to intensify the promotion of a return to breast-feeding has been stated in several documents.2 A resolution adopted by the World Health Organization in May 1974 urged all member countries to undertake vigorous action,4 and an International Pediatric Association seminar on nutrition in 1975 placed special emphasis on education programs.3 For much of the population in developing countries, both economic and health considerations speak conclusively for breast-feeding.2’ The physiologic role of breast-feeding has received less emphasis in the industrialized world because of the low morbidity and mortality of bottle-fed infants, which has resulted from nutritional and technological advances in the formulation and manufacture of infant formulas7 as well as from the higher standards of housing, sanitation, and public health services in these countries. Howeven, newer information suggests that significant advantages still exist for the breast-fed infant, ‘#{176}“ including one study in which a lower morbidity was reported during the first year of life.’2 Therefore, it seemed timely to examine and evaluate present-day information, to provide up-to-date guidance for physicians in counseling mothers with regard to feeding their infants, to discuss factors related to the decline of breast-feeding in the United States and Canada, and to propose ways and means to encourage breast-feeding if the advantages of breast-feeding prove compelling. NUTRITIONAL AND PHYSIOLOGICAL PROPERTIES OF HUMAN MILK