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Breastfeeding for 2 years in the Noble Quran.  Science had confirmed Islam's Divine Claims:

The sections of this article are:

1-  The Noble Quran's Divine Claims.
2-  The Western Scientific facts and proofs about the importance of breast feeding.
3-  Shorter periods of breastfeeding can and did cause malnutrition to infants.
4-  The importance of the Noble Quranic 2-year breastfeeding period using Western scientific proofs.
5-  Conclusion.

1-  The Noble Quran's Divine Claims:

Breast feeding by the mother to her new born infant is greatly beneficial as science had proven, and it is mandatory in the Noble Quran.  Allah Almighty Commanded the mother to breast feed her child for two full years:

"The mothers shall give such to their offspring for two whole years, if the father desires to complete the term. But he shall bear the cost of their food and clothing on equitable terms. No soul shall have a burden laid on it greater than it can bear. No mother shall be Treated unfairly on account of her child. Nor father on account of his child, an heir shall be chargeable in the same way. If they both decide on weaning, by mutual consent, and after due consultation, there is no blame on them. If ye decide on a foster-mother for your offspring, there is no blame on you, provided ye pay (the mother) what ye offered, on equitable terms. But fear God and know that God sees well what ye do.  (The Noble Quran, 2:233)"

In another article on this site, we've seen how Allah Almighty described the blood circulation and the production of milk in the breast.  Please visit:  The blood circulation and the production of milk in the Breast: In the Noble Quran and Science.

Let us now see why Allah Almighty Commanded mothers to breast feed their children for two full years (if possible):

2-  The Western Scientific facts and proofs about the importance of breastfeeding:

The following information was taken from www.BreastFeedingBasics.org:

1-  The advantages of breastfeeding for the baby:

(a)   Nutritional Advantages:

Human breast milk is uniquely composed to meet the needs of human infants:

1. It has a high concentration of lactose (milk sugar). This is an excellent source of carbohydrates.
2. The proteins (largely whey proteins) are much more easily digested than the proteins in formula based on cow's milk (Lawrence, 1999 pgs. 115-124).
3. Infants fed human milk tend to have stools that are less foul smelling and softer than those of infants who are fed cow's milk or soymilk based formula. This is due to the different bacteria in the gastrointestinal tract of infants who are solely breast fed. Constipation, defined as hard stools (not the absence of a daily stool), does not occur in healthy breast fed infants.

   
   The stool of a healthy breastfed baby
   (picture courtesy of Wellstart International)

4. The composition of the milk of mothers who are breastfeeding varies during the time of the day and during the feeding. The hind milk (latter part of a breastfeeding) has a much higher fat content than milk produced during the beginning portion of the feeding. (Lawrence, 1999 pgs. 96-97).
5. The odor and/or taste of breast milk may change depending on the mother's diet. This may help infants get used to different tastes (Mennella, 1991 ).
6. More information on nutritional factors in breast milk is found in the section on Mature Milk Components.

(b)   Immunologic advantages:

Breastfeeding delivers immunologic advantages to the baby

It was noted in the early 1970's that infants in the developing world who were fed formula had a much higher death rate than infants who were fed breast milk. This was due to malnutrition and recurrent infectious diseases.

In the mid 1990's, exclusive breastfeeding was associated with decreased death rates due to acute respiratory infections and diarrhea in infants aged 1 to 11 months in Bangladesh when compared to infants who were partially breastfed (breastfed with the addition of other milks, and/or supplementary foods) (Arifeen, 2001 ).

The causes for this were:

1. Bacterial contamination of the water used to make formula.
2. Bacterial contamination of the infant feeding bottles.
3. Decrease in nutrition due to recurrent episodes of infectious gastroenteritis caused by bacterial contamination of the formula.
   In Bangladesh, breastfeeding has been found to be protective against Shigella into the third year of life (Ahmed, 1992 ). Breastfeeding was also found to be protective against Enterotoxigenic E. Coli in the first year of life (Clemens, 1997 ).
   In Mexico, breastfeeding was associated with decreased incidence of Giardia infection (Morrow, 1992 ).
4. If money is lacking, the formula is watered down so that it lasts longer, and this obviously decreases nutrition (Jelliffe, 1978 pgs 211-241, Habicht, 1988 ). Presently, a day's supply of infant formula costs about $2.50 in the United States. The cost is very similar in the developing world where family income may be $100 - $200 a month.

The mother of this malnourished 11 month old died in a refugee camp when he was 3 months old and weighed 3.4 Kg. He was then fed a mixture of two large spoons of sweetened condensed milk in 8 ounces of water for 8 months. He weighed 3.8 Kg. when hospitalized.

Anti-infective properties that are found in breast milk include the following:

1. Immunoglobulins IgA, IgM, IgG
2. Complement
3. Chemotactic factors
4. Lactoferrin
5. Lysozyme
6. Lactoperoxidase
7. Lactobacillis Bifidus growth factor
8. Cytokines
9. Macrophages
10. T and B cell lymphocytes
11. Plasma cells and neutrophils
12. Interleukins

This list is growing as more substances are discovered. Further information on these substances can be found in the following references: Lawrence, 1999 p. 159-195, Welsh, 1979 , Slusser, 1997 .

Some studies on the health of breast fed babies in the developed world, where sanitation is good and where money is available to buy formula, did not show that breast milk was effective in preventing infection in infants (Rubin,1990 , Bauchner, 1986 ). Of the studies published since 1990 only Rubin's did not show an effect of breastfeeding on infection rates in infants.

Studies that have found a decreased incidence of infectious diseases in breast fed versus formula fed infants in middle class societies in the developed world are summarized below.

1. Breastfeeding and otitis media:
   1. Duncan studied a middle class Tucson, Arizona population, and found that exclusive breastfeeding for four months delayed the first episode of otitis media and decreased recurrent otitis media (Duncan, 1993 ).
   2. In Finland, the incidence of recurrent otitis media was inversely correlated with the duration of breastfeeding (Saarinen, 1982 ).
   3. Infants with cleft palate who were fed their mother's milk from a bottle had less otitis media than infants who were fed formula (Paradise, 1994 ).
   4. Duffy found that peak incidence of acute otitis media was inversely related to rates of breastfeeding beyond 3 months. Approximately 50% of infants exclusively breast fed for 6 months had a first episode of otitis media by 12 months of age, compared to 76% of exclusively formula fed infants (Duffy, 1997 ).
2. Breastfeeding and wheezing:
   1. In Tucson, infants who were breast fed for a month had a decreased incidence of wheezing associated illness in the first year of life (Wright, 1995 ).
   2. Studies from Britain showed that infants who were breast fed had fewer hospital admissions for bronchiolitis (Pullan, 1980 , Downham, 1976 ).
   3. A case control study in a population of Alaska native children found that having ever been breastfed more than half of feedings or having been breastfed within 8 weeks of age at admission for RSV infection was protective against hospitalization for RSV infection (Bulkow, 2002 ).
   4. Fischaut showed that a mother who developed respiratory syncytial virus infection (RSV) while she was breast feeding her infant produced increased RSV specific antibodies in her breast milk (Fishhaut, 1981 ).
   5. Preliminary work on an experimental RSV vaccine that was given to women in the immediate post partum period produced high levels of RSV specific antibody in the women and in their breast milk for at least 12 weeks after immunization (Englund, 1998 ). The effect of this on prevention of RSV disease needs more study.
3. Breastfeeding and gastroenteritis:
   1. Dewey found decreased incidence of diarrheal illness in breast fed infants in the first year of life controlling for day care use and the number of siblings (Dewey, 1995 ).
   2. A large randomized controlled trial in the Republic of Belarus provided breastfeeding support to mothers that resulted in a longer duration of breastfeeding when compared to a control group. Infants in the intervention group had a significant reduction in the risk for one or more episodes of gastrointestinal infections (Kramer, 2001 ).
   3. An intervention that resulted in increased breastfeeding rates on the Navajo reservation was associated with a decline in the percentage of children having pneumonia and gastroenteritis of 32% and 15% respectively (Wright, 1998 ).
4. Breastfeeding and premature infants:
   1. Premature infants fed their mother's milk were found to have decreased incidences of sepsis, meningitis, and necrotizing enterocolitis compared to infants fed premature formula. These infants were also discharged 2 weeks earlier than the formula fed infants (Schanler, 1995 , Hylander, 1998 ).

(c)  Prevention of Allergies & Asthma:

Businco evaluated the prophylactic effect of exclusive breastfeeding until 6 months of age on the development of atopic disease in 101 newborns with a strong family history of allergic disease. This study further confirmed that prolonged breastfeeding or breastfeeding supplemented with soy milk decreased the incidence of atopic disease by 2 years of age (Businco, 1983 ).

A Finnish study showed a significant decrease in substantial atopic disease at age 17 years for children breastfed for more than 6 months compared to not breastfed or breastfed for less than one month (Saarinen, 1995 ).

Some mothers with a strong family history of allergy, may need to eliminate some allergy causing foods from their diet while breastfeeding (Businco, 1983 and Sigurs, 1992 ).

Breastfeeding is not a guarantee that a child will not have allergies, but should reduce the risk of allergic disease.

Exclusive breastfeeding up to 4 months of age was associated with a reduced risk of asthma diagnosed by a physician (with an odds ratio of 1.25); a reduced risk of wheezing at 5 years of age (OR: 1.31); and a reduced risk of sleep disturbance due to wheezing at 5 years of age (OR: 1.42) (Oddy, 1999 ).

A meta-analysis of the association of breastfeeding and asthma in 12 prospective studies that met inclusion criteria found a summary odds ratio of 0.7 (95% CI 0.6, 0.81) for the protective effect of breastfeeding. These studies all evaluated exclusive breastfeeding for at least 3 months (Gdalevich, 2001 ).

(d)   Bonding and Psychosocial effects:

Bonding is the emotional tie from parent to infant (Kennell, 1998 ). It begins during pregnancy and increases with birth. This attachment enables parents to make sacrifices for their infant.

Many women maintain that their breastfeeding experience was a very special time during their life and they valued this closeness to their infant.

If a woman is unable to breastfeed her infant she needs to be reassured that she will still be able to bond with her infant.

A recent small study in Boston evaluated the behavioral effects of a heel prick procedure (for drawing newborn genetic screening) when mothers were breastfeeding their infants compared to a control group of infants who were swaddled in a bassinet. All infants in the experimental group were latched onto their mother's breast lying skin to skin before the heel prick. Video monitoring of both groups revealed the the infants breastfed during the procedure had crying and grimacing reduced by 91% and 84% respectively compared to the infants who underwent the procedure in their bassinet. Breastfeeding also prevented the tachycardia associated with the procedure in the control group. (Gray, 2002 ).

(e)  Intellectual development:

Since 1929, many studies have looked at the effect of breastfeeding on the cognitive development of children. Most of these studies have shown a statistically significant increase in developmental test scores of 2% to 5% for breastfed children when compared against formula fed children.

This topic is discussed in detail in the Growth and Development module.

(f)  Other Advantages:

A number of studies show "a possible protective effect of human milk feeding" agents upon:

1. Sudden infant death syndrome
2. Diabetes mellitus
3. Crohn's disease and ulcerative colitis
4. Lymphoma
5. Celiac Disease
6. Elevated Cholesterol level in adults

AAP Breastfeeding, 1997 , Lawrence, 1997

Recent work on populations which are susceptable to non-insulin dependent diabetes shows that breastfeeding is associated with a lower risk of later non-insulin dependent diabetes. Data from the Pima Indians in the United States found that exclusive breastfeeding for greater than 2 months was protective against the development of non-insulin dependent diabetes with an odds ratio of 0.41. In Native Americans in Canada, breastfeeding for longer than 12 months was protective for the later development of non-insulin dependent diabetes with an odds ratios of 0.24 (Pettitt, 1997 , Young, 2002 ).

Work in Finland studying infants at risk for insulin dependent diabetes showed that these infants who had been breastfed exclusively for at least 4 months had a lower risk of developing islet cell antibodies in the first 4 years of life. Islet cell antibodies are precursors of insulin dependent diabetes. In both these cases, the protective effect of breastfeeding may be due to decreased exposure to cows milk proteins early in life (Kimpimaki, 2001 ).

Celiac disease is associated with genetic susceptibility and environmental exposure to gluten. Breastfeeding may also delay early exposure to gluten and delay onset of this disease (Davis, 2001 ).

Review of the literature on the effect of breastfeeding on cholesterol levels in children and adults reveals the following: breastfeeding is associated with increased average cholesterol and low density lipoprotein levels in infancy, no effect during childhood and adolescence, but lower average levels of these 2 substances in adults. Breastfeeding may have long-term benefits for cardiovascular health. This may be due to the early exposure of breastfed infants to cholesterol in human milk (Owen, 2002 ).

2-  The advantages of breastfeeding for the mother:

(a)  Economics:

In all countries of the world it is cheaper to breast feed a baby than to feed the baby formula. In the United States, one day's supply of a cow's milk based formula costs approximately $2.50. Women who are breastfeeding need about 500 extra kilocalories per day in their diet. This can be supplied by a peanut butter sandwich and 8 oz. of milk. In the developing world, actual formula costs are comparable to those in the United States, but the family's income may be only the equivalent of $200 US per month. Formula for one infant could thus require around 40% of the family income.

In a study from Scotland and the United States, infants who were exclusively breastfed for the first three months of life are estimated to save $330 to $475 in health care costs during the first year of life (Ball, 1999 ).

(b)  Uterine involution:

Breastfeeding causes the release of prolactin and oxytocin. Oxytocin is a hormone that causes uterine contractions. The release of oxytocin while breastfeeding speeds uterine involution. This may also cause cramps while breastfeeding in the postpartum period.

(c)  Bonding and psychosocial effects:

Please refer to the Bonding and Psychosocial Effects section in the Advantages of Breastfeeding for the Baby for an introduction to this topic.

(d)  Child spacing (Case Study 1):

See link for questionnaire:  http://www.breastfeedingbasics.org/cgi-bin/deliver.cgi/content/Introduction/adm_spacing.html

(e)  The Lactational Amenorrhea Method (LAM):

Breastfeeding has been found to delay the return of the menses after childbirth. This is not a reliable method of birth control but it may increase the time between pregnancies.

The Lactational Amenorrhea Method (LAM) consists of:

1. Sole breastfeeding in the first six months of an infant's life.
2. No interval between feedings of more than five hours.
3. No supplementation for the infant.

Return of menses and pregnancy are very unlikely if all 3 parameters of LAM are present (Perez, 1992 ).

Once the infant is older than six months of age, is taking supplemental foods or is sleeping for more than five hours the effect of breastfeeding as a form of birth control is not consistent.

Women who do not want to become pregnant and are breastfeeding even in the first months postpartum should use another form of birth control.

(f)  Prevention of breast cancer (premenopausal):

Studies have shown that women who breast feed have a decreased incidence of premenopausal breast cancer (Newcombe, 1994 ).

1. The relative risk for premenopausal breast cancer in women who have breast fed is .78 (95% confidence interval .66 - .91).
2. With an increasing cumulative duration of breastfeeding there was a decreasing risk of breast cancer among premenopausal women (p < 0.001, for trend).
3. A younger age at first breastfeeding was associated with a decreased risk of breast cancer in premenopausal women (Newcombe, 1994 ).

A meta-analysis of 47 epidemiological studies comparing women with breast cancer with controls found that the longer women breast feed the more they are protected against breast cancer. The relative risk of breast cancer decreased by 4.3% for every 12 months of breastfeeding in addition to a decrease of 7.0% for each birth. This decrease did not vary with menopausal status, age, living in developed vs developing country or other characteristics studied. (Beral, 2002 ).

(g)  Postpartum weight loss (Case Study 2):

During pregnancy most women are advised to gain 25 to 30 pounds. This breaks down as follows:

1. The baby will weigh approximately 7 to 8 pounds.
2. Increased uterine blood vessels and amniotic fluid weigh approximately 3-6 pounds.
3. At least 10 pounds of the weight gain are fat stores that are laid down to enable a woman to breastfeed.

Women who choose not to breastfeed will have to diet to lose those ten pounds.

The 10 pounds of stored fat allow a breastfeeding woman to continue to nurse her baby, eat an extra 500 kilocalories a day, and still slowly lose weight over the first six months of breastfeeding.

Obese women who limited their caloric intake to approximately 500 Kcal per day less than their daily normal intake plus lactation needs and exercised 4 days per week averaged a 4.8 Kg. weight loss over 10 weeks of a study. Their infants grew similarly to the infants of a control group of similarly obese women who lost an average of 0.8 Kg. (Lovelady, 2000 ).

Case Study 2, part A

A mother brings her 2 month old infant in for his routine check-up. He has been growing well on only breast milk, however she plans to wean the baby because she is having "dizzy spells," especially after the first nursing in the morning.

See link for Questionnaire: http://www.breastfeedingbasics.org/cgi-bin/deliver.cgi/content/Introduction/adm_weightloss.html

3-  Shorter periods of breast feeding can and did cause malnutrition to infants:

This is true especially in many of the under-developed countries.  The following article was taken from: http://www.chennaionline.com/health/kids/malnutrition.asp:

Shorter periods of breast-feeding causing malnutrition in India 

Shorter periods of breast-feeding leads to malnutrition at an early age among children living in Indian slums, according to the results of a study conducted in Pune, a rapidly growing city in India.

'Slum populations living in adverse conditions represent nutritionally vulnerable groups that need immediate attention,' Dr. Shobha Rao and colleagues write in the October issue of Indian Pediatrics.

Over a 2-year period, Rao and her team, from the Agharkar Research Institute, Pune, studied changes in diet and illness in 845 preschool children in three Pune slums.

The average duration of exclusive breast-feeding was 3.5 months, a significantly shorter period than in rural areas, the investigators found.

The weights and heights of the slum children were satisfactory only up to the age of 4 months, and fell significantly below the standard levels by 6 months of age. During infancy, 22% of children were underweight and by 5 years of age more than 40% were underweight. Children were most likely to be malnourished at around 18 months of age.

Rao's group suggests that undernutrition after 4 months of age is probably attributable to the short duration of exclusive breast-feeding and lack of appropriate supplementary weaning foods.

The researchers also observed that rates of illness were higher in the youngest and least well-nourished children.

Also, lack of proper nutrient intake stunted the growth of the children, causing them to only reach heights 10 centimeters lower than standard values by 5 years of age, Rao and colleagues note. 'This highlights the importance of early life undernutrition, which may be responsible for shorter adult size in poor communities of India,' the team writes.

4-  The importance of the Noble Quranic 2-year breastfeeding period using Western scientific proofs:

Please pay close attention to the dark green bolded and underlined quotes below.

From http://www.region.peel.on.ca/health/commhlth/breastfeed/2004week.htm:

World Breastfeeding Week 2004
Breastfeeding:  The Gold Standard

Learn more about Breastfeeding so you can answer the quiz questions!
Or go directly to the quiz. >>

October 1 to 7 marks the 13th annual celebration of World Breastfeeding Week in Canada. This week is the 40th week of the year to recognize the 40th week of pregnancy and a time when breastfeeding is started.

This week celebrates the importance of breastfeeding. It is a yearly event initiated by the World Alliance for Breastfeeding Action (WABA). In Canada, World Breastfeeding Week has events all over the country to promote and honour breastfeeding and its contribution to child and mother’s health.  This year’s theme is:

Exclusive Breastfeeding: The Gold Standard - Safe, Sound, Sustainable

This theme recognizes that exclusive breastfeeding for the first six months with continued breastfeeding to two years and beyond provides the best possible nutrition that babies need to grow and develop.

World Breastfeeding Week is symbolized by a GOLDEN BOW.  This bow signifies that breastfeeding is the “Gold Standard” and that it is the ideal exclusive and continued food for babies. One loop of the bow represents the mother and the other represents the child. The knot symbolizes the father, family and society which support them. One of the ends is for timely complementary food after 6 months, the other is for the spacing of children.  The Golden Bow is a joint outreach initiative of UNICEF and WABA. Wear one proudly and tell others of its many meanings.

A series of messages about breastfeeding will be posted throughout Breastfeeding Week.   This will be followed by a quiz to test your breastfeeding knowledge. 

Breastmilk is all a baby needs!

Breast milk has all the water a baby needs. Exclusive breastfeeding prevents diarrhea that can lead to dehydration. A baby’s stomach is small and filling it with water/juice leaves no room for nutritious breast milk.  Breastmilk is all that is needed for baby’s rapid growth and development.

Breasts are never completely empty. They are continuously making milk, even while the child is feeding.

The best way to feed your child is:

0 - 6 months: breastmilk only

6 months - 2 years and beyond:
           - continue to feed breastmilk
           - gradually add other nutritious foods

Research shows this to be true. The World Health Organization has made a formal, global, public health recommendation that this is the optimal way to feed a child.

Breastfeeding: What is normal?

According to BFHI  (Baby Friendly Hospital Initiative) mothers should initiate breastfeeding within a half hour of birth.  Early and frequent breastfeeding is the best way to build a good milk supply.

Mothers should practise demand feeding or baby-led feeding, feeding frequently and for as long as baby wants at each feeding. 

Frequency and duration of feedings:

• Babys' stomachs are small at birth so they need to eat often.
• Expect a minimum of 8-12 feedings in a 24 hour period.
• Each baby will develop its own pattern of eating and sleeping. 
• The mother will be comfortable and have lots of milk if baby attaches and suckles well.
• Ask your health professional how to tell if your baby is getting enough breastmilk.

Benefits of breastfeeding!

Breastfeeding provides protective factors which may help reduce infections, such as diarrhea and ear infections. Breastfeeding may reduce the risk of allergic conditions, including asthma.

Breasts will provide milk in adequate quantity and quality as long as milk is removed from the breast.

Breastfeeding is ideal for travel.  It is always available and at the right temperature.

Breastfeeding avoids the dangers of artificial milk such as: unsafe water, improper storage, etc.

Eating tips for breastfeeding mothers!

For generations all over the world, mothers with all varieties of diet have been breastfeeding.  A mother's milk continues to contain adequate amounts of nutrients even if her diet is less than ideal. Her milk is still best for baby. However, the mother will feel the effects of eating poorly; her resistance to disease may go down, she may have less energy, and she may feel less able to cope. For her own sake, it is wise for her to eat a healthy diet.

Most mothers can eat any food they like without it causing any problem for their babies. Even so, many mothers restrict their diets unnecessarily because they have been told they should avoid cabbage, chocolates, spicy foods, peas, onions and cauliflower because these foods are thought to cause their babies colic, gas, diarrhea, and rashes with breastfeeding.

A mothers varied diet may be an advantage to her breastfeeding baby because it alters the flavour of her milk, providing baby with a variety of tastes which prepares baby for the solid foods baby will receive at the family table after 6 months of age.

Breastfeeding mothers who eat whenever they feel hungry tend to lose weight gradually. On average, breastfeeding women who eat when hungry lose weight at the rate of 0.6 to 0.8kg (1.3 to 1.6 pounds) per month in the first 4-6 months of breastfeeding.

Extra pounds are added during pregnancy to store energy for producing milk; breastfeeding makes it easier to shed these extra pounds. It is important to lose weight slowly. During the first two months postpartum the mother's body needs to recover from childbirth and establish a good milk supply.  Dieting is not recommended during this period.

From http://beehive.thisisgrimsby.co.uk/default.asp?WCI=SiteHome&ID=3542&PageID=17048: