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‘Optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation?

Background: Promoting breastfeeding is an important public health intervention, with benefits for infants and mothers. Even modest increases in prevalence and duration may yield considerable economic savings. However, despite many initiatives, compliance with recommendations is poor in most settings...

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Main Authors: Fewtrell, Mary, Mohd Shukri, Nurul Husna, Wells, Jonathan C. K.
Format: Article
Language:English
Published: BMC 2020
Online Access:http://psasir.upm.edu.my/id/eprint/87561/1/ABSTRACT.pdf
http://psasir.upm.edu.my/id/eprint/87561/
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1473-8#:~:text=We%20argue%20that%20broader%20consideration,to%20improve%20initiation%20and%20maintenance.
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spelling my.upm.eprints.875612022-07-06T08:10:28Z http://psasir.upm.edu.my/id/eprint/87561/ ‘Optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation? Fewtrell, Mary Mohd Shukri, Nurul Husna Wells, Jonathan C. K. Background: Promoting breastfeeding is an important public health intervention, with benefits for infants and mothers. Even modest increases in prevalence and duration may yield considerable economic savings. However, despite many initiatives, compliance with recommendations is poor in most settings – particularly for exclusive breastfeeding. Mothers commonly consult health professionals for infant feeding and behavioural problems. Main body: We argue that broader consideration of lactation, incorporating evolutionary, comparative and anthropological aspects, could provide new insights into breastfeeding practices and problems, enhance research and ultimately help to develop novel approaches to improve initiation and maintenance. Our current focus on breastfeeding as a strategy to improve health outcomes must engage with the evolution of lactation as a flexible trait under selective pressure to maximise reproductive fitness. Poor understanding of the dynamic nature of breastfeeding may partly explain why some women are unwilling or unable to follow recommendations. Conclusions: We identify three key implications for health professionals, researchers and policymakers. Firstly, breastfeeding is an adaptive process during which, as in other mammals, variability allows adaptation to ecological circumstances and reflects mothers’ phenotypic variability. Since these factors vary within and between humans, the likelihood that a ‘one size fits all’ approach will be appropriate for all mother-infant dyads is counterintuitive; flexibility is expected. From an anthropological perspective, lactation is a period of tension between mother and offspring due to genetic ‘conflicts of interest’. This may underlie common breastfeeding ‘problems’ including perceived milk insufficiency and problematic infant crying. Understanding this – and adopting a more flexible, individualised approach – may allow a more creative approach to solving these problems. Incorporating evolutionary concepts may enhance research investigating mother–infant signalling during breastfeeding; where possible, studies should be experimental to allow identification of causal effects and mechanisms. Finally, the importance of learned behaviour, social and cultural aspects of primate (especially human) lactation may partly explain why, in cultures where breastfeeding has lost cultural primacy, promotion starting in pregnancy may be ineffective. In such settings, educating children and young adults may be important to raise awareness and provide learning opportunities that may be essential in our species, as in other primates. BMC 2020 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/87561/1/ABSTRACT.pdf Fewtrell, Mary and Mohd Shukri, Nurul Husna and Wells, Jonathan C. K. (2020) ‘Optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation? BMC Medicine, 18 (4). pp. 1-10. ISSN 1741-7015 https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1473-8#:~:text=We%20argue%20that%20broader%20consideration,to%20improve%20initiation%20and%20maintenance. 10.1186/s12916-019-1473-8
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
language English
description Background: Promoting breastfeeding is an important public health intervention, with benefits for infants and mothers. Even modest increases in prevalence and duration may yield considerable economic savings. However, despite many initiatives, compliance with recommendations is poor in most settings – particularly for exclusive breastfeeding. Mothers commonly consult health professionals for infant feeding and behavioural problems. Main body: We argue that broader consideration of lactation, incorporating evolutionary, comparative and anthropological aspects, could provide new insights into breastfeeding practices and problems, enhance research and ultimately help to develop novel approaches to improve initiation and maintenance. Our current focus on breastfeeding as a strategy to improve health outcomes must engage with the evolution of lactation as a flexible trait under selective pressure to maximise reproductive fitness. Poor understanding of the dynamic nature of breastfeeding may partly explain why some women are unwilling or unable to follow recommendations. Conclusions: We identify three key implications for health professionals, researchers and policymakers. Firstly, breastfeeding is an adaptive process during which, as in other mammals, variability allows adaptation to ecological circumstances and reflects mothers’ phenotypic variability. Since these factors vary within and between humans, the likelihood that a ‘one size fits all’ approach will be appropriate for all mother-infant dyads is counterintuitive; flexibility is expected. From an anthropological perspective, lactation is a period of tension between mother and offspring due to genetic ‘conflicts of interest’. This may underlie common breastfeeding ‘problems’ including perceived milk insufficiency and problematic infant crying. Understanding this – and adopting a more flexible, individualised approach – may allow a more creative approach to solving these problems. Incorporating evolutionary concepts may enhance research investigating mother–infant signalling during breastfeeding; where possible, studies should be experimental to allow identification of causal effects and mechanisms. Finally, the importance of learned behaviour, social and cultural aspects of primate (especially human) lactation may partly explain why, in cultures where breastfeeding has lost cultural primacy, promotion starting in pregnancy may be ineffective. In such settings, educating children and young adults may be important to raise awareness and provide learning opportunities that may be essential in our species, as in other primates.
format Article
author Fewtrell, Mary
Mohd Shukri, Nurul Husna
Wells, Jonathan C. K.
spellingShingle Fewtrell, Mary
Mohd Shukri, Nurul Husna
Wells, Jonathan C. K.
‘Optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation?
author_facet Fewtrell, Mary
Mohd Shukri, Nurul Husna
Wells, Jonathan C. K.
author_sort Fewtrell, Mary
title ‘Optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation?
title_short ‘Optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation?
title_full ‘Optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation?
title_fullStr ‘Optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation?
title_full_unstemmed ‘Optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation?
title_sort ‘optimising’ breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation?
publisher BMC
publishDate 2020
url http://psasir.upm.edu.my/id/eprint/87561/1/ABSTRACT.pdf
http://psasir.upm.edu.my/id/eprint/87561/
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1473-8#:~:text=We%20argue%20that%20broader%20consideration,to%20improve%20initiation%20and%20maintenance.
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score 13.211869

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