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It is a well-known fact Mississippians struggle with all manner of health problems. New and long-standing efforts at the University of Mississippi Medical Center are going back to the basics and confronting the problems with one of the best weapons we have - breast milk.
"The whole newborn division is trying to promote, educate and support mothers to initiate breast feeding and continue at least up to six months," said Dr. Norma Ojeda, associate professor in neonatology. "If they can reach up to 12 months, even better."
Ojeda's latest research adds to the mounting medical evidence that the best thing for a baby is mother's milk.
In a state with the highest rate of low birth weight and premature babies, the benefits of breastfeeding are crucial to a newborn's future development, said Ojeda. She has been looking at events that occur before and after birth that impact a child's long-term development.
"My focus was to study all the mechanisms associated with low birth weight and premature babies and all the morbidities and mortalities associated with these newborns," said Ojeda. "What are the outcomes of low birth weight on the child's later health, nutritional health or even behavioral health?"
Ojeda began with an experimental model where she induced low birth weights in newborn rats by reducing the blood flow to the animal fetuses, effectively limiting the nutrients they received in the womb and ensuring they were born smaller. "This is mimicking what happens with women who have preeclampsia or high blood pressure during pregnancy who then deliver smaller babies," explained Ojeda.
What she found read like a list of the state's most pressing health issues.
"Those newborn rats were more prone to develop hypertension," she said. "They had some vascular dysfunction and their blood vessels didn't work properly. Additionally, they were more prone to become obese and have more fat deposits in the abdominal area."
Ojeda then turned her attention to finding a way to help human newborns - especially those with low birth weights - get a better start. She turned to the best source of nutrition for a baby - breast milk.
"It's easier. It's cheaper. And it's the best nutrients for babies," said Ojeda. "Studies show that with full-term pregnancies, the breast milk is richer in nutrients, but I wanted to check that in our population."
Ojeda looked at a protein called leptin in both African-American and Caucasian women's breast milk. She said research already exists that shows differences in milk composition among women of different races.
She found that mothers who delivered premature babies had lower levels of leptin in their milk. This is important because premature babies are already at risk for health problems and leptin can have positive effects on a baby's development.
"This leptin is a protein that will impact the intestinal tract of the baby," she said. "It will act as a growth hormone and induce maturation of the gastrointestinal tract, so it will make the baby more able to digest food.
"Also leptin increases the neuro-development of the baby. Also it can influence how smart they will be later on. There are studies that show children who were breastfed have better academic achievement 10 years later compared to those children who were not."
The positive impacts of the protein further highlight the advantages full-term babies who nurse receive later in life. For premature babies, the milk still has a positive impact, but more must be done to ensure they are receiving leptin-rich breast milk in order to reap the full benefits of breastfeeding.
Moreover, human milk contains friendly microorganisms called "microbiomes" that will colonize the newborn's digestive system, affecting how food will be processed during digestion, said Ojeda.
"It has been shown that children who receive those types of microbiomes develop a healthier gastrointestinal system for absorption and that they also affect how they manage food, so they will absorb just what the body needs and eliminate what the body doesn't need so they won't store extra fat in their bodies," she said.
Comparing two people of the same gender and age, Ojeda said one might be able to eat a donut and gain a pound, while the other could eat the same donut and lose weight. "Why is it that this happens?" she asked. "It could be the effect of this microbiome that a newborn would get when nursing."
Even if the full list of long-term positive effects of breast milk hasn't been written just yet, Ojeda said research already shows babies who are breastfed are less likely to get sick, have lower levels of stress and are less prone to develop hyperactive and attention deficit disorders in childhood.
Getting that message out is the job of certified lactation consultants, who support breastfeeding moms and promote the benefits of breastfeeding. Cheryl Lloyd, a registered nurse and board-certified lactation consultant at UMMC's Wiser Hospital for Women and Infants, said Mississippi has a way to go
to catch up with the national average on mothers who breastfeed.
The Centers for Disease Control 2014 Breastfeeding Report Card listed Mississippi in the bottom five states for mothers who breastfeed exclusively at three months (28.8 percent) and at six months (10.1 percent).
The state is in last place in the nation when it comes to mother's who continue breastfeeding with other food until 12 months (10 percent), the recommendation for maximizing the benefits of breast milk for the child.
Simply informing mothers about the benefits of breastfeeding may help turn around the state's ranking.
"One of the biggest sellers for breastfeeding is that it helps moms lose weight," said Lloyd. "When you ask a lot of moms what really made them decide, they'll tell you they felt they could lose their baby weight because of the breastfeeding."
When it comes to the benefits for the baby, Lloyd said she always starts from the head and works down.
"We know that breastfed babies have fewer ear infections. We know there are special fats in breast milk that help with retinal development and help with brain development. We know they have less allergies, less asthma, less respiratory problems.
"Then we're down to the stomach," she said. "Breastfed babies have less gastrointestinal problems, easier digestion. It's very seldom that a baby who is breastfeeding gets constipated, because the milk is so easy to digest. We do know that when a baby is exclusively breastfed, even just the first few days of life, the colostrum that the first milk mom has coats the intestinal tract and sets that baby's tract up to be different and healthier for the rest of that baby's life."
There are also benefits for the mother who breastfeeds, said Lloyd, including some protection against breast, ovarian and uterine cancer before menopause. Post-menopause, these mothers have fewer hip fractures because breastfeeding gives the woman a better bone density and mass, a preventive measure against osteoporosis.
While the act can prove frustrating, lactation specialists like Lloyd educate mothers on how to successfully breastfeed.
"Breastfeeding is the first step toward affordable health care," said Lloyd. "If a baby is started off with breastfeeding, they have less risk of obesity. We know they can have lower risk of high blood pressure later in life. There's less risk of diabetes - Type I and Type II.
"It's a tumble down effect. It's one of those things that people don't understand - this base layer, if you can just get a baby breastfeeding well, you are making a huge impact on their lifetime.
"That's where we need to start," Lloyd said. "If we can convince moms to at least give it a try, then we are at least two steps forward."
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