title: [Breastfeeding: health, prevention, and environment].
abstract: Recently, a great deal of research in the field of neuroscience and human microbiome indicates the primal period (from preconceptional up to the early years of a child's life) as crucial to the future of the individual, opening new scenarios for the understanding of the processes underlying the human health. In recent decades, the social representation of infant feeding moved in fact from the normality of breastfeeding to the normal use of artificial formulas and bottle-feeding. Even the scientific thinking and the research production have been influenced by this phenomenon. In fact, a clear dominance of studies aimed to show the benefits of breast milk compared to formula milk rather than the risks of the latter compared to the biological norm of breastfeeding. Mother milk affects infant health also through his/her microbiome. Microbial colonisation startes during intrauterine life and continues through the vaginal canal at birth, during skin to skin contact immediately after birth, with colostrum and breastfeeding. The microbial exposure of infants delivered by the mother influences the development of the child microbiota, by programming his/her future health. However, rewriting the biological normality implies also a health professional paradigm shift such as departing from the systematic separation mother-child at birth, sticking at fixed schedules for breastfeeding time and duration, as it still happens in many birth centres. Breastfeeding has economic implications and the increase of its prevalence is associated with significant reduction of avoidable hospital admissions and medical care costs, both for the child and for the mother. Success in breastfeeding is the result of complex social interactions and not simply of an individual choice. However, any successful strategy must be oriented to the mother empowerment. Therefore, health professionals and community stakeholders have to learn and practice the health promotion approach, particularly avoiding prescribing appropriate breastfeeding behaviours to the mothers, but emphasizing her needs and preferences and her values system.
authors.affiliation: Centro nazionale di epidemiologia, sorveglianza e promozione della salute, Istituto superiore di sanità, Roma. angela.giusti@iss.it.
authors.forename: Angela
authors.initials: A
authors.lastname: Giusti
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D017408:Guidelines as Topic; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012931:Social Environment