Babies fully breastfed for six months are less likely to suffer from respiratory illnesses in their first two years than babies fully breastfed for only four months, according to research conducted by investigators at UC Davis Children’s Hospital, the University of Rochester and the American Academy of Pediatrics, Center for Child Health Research.

“We found that babies who received an additional two months of full breastfeeding were over four times less likely to contract pneumonia and half as likely to suffer recurrent ear infections,” said lead author Caroline Chantry, a pediatrician with UC Davis Children’s Hospital. Chantry and her colleagues found that the health benefits of the additional two months of full breastfeeding continued to protect babies from respiratory illnesses through their second birthdays.

“This finding adds to the mounting evidence that the longer a mother breastfeeds her infant, the greater the health benefits,” Chantry said.

Previous research by others has shown that exclusive breastfeeding for six months also provides greater protection against gastrointestinal infections, she added.

The current findings appear in the February 2006 issue of Pediatrics. They were first reported in 2002 at a joint meeting of the Pediatric Academic Societies and American Academy of Pediatrics in Baltimore, Md. Since then, those preliminary findings have been used to support the recommendation that women breastfeed exclusively for the first six months of their baby’s lives. The AAP first began making that recommendation in 1997.

As recently as 2005, however, the AAP Committee on Nutrition said more research was needed to support the position on breastfeeding. Chantry said she hopes the peer-reviewed publication of her research will finally settle the lingering controversy over the advice American women receive from their physicians and organizations like the AAP.

In the published study, Chantry and her colleagues conducted an analysis of a nationally representative, cross-sectional survey of 2,277 children between the ages of 6 and 24 months. They identified five groups - formula-fed only, full breastfeeding for less than one month, full breastfeeding from one to four months, full breastfeeding from four to less than six months and full breastfeeding for six months or more. Full breastfeeding allows for the use of formula on less than a daily basis.

The researchers then looked at the percent of children in each group who experienced pneumonia, wheezing and recurrent (three or more) colds or ear infections. The results showing the protective effects of the additional two months of breastfeeding held even when the data were adjusted for age, birth weight, ethnicity, poverty, two-parent household, parental education, family size, child care and passive smoke exposure.

Despite the proven benefits of breastfeeding, the reality for many women is that breastfeeding is difficult to maintain after going back to work. By law, employers only have to give women six weeks of maternity leave.

“It may become burdensome to pump regularly even if a woman has an accommodating employer,” Chantry said.

Chantry said research here and in other countries has shown that longer maternity leaves, pump-friendly workplaces and child care in the workplace all result in longer lengths of breastfeeding. In addition, employers who provide clean, comfortable places to pump and on-site child care save money due to decreases in absenteeism due to child illness, lower employee turnover due to dissatisfaction and lower direct health care costs.

While many women need support to continue breastfeeding when returning to work, others need help right from the start.

“Most women experience difficulties when they leave the hospital. These challenges often lead to premature weaning,” Chantry explained. Women need access to lactation consultants and others who can support their efforts to fully breastfeed their babies. Supporting women early on, she added, means healthier babies and children in the long run.