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JCHR 2024, 13(1): 237-242 |
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Yavari M R, Salmani M J, Barzegar K, Salmani M H. A Review of the Breastfeeding Importance from the Perspective of the Holy Quran and Medical Literature. JCHR 2024; 13 (1) :237-242
URL: http://jhr.ssu.ac.ir/article-1-1078-en.html
URL: http://jhr.ssu.ac.ir/article-1-1078-en.html
1- Department of Islamic Sciences, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Department of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
3- Department of English Language, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
4- Food Safety and Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,mhsn06@yahoo.com
2- Department of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
3- Department of English Language, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
4- Food Safety and Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,
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References
1. Shamir R. The benefits of breast feeding. Protein in neonatal and infant nutrition: recent updates. 2016; 86: 67-76.
2. Mehrpisheh S, Memarian A, Ameri M, et al. The importance of breastfeeding based on Islamic rules and Qur’an. Hospital Practices and Research. 2020; 5(2): 37-41.
3. Bayyenat S, Hashemi SA, Purbafrani A, Saeidi M, Khodaee GH. The importance of breastfeeding in Holy Quran. International Journal of Pediatrics. 2014; 2(4): 339-47.
4. Alimoradi F, Javadi M, Barikani A, et al. An overview of importance of breastfeeding. Journal of Comprehensive Pediatrics. 2014; 5(2).
5. Pereira PC. Milk nutritional composition and its role in human health. Nutrition. 2014; 30(6): 619-27.
6. Ciampo LA, Ciampo IR. Breastfeeding and the Benefits of Lactation for Women’s Health. Revista Brasileira de Ginecologia e Obstetrícia. 2018; 40(06): 354-9.
7. Firoozabadi MD, Ali MS. Breastfeeding from Quran to medical science. Int J Curr Res Acad Rev. 2015; 3(7): 134-7.
8. Nuri M. Mustadrak Al-wasa'il: Mu'assisa Al al-Bayt li Ihya' al-Turath. 1988; 15: 156-157.
9. Brahm P, Valdes V. Benefits of breastfeeding and risks associated with not breastfeeding. Rev Chil Pediatr. 2017; 88(1): 15-21.
10. Quran Holy. Al-baqarah (233). Avalible at: URL: https://quran.com/en/al-baqarah/233
11. Nuri MH. Musdrak Al-vasa'il: Mu'assisa Al al-Bayt li Ihya' al-Turath. 1988; 21(15).
12. Al-Amili, A.-H., Wasa"ll Al-Shia, 1988. 21.
13. Cheng YJ, Yeung CY. Recent advance in infant nutrition: Human milk oligosaccharides. Pediatrics & Neonatology. 2021; 62(4): 347-53.
14. Hassiotou F, Geddes DT. Immune cell-mediated protection of the mammary gland and the infant during breastfeeding. Adv Nutr. 2015 15;6(3):267-75. doi: 10.3945/an.114.007377.
15. Power ML, Schulkin J. Milk: the biology of lactation. JHU Press; 2016.
16. Mirghafourvand M, Kamalifard M, Ranjbar F, et al. Relationship of breastfeeding self-efficacy with quality of life in Iranian breastfeeding mothers. The Journal of Maternal-Fetal & Neonatal Medicine. 2018; 31(20): 2721-8.
17. Meek JY, Noble L. Breastfeeding and the use of human milk. Pediatrics. 2022; 150(1): e2022057988.
18. Quigley MA, Carson C, Sacker A, et al. Exclusive breastfeeding duration and infant infection. European journal of clinical nutrition. 2016; 70(12): 1420-7.
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| A Review of the Breastfeeding Importance from the Perspective of the Holy Quran and Medical Literature |
Mohammad Reza Yavari 1
, Kazem Barzegar 3 ,
Mohammad Hossein Salmani Nodoushan 4 *
, Kazem Barzegar 3 Mohammad Hossein Salmani Nodoushan 4 *
- Department of Islamic Sciences, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
- Department of English Language, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
- Food Safety and Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| ARTICLE INFO | ABSTRACT | |
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Review Article
Received: 02 Aug 2024Accepted: 21 Dec 2024 |
Background: Mother's breast milk is the sole and best food for a neonate. It is one of the blessings of Almighty God that is physiologically given to the child through the mother’s breast. Breastfeeding is one of the issues receiving special attention in the Holy Quran. Nowadays, this issue has been explored and investigated in scientific and medical literature. In the present review, the importance of breastfeeding was examined from the reported medical scientific studies and articles and compared with the verses of the Holy Quran and authentic Islamic traditions. Methods: This scoping review was developed by PubMed, Web of Science, and Google Scholar using predetermined keywords. Authentic narrations related to breastfeeding in Arabic and articles published in English during 2014-2024 on its importance in neonatal health were selected by the present researchers. After applying inclusion criteria, the papers related to this topic were screened by experts for suitability. Results: This review included one verse of the Holy Quran, 3 valid authentic Islamic traditions, and 6 scientific medical literature highlighting the importance of mothers’ breastfeeding. Thematic analysis indicated the health and safety of mothers during breastfeeding. Breastfeeding duration and breastfeeding time are important points in the Holy Quran and traditions emphasized by researchers. Conclusion: The present study revealed that the results of scientific medical literature, like the Holy Quran, emphasizes the importance of breastfeeding. There are special instructions for breastfeeding in the Holy Quran. Today, the guidelines of the Quran in this field of study are emphasized in scientific research articles. Keywords: Holy Quran, Breastfeeding, Medical literature, Scientific, Mothers |
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Corresponding Author: Mohammad Hossein Salmani Nodoushan
mhsn06@yahoo.com |
How to cite this paper:
Yavari MR, Salmani MJ, Barzegar K, Salmani Nodoushan MH. Review the Importance of Breastfeeding from the Perspective of the Holy Quran and Medical Literature. J Community Health Research 2024; 13(1): 237-242.
Introduction
Yavari MR, Salmani MJ, Barzegar K, Salmani Nodoushan MH. Review the Importance of Breastfeeding from the Perspective of the Holy Quran and Medical Literature. J Community Health Research 2024; 13(1): 237-242.
Introduction
From medical perspective, the birth of a neonate is actually the continuation of its intrauterine life. In other words, it is the continuation of the baby's development outside the womb. At this stage, there is the need for useful foods such as amino acids, specific vitamins, mineral salts, and useful fats for the rapid development of the baby's cardiovascular and neuro-cerebral systems and immune factors to help the growth and development of the newborn (1). These foods are sufficiently and properly present in breast milk. Thus, the need of the child to be fed with the mother's milk is of utmost importance, which is highly emphasized in Islam by the Quran (2, 3). Moreover, the results of scientific and medical studies have determined that breastfeeding is the child's need. Many scientists emphasized that the best way to prevent malnutrition and child mortality is natural breastfeeding from the moment of birth (4). The sole and best food for a newborn is mother's milk, which is one of the blessings of Almighty God, physiologically given to the child through the mother’s breast. Milk contains numerous vitamins and nutrients for the growth of the body, especially at the postnatal stage (5). It is a perfect food for the suckling; that's why the Prophet of Islam (PBUH) says that nothing but milk can be a substitute for a child's food. Breastfeeding for two years is very important for a baby's life, including enhancing the body's defense system, resistance to diseases, and increasing the child's intelligence (6). Natural breastfeeding has many benefits, especially if it is completed for two years. The religion of Islam introduces mother's milk as the best food for an infant and orders that mothers complete the breastfeeding period to the best of their ability. Examining the existing verses and hadiths/traditions as well as medical scientific literature, we found that there are very important points about maternal and neonatal health during breastfeeding. The important tips to which attention must be paid during breastfeeding are: the breastfeeding importance, breastfeeding etiquette, and mother's milk as the best food. Islam considers great significance for mothers’ breastfeeding so that it greatly emphasizes the importance of breastfeeding and considers many benefits for mothers in so doing. It pronouncedly asserts that all the sins of the nursing mother will be forgiven and erased after finishing breastfeeding (7). Nonetheless, despite all explanations, the mother is free to choose to breastfeed. Imam Sadiq (PBUH) says in this regard that a free woman is not forced to breastfeed her child, but a slave woman (called kaniz, i.e., a woman bought by paying money) is forced to do so (8). Breastfeeding suckling from the point of view of the Qur'an and Hadith is such that Islamic law has established the mother-child rule with regard to breastfeeding. The most important result was that the length of breastfeeding exerts an effect on the mother's biological system. Breastfeeding reduces the pain and stress caused by childbirth, reduces weight after pregnancy, strengthens the immune system, diminishes the incidence of sensitivity and allergy, and also decreases the incidence of cardiovascular diseases (9). Finally, various scientific articles have suggested that breastfeeding brings forth many benefits, including faster postpartum stopping of uterine bleeding, reducing the incidence of breast cancer, diminishing the possibility of ovarian cancer, and the complications of endometrial cancer in the mother.
Methods
The present review study explored the importance of breastfeeding using the verses of the Holy Quran and authentic valid Islamic traditions, as well as some of the reported medical articles. Quranic verses were searched from the Islamic Knowledge database with combined keywords of mother's milk. Five search keywords including “breastfeeding, breast milk, lactation, maternal health, and infant” were applied to search in religious magazines/journals using search engines in PubMed, Web of Science, and MagIran databases. After removing duplicates, two inclusion criteria were applied to empirical articles published during 2014-2024 in peer-reviewed journals with a specific focus on women’s breastfeeding, as well as the time and effect of breastfeeding. Only articles written in English were included in the review. The papers including original research articles and clinical trials had to be peer-reviewed. Reviews, editorials, comments, or discussions were excluded prior to analysis.
The search yielded 902 articles which were screened for eligibility. After removing duplicates and applying inclusion criteria to the abstract/title of articles, 76 remained for full text review. Two independent experts assessed the abstract of articles and the 68 articles were excluded from this step. Finally, 4 papers focusing on the composition of breastfeeding and 2 quantitative studies about breastfeeding time were analyzed for the review. Immersed verses and narrations were studied and analyzed by experts in religious and Quranic sciences, as well as scientific articles in basic medical sciences and then their results were compared.
Results
The results of the present study are presented in two parts: a) investigating the Quranic literature, and b) investigating the scientific medical literature. Each section is discussed briefly below.
a) Investigation of Quranic Literature
As the divine book of the laws of the Islamic community, the Quran emphasizes some important issues. One of these issues, announced centuries ago and the results of which have been proven today, is the importance of breastfeeding by the mother. The verses of the Quran mention the issue of breastfeeding children in several cases. Among the numerous verses emphasizing various familial issues and the importance and sensitivity of breastfeeding, three verses of the Quran (Al-Baqarah 233, Al-Ahqaf 15, and Loqman 14) explicitly address breastfeeding, the most important of which is verse 233, Surah Al-Baqarah. In this verse, the duration of breastfeeding, minimum breastfeeding time, and breastfeeding etiquette are clearly elaborated on. This verse is given below in Arabic and English.
وَالْوالِداتُ یُرْضِعْنَ أَوْلادَهُنَّ حَوْلَیْنِ کامِلَیْنِ لِمَنْ أَرادَ أَنْ یُتِمَّ الرَّضاعَهَ وَ عَلَی الْمَوْلُودِ لَهُ رِزْقُهُنَّ وَ کِسْوَتُهُنَّ بِالْمَعْرُوفِ لا تُکَلَّفُ نَفْسٌ إِلاَّ وُسْعَها لا تُضَارَّ والِدَهٌ بِوَلَدِها وَ لا مَوْلُودٌ لَهُ بِوَلَدِهِ وَ عَلَی الْوارِثِ مِثْلُ ذلِکَ فَإِنْ أَرادا فِصالاً عَنْ تَراضٍ مِنْهُما وَ تَشاوُرٍ فَلا جُناحَ عَلَیْهِما وَ إِنْ أَرَدْتُمْ أَنْ تَسْتَرْضِعُوا أَوْلادَکُمْ فَلا جُناحَ عَلَیْکُمْ إِذا سَلَّمْتُمْ ما آتَیْتُمْ بِالْمَعْرُوفِ وَ اتَّقُوا اللَّهَ وَ اعْلَمُوا أَنَّ اللَّهَ بِما تَعْمَلُونَ بَصِیرٌ.
“Mothers ought to breastfeed their children for two whole years. This is for the mother who wants to complete the period of breastfeeding, and for the father whose wife gives birth to a child, it is necessary to pay for the mother's food and clothing appropriately during the breastfeeding period, even if she is divorced. No one is obliged to do more than their ability! Neither the mother has the right to harm the child due to a dispute with the father, nor the father, and heir is also required to do this; and if they both, with mutual consent and consultation, want to wean the child from the mother’s breast, there is no sin on them; if you want to hire a nanny for your children, there is no sin on you, provided that you pay the mother's past due in a worthy manner and avoid opposing the command of God and know that God sees what you do” (10).
Imam Sadiq (PBUH) narrates from the Prophet (PBUH) that:
إذا حَمِلَتِ المَرأَهُ کانَت بمنزله الصائم القائم المُجاهِدِ بِنَفْسِهِ وَ مَالِهِ وَ فِی سَبیل الله، فَإِذَا وَضَعَت کَانَ لَهَا مِنَ الأجر ما لا یدری أحَدَ ما هُوَ لِعَظمِهِ، فَإِذا أَرضَعَت کانَ لَها بِکُلِّ مِصَّهُ کَعِدل عِتق مُحَرِّر مِن وَلدِ اسماعیلَ، فَإِذا فَرَغتَ مِن رِضَاعِهِ ضَرَبَ مَلَکَ کَریمٌ عَلی جَنبها وَقالَ اسْتَأْنِفِی العَمَلَ فَقَد غَفَرَ لَکِ.
“So, when the mother gives birth to a child and starts to breastfeed the baby, every time it sucks the mother's milk, on the Day of Resurrection, a bright divine light will appear before her, and everyone from the past and the future will be amazed when s/he observes the light. Night-praying and fasting will be registered in her worldly workbook for breastfeeding. Thus, if she weaned her child, may Almighty God say to her, Oh woman, know that I have forgiven all your sins, so resume your actions from anew”.
The Holy Prophet (PBUH) said:
" لَیسَ لِلصَّبّیِ لَبَنٌ خَیرٌ مِن لَبَنِ اُمِّهِ."
“No milk is better for a suckling than mother's milk” (11).
Imam Sadiq (PBUH) narrates from Imam Ali (PBUH):
"ما مِن لَبَنٍ رُضِعَ به الصبیِّ اَعظَمُ بَرَکَهً عَلَیهِ مِن لَبَنِ اُمِّهِ."
"There is no milk for feeding a newborn that is more blessed than its mother's milk."
Ammar Sabatid narrates from Imam Sadiq (PBUH):
"لابأس ان تحمل المرأه صَبِیَّها وَ هِیَ تُصَلیّ وَتَرِضُعَهُ وَ هَیِ تَشَهَّدُ."
“There is nothing wrong with a woman taking the child with her while praying and breastfeeding it while reciting Tashahhud.
Ali Ibn-e Jafar, the brother of Imam Moosa Kazem (PBUH) says:
"سَأَلتُهُ عن المَرأَهِ تَکُونُ صَلوهِ الفَریضَه وَ وَلدُها اِلی جَنبِها یبکی و هی قاعده هَل یَصلَحُ لَها اَن تتناولُه فَتُقعِدَهُ فی حَجرِها و تُسکِتَهُ وَ تَرضِعَهُ؟ قالَ لاَبأسَاز."
“I asked that Imam about a woman who was saying her obligatory prayer and her child was crying next to her. Is it permissible to hold her baby while sitting and put it on your lap and soothe it and breastfeed it? He said: There is no problem with it” (12).
b) Investigation of Scientific Medical Literature
In this regard, numerous studies directly determined the effect of breastfeeding duration on the mental and physical health of mother and child. Four articles were identified on the importance of breastfeeding concerning mother’s milk constituents and two articles concerning breastfeeding time.
Cheng YJ & Yeung ChY (2021) demonstrated that human milk oligosaccharides (HMOs) are the third most abundant solids in human milk. To date, more than 200 structurally different HMOs have been identified, some of which can be synthesized by the food industry. HMOs form one of the major differences between human milk and formula; current evidence suggests their various beneficial effects on infant health such as acting as antimicrobials, modulators, and immuno-modulators, and of the intestinal cellular response, as well as providing a prebiotic effect. The effects of HMOs compounds vary among mothers, being influenced by the stage of lactation, the duration of pregnancy, and the mother's genetic factors. Yet, there are still some unknown factors that affect the composition of HMOs and need further research to be clarified. A combination of preclinical and clinical cohort studies may help identify whether an individual HMO contributes to disease protection. In recent years, 20-fucosyllactose (20-FL) and lacto-N-neotetraose (LNnT) have been approved as food ingredients by official authorities. Nevertheless, more prospective clinical studies are mandatory to clarify the importance of HMOs in infant nutrition. Breastfeeding is the best option for baby nutrition and growth (13).
Generally, the nutrients (water, proteins, lipids, carbohydrates, vitamins, and minerals) were considered as the important components of milk serving the growth needs of the infant for optimum growth. However, human milk contains factors other than the defined nutrients including microbes and maternal cells; researchers investigated their potential roles in infant and maternal development and health. Hassiotou et al. (2014) indicated that 0–2% of human milk immune cells exist in the milk of healthy mother/infant dyads during established lactation. Immune cell numbers increase rapidly in response to infection of the mammary gland and other maternal infections, as well as infant infections, returning to baseline amounts during recovery. It is worth noting that the breast milk of mothers exclusively breastfeeding their infants had higher baseline immune cell content than that of mothers who do not exclusively breastfeed, further supporting the important protective role of human milk. In recent years, immune cells have been known to be present in human milk, but recent evidence investigates that their impact is as much on the infant as on the health of the lactating mammary gland (14).
Power & Schulkin (2016) studied the biology of lactation. They found that human breast milk is a complex matrix with a total composition of 87% water, 3.8% fat, 1.0% protein, and 7% lactose. Fat and lactose provide 50% and 40% of the total energy of milk, respectively. However, the composition of human breast milk is dynamic and changes over time to adapt to the growing needs of the child. For instance, during each breastfeeding session, the milk that is squeezed and milked first (foremilk) is thinner with a higher lactose content, which quenches the baby's thirst, and after the foremilk, the hind milk is creamier with a much higher fat content for the infant. Baby's needs also vary with the stage of breastfeeding (baby's age), mother's diet, mother's health, and environmental exposure. The protein content of human milk varies from 1.4 to 1.6 g/100 ml at the beginning of lactation, from 0.8 to 1.0 g/100 ml after three to four months of lactation, and from 0.7 to 0.8 g/100 ml after six months (15).
Mirghafourvand et al. (2018) conducted a descriptive cross-sectional study on 547 breastfeeding mothers. Their study was performed by Dennis’ breastfeeding self-efficacy scale, and WHO’s Quality of Life (WHOQOL) questionnaire through interviews. They obtained a direct and significant relationship between breastfeeding self-efficacy and some variables such as the environmental dimension of quality of life, education, spouse’s age, spouse’s job, as well as the mean duration of the previous breastfeeding period (16).
Meek et al. (2022) recognized that the time of breastfeeding exerted some effect on public health. Their results indicated that human milk and breastfeeding are the main standards for infant nutrition. The neurodevelopmental benefits of breastfeeding and short-term and long-term medical advantages make breastfeeding a public health issue. The American Academy of Pediatrics (AAP) recommends unique breastfeeding for
about 6 months after birth. In addition, the AAP supports continued breastfeeding and appropriate complementary foods, introduced around 6 months of age, until mother and child tend for 2 years or more; this is consistent with the recommendations of the World Health Organization (WHO). The AAP recommends that hospitals or delivery centers implement maternity care practices that improve the initiation, duration, and exclusivity of breastfeeding (17).
Quigley et al. (2016) analyzed the data on 15,809 term singleton infants from the UK Millennium Cohort Study for the association between exclusive breastfeeding and infection in infancy (chest, diarrhea, and ear). They grouped infants according to months of exclusive breastfeeding: never, < 2, 2–4, 4–6, and 6 months. Among those with exclusive breastfeeding for 4–6 months, they separated those who started solids, but not formulae, before 6 months, and were still breastfeeding at 6 months from other patterns. Their results indicated that exclusive breastfeeding was associated with chest infection and diarrhea. Exclusive breastfeeding for < 4 months was associated with a significantly increased risk of chest infection (adjusted risk ratios (RR) 1.24–1.28) and diarrhea (adjusted RRs
1.42–1.66). They showed an excess risk of chest infection (adjusted RR 1.19, 95% confidence interval (CI): 0.97–1.46) and diarrhea (adjusted
RR 1.66, 95% CI: 1.11, 2.47) among infants with exclusive breastfeeding for 4–6 months, but who stopped breastfeeding by 6 months. Their results indicated that there was an increased risk of infection in infants with exclusive breastfeeding
for <4 months or exclusive breastfeeding for 4–6 months who stopped breastfeeding by 6 months. These results support current guidelines of exclusive breastfeeding for either 4–6 or 6 months, with continued breastfeeding thereafter (18).
Conclusion
The importance of breastfeeding has been emphasized in the Quran, traditions, and narrations. The characteristics of breast milk have recently been determined by researchers; today, advanced
chemical and biological analyses have identified and determined many specific components which are present in human milk. Analyses suggest that neonates who receive breast milk for a longer period of time during infancy are less likely to show developmental or immunological defects later in life. While the role of each milk component in infant nutrition is not yet understood clearly, the evidence that exclusive breastfeeding early in life promotes optimal growth and development is almost undeniable. This point is clearly emphasized in the Quran. The consistency of the medical research results with the Quran verses demonstrated that the Holy Quran verses and the reported scientific studies emphasize the importance of breastfeeding by mothers.
Acknowledgment
The authors would like to thank Yazd University of Medical Sciences for their financial support.
Conflict of interest
The authors declare no competing interest.
Funding
This review receiving no external funding.
Ethical considerations
Not applicable.
Code of ethics
Not applicable.
Authors’ contributions
MH. SN and MR. Y participated in designing the study and project administration. K. B. wrote the English draft. MH. SN and K. B. edited the final revision of the manuscript. MH. SN. and MJ. S. contributed in searching and writing the original draft. K. B and MR. Y participated in resources. All authors have read and approved the manuscript.
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Methods
The present review study explored the importance of breastfeeding using the verses of the Holy Quran and authentic valid Islamic traditions, as well as some of the reported medical articles. Quranic verses were searched from the Islamic Knowledge database with combined keywords of mother's milk. Five search keywords including “breastfeeding, breast milk, lactation, maternal health, and infant” were applied to search in religious magazines/journals using search engines in PubMed, Web of Science, and MagIran databases. After removing duplicates, two inclusion criteria were applied to empirical articles published during 2014-2024 in peer-reviewed journals with a specific focus on women’s breastfeeding, as well as the time and effect of breastfeeding. Only articles written in English were included in the review. The papers including original research articles and clinical trials had to be peer-reviewed. Reviews, editorials, comments, or discussions were excluded prior to analysis.
The search yielded 902 articles which were screened for eligibility. After removing duplicates and applying inclusion criteria to the abstract/title of articles, 76 remained for full text review. Two independent experts assessed the abstract of articles and the 68 articles were excluded from this step. Finally, 4 papers focusing on the composition of breastfeeding and 2 quantitative studies about breastfeeding time were analyzed for the review. Immersed verses and narrations were studied and analyzed by experts in religious and Quranic sciences, as well as scientific articles in basic medical sciences and then their results were compared.
Results
The results of the present study are presented in two parts: a) investigating the Quranic literature, and b) investigating the scientific medical literature. Each section is discussed briefly below.
a) Investigation of Quranic Literature
As the divine book of the laws of the Islamic community, the Quran emphasizes some important issues. One of these issues, announced centuries ago and the results of which have been proven today, is the importance of breastfeeding by the mother. The verses of the Quran mention the issue of breastfeeding children in several cases. Among the numerous verses emphasizing various familial issues and the importance and sensitivity of breastfeeding, three verses of the Quran (Al-Baqarah 233, Al-Ahqaf 15, and Loqman 14) explicitly address breastfeeding, the most important of which is verse 233, Surah Al-Baqarah. In this verse, the duration of breastfeeding, minimum breastfeeding time, and breastfeeding etiquette are clearly elaborated on. This verse is given below in Arabic and English.
وَالْوالِداتُ یُرْضِعْنَ أَوْلادَهُنَّ حَوْلَیْنِ کامِلَیْنِ لِمَنْ أَرادَ أَنْ یُتِمَّ الرَّضاعَهَ وَ عَلَی الْمَوْلُودِ لَهُ رِزْقُهُنَّ وَ کِسْوَتُهُنَّ بِالْمَعْرُوفِ لا تُکَلَّفُ نَفْسٌ إِلاَّ وُسْعَها لا تُضَارَّ والِدَهٌ بِوَلَدِها وَ لا مَوْلُودٌ لَهُ بِوَلَدِهِ وَ عَلَی الْوارِثِ مِثْلُ ذلِکَ فَإِنْ أَرادا فِصالاً عَنْ تَراضٍ مِنْهُما وَ تَشاوُرٍ فَلا جُناحَ عَلَیْهِما وَ إِنْ أَرَدْتُمْ أَنْ تَسْتَرْضِعُوا أَوْلادَکُمْ فَلا جُناحَ عَلَیْکُمْ إِذا سَلَّمْتُمْ ما آتَیْتُمْ بِالْمَعْرُوفِ وَ اتَّقُوا اللَّهَ وَ اعْلَمُوا أَنَّ اللَّهَ بِما تَعْمَلُونَ بَصِیرٌ.
“Mothers ought to breastfeed their children for two whole years. This is for the mother who wants to complete the period of breastfeeding, and for the father whose wife gives birth to a child, it is necessary to pay for the mother's food and clothing appropriately during the breastfeeding period, even if she is divorced. No one is obliged to do more than their ability! Neither the mother has the right to harm the child due to a dispute with the father, nor the father, and heir is also required to do this; and if they both, with mutual consent and consultation, want to wean the child from the mother’s breast, there is no sin on them; if you want to hire a nanny for your children, there is no sin on you, provided that you pay the mother's past due in a worthy manner and avoid opposing the command of God and know that God sees what you do” (10).
Imam Sadiq (PBUH) narrates from the Prophet (PBUH) that:
إذا حَمِلَتِ المَرأَهُ کانَت بمنزله الصائم القائم المُجاهِدِ بِنَفْسِهِ وَ مَالِهِ وَ فِی سَبیل الله، فَإِذَا وَضَعَت کَانَ لَهَا مِنَ الأجر ما لا یدری أحَدَ ما هُوَ لِعَظمِهِ، فَإِذا أَرضَعَت کانَ لَها بِکُلِّ مِصَّهُ کَعِدل عِتق مُحَرِّر مِن وَلدِ اسماعیلَ، فَإِذا فَرَغتَ مِن رِضَاعِهِ ضَرَبَ مَلَکَ کَریمٌ عَلی جَنبها وَقالَ اسْتَأْنِفِی العَمَلَ فَقَد غَفَرَ لَکِ.
“So, when the mother gives birth to a child and starts to breastfeed the baby, every time it sucks the mother's milk, on the Day of Resurrection, a bright divine light will appear before her, and everyone from the past and the future will be amazed when s/he observes the light. Night-praying and fasting will be registered in her worldly workbook for breastfeeding. Thus, if she weaned her child, may Almighty God say to her, Oh woman, know that I have forgiven all your sins, so resume your actions from anew”.
The Holy Prophet (PBUH) said:
" لَیسَ لِلصَّبّیِ لَبَنٌ خَیرٌ مِن لَبَنِ اُمِّهِ."
“No milk is better for a suckling than mother's milk” (11).
Imam Sadiq (PBUH) narrates from Imam Ali (PBUH):
"ما مِن لَبَنٍ رُضِعَ به الصبیِّ اَعظَمُ بَرَکَهً عَلَیهِ مِن لَبَنِ اُمِّهِ."
"There is no milk for feeding a newborn that is more blessed than its mother's milk."
Ammar Sabatid narrates from Imam Sadiq (PBUH):
"لابأس ان تحمل المرأه صَبِیَّها وَ هِیَ تُصَلیّ وَتَرِضُعَهُ وَ هَیِ تَشَهَّدُ."
“There is nothing wrong with a woman taking the child with her while praying and breastfeeding it while reciting Tashahhud.
Ali Ibn-e Jafar, the brother of Imam Moosa Kazem (PBUH) says:
"سَأَلتُهُ عن المَرأَهِ تَکُونُ صَلوهِ الفَریضَه وَ وَلدُها اِلی جَنبِها یبکی و هی قاعده هَل یَصلَحُ لَها اَن تتناولُه فَتُقعِدَهُ فی حَجرِها و تُسکِتَهُ وَ تَرضِعَهُ؟ قالَ لاَبأسَاز."
“I asked that Imam about a woman who was saying her obligatory prayer and her child was crying next to her. Is it permissible to hold her baby while sitting and put it on your lap and soothe it and breastfeed it? He said: There is no problem with it” (12).
b) Investigation of Scientific Medical Literature
In this regard, numerous studies directly determined the effect of breastfeeding duration on the mental and physical health of mother and child. Four articles were identified on the importance of breastfeeding concerning mother’s milk constituents and two articles concerning breastfeeding time.
Cheng YJ & Yeung ChY (2021) demonstrated that human milk oligosaccharides (HMOs) are the third most abundant solids in human milk. To date, more than 200 structurally different HMOs have been identified, some of which can be synthesized by the food industry. HMOs form one of the major differences between human milk and formula; current evidence suggests their various beneficial effects on infant health such as acting as antimicrobials, modulators, and immuno-modulators, and of the intestinal cellular response, as well as providing a prebiotic effect. The effects of HMOs compounds vary among mothers, being influenced by the stage of lactation, the duration of pregnancy, and the mother's genetic factors. Yet, there are still some unknown factors that affect the composition of HMOs and need further research to be clarified. A combination of preclinical and clinical cohort studies may help identify whether an individual HMO contributes to disease protection. In recent years, 20-fucosyllactose (20-FL) and lacto-N-neotetraose (LNnT) have been approved as food ingredients by official authorities. Nevertheless, more prospective clinical studies are mandatory to clarify the importance of HMOs in infant nutrition. Breastfeeding is the best option for baby nutrition and growth (13).
Generally, the nutrients (water, proteins, lipids, carbohydrates, vitamins, and minerals) were considered as the important components of milk serving the growth needs of the infant for optimum growth. However, human milk contains factors other than the defined nutrients including microbes and maternal cells; researchers investigated their potential roles in infant and maternal development and health. Hassiotou et al. (2014) indicated that 0–2% of human milk immune cells exist in the milk of healthy mother/infant dyads during established lactation. Immune cell numbers increase rapidly in response to infection of the mammary gland and other maternal infections, as well as infant infections, returning to baseline amounts during recovery. It is worth noting that the breast milk of mothers exclusively breastfeeding their infants had higher baseline immune cell content than that of mothers who do not exclusively breastfeed, further supporting the important protective role of human milk. In recent years, immune cells have been known to be present in human milk, but recent evidence investigates that their impact is as much on the infant as on the health of the lactating mammary gland (14).
Power & Schulkin (2016) studied the biology of lactation. They found that human breast milk is a complex matrix with a total composition of 87% water, 3.8% fat, 1.0% protein, and 7% lactose. Fat and lactose provide 50% and 40% of the total energy of milk, respectively. However, the composition of human breast milk is dynamic and changes over time to adapt to the growing needs of the child. For instance, during each breastfeeding session, the milk that is squeezed and milked first (foremilk) is thinner with a higher lactose content, which quenches the baby's thirst, and after the foremilk, the hind milk is creamier with a much higher fat content for the infant. Baby's needs also vary with the stage of breastfeeding (baby's age), mother's diet, mother's health, and environmental exposure. The protein content of human milk varies from 1.4 to 1.6 g/100 ml at the beginning of lactation, from 0.8 to 1.0 g/100 ml after three to four months of lactation, and from 0.7 to 0.8 g/100 ml after six months (15).
Mirghafourvand et al. (2018) conducted a descriptive cross-sectional study on 547 breastfeeding mothers. Their study was performed by Dennis’ breastfeeding self-efficacy scale, and WHO’s Quality of Life (WHOQOL) questionnaire through interviews. They obtained a direct and significant relationship between breastfeeding self-efficacy and some variables such as the environmental dimension of quality of life, education, spouse’s age, spouse’s job, as well as the mean duration of the previous breastfeeding period (16).
Meek et al. (2022) recognized that the time of breastfeeding exerted some effect on public health. Their results indicated that human milk and breastfeeding are the main standards for infant nutrition. The neurodevelopmental benefits of breastfeeding and short-term and long-term medical advantages make breastfeeding a public health issue. The American Academy of Pediatrics (AAP) recommends unique breastfeeding for
about 6 months after birth. In addition, the AAP supports continued breastfeeding and appropriate complementary foods, introduced around 6 months of age, until mother and child tend for 2 years or more; this is consistent with the recommendations of the World Health Organization (WHO). The AAP recommends that hospitals or delivery centers implement maternity care practices that improve the initiation, duration, and exclusivity of breastfeeding (17).
Quigley et al. (2016) analyzed the data on 15,809 term singleton infants from the UK Millennium Cohort Study for the association between exclusive breastfeeding and infection in infancy (chest, diarrhea, and ear). They grouped infants according to months of exclusive breastfeeding: never, < 2, 2–4, 4–6, and 6 months. Among those with exclusive breastfeeding for 4–6 months, they separated those who started solids, but not formulae, before 6 months, and were still breastfeeding at 6 months from other patterns. Their results indicated that exclusive breastfeeding was associated with chest infection and diarrhea. Exclusive breastfeeding for < 4 months was associated with a significantly increased risk of chest infection (adjusted risk ratios (RR) 1.24–1.28) and diarrhea (adjusted RRs
1.42–1.66). They showed an excess risk of chest infection (adjusted RR 1.19, 95% confidence interval (CI): 0.97–1.46) and diarrhea (adjusted
RR 1.66, 95% CI: 1.11, 2.47) among infants with exclusive breastfeeding for 4–6 months, but who stopped breastfeeding by 6 months. Their results indicated that there was an increased risk of infection in infants with exclusive breastfeeding
for <4 months or exclusive breastfeeding for 4–6 months who stopped breastfeeding by 6 months. These results support current guidelines of exclusive breastfeeding for either 4–6 or 6 months, with continued breastfeeding thereafter (18).
Conclusion
The importance of breastfeeding has been emphasized in the Quran, traditions, and narrations. The characteristics of breast milk have recently been determined by researchers; today, advanced
chemical and biological analyses have identified and determined many specific components which are present in human milk. Analyses suggest that neonates who receive breast milk for a longer period of time during infancy are less likely to show developmental or immunological defects later in life. While the role of each milk component in infant nutrition is not yet understood clearly, the evidence that exclusive breastfeeding early in life promotes optimal growth and development is almost undeniable. This point is clearly emphasized in the Quran. The consistency of the medical research results with the Quran verses demonstrated that the Holy Quran verses and the reported scientific studies emphasize the importance of breastfeeding by mothers.
Acknowledgment
The authors would like to thank Yazd University of Medical Sciences for their financial support.
Conflict of interest
The authors declare no competing interest.
Funding
This review receiving no external funding.
Ethical considerations
Not applicable.
Code of ethics
Not applicable.
Authors’ contributions
MH. SN and MR. Y participated in designing the study and project administration. K. B. wrote the English draft. MH. SN and K. B. edited the final revision of the manuscript. MH. SN. and MJ. S. contributed in searching and writing the original draft. K. B and MR. Y participated in resources. All authors have read and approved the manuscript.
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Received: 2024/08/2 | Accepted: 2024/12/21 | Published: 2024/12/25
Received: 2024/08/2 | Accepted: 2024/12/21 | Published: 2024/12/25
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