Tuesday, July 26, 2011

Breast Feeding and Islamic Teaching

Mohammad Ali Al-Bar, MB, ChB, MRCP
Dr AI-Bar is a Consultant of Islamic Medicine
at the King Fahd Medical Research Centre,
King Abdul Aziz University, Jeddah, Saudi Arabia
(Note from Islamic Garden Editors: The following are verses from theQur'an, the Holy Book of Muslims.)
"The mothers (including those divorced) shall nurse their children for two whole years if they wish to complete the period of nursing. The father shall bear the cost of their feeding and clothing on equitable terms. No soul has a burden laid on it greater than it can bear. No mother shall suffer because of her child. Similarly the father should not suffer. The same duties rest upon the heir (that is, if the father dies). If they (that is, the parents) both decide on weaning (the child) by mutual consent and after due consultation they are not to blame. Also they are not to blame if they decide on a foster mother, provided they insure, in a fair manner the safety of the child."
"Remain conscious of God, and know that God sees all that you do." (Qur'an 2:233)
"His mother bore him by strain after strain. His nursing (suckling) period lasts two years. Be grateful to Me and to your parents." (Qur'an 31:14)
"In pain did his mother bear him, and in pain did she give him birth, and her bearing and his suckling period took thirty months." (Qur'an 46:15)
"Let the women divorced (in the waiting period) live in the same house you live in and in the same manner, in accordance with your means. Do not harass them, and if they are pregnant spend freely on them until they deliver their burden. If they nurse your offspring, give them their due recompense. Counsel each other in a fair manner about the child's future. If you get in discord, let another woman nurse him; and the father should pay for the nurse."
"The wealthy should spend in accordance to his wealth, and the poor should spend in accordance to his income. God does not burden any soul more than it can bear."
"God will grant after hardship ease." (Qur'an 5,6:7)
From these verses we can understand the following points regarding the "nursing of the child."
  • Mothers are encouraged to nurse their babies for a period varying from 16 to 24 months.
  • Even if the mother is divorced, she should be supported in her nursing of her child for that period. The father should pay her cost of living as she will be fully occupied by nursing his offspring.
  • If the parents are separated or divorced they should frequently counsel each other for the sake of the child's future.
  • If it is decided that the mother cannot nurse the baby (for example, if she lacks milk in her breasts), then a wet nurse must be asked to help. The wet nurse in Islam is a foster mother; she is also considered as the child's mother. Her children become the baby's brothers and sisters, and her husband becomes another father for the baby. No marriage, however, is allowed between the baby and its foster mother's children, brothers, sisters and husband. The true father should pay the foster mother recompense.
  • If the mother dies, the baby's heir should support both the nursing mother and her baby for the period of breast-feeding. The custody of the baby remains in the hands of the nursing mother.
During the reign of Khalifa Omer Ibn AI-Khatab, every Muslim in the community, except for new born babies up to and including the weaning stage, received social security benefits from Baitulmal, the Government treasury. When Omar noticed that mothers tended to wean their babies too early to get the benefit of social security he cried, "How many young Muslim souls you have deprived from their food O, Omar!" So he ordered that every new-born should get the subsidy from birth.
From Surah 2:233 and from Surah Al Hakaf 46:15 (Chapters from the Qur'an -ed.), Ali lbn Abi Talib deduced that the shortest period of pregnancy for a child to survive was six months.
It was not recognised until recently that a six-month-old baby can survive (outside the womb-ed.). Until the sixties it was taught in medical schools that viability is not possible before 28 weeks: that is, seven months.
The Islamic communities paid great attention to breast-feeding and wet nurses were very common until recently. Even if the mother nurses her baby it is not uncommon for a neighbor, relative or friend to breastfed the newcomer. Extended families also have the advantage of relieving the burden from young mothers.
If we remember that many girls marry at 15 or less, and boys under 18 too, then we are aware of their need for help and guidance from older generations.
I personally saw a lady in my clinic in Jeddah who became a grandmother at the age of 27. Al Imam AI Shafi saw a girl of 21 who had become a grandmother.
However, the tide of western civilisation is quickly changing the pattern of social and cultural attitudes in all Muslim countries. This is more pronounced in the urban areas. Breast-feeding is rapidly declining not only in urban areas but also in rural areas. There are many reasons such as the influence of the western and industrial culture, the dramatic changes in the structure of Islamic and Third World societies, and promotion of bottle feeding by multi-nationals. The baby food companies are the vital cause of the decline of breastfeeding in developing countries. The companies saw the potential of increasing their sales and profits to the large and rising infant population of the developing world. The sales of these companies to the Third World alone have already exceeded $8,000m annually.
The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) consider these companies as the number one killer of babies in the Third World and have strongly advised Third World governments to ban the advertising of manufactured baby foods.
Bottle-fed infants in the Third World often receive dilute and contaminated feeds containing little nutrients and massive doses of micro-organisms. It is estimated that 9.4 million cases of severe malnutrition occur in the Third World annually, of which at least half are due to bottle feeding.Similarly, there are annually about 10 million infant deaths due to GE in the Third World. At least half of them are due to bottle feeding.
Thus, we find 10 million babies die annually due to the widespread use of bottle feeding in the Third World. They can be saved by the simple measure of breast feeding.

All the bodies concerned with infant health, including WHO and UNICEF, stress the importance of breast-feeding, especially in the Third World. Breast feeding in these poor countries will not only save 2,000 million dollars annually that is badly needed for health and education, but also has many other advantages:
  • Human milk contains the nutrition which a child needs, including the proportion and suitability for its body and digestion and absorption. The various nutritional elements are not static. They change daily, according to the infant's needs. A premature baby has a special formula prepared in his mother's breast to make it a suitable diet. Gracious and bountiful God provides the mammary glands with the know-how to adjust its secretions according to the variable and changing needs of the growing infant.
  • Human milk is naturally stored at the right temperature making it completely aseptic and automatically adjusted to infant needs. It is always available on demand.
  • It involves less work, as there are no teats or bottles to be cleansed or feeds to be prepared.
  • It has definite psychological benefits, both to the nursing mother and suckling baby.
  • Breast-feeding helps the mother to return to her pre-pregnant size and weight. It helps the uterus to involute under the effect of oxytocin secreted by the pituitary gland and released by reflexes through suckling.
  • Breast-feeding protects the baby from many diseases and problems such as diarrhea and chest infections. Recent studies have proved that infants who are breast-fed are less liable to suffer from respiratory and gastrointestinal diseases. Those who do catch the diseases are less morbid and have a much lower mortality rate than those who are bottle fed.
  • Human milk contains IgA specific antibodies in the mammary glands manufactured by lymphocytes that have migrated from the gut of the mother.
  • The clostrum, which is the pre-milk secretion from the breast at parturition, contains a huge amount of antibodies. The IgA forms 97 percent of the cholesterol protein on the first day which falls to 25 per cent on the fourth day of lactation.
  • Furthermore, breast milk supplies the infant with viable immunological cells and non-specific humoral factors. These provide both cellular and humoral immunity against a variety of organisms, especially E Coli, Staph areus, Coxackie B5 virus, Herpes Simples virus, polio virus and Pneumococcus.
  • The lacteal antibodies against entero bacteria are largely of IgA class. They are synthesised in the mammary gland by the B-Lymphocyte migrating from the mother's gut.
  • Further studies have shown that antitoxins against Vibreo cholera and E Coli are secreted in the colostrum and are not absorbed by the intestine of the baby, remaining as protective barriers in the infant's gut.
  • Similarly, cholesterol cells secreting anti E Coli antibodies have been detected in mothers who ingested the antigen. Antibodies to other bacteria or antigens have been detected. Recently, tuberculin sensitive mothers were found to pass a long lasting immunity to their infants by breast feeding.
  • Breast feeding is crucial in providing humoral and cellular immunity, especially in the infant's first weeks, as the infant is less susceptible to gastro-intestinal and respiratory infections.
  • Cow's milk and other types of non-human milk are more liable to cause sensitivity and allergy in the bottle-fed infant. The infant is more liable to get eczema, bronchial asthma and gastro-intestinal upsets caused by sensitivity to the proteins of the non-human milk.
  • The colostum not only contains high amounts of cellular and humoral-immune bodies, but also has a laxative effect which helps discharge the muconium of the new born baby.
  • It is no wonder, therefore, to find breast-fed infants thriving better and less liable to infections and immunological diseases.
  • It has the advantage of being a contraceptive measure in itself. It has been found that if the lactating mother is somewhat debilitated the contraceptive effect of breast feeding is enhanced.
  • It is also suggested that breast-feeding may decrease the incidence of breast cancer.
  • The Holy Qur'an has stressed the importance of prolonged breast feeding. The advantages of prolonged breast-feeding are starting to be known. Recent studies have shown that breast fed infants may not need complementary or supplementary feeding during the first nine to 12 months.
  • The psychological benefits for both the nursing mother and the baby are well established.
  • Human milk contains PGE2 which acts as a zinc ligand while cow's milk contains none. Zinc deficiency is, therefore, more liable to occur in bottle-fed infants or after premature weaning of breast-fed infants. Zinc deficiency causes acute or chronic dermatological manifestations. The acute ones are characterised by vesiculo pustular eruptions with marked erythema that turns into haemorrhagic erosive lesions with crusts, mainly around the body orifices (mouth and perianal region), and extremities.
  • Verrucous patches on the extremities are chronic manifestations, with eczema, alopecia, nail dystrophy, paronychia and angular stomatisis being common.
  • A rare hereditary autosomal recessive disorder "Acrodermatitis Enteropathica" is associated with zinc deficiency. Manifestations of the disease only occur if the baby is bottle-fed or weaned prematurely. Acrodermatitis Enteropathica is a persistent dermatitis manifested by a vesicular rash around the mouth and extremities. The vesicles soon crust and thicken and become secondarily infected with bacteria or candida. It is also associated with diaorrhea, T. cell mediated immunity deficiency, absent thymus, lack of germinal centres and plasmocytosis of lymph glands and spleen. Plasma zinc is also low. The management of this type of case depends on both prolonged breast feeding and zinc supplements.
Islamic teaching encourages mothers to nurse their children. The renowned Ibn Hazim said, "A mother should nurse her baby even if she was the daughter of the king. She is not exempted from that duty, unless she is incapable of nursing."
The nursing mother should be financially supported by the husband, even if she is divorced. If the father dies, his heirs should support her fully during lactation. If there is no heir, the government takes responsibility.
If Islamic teachings are adhered to many evils that befall children and their mothers could be avoided.
Islamic World Medical Journal
July/August 1986/D.Qudah 1406
Pages 55, 56 and 57

Breastfeeding is NATURAL...

Nurturing Through Breast Feeding

"We have enjoined on man kindness to his parents: In pain did his mother bear him, and in pain did she give him birth. The carrying of the (child) to his weaning is (a period of) thirty months. At length, when he reach the age of full strength and attains forty years, he says, 'O my Lord! Grant me that I may be grateful for Thy favor which thou hast bestowed upon me, and upon both my parents....'"
Holy Quran 46:15

Family Life Question: 
"Breast feeding our new baby will be a new experience for me, and I'm concerned about providing an adequate amount of milk. What are some helpful things to know?"

Dear New Mother:
It is from the breast that "the milk of human kindness" literally flows. Human milk contains thousands of nutrients, some of which are not found anywhere else in nature. It is very specific in its design for the optimum growth and development of the human infant.

Breast feeding is a part of the continuation of life, that is evolving in the manner Allah has ordained. Breast feeding is natural. We have abandoned many of the beautiful natural things that Allah has given to us that would assure the sanctity of human life. We need guidance to adhere to the more natural ways of life that are in accordance with Allah's universal order. 

"There is no moving creature on earth but its sustenance dependeth on Allah."
 (Quran 11:6)

Not only are the physical qualities of breast milk best, the emotional and spiritual bonding that takes place between mother and child is immeasurably vital to life. Breast feeding encourages bonding for the entire family. Allah has given the woman the role of nurturer of life, the role of providing the warmth, comfort, security and compassion that sets life on the best course.

There are many herbal remedies for breast feeding mothers. More than 30 herbs are considered to promote healthy milk producing. Nutritionists advise the widely know herb, fenugreek. Dr. Mohammed El-Shatet of Fouad University in Cairo, Egypt, reports in Mothering magazine (July-Sept. 1988) that fenugreek could increase breast milk production by as much as 900 percent. Mothers who had experienced their babies failing to gain weight found that infants thrived when they began drinking fenugreek tea. Even adoptive mothers have been able to produce milk for their babies after drinking this tea regularly. (3)

The effectiveness of an herbal remedy is dependent upon its preparation. Healing qualities are increased when herbs are grown in a kitchen garden with loving care and without pesticides and herbicides. There are natural pros and cons to using herbs while breast feeding: herbs may flavor milk; some herbs that affect the infant and are as potent as pharmaceutical products; herbal remedies may alter the composition of milk; herbs can influence the quantity of milk. When there is any room for concern, consult a nutritionist and always consult your caring physician.

Breast feeding is one way that Allah has given us as mothers to nurture life and through it, Allah wants us to feed our young ones the physical, emotional and spiritual food vital to life. Studies have revealed that "African" youth who are breastfed and carried about on the mother's back as she goes about through the day are among the youth with the highest intelligence levels in the world.

Kabongo, a Kikiyu chief in Africa, spoke these beautiful words about his mother when he was eighty years old: "My early years are connected in my mind with my mother. At first she was always there; I can remember the comforting feeling of her body as she carried me on her back and the smell of her skin in the hot sun. Everything came from her," as related in Touching the Human Significance of the Skin by Ashley Montagu. (4)

3. "Herbal Remedies For The Breast feeding Mother, " Mothering, No. 48 (Summer 1988), p.69.
4. Ashley Montagu, TOUCHING The Human Significance of the Skin, (Harper and Row Publishers, 1978), p. 75.
The previous article is reprinted from Family Roots: The Quranic View of Family Life, by Mildred M. El-Amin, 1991, pp. 109-111, 219, 220.

Breastfeed your baby even if with your eye-drops … !

  • In a very accurate scientific reference, the Quran determines the period of lactation with almost two years.  In verse 14 of Surat Luqman: “And We enjoined on man concerning his parents- his mother bore him in weakness upon weakness, and his weaning was in two years.” (31:14)
الآية رقم (14) في سورة [لقمان]: (ووصينا الإنسان بوالديه حملته أمه وهنـًا على وهن وفصاله في عامين)
It is understood that lactation for two years is not a must, but a complete period; “Mothers shall breastfeed their children for two whole years, for such as desire to complete the term ” ( 2:233)
            ( وَالْوَالِدَاتُ يُرْضِعْنَ أَوْلاَدَهُنَّ حَوْلَيْنِ كَامِلَيْنِ لِمَنْ أَرَادَ أَن يُتِمَّ الرَّضَاعَةَ  ) – البقرة 233.

There are many benefits of breastfeeding , some of them will be discussed here :
For the mother:
- Protects against post-partum uteritis.
- Helps stop bleeding resulting from delivery, thus preventing loss of extra blood..
- Helps uterine restore normal size and place quickly after delivery.
- Prevents the recurrence of pregnancy with a rate of more than 98%, without contraceptives.
- Protects the lactating mother against breast and uterine cancer.
For the baby:
Breast feeding protects the baby from viral infections, as it contains immunity agents.
· It protects against food allergy, as it is free of protein that causes such kind of allergy, and which is usually found in extracted and manufactured cows milk.
It prevents shortage of calcium in the baby’s blood, thus helping to construct strong bones.
It returns with spiritual and psychological benefits to the baby, as it helps build a well composed, righteous and straight personality, and strengthens the spiritual and passionate links between the baby and the mother.
As revealed in a research published in Pediatric Clinics of North America in February 2001, the mental abilities of babies who receive breast feeding from their mothers are stronger and higher than otherwise, and the longer the period of breast feeding, the higher the mental abilities are.
It was shown that mother’s milk also provides protection against cancer. After showing that the incidence of the lymph cancer observed in childhood was nine times greater in formula-fed children, they realised that the same results applied to other forms of cancer. According to the results, mother’s milk accurately locates the cancer cells and later destroys them. It is a substance called alpha-lac (alphalactalbumin), present in large quantities in mother’s milk, that locates and kills the cancer cells. Alpha-lac is produced by a protein that assists in the manufacture of the sugar lactose in the milk.
In addition to some practical benefits of breast feeding. The milk is always ready with steady and appropriate heat, fresh, sterilized, digestible and saves money and time !
Researchers indicated that breast feeding alleviates the baby’s fear of needle pricks and helps as analgesic during painful operations such as circumcision.
A new theory emerged in the recent years indicating that the protein in cows milk can cause a biological reaction that destroys the pancreatic beta cells excreting insulin. This theory is supported with the high rate of the presence of cow milk proteins in the serum of children with diabetes in comparison with study group of non-diabetic children.
But why is it that cows milk causes this harm before the second year, and then disappears after this period?

In a study conducted in Finland in 1994 and published in Auto-immunity Journal, the authors state that the protein of cow milk passes in natural form through the lining membrane of digestive system which is not yet fully grown. As the enzymes of the digestive system cannot break the protein into amino acids, the protein of cow milk enters as a complex protein and works as a catalyst to produce immunity agents in the body of the child.
New references reveal that enzymes and the lining membrane of the digestive system and kinetics of digestion and absorption do not attain complete function except in the second year after delivery.
Many studies stress on breast feeding in the first two years 

The Qur'an and Breastfeeding

Allah said in the holy quran  : The mothers shall give suck to their offspring for two whole years, if the father desires to complete the term" ( SURAH ABAQARAH:233)
Allah's Messenger (my peace be upon him) said"You must nurse your baby even with your tears." as he recommended Asmaa Bent AbI Bakr (may God be pleased with him) to nurse her baby at the breast.
What has been mentioned above assures that women should nurse their babies at breast, without using any other method such as the artificial suckling, cow's milk or others. This raises the argument about the reason for this.
Comparing the natural suckling to artificial one proved the following:
  1. The milk's composition: The composition of mother's milk changes from feeding to another depending on the nutrient needs of the newborn, its endurance, and what suits its instinct and body's organs, which develop day after day. In the contrast, the artificial milk has a constant composition. For instance, the breast releases colostrum in the early days of lactation which contains many times as much protein and mineral element as the artificial milk. But mother's milk has poor cream and sugar, besides to the antibodies which sustain the baby's immunity. So, it is the perfect nutrition for the baby. The production of the breast milk's density decreases from feeding to another in natural way to displace the gastrointestinal tract of the baby then it changes to fulfill  the baby then it changes to fulfill the child's needs.
  2. Digestion: The mother's milk is easily digested because it contains digestive enzymes that aid the child's stomach enzymes in this process. The stomach gets rid of its content through one hour and half .Besides, the gastric acidity becomes normal and proper to kill germs that reach it, while it takes time in digesting the cheese's curdles of cow's milk up to 3 or 4 hours. Salts, which exist in cow's milk, modify and decrease the gastric acidity. This allows germs especially the colonic ones to reproduce then they cause diarrhea and vomit.
  3. Cleaning (purging): Mother's milk is pasteurized while the artificial milk is contaminated with bacteria as this occurs through the process of milking or when the bottle is contaminated.
  4. The temperature of mother's milk is constant and proper for the child's. The mother's milk is always the right temperature and it suits the child's temperature, while it is not always available in the artificial milk.
  5. Breast feeding is less expensive and even it costs nothing to mention economically.
  6. The mother' milk contains variety of autoimmune antibodies that aid in the development of baby's immune system against diseases. The varieties of autoimmune antibodies are much less existed in cow's milk .It is proved that breast fed babies are less exposed to have skin infection than bottle fed ones.
  7. The breastfeeding supports the natural bacteria that exist in the intestines. It has an effective role in absorbing vitamins and others nutrient elements, while the artificial milk irritates the natural bacteria.
  8. Cow's milk causes the effects of non endurance and sensitization, while it is not found in breastfeeding cases. These effects are diarrhea, colick, black stool and the symptoms of the common sensitization. Breast fed babies have less chance of having stomach ach and eczema.
  9. The acceptance of having different diseases: Bottle-fed babies are much more expected of affecting with different ailments such as aspiratory tracts infection and chronic atlactesis which is connected to the sediment of the milk's protein in the child plasma. While omitting the cow's milk from the child's feeding leads to his recovery from disease. Bottle feeding in creases babies risk of otitis media because when he makes first swallowing after suckling, lying on his back, the eustachian tube opens, so the milk and saliva go through the ear causing the otitis media. Having pyorrhea and the inflammation of the supporting tissues around the tooth are increased by 3 times more than the breast fed babies, besides to they don't suffer from laryngeal spasms. These differences explain why the death rate among bottle fed babies increases to about 4 times more than the breast fed babies. Despite today's technology which have been added to the way of preparing the milk in artificial ways and to the way of giving it to the baby.

The way of suckling and the turning benefits for mother:
 Suckling at the breast is always in the interest of mother because of many things. Firstly, baby's suckling helps shrink mother's uterus after childbirth as a result of suckling the nibble. So, it helps the uterus to back more quickly to its pre-pregnancy size. This helps prevent post-partum hemorrhage in mother.
 Secondly, breastfeeding mothers have less risk of developing breast cancer than bottle feeding moms. It is more common among virgins, non breastfeeding moms and women who have fewer children, so more lactation, less chance of cancer. Thirdly, suckling at breast is the perfect and the natural way of birth control. It encourages longer amenorrhea (periodlessness) naturally. It contributes to optimum child spacing or birth control, as it prevents using tablets, injections, or loop. Its mechanism lies in the action of the nipple's suckling which stimulates the release of the hormone prolactin from the anterior lobe of pituitary gland. The prolactin stimulates the ejection in the glandular tissue in the breast to decrease the releasing of gonadtrophic that is responsible of the changes during the menstrual cycle. This occurs for 60% breastfeeding women.

Lactation and spiritual bond:
 The maternal lactation strengthens the bonding and the emotions between mother and her new baby, as well as it makes the mother more passionate on her baby .This bond is the only guarantee for mother to take care of her baby by her own, because lactation is not just a concrete process but a sacred relationship between two creatures. Lactation satisfies woman's need of being a mother and responsible for bringing up a little child as it works as growing a plant in her life's orchard, besides to the overwhelming happiness that she obtain.
 Breastfeeding satisfies the baby's psychological and emotional needs and makes him pleasant and happy .There no more comforting feeling than being held close to his mother's heart beats, hearing its soft melody that provides him with tranquility and security ,besides to latching at her breast following by falling into sleep in peace.
 This strong bond could be weakened for bottle fed babies. It becomes worst when someone else than the mother takes care of the baby such as a maid or a baby sitter .By this way the child loses the normal peace, the most important thing for his early years, to achieve sound and affective interaction .The little baby has a strong personal relationship with the person who supplies nutrition, warm and comfort. So, it is necessary for mother to be this person.
 Recently, WHO (the World Health Organization) and UNICEF (United Nations International Children's Fund) state that breastfeeding should last for two years. They addressee the all mothers allover the world to follow their recommendations. An article was published in Pediatric Clinics of North America, an American magazine, issued in February 2001, calls the American women to follow the recommendations of the Pediatric Academy of America. They recommend having the babies nursed at breast for 12 months as a minimum period, but it is preferable to follow the instruction of WHO.
 These statements were miraculously stated by the Qur'an 14 centuries ago. Allah obligates mothers to nurse their babies at breast up to two years. God, to whom be ascribed all perfection and majesty, knows that this duration is the best from all sides of health and psychology. Today's researches of health and medicine have proved the necessity of a two year breastfeeding to have a sound growing up baby. God has mentioned this in the holy Qur'an before the human beings discover it lately. This is a sign of God's mercy on his people, especially those innocent children.
 The modern studies assure that the consumed mother's milk is prophylactic against many bacterial inflammations. Lactation reduces the risk of leukemia for children. The longer the baby was breastfed, the higher was the rate of prophylaxis against such kinds of cancers. That is not only everything but it also protect from lymphoma or the cancer of the lymph system.
 Moreover, a research, from Pediatric Clinics of North America of the same issue, has found that the kids who had consumed mother's milk have a significantly higher IQ than those who have no maternal milk. Also, this was heightened by the observation that the longer the baby was breast fed, the higher the IQ through the all years of life.

The research is prepared by Feras Nouralhak , the editor of the web site and translated by Maha Abdel Meguid Hussien.
Reference  : "With medicine in the Holy Qur'an" by Dr. Abdel Hamid & Dr. Ahmed Az'oz, The administration of Qur'an science, Damascus, and an article by Dr. Hassan Shamsi Basha