The article “Breastfeeding and the Use of Human Milk” published Monday morning in the online version of the journal Pediatrics lays out the case for breast-feeding, reaffirming its standing recommendation that babies be exclusively breast-fed for about the first six months of life. After that, the paper says breast-feeding should continue until the baby is at least a year old, even as new foods are introduced, and should last “for as long as mutually desired by mother and baby.”

Revisiting its breast-feeding recommendation for the first time in five years, the AAP notes that research published since its last recommendation has bolstered the case for exclusive breast-feeding for young babies. Compared to babies who never or are only partially breast-fed, babies who are exclusively breast-fed have been found to have reduced risk of respiratory illnesses, ear infections, gastrointestinal diseases, and allergies including asthma, eczema and atopic dermatitis, the paper notes. Beyond that, the paper says, breast-fed babies are more that a third less likely than others to suffer sudden infant death syndrome and 15 percent to 30 percent less likely to be obese as adolescents and adults.

The authors observe that different socioeconomic and cultural groups embrace breast-feeding at different rates. For instance, more than 79 percent of mothers older than 30 initiate breast-feeding, while just 30 percent of non-Hispanic black mothers under age 20 do so. Overall, only 13 percent of the U.S. population breast-feeds for a full six months after a baby’s birth.

The paper acknowledges the presence of barriers to breast-feeding and suggests that pediatricians, hospitals and businesses do more to promote the practice; hospitals, for one thing, could stop pushing infant formula on new mothers, and businesses can make better arrangements to accommodate breast-feeding employees.

The AAP statement moves breast-feeding from the realm of the purely personal decision to the public-health arena: “Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding,” the paper says, “infant nutrition should be considered a public health issue and not only a lifestyle choice.”