WB W 201 2

Breastfeeding for Enhancing Child Growth and Development

Presenta tion By:

SK Tegta

Theme for World Breatfeeding Week Facts on Breastfeeding Definition of Infant Feeding Advantages of Breast milk & Breast feeding. Nutrients in Breast Milk How Breastmilk is produced Establishing Breastfeeding Skills Expressing Breastmilk

WB W 201 2

Presenta tion By:

SK Tegta

WB W 201 2

Presenta tion By:

SK Tegta

Objectives: To take stock of implementation of policies and programmes on breastfeeding & infant and young child feeding in India. To celebrate successes and achievements of past 20 years. To identify the gaps that exist and call for action to bridge these gaps. To raise awareness among public and policy makers about these gaps in policies and programmes related to breastfeeding and infant and young child feeding. To share the action taken with the national and global community.

WB W 201 2

Presenta tion By:

SK Tegta

1992 1993 1994 1995 1996 1997 1998 1999 2001 2002 2001 2000

Baby-Friendly Hospital Initiative (BFHI) Women, work and breastfeeding: Everybody benefits! Protect Breastfeeding: Making the Code Work Breastfeeding: Empowering Women Breastfeeding: A Community Responsibility Breastfeeding: Natures Way Breastfeeding: Best Investment Breastfeeding: Education for Life Breastfeeding in the Information Age Breastfeeding: Healthy Mothers and Healthy Babies Breastfeeding in the Information Age Breastfeeding It's Your Right

WB W 201 2

Presenta tion By:

SK Tegta

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Breastfeeding in a Globalised World for Peace and Justice Exclusive Breastfeeding: the Gold Standard Breastfeeding and Family Foods: Loving & Healthy The IMS Act: Making it Known to People Breastfeeding: The 1st Hour - Save ONE million babies! Mother Support : Going for the Gold Breastfeeding: A Vital Emergency Response Breastfeeding: Just 10 Steps. The Baby-Friendly Way Talk to me! Breastfeeding - a 3D Experience Taking Stock of Policies and Programmes

WB W 201 2

Presenta tion By:

SK Tegta

It has been estimated that about 2 million child deaths could be averted every year through effective breastfeeding. Exclusively breastfed infants have at least 2 times fewer illness episodes than infants fed breast-milk substitutes. Infants are as much as 25 times more likely to die from diarrhoea in the first 6 months of life if not exclusively breastfed. Among children under one year, those who are not breastfed are 3 times more likely to die of respiratory infection than those who are exclusively breastfed.

WB W 201 2

Presenta tion By:

SK Tegta

Infants exclusively breastfed for 4 or more months have half the mean number of acute otitis media episodes of those not breastfed at all. In low-income communities, the cost of cows milk or powdered milk, plus bottles, teats, and fuel for boiling water, can consume 25 to 50% of a familys income. Breastfeeding contributes to natural birth spacing, providing 30% more protection against pregnancy than all the organized family planning programmes in the developing world.

WB W 201 2

Presenta tion By:

SK Tegta

The peak period of malnutrition is between 6 and 28 months of age. Malnutrition contributes to about half of under-five mortality & a third of this is due to faulty feeding practices. Counseling on breastfeeding and complementary feeding leads to improved feeding practices, improved intakes and growth. Counseling on breastfeeding and complementary feeding contributes to lowering the incidence of diarrhoea.

WB W 201 2

Presenta tion By:

SK Tegta

Initiate breastfeeding hour of birth.

within

one

WB W 201 2

Breastfeed exclusively for the first six months of age (180 days). Thereafter give nutritionally adequate and safe complementary foods to all children. Continue breastfeeding for up to two years of age or beyond.
Presenta tion By:

SK Tegta

Initiate breastfeeding within one hour of birth. Breastfeed exclusively for the first six months of age (180 days). Thereafter give nutritionally adequate and safe complementary foods to all children.

45.4%

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27.1%

66.0%

Presenta tion By:

SK Tegta

WBW 2012

Feeding

the fetus

Feeding the pregnant mother

Feeding

the infant 0-6 monthsExclusive breast feeding beyond 6 monthsComplementary feeding +BF
Presentation By:

Feeding

SK

WBW 2012

Presentation By:

SK

 Optimal

WHAT IS OPTIMAL INFANT AND YOUNG CHILD FEEDING?

WBW 2012

feeding is defined as exclusive breastfeeding from birth to six months of age and there after continued breastfeeding for 2 years or beyond with adequate and safe complementary feeds to meet nutritional needs of a young child
Presentation By:

SK

DEFINITIONS FOR INFANT FEEDING

Exclusive breastfed
Only breastmilk is given . No other food or drink, Not even water is given

WBW 2012

Predominantly breastfed
The main source of nutrition is breastmilk but the child is also receiving other fluids (non-nutritive) or water
Presentation By:

SK

DEFINITIONS FOR INFANT FEEDING

WBW 2012

Mixed feeding the child receives animal milk, formula or cereal based foods in addition to breast milk Replacement feeding Is the process of feeding a child who is not receiving any breast milk

with a diet that provides all the nutrients the child needs until the child is fully fed on family foods
Presentation By:

SK

WB W 201 2

Presenta tion By:

17

SK Tegta

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Presenta tion By:

18

SK Tegta

Advantages of Breastfeeding

WB W 201 2

Presenta tion By:

SK Tegta

Advantages of Breastfeeding
Breastmilk
Perfect nutrients Easily digestible Ready to serve Protects against infection Protects against adult onset diseases (diabetes, high blood pressure)

Breastfeeding

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Helps bonding and development Helps in adequate growth and development Enhances brain & visual development Baby has higher intelligence quotient Prevents hypothermia

Presenta tion By:

SK Tegta

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Mother

Family
Low cost involved Less illnesses Family bonding

Society
Eco-friendly Human resource development Economy development

Reduces post delivery bleeding and anemia Delays next pregnancy Protects breast and ovarian cancer Protects obesity and shapes body Convenient

Presenta tion By:

SK Tegta 7

Brain.Higher IQ in breastfed children. Cholesterol and other types of fat in human milk support the growth of nerve tissue. Eyes.Visual acuity is higher in babies fed human milk. Ears.Breastfed babies get fewerear infections.

WB W 201 2

Presenta tion By:

SK Tegta 7

Mouth.Less need for orthodontics in children breastfed more than a year. Improved muscle development of face from suckling at the breast. Subtle changes in the taste of human milk prepare babies to accept a variety of solid foods. Throat.Children who are breastfed are less likely to require tonsillectomies.

WB W 201 2

Presenta tion By:

SK Tegta 7

Respiratory system.Evidence shows that breastfed babies have fewer and less severe upper respiratory infections, less wheezing, less pneumonia and less influenza. Heart and circulatory system.Evidence suggests that breastfed children may havelower cholesterolas adults. Heart rates are lower in breastfed infants.

WB W 201 2

Presenta tion By:

SK Tegta 7

Digestive system.Less diarrhoea, fewer gastrointestinal infections in babies who are breastfeeding. Six months or more of exclusive breastfeeding reduces risk offood allergies. Also, less risk ofCrohn's diseaseand ulcerative colitisin adulthood. Immune system.Breastfed babies respond better to vaccinations. Human milk helps to mature baby's own immune system. Breastfeeding decreases the risk ofchildhood cancer.

WB W 201 2

Presenta tion By:

SK Tegta 7

Endocrine system.Reduced risk of getting diabetes. Kidneys.With less salt and less protein, human milk is easier on a baby's kidneys. Appendix.Children with acute appendicitis are less likely to have been breastfed. Urinary tract.Fewer infections in breastfed infants.

WB W 201 2

Presenta tion By:

SK Tegta 7

Joints and muscles.Juvenile rheumatoid arthritis is less common in children who were breastfed. Skin.Less allergic eczema in breastfed infants. Growth.Breastfed babies are leaner at one year of age and less likely to be obese later in life. Bowels.Less constipation. Stools of breastfed babies have a less-offensive odor

WB W 201 2

Presenta tion By:

SK Tegta 7

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Presenta tion By:

SK Tegta 7

What are the differences between these milks?

WB W 201 2

Presenta tion By:

Tegta 8

29 SK

DIFFERENCES IN THE QUALITY OF THE PROTEINS IN DIFFERENT MILKS

Whey Proteins
Anti-Infective Proteins

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35% Casein

Presenta tion By:

SK Tegta 9

HUMAN

COW`S

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Contains Essential Fatty Acids, Enzyme Lipase

Contains No Essential Fatty Acids No Enzyme Lipase

Presenta tion By:

SK Tegta 10

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Presenta tion By:

SK Tegta 11

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Presenta tion By:

SK Tegta 12

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When Mother infected White cells in mothers body make antibodies to protect her

These antibodies are secreted in breastmilk to protect baby

Some white cells go to her breast and make antibodies there

Presenta tion By:

SK Tegta 13

VARIATIONS IN THE COMPOSITION OF BREASTMILK

What differences do you notice here?
COLOSTRUM

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Mature Milk

Presenta tion By:

Tegta 14

35 SK

Property

Importance

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Antibody rich Many white cells Purgative effect Growth factors Vitamin A rich

protects against infection and allergy protect against infection clears meconium helps to prevent jaundice help intestine to mature prevents allergy, intolerance reduces severity of infection
Presenta tion By:

SK Tegta 15

WB W 201 2 Animal Kingdom: Human Beings

1.Offspring on feet 1.Baby holds neck at 3 month 2.Moves to udders 2.Walks at 1 yr 3.Makes position 3.Mother makes position
No role of Mother No role of Baby

Presenta tion By:

SK Tegta

WB W 201 2
First

few days after delivery- the breast feel soft and empty- only small amount of yellowish first milk (colostrum) is secreted After few days (may vary from 2 days to one week)-the breast begins to feel full , and sometimes hard- Milk has come in
Presenta tion By:

SK 8 Tegta

WB W 201 2
The

breast consists:
Gland

tissues Supporting tissues, and Fats

Presenta tion By:

SK 8 Tegta

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The gland tissue (known as alveoli) are small sacs, made up of millions of milk secreting cells which goes along small tubes towards the nipple

Presenta tion By:

SK 8 Tegta

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Before they reach the nipple, the tubes become much wider, and form lactiferous sinuses in which milk collects.
Presenta tion By:

SK 8 Tegta

WB W 201 2
Hormonal

secretions in the
helps in production of causes ejection of

mother
Prolactin

milk
Oxytocin

milk

Reflexes in the baby rooting, sucking & swallowing

Presenta tion By:

SK Tegta

PROLACTIN REFLEX
Secretion continues AFTER feed to produce NEXT feed

WB W 201 2

Presenta tion By:

Frequent Suckling Increases Milk Production

SK 9 Tegta

Enhancing factors
Emptying of breast

Hindering factors
Bottle feeding

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Sucking

Incorrect Positioning

Expression of milk Night feeds

Painful Breast

Prolactin in blood

Sensory impulse from nipple

Presenta tion By:

SK Tegta

WB W 201 2

Enhanced by: How early the baby is put to the breast How often and how long baby feeds at breast How well the baby is attached to the breast

Presenta tion By:

SK Tegta

Hindered by Delayed initiation of breastfeeds Prelacteal feeds Making the baby wait for feeds Dummies, pacifiers, bottles Certain medication given to mothers Painful breast conditions

WB W 201 2

Presenta tion By:

SK Tegta

OXYTOCIN REFLEX

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Presenta tion By:

For milk ejection

SK 10 Tegta

Helping and Hindering the Oxytocin Reflex

Stimulated by Inhibited by

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Thinks lovingly of baby Sound of the baby Sight of the baby CONFIDENCE

Worry Stress Pain Doubt

Presenta tion By:

SK Tegta

FEEDING REFLEXES
Rooting reflex When something touches lips, baby opens mouth puts tongue down and forward Sucking reflex When something touches palate baby sucks

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Skill Mother learns to position baby Baby learns to take breast

Swallowing reflex Gag reflex When something touches anterior part of the tongue, baby pushes it out. When mouth fills with milk, baby swallows

Presenta tion By:

SK 13 Tegta

Mechanism of Sucklin g Cycle

WB W 201 2

Presenta tion By:

SK 15 Tegta

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For

effective suckling the baby does not take just the nipple but a mouthful of the areola and the breast tissue beneath, which contains the lactiferous sinuses

Presenta tion By:

SK 14 Tegta

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Presenta tion By:

SK Tegta

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lightly back. His body is turned towards you. His body is close to you . His whole body is supported. There is eye contact between you and your baby.

Presenta tion By:

SK Tegta

WB W 201 2

Presenta tion By:

SK Tegta

To nurse your baby while cradling or holding him across your lap, he should be lying on his side, resting on his shoulder and hip with his mouth level with your nipple. Use pillows lifting your baby and supporting your elbows to bring your baby up to nipple height especially during the first few weeks. Support your breast with either the "U" hold" or "C" hold

WB W 201 2

Presenta tion By:

SK Tegta

baby is supported on a pillow across your lap to help raise him to your nipple level. Pillows should also support both elbows so your arms don't hold the weight of the baby; they will tire before the feeding is finished. If you are preparing to breastfeed on the left breast, your left hand supports that breast in a "U" hold.

WB W 201 2

Presenta tion By:

SK Tegta

WB W 201 2

Presenta tion By:

SK Tegta

This is a good position for a mother who has had a Cesarean birth, as it keeps the baby away from the incision. In the clutch position you support your baby's head in your hand and his back along your arm beside you. You support your breast with a "C" hold. baby's legs and feet are tucked under your arm with his hips flexed and his legs resting along side your back rest so the soles of his feet are pointed

WB W 201 2

Presenta tion By:

SK Tegta

WB W 201 2

Presenta tion By:

SK Tegta

Feeding Positions Side Lying Position

Many mothers find lying down to nurse a comfortable position, especially at night Both mother and baby lie on their sides facing each other. The baby can be cradled in your arm with his back along your forearm. Having his hips flexed and his ear, shoulder and hip in one line helps your baby get milk more easily.

WB W 201 2

Presenta tion By:

SK Tegta

Proper Attachment

WB W 201 2

Presenta tion By: Presenta Tegta tion By:

SK

SK Tegta

Signs of good attachment are Chin touching breast Mouth wide open Lower lip turned outward More areola visible above than below the mouth There should be no pain

WB W 201 2

Presenta tion By:

SK Tegta

Signs that a baby is attached well at the breast

lower lip is curled outward babys mouth is wide open

WB W 201 2

chin touches the breast

lower portion of the areola is not visible

Presenta tion By:

SK Tegta

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Presenta tion By:

SK 24 Tegta

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Is this baby well attached?

Presenta tion By:

- YES

SK Tegta

 His neck is twisted or bent forward. His body is turned away from you His body is not close to you. Only his head and neck are supported. There is no eye contact between you and your baby.

WB W 201 2

Presenta tion By:

SK Tegta

Signs of poor attachment are Chin separated from the breast Mouth looks closed Lower lip pointed forward More areola visible below the mouth and lower lip You feel nipple pain

WB W 201 2

Presenta tion By:

SK Tegta

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Chin touching the breast Mouth wide open Lower lip turned outwards More areoala visible above than below

No Yes yes No

INFANT NOT WELL ATTACHED

Presenta tion By:

SK Tegta 68

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Presenta tion By:

23 Tegta

SK

WB W 201 2

Is this baby well attached ?

Presenta tion By:

- NO

SK Tegta 70

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This infant is sucking only from the nipple and is not well attached

Presenta tion By:

SK Tegta 71

Nipple Confusion
When Baby Bottlefeed:
He doesn't have to open his mouth as wide or correctly turn out the lips to form a tight seal.

WB W 201 2

The bottle nipple does not need to be far back into the mouth, nor is the milking action of the tongue necessary. Baby can lazily gum the nubbin of the rubber and suck with only his lips. When the milk comes out too fast, baby may thrust his tongue forward and upward, to stop the flow from the nipple. Milk keeps on coming during feedings from bottles--whether or not baby sucks--so there are no pauses to rest during bottlefeedings.

Presenta tion By: Presenta Tegta tion By:

SK

SK Tegta

Nipple Confusion
When Baby Breastfeed:
Baby opens his mouth wide and draws the nipple and areola tissue far back into his mouth.

WB W 201 2

The tongue holds the breast tissue against the roof of baby's mouth The gums compress the milk sinuses underneath the areola while the tongue rhythmically "milks" the breast with a wave-like motion from front to back, drawing the milk from the areola and the nipple. Since the nipple is far back in baby's mouth, it's not compressed by the gums, so it's less likely to get sore.

Presenta tion By: Presenta Tegta tion By:

SK

SK Tegta

Nipple Confusion
Babies who bottlefeed may thrust their tongue upward during sucking and push the breast nipple out of their mouth. They don't open their mouths wide enough when latching-on, so they suck only the tip of the nipple. They don't get enough milk, and mother's nipples get sore. Baby becomes accustomed to the immediate flow of milk that comes from the bottle; at the breast, babies have to suck for a minute or two to stimulate mother's milk ejection reflex and get the milk flowing.

WB W 201 2

Presenta tion By: Presenta Tegta tion By:

SK

SK Tegta

WB W 201 2

Presenta tion By:

SK Tegta

Expressing milk is useful to: Feed a low birth weight or sick baby. Relieve engorgement. Maintain the milk supply when the mother is ill. Relieve leaking breasts. Leave milk for the baby when you go out to work. Feed a baby while he learns suckling from inverted nipples.

WB W 201 2

Presenta tion By:

SK Tegta

 Wash your hands thoroughly Sit or stand comfortably holding a clean container near the breast Support your breast with one hand and Use the other to stroke downwards from the top towards the areola.

Squeeze the lower part of the breast between your thumb and forefinger, pressing firmly to force the milk out.

Move your fingers and thumb around the outer sides of your breast.Express this milk into a sterile container.

 Breastmilk can be stored in a refrigerator for 24 hours and at room temperature for 8 hours. Refrigerated breastmilk should not be heated, as it will destroy protective substances. It should be brought to room temperature before being fed by a cup.

WB W 201 2

Presenta tion By:

SK Tegta

WB W 201 2

Presenta tion By:

SK Tegta