BREASTFEEDING

Effects of poor infant feeding practices:

About 5500 children die everyday
Suffer long-term effects:
> impaired development
> malnutrition
> increased infectious / chronic
illness
> rising rates of obesity in
children
 Effects of poor infant feeding practices:
Malnutrition has been responsible,
directly or indirectly, for 60% of the
10.9 million deaths annually among
children <5 years

Over two-thirds of these deaths occur

in the first year of life
 Exclusive Breastfeeding

Breastfeeding provides ideal food for

the healthy growth and development
of infants

Infants should be exclusively breastfed

for the first six months of life
 Definition of Exclusive
Breastfeeding

Exclusive breastfeeding means giving a

baby only breast milk, and no other
liquids or solids, not even water.
Drops or syrups consisting of
vitamins, mineral supplements or
medicines are permitted.
Advantages of breastfeeding

Breast milk Breastfeeding

• Perfect nutrients • Helps bonding
• Easily digested; and development
efficiently used • Helps delay a new
pregnancy
• Protects against
infection • Protects mothers’
health

 Costs less than artificial feeding

 Nutrients in human and animal
milks

Human Cow Goat

Fat

Protein

Lactose
Differences in the quality of proteins
in different milks
Human milk Cow’s milk

Whey protein

Curds

Easy to digest Difficult to digest

 Protection against infection

1. Mother infected 2. White cells in

mother’s body
make antibodies
to protect mother

4. Antibodies to 3. Some white cells

mother’s infection go to breast and
secreted in milk to make antibodies
protect baby there
Differences between colostrum and mature
milk

Hindmilk
Foremilk

Fat

Protein

Lactose

Colostrum
Mature milk
 Colostrum

Property Importance
• Antibody rich - protects against allergy &
infection
• Many white cells - protects against infection
• Purgative - clears meconium
- helps to prevent jaundice
• Growth factors - helps intestine to mature
- prevents allergy, intolerance
• Rich in Vitamin A - reduces severity of infection
 Psychological benefits of
breastfeeding
Emotional bonding
• close, loving relationship between mother and
baby
• mother more emotionally satisfied
• baby cries less
• baby may be more emotionally secure
Development
• children perform better on intelligence tests
 Disadvantages of artificial feeding

• Interferes with bonding

• More diarrhea and persistent diarrhea
• More frequent respiratory infections
• Malnutrition; Vitamin A deficiency
• More allergy and milk intolerance
Disadvantages of artificial feeding

• Increased risk of some chronic diseases

• Obesity

• Lower scores on intelligence tests

• Mother may become pregnant sooner

• Increased risk of anemia, ovarian cancer,

and breast cancer in mother
Risk to children who are NOT breastfed

1. More likely to get sick or die from

diarrhea and GI infections or chest
infections
2. Become underweight, not grow well
3. Overweight and to have later heart
problems
 Risk of diarrhea by feeding method
Philippines, infants aged 0-2 months

20
18 17.3
16
14 13.3
12
10
8
6
4 3.2
2 1
0
Breast milk only Breast milk and Breast milk and No breast milk
non-nutritious nutritious
liquids supplements
 3/3

Prolactin
Secreted during and after feed to produce next feed

Sensory impulses
from nipples

Prolactin in blood

Baby suckling
• More prolactin
secreted at night
• Suppresses
ovulation
What can we suggest to a mother so she could INCREASE her milk supply ?

The more the baby suckles the more milk

is produced

Mother to eat and drink enough

More prolactin is produced at night

Hormones related to prolactin suppresses

ovulation so breastfeeding can help delay a
new pregnancy
 Oxytocin reflex
Works before or during feed to make milk flow

Sensory impulses
Oxytocin in from nipples
blood

Baby
suckling • Makes uterus
contract
Oxytocin is
produced more quickly than
prolactin

makes the milk in the breast flow for

this feed

can start working when mother

expects a feed, even before a baby
suckles

If oxytocin reflex does not work well,

breast produce milk BUT not flowing
out
Oxytocin

makes uterus contracts after

delivery
helps reduce bleeding
sometimes causes uterine pain
and a rush of blood during a feed
for the first few days
Helping and hindering of oxytocin reflex

These help reflex These hinder reflex

• Thinks lovingly of • Worry

baby •Stress
• Sounds of baby
• Pain
• Sight of baby
• Doubt
• Touches baby (temporary)
• Confidence
Signs & sensations of an active Oxytocin reflex

Mother may notice:

Squeezing or tingling sensation in her breast
Milk flow from breast
Milk dripping from other breast when baby is
suckling
Pain from uterine contraction, sometimes with
rush of blood
Slow deep sucks and swallowing by the baby
which shows that milk is flowing into the mouth
 Mother’s position

1. Sitting on the floor or ground

2. Sitting on a chair
3. Lying down
4. Standing up

• Comfortable with back supported

• Feet supported
• Breast supported
 Baby’s Position
 Along mothers arm
 Under mothers’ arm
 Along her side

demo
 7/1

Breastfeeding Positions
4
1
>In line
>Close
>Supported
>Facing
3

Breastfeeding Counselling: a training course,

WHO/CHD/93.4, UNICEF/NUT/93.2
 Four key points for proper BF position

1. Baby’s head and body in line

2. Baby held close to mother’s body

3. Baby’s body supported by head and neck

4. Baby approaches breast, nose to nipple

 Correct Position

Baby’s body needs to be

 In line with ear, shoulder and hip
in a straight line,
 Close to mother’s body
 Supported at the head, shoulders
and if newborn, the whole body
 Facing the breast
 Breastfeeding in a sitting position
 Mother’s position is
important

 Sit with back and feet

supported

 Bring the baby level with the

breast using rolled up towel or
clothes, cushion or pillow demo
 Breastfeeding in a lying
position
 Mother to lie on her side
 Rolled pillow under her head &
between her knees
 Her back needs support
 Can support baby’s back
 Can support breast
(if necessary)
Attachment to the breast
 3/7
Attachment to the breast

More areola &

underlying tissue inside
mouth
Large ducts inside
mouth
Formed long teat
Nipple forms only 1/3 of
the “teat”
Baby suckling from
breast and NOT nipple
 3/7

Attachment to the breast

Baby’s tongue …
forward over his lower
gum and beneath the
larger ducts
cupped round the “teat”
presses milk out of
larger ducts into baby’s
mouth
 3/8

Good and poor attachment

What differences do you see?

1 2
 Complementary Feeds:

Infants are particularly vulnerable during

the transition period when
complementary feeding begins. Ensuring
that their nutritional needs are met
requires that complementary foods be:
 Complementary feeds are
Timely- they are introduced when the need
for energy and nutrients exceeds what
can be provided through exclusive and
frequent breastfeeding

Adequate- they provide sufficient energy,

protein and micronutrients to meet a
growing child’s nutritional needs
 Complementary feeds are
Safe- hygienically stored and prepared and
fed with clean hands using clean utensils
and not bottles and teats

Properly fed- they are given in response to a

child’s signals of hunger and that meal
frequency and feeding methods are
suitable for the child’s age
Feeding in exceptionally difficult
circumstances

Emergency situations
Malnourished children
Low birth weight babies
Infants of HIV infected mothers
Orphans
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