Download Exclusive Breast Feeding – Dr Faridi

Successful Early
Initiation and Exclusive
Breastfeeding up to Six
Months of Age
Helping Women to Be
Successful in
Breastfeeding the Baby
Global and National Recommendations
for Infant and Young Child Feeding




Initiate breastfeeding
within one hour of birth
Exclusive breastfeeding
for first 6 months of life
Introduce nutritionally
adequate and safe
complementary foods
after the infant reaches
6 months of age
Continue to breastfeed
for 2 years or beyond.
Benefits to the Baby







Complete food for the first six months
Perfect nutrition
Higher IQ
Emotional bonding
Prevents infections
Prevents chronic diseases
Easily digested
Benefits to the Mother






Reduces post delivery bleeding and anemia
Helps delay next pregnancy - LAM
Protective effect against breast and ovarian
cancer
Helps to loose weight
Emotional bonding
Needs no preparation
Benefits to the Society



Reduces absenteeism of mothers from work
as they are less prone to disease.
Economical
Enhances Bonding
Economic benefits of BF
US $3.6 billion saving if EBF
↑ 64% to 75% (in hospital)
↑ 29% to 50% (at 6 months)
[Weimer J,US dept. Agriculture Report-13]

Medical cost at 12 months US $200 less in BF
compared to formula fed
[Honey & ware 1997]

Exclusive Breastfeeding
& Lipid Profile
S. Cholesterol, total triglycerides and poor
HDL/LDL ratio
significantly more in EBF infants
compared to mixed-feds and formula-feds
and improve by six months of age for
better brain growth
[Eur J Clin Nutr 2008; 62:203-209]
Exclusive Breastfeeding &
Anemia
Term AGA infants on
Exclusive Breastfeeding till 6 months
born to
Anemic or Non-anemic mothers
Do not develop
Iron Deficiency Anemia
[International Breastfeed J 2007;3:3]
First year is critical!
Malnutrition strikes the most in infancy beginning in 3-4th month ,
29-30 % at 6 months, goes up and peaks about 46% by 18
months, flat curve after that (NFHS 3).
Brain development
10 lakh children
die during
first month,
14 lakhs by
1 year, and 20 lakhs
by 5 yrs. 2/3rd are related to poor feeding.
Underweight (-2sd) NFHS-3
Years of life
Over 60 million
Percentage of Neonatal Deaths (2-28
days) Saved with Early Initiation
25
Risk of neonatal
death is 4 fold, if
milk based fluids or
solids are given to
breastfed neonates
Imitation after day 1
is associated with
2.4 fold increase in
risk of death
22.3
16.3
20
15
10
5
0
Within 1 hour
1-24 hour
Initiation of breastfeeding
PEDIATRICS 2006; 117:380-386
1/18
U-5 deaths reduction by preventive
Interventions
Percent
0%
2%
4%
6%
8%
10%
12%
14%
16%
Breastfeeding
Complementary feeding
Clean delivery
Hib vaccine
Clean water, sanitation, hygiene
Intervention
Zinc
Vitamin A
Antenatal steroids
Newborn temperature management
Tetanus toxoid
Antibiotics for PRM
Measles vaccine
Nivirapine and replacement feeding
Insecticide-treated materials
Antimalarial IPT in pregnancy
Source: Jones et al. LANCET 2003;362:65-71
Breastfeeding is
defined as exclusive
breastfeeding for first
6 months and
continued
breastfeeding during
6-11 months
18%
Successful Breastfeeding…

Initiate Breastfeeding Within One Hour of Birth
What is Exclusive
Breastfeeding?



Giving an infant only
breastmilk
No food or drink other
than breastmilk— not
even water
No Ghutti/Honey etc.
Is Breast feeding So Simple?
Animal Kingdom:
1.Offspring on feet
2.Moves to udders
3.Makes position
No role of Mother
Human Beings:
1.Baby holds neck 3 mo
2.Walks at 1 yr
3.Mother makes
position
No role of Baby
How to Protect Breastfeeding



Make National
breastfeeding policy
Include Breastfeeding
in clinical practice
Obtain Training in
breastfeeding
management
Global Strategy for Infant and
Young Child Feeding

Adopted by the WHA
and UNICEF Executive
board in 2002
Strategies






Development of BREASTFEEDING support clinics/
Lactation management clinics in hospitals run by skilled/
trained counselors
Promoting BREASTFEEDING friendly PHCs/Private
clinics/hospitals supported by SKILLED staff.
Building IYCF counselling as service in job profile of
workers
Developing community led initiatives :Peer counselling
support groups
Eliminate MISINFORMATION from media (International
Code)
Establishing national and state level resource centers
Successful Breastfeeding…
Major Hurdles
 Lack of family support
 Lack of support by health professionals
 Commercial influence
 Feeling of not enough milk among women
Successful Breastfeeding…
Important Do’s
 Initiate breastfeeding as early as possible within one
hour of birth.
 Do not give the baby any prelacteal feeds
 No bottles, artificial teats or pacifier
 Breastfeeding on demand at least 8-10 times in a
day and at night a
 Breastfeed in a correct position
 Build mother’s confidence to sustain good milk
supply and alleviate feeling of not enough milk.
Successful Breastfeeding…
No Prelacteal Feeds
 Replace colostrum
 Reduce baby’s desire for
breastfeeding
 Greater risk of infection
 Risk of intolerance,
allergy
Successful Breastfeeding…

No Bottles, Artificial
Teats or Pacifiers for
Breastfeeding Infants
It lead to nipple confusion
Successful Breastfeeding…
Breastfeeding in the Correct Position





Milk producing glands
Lactiferous canaliculi
Lactiferous sinuses
Myoepithelial tissue
Adipose tissue
Anatomy of the Breast
Successful Breastfeeding…
Build Mother’s Confidence
 During prenatal period
 During antenatal Period
 During postnatal period
The Feeling of “Not Enough
Milk”
Not true. Just a perception
 Reinstate mother’s confidence
 Ensure frequent, effective suckling
Breastmilk Production
The Prolactin reflex
Prolactin
in blood
Sensory Impulses
from nipple
• More prolactin
secreted at night
• Secreted after feed
to produce next feed
Baby
sucking
• Suppresses
ovulation
Breastmilk Transfer
The Oxytocin reflex
Oxytocin
in blood
Baby
sucking
Sensory Impulses
from nipple
• Works before or during
feed to make milk flow
• Makes uterus contract
Breastmilk Transfer
How does the mother’s
confidence play part
Thinks lovingly
of baby
CONFIDENCE
Sound of baby
Sight of baby
Pain
Worry
Stress
Doubt
Feeding reflexes in the baby
Rooting reflex
Mother learns to
position baby
Sucking reflex
Baby learns to take
breast
Swallowing reflex
Signs of Correct Attachment






Mouth wide open
Lower lip is turned outside
Chin touching the breast
Black part of the breast not
visible below the lower lip
Large black portion of
breast and nipple including
milk collecting ducts are
inside baby’s mouth
Tongue under the teat
Incorrect Sucking Position





Mouth is not wide open
Chin is away from the
breast
Baby is sucking only
nipple
Most black portion of
the breast is outside
the baby’s mouth
Tongue away from the
teat
Causes of Incorrect
Attachment




Use of feeding bottles. Leads to nipple
confusion
Inexperienced mother
Functional difficulty with the mother or the
baby
Lack of skilled support
Conclusion
Exclusive Breastfeeding for First Six
Months
Being Successful Initiate breastfeeding as early as possible within one hour of
birth.
 Do not give the baby any prelacteal feeds
 No bottles, artificial teats or pacifier
 Breastfeeding on demand at least 8-10 times in a day and at
night a
 Breastfeed in a correct position
 Build mother’s confidence to sustain good milk supply and
alleviate feeling of not enough milk.
Be
a
leader
Thank you friends