Title: Successful Early Initiation and Exclusive Breastfeeding up to Six Months of Age
1Successful Early Initiation and Exclusive
Breastfeeding up to Six Months of Age
2Helping Women to Be Successful in Breastfeeding
the Baby
3Global 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.
4Benefits to the Baby
- Complete food for the first six months
- Perfect nutrition
- Higher IQ
- Emotional bonding
- Prevents infections
- Prevents chronic diseases
- Easily digested
5Benefits 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
6Benefits to the Society
- Reduces absenteeism of mothers from work as they
are less prone to disease. - Economical
- Enhances Bonding
7Economic 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
-
-
8Exclusive 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 62203-209
9Exclusive 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 200733
10First 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).
1
2
3
4
5
Years of life
11Percentage of Neonatal Deaths (2-28 days) Saved
with Early Initiation
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
PEDIATRICS 2006 117380-386
1/18
12U-5 deaths reduction by preventive Interventions
Percent
0
2
4
6
8
10
12
14
16
18
Breastfeeding
Complementary feeding
Clean delivery
Hib vaccine
Clean water, sanitation, hygiene
Zinc
Vitamin A
Breastfeeding is defined as exclusive
breastfeeding for first 6 months and continued
breastfeeding during 6-11 months
Intervention
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 200336265-71
13Successful Breastfeeding
- Initiate Breastfeeding Within One Hour of Birth
14What is Exclusive Breastfeeding?
- Giving an infant only breastmilk
- No food or drink other than breastmilk not even
water - No Ghutti/Honey etc.
15Is 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
16How to Protect Breastfeeding
- Make National breastfeeding policy
- Include Breastfeeding in clinical practice
- Obtain Training in breastfeeding management
17Global Strategy for Infant and Young Child Feeding
- Adopted by the WHA and UNICEF Executive board in
2002
18Strategies
- 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
19Successful Breastfeeding
- Major Hurdles
- Lack of family support
- Lack of support by health professionals
- Commercial influence
- Feeling of not enough milk among women
20Successful Breastfeeding
- Important Dos
- 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 mothers confidence to sustain good milk
supply and alleviate feeling of not enough milk.
21Successful Breastfeeding
- No Prelacteal Feeds
- Replace colostrum
- Reduce babys desire for breastfeeding
- Greater risk of infection
- Risk of intolerance, allergy
22Successful Breastfeeding
- No Bottles, Artificial Teats or Pacifiers for
Breastfeeding Infants - It lead to nipple confusion
23Successful Breastfeeding Breastfeeding in the
Correct Position
- Milk producing glands
- Lactiferous canaliculi
- Lactiferous sinuses
- Myoepithelial tissue
- Adipose tissue
Anatomy of the Breast
24Successful Breastfeeding
- Build Mothers Confidence
- During prenatal period
- During antenatal Period
- During postnatal period
25The Feeling of Not Enough Milk
- Not true. Just a perception
- Reinstate mothers confidence
- Ensure frequent, effective suckling
26Breastmilk Production
The Prolactin reflex
Sensory Impulses from nipple
Prolactin in blood
- More prolactin secreted at night
- Secreted after feed to produce next feed
- Suppresses ovulation
Baby sucking
27Breastmilk Transfer
The Oxytocin reflex
Sensory Impulses from nipple
Oxytocin in blood
- Works before or during feed to make milk flow
- Makes uterus contract
Baby sucking
28Breastmilk Transfer
How does the mothers confidence play part
Pain Worry Stress Doubt
Thinks lovingly of baby CONFIDENCE Sound of baby
Sight of baby
29Feeding reflexes in the baby
Rooting reflex
Mother learns to position baby
Sucking reflex
Baby learns to take breast
Swallowing reflex
30Signs 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 babys
mouth - Tongue under the teat
31Incorrect 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
babys mouth - Tongue away from the teat
32Causes 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
33Conclusion
- 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 mothers confidence to sustain good milk
supply and alleviate feeling of not enough milk.
34Be a leader
35Thank you friends