Breast Milk and Postpartum Flashcards
Breast Milk: Benefits for infants
Benefits for Infants:
* Provides vitamins, minerals, carbohydrates, proteins and fats in the right proportions for healthy baby development
* Contains bifidobacteria and prebiotic oligosaccharides to help colonise the digestive tract and build the immune system.
* Breastfeeding ensures best possible health, developmental and psychosocial outcomes.
* Reduces the risk of conditions such as eczema , asthma and food allergies
Breast Milk: Benefits for mothers
Benefits for mothers:
* Breast milk is cheap and convenient.
* Delays the return of regular ovulation, lengthening birth intervals (prolactin inhibits GnRH release).
* Conserves iron stores (= energy and cognition).
* Studies show protection against breast and ovarian cancer (↓ oestrogen and ↓ ovulation)
* Aids post birth weight loss due to increased energy
expenditure.
* Supports the mother baby relationship (oxytocin
* Assists in a swifter recovery from symptoms of postpartum depression (PPD). Homeopathy is recommended for
Macronutrient composition of breast milk
- 88% Water
- 6-7% Carbohydrate: Lactose ; easily digested by infants and enhances calcium absorption.
- 3-5% Lipids: Linoleic and linolenic acid as well as arachidonic (AA) acid and DHA .
- Less than 1% Protein: Mostly alpha-lactalbumin and whey
- Enzymes: Specific for digestion of proteins, fats and
carbohydrates. Certain enzymes also serve as transport for
other nutrients such as zinc, selenium and magnesium.
Breast Milk: Immune Protection
- Colostrum is high in secretory IgA , vitamin A and zinc , and
also provides bifidus factors , which favour the growth of the
‘friendly bacterium’ lactobacillus bifidus in an infant’s GIT so
that other, harmful bacteria cannot gain a foothold there. - Protects the infant from infections against which the mother has developed immunity.
- The maternal antibodies inactivate pathogenic bacteria within the infant’s digestive tract. This is partly the reason why breast fed infants have fewer intestinal infections than formula fed infants.
- Has a laxative effect to expel wastes that accumulated in the digestive tract during foetal development.
- An iron binding protein in breast milk, lactoferrin prevents bacteria from accessing the iron they can use to grow. It also aids iron absorption and kills some bacteria directly.
- The protein lactadherin in breast milk fights off the virus that causes most infant diarrhoea (rotavirus)
*Several other growth factors and enzymes stimulate the development of the digestive tract and protect against infections.
Breast Milk: Minerals
- The calcium content of breast milk is ideal for infant bone growth
- Zinc has also high bioavailability, thanks to the presence of zinc binding protein
- Breast milk is low in sodium, which is a benefit for immature kidneys .
- Breast milk contains relatively small amounts of iron, but the iron has a high bioavailability . Historically, babies got more iron by delaying cord clamping.
Breast Milk: Iron
- Iron is transferred to the baby across the placenta in the third trimester.
- Pre-term babies have less iron per kg than full term babies.
- Iron stores are used up in infancy as blood volume increases with body size.
- At birth, one third of a baby’s blood is outside its body.
- By delaying umbilical cord clamping until it stops pulsating, babies can get 30% more iron rich blood, oxygen, erythrocytes, leukocytes and stem cells.
- Leave the navel to air dry and let the stump fall off on its own.
Establishing Successful Lactation
Guidance to support your clients:
* Consider hiring a doula or lactation consultant straight after birth to help start your breastfeeding journey and address any issues.
* Familiarise yourself with local breastfeeding support (‘milk spots’) in your area
* Spend the first week postpartum at home with your baby with plenty of skin to skin contact
* Feed on demand (especially at night).
* Consider pumping one feed in order for the mother to get some rest between feeds.
Key Postpartum Nutrients
Protein
Iron
Zinc
B Vitamins
EPA/DHA
Magnesium
Vitamin C
Vitamin D
Probiotic Foods
Key Postpartum Nutrients: Protein
Needed to replenish reserve.
* Needed for breast milk production to support growth: extra 11g / day
Key Postpartum Nutrients: Iron
- ↑blood volume (anaemia is common in pregnancy).
- ↓iron = fatigue, altered
Key Postpartum Nutrients: Zinc
- Involved in production of ovarian hormones; has a high trace of mineral concentration in the brain.
- ↓ zinc can contribute to PPD.
Key Postpartum Nutrients: B vitamins
- ATP production ( B1, B2, B3, B5)
- B2 -> PPD protection.
- Folate -> depleted with lactation.
- B12 -> cofactor for DNA production, myelination (nervous
system development). Can be depleted by nitrous oxide in labour.
Key Postpartum Nutrients: EPA/DHA
- Essential for neural and eye development of foetus.
- ↑ need postpartum, mother at risk of losing DHA from brain tissue as passed to foetus / breastfed infant.
Key Postpartum Nutrients: Magnesium
- Mg needed to convert ADP to ATP (essential for energy postpartum)
- Absorbed by foetus in pregnancy & lactation.
- ↓ levels can contribute to PPD.
Key Postpartum Nutrients: Vitamin C
- Co-factor for collagen synthesis aids in wound healing postpartum
- Increases absorption of non-haem iron.
- Depleted in times of stress (adrenals)
- Synthesis of thyroxine and adrenal steroid hormones (postpartum thyroiditis).
