Breastfeeding Flashcards
what is unique about the makeup of a mothers milk? How is it important to the infant?
- the mother makes milk specific to the child with all the requirements for growth and development
- it is the ultimate super-food and the only thing a baby needs to be sustained for 6m postpartum (including water)
What does breast milk provide the infant with? Does breast milk change as the infant gets older?
- breast milk provides all. the fluid and nutrients for optimal growth and development
- the milk adapts to the age of the infant - constantly changes to meet the nutritional requirements of the infants
Colostrum
- present right after birth – changes to mature milk a couple days after birth
- “liquid gold” - yellowish and sticky
- can sustain a newborn and should be given to them within the first hour after birth
hormones involved in breastfeeding
- estrogen
- progesterone
- prolactin
- oxytocin
prolactin - what is its role?
peaks during every breastfeed (supply and demand) helps with milk supply
oxytocin - whats its role?
important for a mother, infant bonding, released overtime they are breastfeeding
- stimulates uterine contractions
breastfeeding recommendations and what percentage of the world is exclusively breastfed?
- breastfeeding exclusively for the first 6months and sustained up to 2yrs
- most women who give birth start breastfeeding in the hospital and slowly declines after 6months and beyond (less than 30% breastfeed after hospital)
- 36% of infants 0-6m are exclusively breastfed
how is breastfeeding portrayed in TV shows?
- caucasian educated women breastfeed newborns
- does not show a range of ethnicities or socioeconomic statuses
- breastfeeding in public and extended breastfeeding is still not acceptable in TV shows
what are some benefits to breastfeeding (in terms of school)
- improves IQs
- better school attendance
- associated with higher income in adult life
what are the main components of human milk?
low in protein but high in high in brain development substances
what are some short-term benefits of breastfeeding for babies? (6)
- infection: relationship between duration and exclusivity of breastfeeding and protection from many infections (more milk = more protection - reduced risk)
- Sudden infant death syndrome (SIDS):
- could happen by suffocation
- breastmilk is digested quickly so babies wake up more and do not fall in deep sleep - mortality:
- not breastfeeding increases a child’s risk of dying in infancy
- in developing countries infants have a higher risk of diarrhoea and respiratory diseases
- estimated 800,000 lives could be saved if children younger than 5yrs if all children 0-23m were optimally breastfed - overweight and obesity?: debateable!
- relationship between breastfeeding and obesity prevention
- will not over feed on breast but will on bottle
- 2014 systematic review suggests this is hard to prove bc there are many other factors (ie. genetics and environment) - issues related to temperature and respiratory regulation:
- bottle feeding increases physiological instability
- oxygen saturation and body temperature are lower in preterm infants who were bottle fed vs. breastfed
- there importance of skin-to-skin (kangaroo care) - pain: not breastfeeding increases infants response to pain
- analysis of 11 studies showed that both breastfeeding and human milk are pain relieving
in developing countries what are the main causes of death among infants?
- diarrhoea
2. respiratory diseases
what are the long-term benefits of breastfeeding for babies? (4)
- reduced risk of some childhood cancers: need more research
- several studies have found that increased risk for some childhood cancers when children have not been breastfed (ie. leukaemia, lymphoma, Hodgkin’s disease) - reduced risk of asthma
- increased cognitive development (debated issue):
- associated with higher scores on developmental and cognitive screening tools
- 2013 study –> babies breastfed for 1yr were better able to understand others at 3yrs old and had higher verbal and nonverbal intelligence at 7yrs old - reduced risk of type 1 and type 2 diabetes:
- infant formula appears to be associated with an increased risk for diabetes
what are the benefits for mothers by breastfeeding?
- premature weaning or not breastfeeding are associated with health risks
- the degree of health outcomes is based on the duration, frequency and exclusivity of breastfeeding
(many studies associations are based on lifetime duration of breastfeeding)
benefits for mothers: health outcomes with NOT breastfeeding (5)
- increased prevalence for hypertension, diabetes, cardiovascular disease, metabolic syndrome
- increased risk of breast cancer, ovarian cancer, postpartum depression
- reduction in bone health
- increased sleep disturbances
- decreased postpartum weight loss
how does formula feeding compare to breast milk in terms of nutritional requirements?
- infants fed formula have an increased risk of compromised nutritional status, growth and development and overall health and survival
What is a hazard for bottle feeding and formula? and what is pathogen contamination?
- milk based powered infant formula is an ideal substrate for bacteria growth
- pathogen contamination: enterobacter sakazakii has been detected in powerded infant formula
what happened in 2008 to thousands of children in China, Taiwan, Vietnam, and Singapore?
- melamine was added to 22 brands of infant formula
- 50,000 hospitalizations and at least 6 died from acute renal failure
what is the problem with melamine? and why was it used? and what happened in response?
- it was used to disguise the low protein content resulting from diluting formula
- increased nitrogen content
- increased protein content and gave the formula a milky appearance
US FDA and WHO set guidelines of how much melamine ingestion - but unclear of how much is safe
hazard for bottle feeding and formula: feeding in emergencies and disasters
- widespread of infant formula exposes an increased risk of death and disease (when clean water is limited to mix formula and wash bottles)
The Baby Friendly Initiative (BFI): what is it?
- global campaign to promote, protect and support breastfeeding
- sponsored by WHO and UNICEF
The Baby Friendly Initiative (BFI): History
- 1920s: Emancipation of women
- other feeding allowed women to pursue their interests and WW2 moved women into the workplace
- Canadian dairy industry grew and public health officials promoted formula feeding
- decline in breastfeeding rates - 1920s-1960s:
- majority of women didnt breastfeed
- higher infant mortality rates due to increased feeding of cow’s milk
- scientist tried to improve artificial baby milk instead of promoting breastfeeding - early 1970s:
- breastfeeding rates were rising in Canada and increased recognition of the importance of breastfeeding
- developing regions: breastfeeding rates still declined… bc of this infant formula was marketed to mothers who could not afford it or who lived in conditions that made formula feeding unsafe
- concern about marketing of infant formula in developing countries increased - 1979:
- WHO and UNICEF held international meeting concerning infant and young child feeding - 1981:
- International Code of Marketing of Breast Milk Substitutes was developed (adapted from WHA)
The international code of marketing of breast milk substitutes - what is it?
- referred to as the WHO code
- provided minimum requirements to protect and promote appropriate infant and young child feeding practices
- MAin focus: regulation of marketing of infant formula and products associated with bottle feeding
- -> focuses attention on how the infant formula industry influences health care providers and consumers to support the use of manufactured milk
what are the details of the WHO code? (10)
- no advertising these products to the public
- no free samples to mothers
- no promotion of these products in health care facilities (including free distribution or low-cost supplies)
- no company sales representatives to advise mothers
- no gifts or personal samples to health care workers
- no words or pictures idealising artificial feeding or pictures of infants on labels of milk containers
- info to health care workers should be scientific and factual
- all info on artificial containers must explain the benefits of breastfeeding and the costs and hazards of artificial feeding
- unsuitable products such as sweetened condensed milk should not be promoted for babies
- products should be high in quality and take account the climatic and storage conditions in the countries where they’re used
Canada and the BFI - when did it give join and does it violate it?
- gave approval to WHO code in 1981 as part of near global consensus
- many violations of the WHO code as it is not legislated in Canada
what does the BFI based on?
- Evidence based
- Outcomes-oriented
- Protects, promotes, and supports breastfeeding
- Benefits all babies
the breastfeeding committee for Canada (BCC) - what is it and what does it do?
- national authority for the BFI in Canada
- each province and territory has representatives on the BCC BFI Implementation Committee
- responsible for outlining the practice outcomes criteria for assessment and designation of “Baby Friendly”
WHO 10 steps to successful breastfeeding
- have a written breastfeeding policy that is routinely communicated to all healthcare providers and volunteers
- ensure all health care providers have the knowledge and skills necessary to implement the breastfeeding policy
- inform pregnant women and their families about the process and importance of breastfeeding
- place babies in uninterrupted skin-to-skin contact with mothers immediately following birth for at least an hour or until completion of the first feeding or as long as the mother wishes
- assist mothers to breastfeed and maintain lactation should they face challenges including separation from their infant
- support mothers exclusively to breastfeed for the first 6 months, unless supplements are medically required
- facilitate 24hrs rooming-in for all mother-infants dyads: mother and infant stay together
- encourage sustained breastfeeding beyond 6months with an appropriate introduction to complementary foods
- support mothers to feed and care for their breastfeeding babies without the use of artificial treats or pacifiers
- provide a seamless transition between the services provide by the hospital, community health services and peer support programs
male partners’ role in breastfeeding - what can they do and how should they get involved?
- supporting the mother
- caring for the infant
- feeding the infant
- housework
- preparing pumping equipment
1. education and access to partner-specific information on breastfeeding
2. online or drop in support groups for men
3. alternatives to breastfeeding
lochia
bloody discharge a woman will experience 3-6 weeks after birth
Postpartum
the period of about 3 months after delivering a baby
when does menstration start occuting after breast feeding is over
within about 10 weeks
