Lifestages - Breast milk

Question 1

The Perfect Baby Food; Benefits for Infants:

Answer 1

Benefits for Infants:
* Provides vitamins, minerals, carbohydrates, proteins and fats in the right proportions for healthy baby development.
* Contains bifidobacterial 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.

Question 2

Benefits for mothers:

Answer 2

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 release).
* Assists in a swifter recovery from symptoms of postpartum depression (PPD). Homeopathy is recommended for PPD.

Question 3

Macronutrient composition

Answer 3

The macronutrient composition of breast milk is as follows:
* 88% Water
* 6-7% Carbohydrate: Lactose; easily digested by infants and enhances calcium absorption.
* 3-5% Lipids: Linoleic & linolenic acid as well as arachidonic (AA) acid & 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.
* Even the most advanced formulas cannot imitate the unique nutrient composition and protective factors of breast milk.

Question 4

Immune Protection: Colostrum

Answer 4

During the first two or three days after delivery, the breasts produce colostrum, a pre-milk substance containing mostly serum with antibodies (Secretory IgA) and white blood cells:
* 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.
* Breast milk and colostrum may contain more than 700 species of bacterial microbiota.

Question 5

Immune Protection: Friendly Bacteria

Answer 5

• A 2012 study found that milk from overweight mothers has considerably less diversity of species than normal-weight mothers.
• Caesarean birth mothers also showed less diversity in their breast milk microflora than in vaginal birth mothers ( stress?).
• Birth and breast milk play the role of early bacterial colonisation in the GIT (and other areas) of the infant.
• Various research confirms that an infant’s bacterial profile is directly related to that of its mother; the role of ‘friendly’ (or commensal) bacteria includes digestive support and immune modulation.
• 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.

Question 6

Immune Protection: Lactadherin and other proteins / enzymes

Answer 6

• 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.

Question 7

Immune Protection: Iron

Answer 7

• 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.

Question 8

Immune Protection: Allergies

Answer 8

• Breastfeeding prevents or delays the occurrence of atopic dermatitis, cow milk allergy and wheezing in early childhood when compared to formula-fed infants, according to research.

Question 9

Immune Protection: Cardiovascular Disease

Answer 9

• Breast milk can offer protection against the development of cardiovascular disease compared with formula-fed infants (possible links to oxytocin release which causes vasodilation); breast-fed infants have lower blood cholesterol as adults.

Question 10

Minerals

Answer 10

• The calcium content of breast milk is ideal for infant bone growth.
• Zinc has 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.

Question 11

Iron

Answer 11

• 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.
• Watch: https://www.youtube.com/watch?v=Cw53X98EvLQ

Question 12

Breast Milk: The Perfect Baby Food

Answer 12

• It is recommended to breastfeed exclusively for six months and continue up to two years or more.
• Human breast milk complements and boosts the immune system as long as it’s offered.
• Breastfeeding also provides feelings of love, comfort and protection and can contribute to a toddler’s feeling of self-esteem.
• Breastfeeding mothers also benefit from being near their child. The physical contact increases oxytocin, which supports bonding, and also has mild anti-inflammatory effects.

Question 13

Establishing Successful Lactation

Answer 13

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.