Nutrition: Breastfeeding Flashcards
What does WHO recommend with regards to infant feeding?
Exclusive breastfeeding for the first 6 months = current WHO recommendation
Shorter periods of breastfeeding is also advantage
Are the number of babies being breastfed in the UK rising or falling?
Rising
In low income countries, breastfeeding dramatically improves survival during infancy, mainly by…
GI infection
In developed countries, is there evidence of reduced mortality associated with breastfeeding?
No
What are the advantages of breastfeeding for the infant?
Provides ideal nutrition for infants during first 4-6 months of life
Life saving in developing countries
Reduces risk of GI and respiratory infection, otitis media, necrotising enterocolitis
Enhances the mother-child relationship
Reduces risk of insulin dependent diabetes, HTN and obesity in later life
What are advantages of breastfeeding for the mother?
Promotes close attachment
Increases time interval between children - important in reducing birth rate in developing countries
Reduces risk of breast and ovarian cancer and DM2
What are some potential complications of breastfeeding?
Difficult to know if baby is getting enough milk, except by regular weight checks - every few days in first couple of weeks, then weekly until feeding well established
Breastfeeding can be achieved with twins, but rarely possible to totally breastfeed triplets
Preterm infants can be breastfed, but mother will need to learn how to express milk until infant can suck
Obtaining sufficient milk can be a problem
Restrictive for mother - others cannot look after baby for prolonged time
Facilities for breastfeeding in public remain limited
Failure to establish breastfeeding may cause emotional distress for the mother
Infection transmission - maternal CMV, hep B and HIV
Breastmilk jaundice - mild and self limiting unconjugated hyperbilirubinaemia
Transmission of drugs
Nutritional inadequacies - breastfeeding beyond 6 months without introduction of appropriate solids may lead to poor weight gain and rickets
Vitamin K deficiency - insufficient vitamin K in breastmilk to prevent haemorrhagic disease, so supplementation required
Potential transmission of environmental contaminants - nicotine, alcohol, caffeine
What is produced in the first few days of breastfeeding?
Colostrum
How does colostrum differ from mature milk?
The content of protein and immunoglobulin much higher
Volumes are low but water or formula supplements are not required while supply of breast milk is becoming established
Why is frequent suckling beneficially?
It enhances secretion if hormones initiating and promoting lactation
How long does WHO recommend to continue breastfeeding for?
Until 2 years
American paediatric association recommends until 1 year
What type of milk is formula feeding based on?
Cow’s milk that has been modified
All infant formula feeds currently available in UK have been modified to make their mineral content and renal solute load comparable to mature human milk
Additional modifications: addition of polyunsaturated fatty acids, nucleotides, probiotics and prebiotics
Pasteurised cow’s milk given before 12 months is associated with…
Increased risk of iron deficiency and it is deficit in vitamins A,C and D
Supplementation will be required unless the infant has good mixed diet of solids
It may be given from 1 years
Breastfeeding and formula feeding is recommended until 12m old, after this what can be given?
Pasteurised cow’s milk+supplements/varied solid diet
Or follow on formula - contain more protein and sodium than infant formula, fortified with iron and vitamins
When should solids be introduced?
From around 6 months - done gradually with small quantities of puréed fruit, root vegetables or rice initially
