Benefits of breast feeding


Theme 1: Benefits of breastfeeding & Composition of Human Milk

  • Activity: objects symbolizing benefits of breastfeeding.
  • Breastfeeding = human norm; rather than ‘advantages; of breastfeeding, risks of artificial baby milk. Also, not ‘formula’ – sounds too scientific. Rather ‘ABM’. We can change breastfeeding culture by changing our language. Words have power. SO: turn around and see what risk each object symbolizes.

Best for baby:

Physical

  • Colostrum – half of baby’s immunities come from it. WHO: baby’s 1st immunization.
  • Laxative effect – helps pass meconium which makes baby hungry, stimulates mother’s milk supply and reduces absorption of bilirubin, lessening likelihood of problematic jaundice.
  • Promotes good health – talk about antibodies. Each drop of milk about one million white blood cells. If baby exposed to germ, he exposes mother’s breasts to it. Within 8 hours he is receiving specific antibodies to that germ through her milk.
  • Breastfeeding protects against diseases like respiratory infections, ear infections, GI infections, appendicitis, meningitis, septicemia, urinary tract infections.
  • Decreases disposition to future diseases like leukemia, diabetes, celiac disease.
  • Cancer: HAMLET. Stemcells.
  • During illness it keeps baby well-hydrated and speeds recovery. No need to stop breastfeeding with vomiting and diarrhea, should be treated as clear fluid.
  • Reduces risk of allergies. Breast milk lining digestive tract – EXCLUSIVE BREASTFEEDING. For interest sake – HIV.
  • Reduces chance of obesity in later life, explain leptin and cholesystokinin.
  • Reduces risk of SIDS: every month of breastfeeding halves baby’s chance to die of SIDS. Explain why and talk about other ways to lessen risk of SIDS.
  • Less need for orthodontic treatment – proper jaw development. Less need for speech therapy.
  • Protects against tooth decay.
  • Snoring and obstructive sleep apnea.
  • Brain food – higher IQ: 7 – 10 points. Tell about study.

Emotional

  • Satisfies hunger immediately – reduces frustration and gives sense of security.
  • Enhances bonding – lots of physical contact.
  • Valuable mothering tool: sucking comforts baby when fussy, overtired, ill or hurt.

Best for Mother

  • Reduces risk of hemorrhage after birth. In case of retained placenta – put baby to breast or manually stimulate nipples if baby won’t feed.
  • Less lochia & amennorhea: lower risk for anemia. Lower iron needs. Explain why goal of solids should be natural iron supplementation.
  • Natural weight loss – lose most weight between 3-6 months.
  • Convenient – gets more rest (after 1st 2 weeks).
  • Prolactin relaxes, makes mothering easier. Helps prevent postnatal depression.
  • Reduces risk of breast and uterine cancer. Dose respondent. Lifetime estrogen exposure as well as HAMLET.
  • Reduces risk of osteoporosis.
  • Saves time and money.
  • Going out is easier – milk always at hand at right temperature. Comes in lovely container.

Best for our Society and Planet

Composition

  • Species-specific. Milk of each mammalian specie has evolved to optimize young’s chance of survival. Elephant seal only drinks every 4 days – needs to gain fat quickly to survive in cold, milk high in fat. Baby cows – need to gain muscle strength to be able to run with herd, need to sleep quietly while mother wanders away to feed. Milk high in protein to build muscle, especially in casein that induces sleep. Human baby born neurologically immature. Brain will triple in weight over next 2 yrs – high in lactose for brain development. Kidneys and liver immature – cannot process high protein feeds (formule fed babies need additional water).
  • Perfect baby food – only food capable of sustaining life, growth and optimal health for 6 months. Nothing else needed – anything else actually harmful.
  • Need to think beyond breastmilk as nutrition. ABM can also supply nutrition, albeit inferior. BM many other functions than nutrition. Helps baby reach full potential.
  • Package deal: components enhance the function and absorption of others. Every nutritional component has more than one role, e.g. lactose is main source of energy for growing body and brain, but also enhances the absorption of calcium.
  • Digests easily – no constipation & fewer gastric upsets. Natural probiotic.
  • Nutritional Quality of breastmilk: Diet of mom: composition of breastmilk fairly constant regardless of maternal diet. Maternal malnutrition will not cause mom to produce milk of markedly lower nutrient content – always perfect. Often get requests for contact nr. of lab that can ‘test’ human milk to see if quality is ok. Water soluble vitamins, type of fat. Encourage moms to keep taking Omegas.
  • Mom needs to eat healthy for OWN sake – not for baby’s.
  • Drink to thirst, no extra.
  • If milk supply low – eating more/more protein will not help.
  • Sudden drop in caloric intake, e.g. crash diet – can cause slight drop in supply.
  • Breastfeeding a ROBUST activity. Stress, malnutrition, starvation etc.
  • Composition: 87.5% WATER.
  • Protein: about 40% casein and 60% whey (levels differ according to stage of lactation). Whey: digests quickly, soft flocculent curd. Casein slower, forming tougher curd. BM digests within about 90 mins!
  • Whey proteins also important immunological function. Alpha-lactalbumin – HAMLET (apoptosis of cancer cells). Anti-bacterial, immuno-stimulatory. Lactoferrin. Immunoglobulin.
  • Baby born with ‘leaky gut’. Gaps between cells of mucosal lining where viruses, bacteria, allergens pass through.
  • SIgA coats intestinal mucosa like putty. Probiotic – even 1 bottle of formula will disrupt balance. Takes 4-6 wks for gut flora to return to normal.
  • Gut sterile at birth. Vaginal birth – proximity to mom’s anus – quickly colonized by maternal intestinal flora. C-section – disrupts. Breastmilk supports: bifidobacteria and lactobacilli – natural probiotic. Promotes digestion, boosts immune systems, controls intestinal pH, inhibits growth of pathogens like Candida and E coli.
  • Baby should not be handled by health care workers until has been in STS contact with mom for few hours.
  • Carbohydrate: Main carbohydrate = lactose. Lactase – produced by brush border of intestines – discuss foremilk-hindmilk imbalance in troubleshooting. Diagnosis of ‘lactose intolerance’ – be very suspicious. Primary lactose intolerance so rare that you are highly unlikely to ever see it. Secondary – after weaning, more common in some races. Damage to brush border: severe gastro-enteritis/food allergy – secondary. Keep breastfeeding – will recover more quickly.
  • Lipids/fat most variable constituent of human milk – directly related to degree of breast fullness. Discuss ‘foremilk’ and ‘hindmilk’: no absolute distinction, very relative term. Possible that morning’s ‘hindmilk’ may contain less fat than evening’s ‘foremilk’.
  • Breastmilk rich in L-PUFA’s like Linoleic acid, Alpha-linoleic acid, arachidonic acid and Docosahexaenoic acid. Essential for development of nervous system and visual acuity.
  • Cholesterol in breastmilk remains constant despite maternal dietary manipulation. Necessary for formation of stable cell membranes – myelin sheath formation, MS. Brain growth. Owens: high cholesterol in breastfed infants: ‘form of nutritional programming’ preventing coronary disease in adulthood. Breastfed infants higher cholesterol that artificially fed ones, reverse true in adulthood. Moms have higher cholesterol levels when breastfeeding – problem for medicals, insurance. Cannot take cholesterol lowering meds when breastfeeding.
  • Lipids broken down by lipase in milk. If expressed milk has soapy smell/taste, baby won’t drink (nothing ‘wrong’), should scald milk before storing. In heavy-based pan, bring milk to just below boiling point. Some steam rising and bubbles at outside edges. Stir occasionally 2 prevent skin.
  • Fat Soluble vitamins (ADEK): Breastmilk excellent source of Vit A.
  • Vit D – found naturally in very few foods. Breastmilk: 20 IU/L, infant needs 200-400IU per day. Maternal stores may be depleted by 2 months, AAP controversial recommendation – all breastfed infants. Babies need 30mins to 2 hrs of sunlight per week if fully clothed (except for head and hands). Very dark-skinned infants or ones not exposed to sunlight may need supplementation.
  • Vit K – even more controversial. Synthesized by bacteria in infant’s gut during first week. Birth become too sterile. Hemorrhagic disease of newborn: days 2-10, umbilical cord site, GI tract, circumcision site. High morbidity/mortality. Intramuscular Vit K recommended.
  • Water-soluble vitamins not stored in body, taken in regularly.
  • Vit B6 – riboflavin – more than 600mgs per day may suppress prolactin levels and lower breastmilk production, but not all mothers. Case study.
  • Vit B12: if mom strict vegan/gastric bypass surgery. Deficiency – serious morbidity – needed for healthy CNS development.
  • Minerals: small quantities but highly bio-available.
  • Calcium supplementation does not increase calcium level in breastmilk. Also no effect on 3-8% loss of bone mineral density during lactation. Recovers BMD around 6 months after weaning, with interest. Breastfeeding best protection against osteoporosis.
  • Copper, iron, zinc levels not affected by maternal intake. Iron in breastmilk low, but highly bio-available. Five times more absorbed. Routine supplementation of breastfed infants younger than 6 months not recommended – binds to available lactoferring, more iron available for pathogens.
  • Iodine – mom iodated salt. Fluoride not given before 6 months. After that – based on area.
  • Volume:

Day

Average Volume produced/24hrs

Baby’s intake/feed

1

37 mℓ

5 mℓ

2

84 mℓ

5-15 mℓ

3

408 mℓ

15-30 mℓ

5

705 mℓ

45-60 mℓ

1-6 months

780-800 mℓ

30-135 mℓ

 

  • Milk volume constant from 1-6 months at about 780mls/24 hrs. Growth spurts – increase and return to normal.
  • ABM formula: 150mg/kg/24 hrs. Divide by nr. of feeds. Example.