Breastfeeding (Lactation) and

The American Academy of Pediatrics’ Statement on

Breastfeeding

I’m a guy--why should I pay attention?

• BOTH parents should be educated for successful breastfeeding to occur

• Support and encouragement by the father can greatly assist the mother.

How long should a woman breastfeed?

• Exclusive breastfeeding for the first 6 months of life and breastfeeding with complementary foods for at least the next 6 months is recommended by these organizations:– The AAP Section on Breastfeeding– American College of Obstetricians and Gynecologists– American Academy of Family Physicians– Academy of Breastfeeding Medicine– World Health Organization– United Nations Children's Fund– many other health organizations

What is exclusive breastfeeding?

• Feeding an infant human milk with no

supplementation of any type (no water, no juice, no nonhuman

milk, and no foods)• During the first 6

months of age, even in hot climates, water and juice are unnecessary for breastfed infants

Babies who are breastfed get fewer and less severe diseases.

• Human milk feeding decreases the incidence and/or severity of a wide range of infectious diseases, including:– bacterial meningitis– bacteremia– diarrhea– respiratory tract infection– necrotizing enterocolitis– otitis media (ear infections)– urinary tract infection– late-onset sepsis (blood infection)

Other conditions which may be affected by breastfeeding

• Some studies suggest decreased rates of:– sudden infant death syndrome (SIDS) in the first

year of life– reduction in incidence of • type 1 and type 2 diabetes• lymphoma, leukemia, and Hodgkin’s disease• overweight and obesity• high blood cholesterol• asthma

Benefits of breastfeeding for the mother – decreased bleeding after

delivering the baby– uterus returns to normal size

more quickly– decreased menstrual blood

loss – increased child spacing – earlier return to

prepregnancy weight– decreased risk of breast

cancer– decreased risk of ovarian

cancer– decreased risk of hip

fractures and osteoporosis in the postmenopausal period

Benefits to society• decreased annual health care costs

of $3.6 billion in the United States• decreased costs for public health

programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

• decreased parental employee absenteeism and associated loss of family income

• more time for attention to siblings and other family matters as a result of decreased infant illness

• decreased environmental burden for disposal of formula cans and bottles

• decreased energy demands for production and transport of

formulas

Who should not breastfeed?

• mothers who have active untreated tuberculosis

• mothers who are receiving radiation• mothers who are receiving chemotherapy• mothers who are using drugs of abuse ("street

drugs")• mothers who have HIV

Maternal Illness

• Mothers CAN breastfeed if they have a cold or other common bug

What are some obstacles to breastfeeding?

• insufficient prenatal education about breastfeeding– People used to learn about breastfeeding from mothers

or family members, but families don’t always live close anymore

• disruptive hospital policies and practices– Nurses in hospital nurseries may feed the baby formula

which will make them not hungry• inappropriate interruption of breastfeeding– Mothers may stop breastfeeding unnecessarily if they

get sick or if they think the baby isn’t getting enough milk

• early hospital discharge in some populations– The mother has less time to relax and regain some

energy• lack of timely routine follow-up care and

postpartum home health visits– Failure to see a doctor to check baby’s growth and

mother’s well being• maternal employment– Can’t breastfeed on demand; hard to pump

• lack of family and broad societal support– families may be negative towards breastfeeding; some

members of society may look down on breastfeeding• media portrayal of bottle feeding as normative

–You often think of a baby with a bottle instead of a breast

• commercial promotion of infant formula through distribution of hospital discharge packs, coupons for free or discounted formula, and some television and general magazine advertising– more advertising for formula than for breast feeding

• misinformation– going by what you’ve heard rather than researching

breastfeeding info• lack of guidance and encouragement from health

care professionals

• commercial promotion of infant formula through distribution of hospital discharge packs, coupons for free or discounted formula, and some television and general magazine advertising– more advertising for formula than for breast feeding

• misinformation– going by what you’ve heard rather than researching

breastfeeding info• lack of guidance and encouragement from health

care professionals

How often should a newborn be breastfed?

• 8 to 12 feedings at the breast every 24 hours during the early weeks

• the breast should be offered whenever the infant shows early signs of hunger such as increased alertness, physical activity, mouthing, or rooting.

How would you keep up with all that?

• The mother should record the time and length of each breastfeeding, as well as pee and poop output during the early days of breastfeeding

Lactation– Nursing mothers produce about 25 ounces of milk

per day.– Nursing mothers use 500 extra calories per day

producing this milk.– 330 extra calories should be eaten; 170 can be

drawn from fat stores left over from pregnancy

Nutrient needs during lactation

• 13 cups of liquid (water, milk, or juice) should be consumed daily

• A healthy diet, as consumed in pregnancy, should be followed

• If mother’s nutrition is lacking, her milk supply will draw from her stores, so she is more likely to be undernourished than is her baby

Babies’ food sensitivities• Some experts believe

that babies may be bothered by certain foods that the mothers eat; others do not find a clear connection

• Foods that possibly cause sensitivity:– Cow’s milk– Onions and garlic– Broccoli and related

vegetables

Do breastfeeding women lose weight more quickly than non-breastfeeding women?

• Some do and some don’t• Breastfeeding women can’t eat unlimited food

and still lose weight• It is better for breastfeeding women to

exercise more rather than eat less so that their milk does not suffer

Harmful substances in breastfeeding

• Alcohol: can affect the amount of milk a woman produces; may make the infant drink less; could harm the infant in high doses

• Cigarettes: cause mothers to produce less milk and milk with a lower fat content; babies are getting nicotine in milk and from secondhand smoke exposure; causes problems such as poor growth, hearing impairment, breathing difficulties, vomiting, and others

Why is breast milk so good for babies?

• Provides the appropriate composition and balance of nutrients

• Is digested more easily and completely than formula• Provides hormones that promote physiological

development• Improves cognitive development• Protects against a variety of infections and possibly

against chronic diseases• Protects against food allergies