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== Breast feeding ==
== Breastfeeding ==


Starting breast-feeding early has the potential to prevent deaths in children under five years of age. Children who are breast-fed have at least six times greater chance of survival in the early months than non breast-fed children; it reduces deaths from acute respiratory infection and diarrhea.
The World Health Organization (WHO) recommends breast milk as the only food or drink offered to infants during the first 6 months of life [1]. To promote breastfeeding, mothers should be empowered to initiate skin-to-skin contact with their infant immediately after birth for at least one hour [7]. Exclusive breastfeeding is recommended for the first 6 months, with continued breastfeeding for 2 years or more, with the appropriate introduction of solid foods [2].  


Breast milk contains all nutrients (fats, protein, carbohydrates, vitamins and mineral). It also contains bioactive factors that protect from infection. It provides protection transmission of immunoglobulins and factors that then allows the infants immune system to develop and mature itself. Other components such as proteins, lysozyme, lipids etc provide non –
immune protection. Hormones and growth factors are also contained within breast milk, which affects the development of the child. Fatty acids present are important for
neurosurgical developments. Colostrum, a yellow, thick fluid secreted during first postpartum week, contains greater percentage of protein, fat-soluble vitamins and minerals than mature milk, and is especially rich in secretary IgA.


== Benefits of breast feeding: ==
The first milk produced by the mother is known as colostrum. This thick creamy milk is rich in protein and antibodies, which help the baby ward of infection [5]. Colostrum is highly nutritious and is the perfect first food for the infant [5].


There are many reasons why a mother should breastfeed their newborn, which include benefits to the mother as well as the child. It provides protection against many infections and chronic diseases and conditions such as, diarrhea, influenza, respiratory infections, bordetella pertussis, diabetes, high blood pressure, and high cholesterol level. It can also provide some protection against allergies, due to copious IgA, and eczema. It also enhances cognitive and social development and intelligence, resulting in a higher IQ.


It also provides benefits to the mother; it helps reduce the risk of post-partum haemorrhage. In the short term, breastfeeding delays the return to fertility and in the long term, it reduces type 2 diabetes and breast, uterine and ovarian cancer and postnatal depression.
Exclusive breastfeeding promotes optimal growth and development. In developing countries, “the most important benefit of breastfeeding is the infant’s immediate survival [3]”. The chance of survival in the early months is at least six times greater among children who are breastfed compared to those who are not [4]. Breastfeeding reduces the risk of death from acute respiratory infection and diarrhea, as well as other infectious diseases [3].
There are benefits to both mother and child due to early newborn contact and initiation of suckling. It plays a role in the maternal caring for the child and also allows better temperature control; higher blood glucose levels and babies tend to cry less. Studies have also shown that earlier initiation is associated with a longer duration of breast-feeding.


== Complementary feeding ==
This is introduced at 6 months when the child requires more nutrients and the amount obtained from breast milk is not sufficient for the child’s needs. A variety of food is needed in order for the child to obtain sufficient nutrients, for example food such as that from an animal origin, pulses, dark green leaves, orange fruit and vegetables, oils, fats and sugars. Feeding should be adequate, safe and hygienic and consistent; the amount given should be increased gradually. The mother should respond to the baby’s needs; if they are hungry and require more, they should be fed more.


The rules for responsive feeding are:
Each mother’s milk is unique and provides the right amount of protein, carbohydrate, fat, vitamins and minerals for her infant at each stage of development [1]. In addition to its nutritional components, breast milk also contains immune factors that help protect the infant from infection and disease [1].  Breastfeeding supports the development of the infant’s immune systems and helps decrease the risk infection and illness during childhood, as well as the risk of chronic conditions, such as obesity and diabetes later in life [2].
* Feed infants and assist older children to feed themselves
 
* Feed slowly and patiently
 
* When the baby refuses food, try different foods, combinations, textures and methods or encouragement
==Vitamin D==
* Avoid the baby being distracted by other things during meals
 
* Talk to the child during feeding bringing his attention to food
Vitamin D is necessary for proper bone development. Vitamin D deficiency may occur among breastfed infants who do not receive much exposure to sunlight [9]. In developed countries, mothers are recommended to give breastfeed infants Vitamin D drops to help prevent deficiency. Breast milk substitutes are fortified therefore supplementation is not necessary in infants who are not breastfed.
 
 
==Importance of Breastfeeding==
 
There are many reasons why a mother should breastfeed. Breastfeeding is associated with important short and long-term health outcomes for both mother and child. Breastfed infants are at lower risk of ear infections, respiratory illnesses, allergies, diarrhea and sudden infant death syndrome [5].  Long term, breastfed children are at lower risk of childhood leukemia, diabetes, asthma, obesity, and have higher IQ scores [5-6].
 
 
For the mother, breastfeeding helps reduce the risk of post-partum haemorrhage, postpartum depression, and delays the return to fertility. Long term mothers who breastfeed are at decreased risk of osteoporosis, ovarian and breast cancer [5]. Both mother and child benefit from early skin-to-skin contact as this helps to establish a bond that promotes healthy social emotional development [7].
 
 
==Complementary Feeding==
 
At 6 months, the child’s nutritional needs begin to change and developmentally they are ready to begin eating small amounts of family foods. Breast milk continues to be the child’s main source of nourishment well beyond the first year of life [9]. At 6-8 months, the child should be offered small meals of complementary foods 2-3 times per day. The first foods introduced should be smooth in texture to minimize the risk of choking.  Parents and caregivers should be encouraged to increase the quantity of food, as the child gets older, while maintaining frequent breastfeeding [9]. By 9 months, meals of complementary foods should be offered 3-4 times per day with nutritious snacks offered between meals 1-2 per day [9].
 
 
Parents and caregivers should offer a variety of foods to ensure the child’s nutrient needs are met [9]. Early on, iron rich foods are particularly important because by 6 months the infant’s iron stores have been depleted [8]. Therefore, meat, poultry, fish or eggs should be eaten daily, or as often as possible [9].
 
 
Continue to modify the texture, progressing from smooth to a slightly more lumpy texture, and finally to small pieces of food when the child is developmentally ready [8]. As the child continues to grow, offer a variety of foods from each food group. Parents and caregivers should be encouraged to pay attention to their child’s hunger and satiety cues, sit with their child while eating, and make meal times pleasant.
 


== References ==
== References ==
1. Public Health Agency of Canada. Breastfeeding & Infant Nutrition (accessed October 29, 2012). Retrieved from http://www.phac-aspc.gc.ca/hp-ps/dca-dea/stages-etapes/childhood-enfance_0-2/nutrition/index-eng.php
2. United Nations Children’s Fund (UNICEF). Infant and Young Child Feeding (accessed October 28, 2012). Retrieved from http://www.unicef.org/nutrition/index_breastfeeding.html
3. Effect of breastfeeding on infant mortality (accessed October 29, 2012). Retrieved from http://www.paho.org/english/ad/fch/bob2.pdf
4. Introduction to Interpreting Area Graphs for Infant and Young Child Feeding. United Nations Children’s Fund (UNICEF) December 2009. Retrieved from http://www.unicef.org/nutrition/files/Area_graphs_introduction_SinglePg.pdf
5. Nova Scotia Department of Health and Wellness. Breastfeeding Basics. Retrieved from http://www.gov.ns.ca/hpp/publications/05003_BreastfeedingBasics_En.pdf
6. Jedrychowski W, Perera F, Jankowski J, Butscher M, Mroz E, Flak E, Kaim I, Lisowska-Miszczyk I, Skarupa A, Sowa A. Effect of exclusive breastfeeding on the development
of children's cognitive function in the Krakow prospective birth cohort study. Eur J Pediatr. 2012 Jan;171(1):151-8. Epub 2011 Jun 10
7. Newman J and Kernerman E. The Importance of Skin to Skin Contact. (accessed October, 30, 2012). Retrieved from http://www.nbci.ca/index.php?option=com_content&view=article&id=82:the-importance-of-skin-to-skin-contact-&catid=5:information&Itemid=17
8. Province of Nova Scotia. Loving Care: 6-12 months. Retrieved from http://www.gov.ns.ca/hpp/publications/09046_LC6to12MonthsBook_En.pdf
9. World Health Organization. Guiding principles for complementary feeding of the breastfed child (accessed Nov 6, 2012). Retrieved from http://whqlibdoc.who.int/paho/2003/a85622.pdf


# http://www.unicef.org/nutrition/index_breastfeeding.html
# http://www.womenshealth.gov/breastfeeding/
# http://www.breastfeeding.com/all_about/all_about_more.html
# http://www.patient.co.uk/health/Breastfeeding-The-Benefits.htm
# http://www.babycenter.com/0_how-breastfeeding-benefits-you-and-your-baby_8910.bc
# Infant and Young Child Feeding, Dr. Eva Kudlova


[[Category:Hygiene]]
[[Category:Hygiene]]
[[Category:Epidemiology]]
[[Category:Epidemiology]]

Revision as of 12:51, 7 November 2012

Breastfeeding

The World Health Organization (WHO) recommends breast milk as the only food or drink offered to infants during the first 6 months of life [1]. To promote breastfeeding, mothers should be empowered to initiate skin-to-skin contact with their infant immediately after birth for at least one hour [7]. Exclusive breastfeeding is recommended for the first 6 months, with continued breastfeeding for 2 years or more, with the appropriate introduction of solid foods [2].


The first milk produced by the mother is known as colostrum. This thick creamy milk is rich in protein and antibodies, which help the baby ward of infection [5]. Colostrum is highly nutritious and is the perfect first food for the infant [5].


Exclusive breastfeeding promotes optimal growth and development. In developing countries, “the most important benefit of breastfeeding is the infant’s immediate survival [3]”. The chance of survival in the early months is at least six times greater among children who are breastfed compared to those who are not [4]. Breastfeeding reduces the risk of death from acute respiratory infection and diarrhea, as well as other infectious diseases [3].


Each mother’s milk is unique and provides the right amount of protein, carbohydrate, fat, vitamins and minerals for her infant at each stage of development [1]. In addition to its nutritional components, breast milk also contains immune factors that help protect the infant from infection and disease [1]. Breastfeeding supports the development of the infant’s immune systems and helps decrease the risk infection and illness during childhood, as well as the risk of chronic conditions, such as obesity and diabetes later in life [2].


Vitamin D

Vitamin D is necessary for proper bone development. Vitamin D deficiency may occur among breastfed infants who do not receive much exposure to sunlight [9]. In developed countries, mothers are recommended to give breastfeed infants Vitamin D drops to help prevent deficiency. Breast milk substitutes are fortified therefore supplementation is not necessary in infants who are not breastfed.


Importance of Breastfeeding

There are many reasons why a mother should breastfeed. Breastfeeding is associated with important short and long-term health outcomes for both mother and child. Breastfed infants are at lower risk of ear infections, respiratory illnesses, allergies, diarrhea and sudden infant death syndrome [5]. Long term, breastfed children are at lower risk of childhood leukemia, diabetes, asthma, obesity, and have higher IQ scores [5-6].


For the mother, breastfeeding helps reduce the risk of post-partum haemorrhage, postpartum depression, and delays the return to fertility. Long term mothers who breastfeed are at decreased risk of osteoporosis, ovarian and breast cancer [5]. Both mother and child benefit from early skin-to-skin contact as this helps to establish a bond that promotes healthy social emotional development [7].


Complementary Feeding

At 6 months, the child’s nutritional needs begin to change and developmentally they are ready to begin eating small amounts of family foods. Breast milk continues to be the child’s main source of nourishment well beyond the first year of life [9]. At 6-8 months, the child should be offered small meals of complementary foods 2-3 times per day. The first foods introduced should be smooth in texture to minimize the risk of choking. Parents and caregivers should be encouraged to increase the quantity of food, as the child gets older, while maintaining frequent breastfeeding [9]. By 9 months, meals of complementary foods should be offered 3-4 times per day with nutritious snacks offered between meals 1-2 per day [9].


Parents and caregivers should offer a variety of foods to ensure the child’s nutrient needs are met [9]. Early on, iron rich foods are particularly important because by 6 months the infant’s iron stores have been depleted [8]. Therefore, meat, poultry, fish or eggs should be eaten daily, or as often as possible [9].


Continue to modify the texture, progressing from smooth to a slightly more lumpy texture, and finally to small pieces of food when the child is developmentally ready [8]. As the child continues to grow, offer a variety of foods from each food group. Parents and caregivers should be encouraged to pay attention to their child’s hunger and satiety cues, sit with their child while eating, and make meal times pleasant.


References

1. Public Health Agency of Canada. Breastfeeding & Infant Nutrition (accessed October 29, 2012). Retrieved from http://www.phac-aspc.gc.ca/hp-ps/dca-dea/stages-etapes/childhood-enfance_0-2/nutrition/index-eng.php

2. United Nations Children’s Fund (UNICEF). Infant and Young Child Feeding (accessed October 28, 2012). Retrieved from http://www.unicef.org/nutrition/index_breastfeeding.html

3. Effect of breastfeeding on infant mortality (accessed October 29, 2012). Retrieved from http://www.paho.org/english/ad/fch/bob2.pdf

4. Introduction to Interpreting Area Graphs for Infant and Young Child Feeding. United Nations Children’s Fund (UNICEF) December 2009. Retrieved from http://www.unicef.org/nutrition/files/Area_graphs_introduction_SinglePg.pdf

5. Nova Scotia Department of Health and Wellness. Breastfeeding Basics. Retrieved from http://www.gov.ns.ca/hpp/publications/05003_BreastfeedingBasics_En.pdf

6. Jedrychowski W, Perera F, Jankowski J, Butscher M, Mroz E, Flak E, Kaim I, Lisowska-Miszczyk I, Skarupa A, Sowa A. Effect of exclusive breastfeeding on the development of children's cognitive function in the Krakow prospective birth cohort study. Eur J Pediatr. 2012 Jan;171(1):151-8. Epub 2011 Jun 10

7. Newman J and Kernerman E. The Importance of Skin to Skin Contact. (accessed October, 30, 2012). Retrieved from http://www.nbci.ca/index.php?option=com_content&view=article&id=82:the-importance-of-skin-to-skin-contact-&catid=5:information&Itemid=17

8. Province of Nova Scotia. Loving Care: 6-12 months. Retrieved from http://www.gov.ns.ca/hpp/publications/09046_LC6to12MonthsBook_En.pdf

9. World Health Organization. Guiding principles for complementary feeding of the breastfed child (accessed Nov 6, 2012). Retrieved from http://whqlibdoc.who.int/paho/2003/a85622.pdf

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