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Successful Early Initiation and Exclusive Breastfeeding up to Six Months of Age

Helping Women to Be Successful in Breastfeeding the Baby

Global and National Recommendations for Infant and Young Child Feeding
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Initiate breastfeeding within one hour of birth Exclusive breastfeeding for first 6 months of life Introduce nutritionally adequate and safe complementary foods after the infant reaches 6 months of age Continue to breastfeed for 2 years or beyond.

Benefits to the Baby        Complete food for the first six months Perfect nutrition Higher IQ Emotional bonding Prevents infections Prevents chronic diseases Easily digested .

Benefits to the Mother       Reduces post delivery bleeding and anemia Helps delay next pregnancy .LAM Protective effect against breast and ovarian cancer Helps to loose weight Emotional bonding Needs no preparation .

Economical Enhances Bonding .Benefits to the Society    Reduces absenteeism of mothers from work as they are less prone to disease.

6 billion saving if EBF ↑ 64% to 75% (in hospital) ↑ 29% to 50% (at 6 months) [Weimer J.US dept.Economic benefits of BF US $3. Agriculture Report-13]  Medical cost at 12 months US $200 less in BF compared to formula fed [Honey & ware 1997]  .

62:203-209] . Cholesterol.Exclusive Breastfeeding & Lipid Profile S. total triglycerides and poor HDL/LDL ratio significantly more in EBF infants compared to mixed-feds and formula-feds and improve by six months of age for better brain growth [Eur J Clin Nutr 2008.

3:3] .Exclusive Breastfeeding & Anemia Term AGA infants on Exclusive Breastfeeding till 6 months born to Anemic or Non-anemic mothers Do not develop Iron Deficiency Anemia [International Breastfeed J 2007.

flat curve after that (NFHS 3). Underweight (-2sd) NFHS-3 Over 60 million Years of life . Brain development 10 lakh children die during first month. 2/3rd are related to poor feeding. and 20 lakhs by 5 yrs.First year is critical! Malnutrition strikes the most in infancy beginning in 3-4th month . goes up and peaks about 46% by 18 months. 14 lakhs by 1 year. 29-30 % at 6 months.

117:380-386 1/18 .4 fold increase in risk of death 20 15 10 5 0 Within 1 hour 1-24 hour Initiation of breastfeeding PEDIATRICS 2006.Percentage of Neonatal Deaths (2-28 days) Saved with Early Initiation 25 22.3 16.3 Risk of neonatal death is 4 fold. if milk based fluids or solids are given to breastfed neonates Imitation after day 1 is associated with 2.

LANCET 2003.U-5 deaths reduction by preventive Interventions Percent 0% Breastfeeding Complementary feeding Clean delivery Hib vaccine Clean water. hygiene Zinc 2% 4% 6% 8% 10% 12% 14% 16% 18% Intervention Vitamin A Antenatal steroids Newborn temperature management Tetanus toxoid Antibiotics for PRM Measles vaccine Nivirapine and replacement feeding Insecticide-treated materials Antimalarial IPT in pregnancy Breastfeeding is defined as exclusive breastfeeding for first 6 months and continued breastfeeding during 6-11 months Source: Jones et al. sanitation.362:65-71 .

Successful Breastfeeding…  Initiate Breastfeeding Within One Hour of Birth .

.What is Exclusive Breastfeeding?    Giving an infant only breastmilk No food or drink other than breastmilk— not even water No Ghutti/Honey etc.

Makes position No role of Mother Human Beings: 1.Offspring on feet 2.Baby holds neck 3 mo 2.Is Breast feeding So Simple? Animal Kingdom: 1.Mother makes position No role of Baby .Moves to udders 3.Walks at 1 yr 3.

How to Protect Breastfeeding    Make National breastfeeding policy Include Breastfeeding in clinical practice Obtain Training in breastfeeding management .

Global Strategy for Infant and Young Child Feeding  Adopted by the WHA and UNICEF Executive board in 2002 .

Strategies       Development of BREASTFEEDING support clinics/ Lactation management clinics in hospitals run by skilled/ trained counselors Promoting BREASTFEEDING friendly PHCs/Private clinics/hospitals supported by SKILLED staff. Building IYCF counselling as service in job profile of workers Developing community led initiatives :Peer counselling support groups Eliminate MISINFORMATION from media (International Code) Establishing national and state level resource centers .

Successful Breastfeeding… Major Hurdles  Lack of family support  Lack of support by health professionals  Commercial influence  Feeling of not enough milk among women .

.  Do not give the baby any prelacteal feeds  No bottles. artificial teats or pacifier  Breastfeeding on demand at least 8-10 times in a day and at night a  Breastfeed in a correct position  Build mother’s confidence to sustain good milk supply and alleviate feeling of not enough milk.Successful Breastfeeding… Important Do’s  Initiate breastfeeding as early as possible within one hour of birth.

allergy .Successful Breastfeeding… No Prelacteal Feeds  Replace colostrum  Reduce baby’s desire for breastfeeding  Greater risk of infection  Risk of intolerance.

Artificial Teats or Pacifiers for Breastfeeding Infants It lead to nipple confusion .Successful Breastfeeding…  No Bottles.

Successful Breastfeeding… Breastfeeding in the Correct Position      Milk producing glands Lactiferous canaliculi Lactiferous sinuses Myoepithelial tissue Adipose tissue Anatomy of the Breast .

Successful Breastfeeding… Build Mother’s Confidence  During prenatal period  During antenatal Period  During postnatal period .

Just a perception  Reinstate mother’s confidence  Ensure frequent. effective suckling .The Feeling of “Not Enough Milk” Not true.

Breastmilk Production The Prolactin reflex Sensory Impulses from nipple • More prolactin secreted at night • Secreted after feed to produce next feed Baby sucking • Suppresses ovulation Prolactin in blood .

Breastmilk Transfer The Oxytocin reflex Oxytocin in blood Sensory Impulses from nipple Baby sucking • Works before or during feed to make milk flow • Makes uterus contract .

Breastmilk Transfer How does the mother’s confidence play part Pain Worry Stress Doubt Thinks lovingly of baby CONFIDENCE Sound of baby Sight of baby .

Feeding reflexes in the baby Rooting reflex Mother learns to position baby Sucking reflex Baby learns to take breast Swallowing reflex .

Signs of Correct Attachment       Mouth wide open Lower lip is turned outside Chin touching the breast Black part of the breast not visible below the lower lip Large black portion of breast and nipple including milk collecting ducts are inside baby’s mouth Tongue under the teat .

Incorrect Sucking Position      Mouth is not wide open Chin is away from the breast Baby is sucking only nipple Most black portion of the breast is outside the baby’s mouth Tongue away from the teat .

Leads to nipple confusion Inexperienced mother Functional difficulty with the mother or the baby Lack of skilled support .Causes of Incorrect Attachment     Use of feeding bottles.

.Conclusion Exclusive Breastfeeding for First Six Months Being Successful Initiate breastfeeding as early as possible within one hour of birth.  Do not give the baby any prelacteal feeds  No bottles. artificial teats or pacifier  Breastfeeding on demand at least 8-10 times in a day and at night a  Breastfeed in a correct position  Build mother’s confidence to sustain good milk supply and alleviate feeling of not enough milk.

Be a leader .

Thank you friends .