FEEDING DURING THE

FIRST YEAR OF LIFE

FITSUM D. MD
Breast Feeding

• Breast milk provides all the necessary

energy & nutrition that an infant needs
during the first six months of life.
• Distribution of calories in human milk
and in well balanced diet are similar
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Breast Feeding

• Composition of breast milk

– Water – 88.1%
– Lactose – 7%
– Fat – 3.8%
– Protein – 0.9%
– Others – 0.2%

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 Advantages of Breast feeding

• Readily available at proper temperature

• Fresh, economic
• Easy to digest & nutrients are well absorbed
– e.g Whey predominant ratio to casein (70:30), easily
digestible unlike cow’s milk
• Meets all nutritional requirements for the 1st 6mo
• Contains
– bacterial & viral antibodies
– Oligosaccharides which prevent bacterial attachment
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Advantages…..

• Source of lactoferrin,
– an iron binding protein reducing binding sites for
iron dependent pathogens
– Immunomodulation,
– antimicrobial action e.g. inhibition of E.coli,
– antiadhesive,
– trophic for intestinal growth.
• Contains different growth factors, cytokines,
nucleotides…
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Advantages….. maternal

• Increased levels of oxytocin / less PPH/,

• Earlier return to prepregnancy weight

• Improved bone remineralization postpartum

• Reduced risk of ovarian cancer

• Reduced risk of premenopausal breast cancer

• Increases mother- to- child bonding

• Decreases work load
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 Good Breast feeding Practice

• Initiate breast feeding within the first hour of birth

• Give colostrum - the first natural immunization
for the baby.
• Do not give prelacteal feed.
• Exclusive till six months / not even water except
medications, vitamins and ORS/.
• Empty one breast before giving the other:
– “Fore” milk contains high water
– “Hind” milk is rich in fat & nutrient
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 Good Breast feeding…

• Practice frequent on demand feeding including night

time i.e. 8 – 12 times/day
• Observe for effective suckling
– Slow deep sucks, some times pausing
• Start complementary feeding at six months
• Seek medical attention if there is breast problem
• Mother needs to take two additional variety of meals
from locally available food types
• Mother need to take iron and iodized salt
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 Good BF…

• Proper positioning
– Infants neck is straight or bent slightly back
– Infants body is close & turned toward the
mother
– Infants whole body is supported
– Mother sited erect & supported / lying down

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 Good BF…

• Proper attachment:- relation of baby to breast

– Chin touching the breast
– Mouth wide open
– Lower lip turned out ward
– More areola visible above than below the mouth

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PPT Slide 39:
PPT Slide 43
Breast milk
• Colostrum, transition (5days – 2 wks), and
mature breast milk (after 2 weeks).

Colostrum
• Is secretion of the breast during the later part of
pregnancy & for the next 2-4 days after delivery.
• Colostrum contains substances such as
immunoglobulins and lactoferrin.

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Breast milk: Colostrum

• Stimulates maturation of white blood cells /B

lymphocytes/ and increases the activity of
macrophages.
• Growth and immune factors which accelerate
wound healing, stimulating fat burning, helping to
maintain stable blood glucose levels, and balancing
blood sugar. 19
 PATTERNS OF MILK SUPPLY
Feeding When the Mother is Away
• Mother should express breast milk in to a clean
container /cup/
• Breast milk stored
 8 – 12 hours at room temperature in cool dry
place
 72 hours in a refrigerator
• Care giver feeds expressed breast milk from cup
• Never use a bottle.

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 Complementary feeding

 Introduction should not occur before 4 mo and

should not be delayed beyond 6 mo.
 Continue on demand breast feeding until 2 years of
age
 Breast milk is a major source of energy / 35-40%/

during 12-24 months and serve as a key source of

fat, vit. A, calcium & riboflavin.
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Complementary feeding

 Increase food quantity as the child’s age

 Frequency of complementary feeding

 6-8 months = 2-3 times/day

 9-12 months = 3-4 times/day

 12-24 months = 4-5 times/day

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Types of complementary foods

• 6 month = mashed & semisolid foods

• 8 months – finger food

• 12 months – family food

• Practice active feeing / self feeding/

• Frequent & active feeding during & after illness

• Diversify the diet

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Principles of complementary feeding

• Introduce 1 single nutrient ingredient food at a

time, and do not introduce other new foods for 3-5
days to observe for tolerance.
• iron-fortified cereals , rice, or pureed meats that are
rich in protein, iron, and zinc.
• Ensure adequate calcium intake.
 Principles of complementary feeding

• When offering a new food, 8-10 attempts might

need to be made before the infant accepts the new
food.
• Limit amounts of 100% juices (4-6 oz/day for ages
1-6 yr, & 8-12 oz/day for ages 7-18 yr)

NB: 1oz = 30ml

 Principles of complementary feeding

• Withhold cow's milk and other milks not formulated

for infants during the 1st yr of life, thereafter
– Give no more than 24 oz/day of cow's milk

• Avoid hot dogs, nuts, grapes, and popcorn in the

first 3-4 yr of life; avoid adding salt or sugar.
PREVETION IS THE BEST MEDICINE!!!!
Thank you!
06/10/22 28
LATCH Assessment Guidelines for
Lactation

Goal:
• Systematic assessment of the breastfeeding dyad
• Identifies areas requiring intervention and/or
education
• Serves as a communication and documentation tool
among
• Increases consistency of evaluation
• Repeated scoring identifies changes in the
breastfeeding.
LATCH Assessment Guidelines for
Lactation

Charting system:
• health care professionals experience
• Based on the Apgar scoring system
• A numerical score is assigned to each component
for each session observed
• Scores are added, total score determines “success”
of infant feeding
LATCH Assessment Guidelines for
Lactation

Charting system:
• Higher score (9-1 0) indicates successful
breastfeeding with minimal assistance
• Lower score (4-5) indicates greater assistance
required, impaired feeding
• Individual low score for particular component
shows where assistance is needed