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Physiology and Benefits of
Breastfeeding and the Risks
of Artificial feeding
Dr. Varsha Atul Shah
Play movie
INDICATORS OF ADEQUATE
BREASTMILK INTAKE
•Breasts full before feeding and softer
afterwards
•Let-Down sensation...
Summary of Differences between Milk
Human milk Animal
milks
Infant
formula
Protein correct amount,
easy
to digest
too much...
What makes Breastmilk different?
HUMAN
Fat
Protein
Lactose
COW
Fat
Protein
Lactose
GOAT
Fat
Protein
Lactose
Too much
prote...
Differences in the Quality of the Proteins
HUMAN
Presence of
Anti-
infective
proteins
35%
Casein
COW’S
80%
Casein
Whey
pro...
Vitamins
HUMAN
B vitamins
Vit. C
Vit. A
COW’S
B
vitamins
Vit. A
Vit. C
Small
Amount
Iron
HUMAN
50 - 70 g/100ml
COW’S
50 - 70 g/100ml
absorbed
10
50
%
Better absorption of breastmilk iron by
the baby
Breast Milk Composition Differences
(dynamic)
• Gestational age at birth (preterm and full term)
• Stage of lactation (col...
COLOSTRUM
Property
• Antibody-rich
• Many white cells
• Laxative
• Growth factors
• Vitamin-A rich
Importance
• Protects a...
Breast milk in 2nd year of life
0
0
0
0
0
1
1
1
1
1
1
ENERGY PROTEIN VITAMIN A VITAMIN C
%DAILYNEEDSPROVIDEDBY500MLBREAST
...
Why should I breastfeed?
- the natural choice for BABIES
- the natural choice of MOTHERS
- the natural choice for the
ENVI...
- The natural choice of
MOTHERS
• Nursing uses up extra calories,
making it easier to lose pounds of
pregnancy
• Breastfeeding lowers the risk of
breast a...
The natural choice for
BABIES
• Breast milk is the most complete
form of nutrition for infants
• Breastfed babies score higher on
IQ tests
• Ensuring yo...
% of Babies Bottledfed and Breastfed for
the 1st 13 weeks that had diarrhoea illness
at various weeks of age during the 1s...
• A study in Dundee, Scotland found that
breastfed infants had much less diarrhoea.
• In babies 0 and 13 weeks of age, alm...
% of Babies Bottlefed and Breastfed for the
1st 13 weeks that had respiratory illness at
various weeks of age during the 1...
• Another study in Dundee, Scotland found that
breastfed infants had much less respiratory
illness.
• In babies 0 and 13 w...
Breastfeeding Decreases the Prevalence
of Obesity in childhood at age 5 & 6 years
Germany4.5
3.8
2.3
1.7
0
0.5
1
1.5
2
2.5...
Lower risk of obesity.
• A study in Germany found that among 9357
children aged 5 and 6 there was an over 5 times
differen...
The natural choice for the
ENVIRONMENT
• The production and feeding of breastmilk have a
far lower impact on our environment and the
world resources than ANY alt...
Benefits for the Hospital
• Warmer and calmer emotional environment
• No nurseries, more hospital space
• Fewer neonatal i...
Risks of Artificial Feeding
RISK OF ARTIFICIAL FEEDING
Baby
• More likely to fall sick
• Increase risk of obesity
• More diarrhoea and
respiratory inf...
Dangers from the Use of Breast-milk
Substitutes
• Powdered Infant formula is not sterile and during
manufacture may be con...
Impact on Society
• Possible increase in use of health care
services, and increase health care costs, both
as infants and ...
Impact on Society
Scenario
• You are speaking to 22 years, Jessica,
beautician, who has delivered healthy 2.7
kg baby girl 24 hours ago. Jes...
Your role is to:
• Ask open-ended questions to find out her thoughts and
feelings about her anxiety
• Use probes to better...
TRUE OR FALSE
1. Giving mothers’ information on risks and benefits of various feeding
options will minimize likelihood of ...
6. Artificially-fed babies are at greater risk of
the developing the following EXCEPT:
a. Gastro-intestinal infections
b. ...
7. Women who choose artificial feeding are
at a higher risk of the having the following
EXCEPT:
a. Breast cancer
b. Ovaria...
8. Numerous studies have shown that artificial feeding
places a higher financial burden on the family due to the
following...
9. Breastfeeding benefits for the hospital
include all of the following EXCEPT:
a. Warmer and calmer emotional environment...
10. Breastfeeding benefits to family,
EXCEPT:
a. Better health, nutrition, and well-being of
mother and child
b. Costs les...
Benefits of Colostrum, EXCEPT
a. Antibody-rich and has many white cells
b. Has laxative effects
c. Causes high incidence o...
12. Which of the following is TRUE for a
Mom who uses milk formula…
a. Does not get pregnant sooner
b. Increased risk of o...
13. AAP guidelines for breastfeeding
advocates
a. Exclusive breast feeding till 6 month
b. Weaning after 4 months in exclu...
14. Harmful effects of breastfeeding are:
a. Loss of mum’s figure
b. High risk of post natal depression
c. Low self-esteem...
15. According to studies, breastfed babies
are at lower risk of the following conditions
EXCEPT:
a. Respiratory and diarrh...
16. Formula fed babies are constipated
because
a. Formula is low in thyroxin
b. Cow’s milk iron do not absorb well in
baby...
17. Which of the following is not an effect of
breastfeeding?
a. Provides superior nutrition for optimum
growth.
b. Protec...
18. All are true, EXCEPT:
a. Iron is higher in breast milk
b. Iron is better absorbed in breastfed
infants
c. Iron supplem...
19. TRUE of NEC, except:
a. Exclusively formula fed infants were 6 to 10
times more likely to develop NEC than those who
r...
Answers
1. 1-T
2. 2-T
3. 3-F
4. 4-T
5. 5-F
6. 2-5
7. 3-5
8. 4-4
9. 5-6
10.6-4
Answers
11.7-3
12.8-1
13.9-1
14.10-6
15.11-4
16.12-2
17.13-5
18.14-1
19.15-3
20.BONUS
Thank You
DO IT WITH PRIDE... BREASTFEED YOUR CHILD!
References:
• Breastfeeding counselling: A training course. Geneva, World Health Organization,
1993(WHO/CDR/93.6).
• Breas...
References:
• Aniansson G,Alm B. Anderson B,Hakansson A, Larsson P.Nylen O,Peterson H,Rigner P.Svanborg M,Sabharnal Het al...
References:
• Breastfeeding counselling: A training course. Geneva, World Health Organization, 1993(WHO/CDR/93.6).
• Breas...
Breast cancer and breastfeeding:
Analysis of data from 47 epidemiological studies
in 30 countries (Beral V et al Lancet 20...
Risk of Ovarian cancer
• This multinational study showed a 20-25%
decrease in the risk of ovarian cancer among
women who l...
Breastfeeding Savings per year (2012)
• For first 3 months of life baby needs average 2
tins of I kg powdered milk per mon...
Intelligence Quotient by Type of Feeding
BF 2POINTS
Higher than FF
Study in 3-7
Years old
1982
BF 2.1 points
higher than F...
Duration of breastfeeding associated with
higher IQ scores in young adults, Denmark
Adapted from: Mortensen EL, Michaelsen...
Breastfeeding Decreases the Risk of Allergic
disorders - A Prospective Birth Cohort
Study
Type of
feeding
Asthma Atopic
de...
Lower risk of allergies.
• It is generally agreed that allergies are less
common in completely breastfed babies. A recent
...
Risk of Allergy and Milk intolerance
• Artificial milk has different proteins from human
milk – slow and difficult to dige...
Artificial Feeding and Risk of Allergy
• Prospective study on Finnish infants of atopic
parents for 17 years found that th...
Increased Risk of Chronic Diseases
• Study done in Amsterdam on 625 adults aged 48-53
years
• Those who are bottle fed at ...
Risk of Otitis Media
• A study in Sweden found that breastfed infants
had less otitis media than artificially fed infants
...
Necrotizing Enteritis in preterm infants
• 926 preterm infants were studied, 51 of whom
developed NEC.
• Exclusively formu...
Risk of Breast cancer
• This multi-centre trial in the USA included more
than 14000 pre- and post-menopausal women. It
con...
Risk of hip fractures in elderly women
• In one study of 311 cases of hip fractures in
women over 65 years of age, it was ...
2 physiology and benefits of bf, risk of artificial feeding230113
2 physiology and benefits of bf, risk of artificial feeding230113
2 physiology and benefits of bf, risk of artificial feeding230113
2 physiology and benefits of bf, risk of artificial feeding230113
2 physiology and benefits of bf, risk of artificial feeding230113
2 physiology and benefits of bf, risk of artificial feeding230113
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2 physiology and benefits of bf, risk of artificial feeding230113

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Physiology and benefits of breast feeding

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  • A study to compare the prevalence of obesity in breastfed children at age five to six in Germany.
  • Infants cry less, are calmer; mothers can more easily respond to their babies’ needs. No need for nurseries when there is rooming-in, which means more space for patients and hospital staff. Rooming-in reduces neonatal infections. Exclusively breastfed infants have fewer infections. Less staff time is needed. Mothers are directly responsible for the care of their babies. Rooming-in and breastfeeding support increases hospital prestige and creates animage of a facility doing its best for mothers and babies. Mothers who breastfeed are less likely to abuse or abandon their babies. Breastfeeding is the safest feeding method during emergencies.
  • There are risks for baby and risks for mother. Lets look at the risks for the baby. Not breastfeeding means lack of the protective elements of breast milk, resulting in a higher illness rate. Babies not breastfed are at higher risk of becoming obese and having more prone to diarrheoa and respiratory infections. Babies not breastfed also have a higher incidence of allergy such as eczema or asthma. Studies have also shown that breastfeeding also decrease the risk of chronic diseases in adulthood such as Diabetes Mellitus and Hypertension. Exclusive breastfeeding also reduces the risk of otitis media in babies. Studies have shown preterm babies not given breast milk are at higher risk of contracting necrotising enterocolitis(NEC) . The risks also extend to mothers if baby is on artificial feeding. As not breastfeeding means mothers need to rely on use of contraceptive devices and methods to delay any unplanned pregnancy. Mothers are also deprived of the bonding process during breastfeeding. Studies have shown mothers who do not breastfeed are at a higher risk of ovarian and breast cancers
  • As baby’s immune system is not yet well developed, breastfeeding provides antibodies that protect your baby from infection. Hence breastfed infants are less likely to suffer from diarrhea, acute respiratory infections and other serious illnesses. Thus infants on formula feeding will not have that protection due to the lack of antibodies or other anti infective factors
  • A study in Germany found that among 9357 children aged 5 and 6 there was an over 5 times difference in the
    prevalence of obesity among those children never breastfed compared to those breastfed for over one year.
    As one can see from the study above, the longer an infant had been breastfed the lower prevalence of obesity at the age of 5 and 6 (von Kries et al.).
  • A study in Dundee, Scotland found that breastfed infants had much less diarrhoea. For example, between 0 and
    13 weeks of age, almost 20% of bottlefed infants had diarrhoea compared with only 3.6% of the breastfed infants
    (Howie et al.).
  • Another study in Dundee, Scotland found that breastfed infants had much less respiratory illness. For example, between 0 and 13 weeks of age, almost 39% of the bottle-fed infants had respiratory illness compared to only 23% of the breastfed infants (Howie et al.).
  • Some of the risks for mothers who chose not to breastfeed their babies are listed here.
  • The impact of the risks of not breastfeeding will extends to the family as well. The lack of protection from breast milk means the child is at higher risk of falling sick more frequently . Parents may need to take leave from work to look after the child. A daily rated worker parent may lose his income by absence from work. In addition the family will need to spend more money and time.
  • One of the dangers of using powdered milk is the risk of contamination by bacteria such as Enterobacteria Sakazakii and Salmonella Enterica. To counteract tie risk WHO has drawn up a set of guidelines for preparation of formula
  • Research shows that babies who are nursed tend to have fewer incidents of illness (from common infant diseases) and less visits to the pediatrician as compared with formula fed babies
  • Artificial feeding also has impact on society. In a study done to assess the numbers of excess hospitliazation,clinic visits and prescriptions issued it was found that 2033 excess visits, 212 hospitalizations and 609 excess prescription given. All these cost an additional $331 to $475 per baby who was not breastfed during the first year of life.
  • This multinational study showed a 20-25% decrease in the risk of ovarian cancer among women who
    lactated for at least 2 months per pregnancy, compared to those who had not. Little or no further
    decrease in risk was seen with increasing duration of lactation.
  • This was a study done to capture the amount of money saved for first 3 months of life for 15410 babies who were breastfed in Singapore. This as based on the prices in 1990s
  • A recent study in Sweden in which a birth cohort of 4089 infants was followed prospectively found that exclusive and partial breastfeeding reduced the risk of allergic disorders.
  • Lack of breastfeeding also posed a higher risk of chronic diseases such cardiovascular diseases in adulthood as shown in the study. Of 625 subjects aged 48-53 years born around the time of a severe period of famine in Amsterdam (1944-45), those were bottle fed at hospital discharge had greater risk factors for cardiovascular
    disease than those who were exclusively breast fed as shown in their oral glucose tolerance test, a higher plasma low density lipoprotein (LDL) cholesterol concentration, a lower high density lipoprotein (HDL) cholesterol
    concentration, and a higher LDL/HDL ratio. However Systolic blood pressure and body mass index were not
    affected by the method of infant feeding.
  • A study in Sweden found that breastfed infants had less otitis media than artificially fed infants. For example, at one to three months of age, 6% of the weaned infants had otitis media, compared to only 1% of the breastfed infants (Aniansson et al.).
  • This is a study done to compare effect of breast milk on the prevalence of necrotising Enterocolitis in preterm babies. 926 preterm infants were studied, 51 of whom developed NEC. Exclusively formula fed infants were 6
    to 10 times more likely to develop NEC than those who received breast milk. Although NEC is rare in
    babies over 30 weeks gestation, it was 20 times more common if the baby had received no breast
    milk.
  • A reanalysis of data from 47 epidemiological studies in 30 countries found that the relative risk of breast cancer decreased by 4.3% for every year of breastfeeding (Beral). The longer women breastfeed the more they are protected against breast cancer. The lack of or short lifetime duration of breastfeeding typical of women in developed countries makes a major contribution to the high incidence of breast cancer in these countries
  • This is a study on the prevalence of hip fractures in women who had not breastfed at all. In a study on 311 women with hip fractures women who had not breastfed their babies had 2 times the risk of hip fractures in old age.
  • Transcript of "2 physiology and benefits of bf, risk of artificial feeding230113"

    1. 1. Physiology and Benefits of Breastfeeding and the Risks of Artificial feeding Dr. Varsha Atul Shah
    2. 2. Play movie INDICATORS OF ADEQUATE BREASTMILK INTAKE •Breasts full before feeding and softer afterwards •Let-Down sensation in mother’s breast •Wet nappies/diapers (6x or more/24h) •Bowel movements (several times/day) •Contented baby between feeds •Audible swallowing during feeding •Average weight gain • 18-30 g/day • 125-210 g/week
    3. 3. Summary of Differences between Milk Human milk Animal milks Infant formula Protein correct amount, easy to digest too much, difficult to digest partly corrected Fat enough essential fatty acids, lipase to digest lacks essential fatty acids, no lipase no lipase Water enough extra needed may need extra Anti- infective properties present absent absent Adapted from: Breastfeeding counselling:A training course.Geneva, World Health Organization, 1993 (WHO/ CDR/93.6).
    4. 4. What makes Breastmilk different? HUMAN Fat Protein Lactose COW Fat Protein Lactose GOAT Fat Protein Lactose Too much protein for muscle building
    5. 5. Differences in the Quality of the Proteins HUMAN Presence of Anti- infective proteins 35% Casein COW’S 80% Casein Whey proteins Curds Easy to digest Harder to digest
    6. 6. Vitamins HUMAN B vitamins Vit. C Vit. A COW’S B vitamins Vit. A Vit. C Small Amount
    7. 7. Iron HUMAN 50 - 70 g/100ml COW’S 50 - 70 g/100ml absorbed 10 50 % Better absorption of breastmilk iron by the baby
    8. 8. Breast Milk Composition Differences (dynamic) • Gestational age at birth (preterm and full term) • Stage of lactation (colostrum and mature milk) • During a feed (foremilk and hindmilk)
    9. 9. COLOSTRUM Property • Antibody-rich • Many white cells • Laxative • Growth factors • Vitamin-A rich Importance • Protects against infection and allergy • Protects against infection • Clears meconium; helps prevent jaundice • Helps intestine mature; prevents allergy, intolerance • Reduces severity of some infection (such as measles and diarrhoea); prevents vitamin A
    10. 10. Breast milk in 2nd year of life 0 0 0 0 0 1 1 1 1 1 1 ENERGY PROTEIN VITAMIN A VITAMIN C %DAILYNEEDSPROVIDEDBY500MLBREAST MILK 31 38% 45% 95 % From: Breastfeeding counselling: A training course. Geneva, World Health Organization ,1993(WHO/CDR/93.6).
    11. 11. Why should I breastfeed? - the natural choice for BABIES - the natural choice of MOTHERS - the natural choice for the ENVIRONMENT
    12. 12. - The natural choice of MOTHERS
    13. 13. • Nursing uses up extra calories, making it easier to lose pounds of pregnancy • Breastfeeding lowers the risk of breast and ovarian cancers • Breastfeeding can help you bond with your baby • Save more money, easy, convenient and more portable • Breastfeeding has contraceptive effect
    14. 14. The natural choice for BABIES
    15. 15. • Breast milk is the most complete form of nutrition for infants • Breastfed babies score higher on IQ tests • Ensuring your baby has only breastmilk for at least 6 months may help minimize allergy problems • Babies breastfeed for comfort and closeness as well as to satisfy their hunger and thirst
    16. 16. % of Babies Bottledfed and Breastfed for the 1st 13 weeks that had diarrhoea illness at various weeks of age during the 1st year, Scotland 19.5 19.1 22.3 22.4 3.6 7.1 12.9 11.9 0 5 10 15 20 25 0-13 14-26 27-39 40-52 Incidence of diarrhoea illness by age in weeks %withdiarrhoea bottle-fed Breast fed Adapted from: Popkin BM, Adair L, Akin JS ,Black R et al.Breastfeeding and diarrheoa morbidity.Pediatric, 1990,86(6):874-882.
    17. 17. • A study in Dundee, Scotland found that breastfed infants had much less diarrhoea. • In babies 0 and 13 weeks of age, almost 20% of bottle-fed infants had diarrhea compared with only 3.6% of the breastfed infants - Howie, et al
    18. 18. % of Babies Bottlefed and Breastfed for the 1st 13 weeks that had respiratory illness at various weeks of age during the 1st year, Scotland 40 54.1 45.547.1 38.9 42.4 36.2 23.1 0 10 20 30 40 50 60 0-13 14-26 27-39 40-52 Incidenceof respiratory illness by age in weeks %withrespiratoryillness Bottle-fed Breastfed Adapted from:Howie PW,Forsyth JS,Ogston SA,Clarke A Florey CV.Protective effect of breastfeeding against infection.BR Med J,1990,300:11-15.
    19. 19. • Another study in Dundee, Scotland found that breastfed infants had much less respiratory illness. • In babies 0 and 13 weeks of age, almost 39% of the bottle-fed infants had respiratory illness compared to only 23% of the breastfed infants Howie et al
    20. 20. Breastfeeding Decreases the Prevalence of Obesity in childhood at age 5 & 6 years Germany4.5 3.8 2.3 1.7 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 Prevalence (%) Months Breastfeeding 0 months 2 months 3-5 months 6-12 months Adapted from: Von Kries R, Koletzko B, Sauerwald T et al. Breast feeding and obesity: cross sextional study .BMJ, 1999,319:147-150.
    21. 21. Lower risk of obesity. • A study in Germany found that among 9357 children aged 5 and 6 there was an over 5 times difference in the prevalence of obesity among those children never breastfed compared to those breastfed for over one year • The length of time an infant was breastfed was inversely proportional to the prevalence of childhood obesity von Kries et al
    22. 22. The natural choice for the ENVIRONMENT
    23. 23. • The production and feeding of breastmilk have a far lower impact on our environment and the world resources than ANY alternative feeding method • Breastfeeding saves food resources, fuel and energy • No packaging is required and NO CHEMICALS are needed for preparation and disinfection
    24. 24. Benefits for the Hospital • Warmer and calmer emotional environment • No nurseries, more hospital space • Fewer neonatal infections • Less staff time needed • Improved hospital image and prestige • Fewer abandoned children • Safer in emergencies
    25. 25. Risks of Artificial Feeding
    26. 26. RISK OF ARTIFICIAL FEEDING Baby • More likely to fall sick • Increase risk of obesity • More diarrhoea and respiratory infections • More allergy and milk intolerance • Increased risk of chronic diseases • Risk of otitis media • Risk of NEC in preterm Mother • Pregnant sooner • Increased risk of ovarian and breast cancer • Interferes with bonding • Hip fractures in older age
    27. 27. Dangers from the Use of Breast-milk Substitutes • Powdered Infant formula is not sterile and during manufacture may be contaminated with bacteria such as Enterobacteria Sakazakii & Salmonella enterica. • WHO has developed guidelines for careful formula preparation in order to minimize the risk to infants Adapted from:16 guidelines for the safe preparation, Storage and Handling of powdered Infant Formula, Food Safety, WHO(2007)
    28. 28. Impact on Society • Possible increase in use of health care services, and increase health care costs, both as infants and later.
    29. 29. Impact on Society
    30. 30. Scenario • You are speaking to 22 years, Jessica, beautician, who has delivered healthy 2.7 kg baby girl 24 hours ago. Jessica intent to exclusively breastfeed. Jessica was concerned about her daughter, since she has not passed BO since birth and is passing pink colour urine. She had only changed diaper 2 times since birth.
    31. 31. Your role is to: • Ask open-ended questions to find out her thoughts and feelings about her anxiety • Use probes to better understand what she means. • Affirm her feelings and release her anxiety • Your role is to communicate about her concerns and discuss your action plan.
    32. 32. TRUE OR FALSE 1. Giving mothers’ information on risks and benefits of various feeding options will minimize likelihood of breastfeeding mothers influenced to use formula True/ False 2. Breast-milk substitutes include formula, teas, and juices (and other products) True / False 3. Giving supplements increase protective benefits of breastfeeding True/ False 4. Some of the risks from using breast milk substitutes could be reduced by attention to process of preparation and hygienic elements but the differences in the constituents of breast milk and infant formula remain True/ False 5. Prospective study done on infants of atopic parents found that there is no difference in the prevalence of atopic disease between breastfed and artificially fed children True/ False
    33. 33. 6. Artificially-fed babies are at greater risk of the developing the following EXCEPT: a. Gastro-intestinal infections b. Respiratory infections c. Necrotising enterocolitis d. Urinary tract infections e. Tonsillitis
    34. 34. 7. Women who choose artificial feeding are at a higher risk of the having the following EXCEPT: a. Breast cancer b. Ovarian cancer c. Hip fractures and bone density d. Anaemia e. Infertility
    35. 35. 8. Numerous studies have shown that artificial feeding places a higher financial burden on the family due to the following EXCEPT: a. Cost of buying infant formula and other necessary supplies b. Increased medical bills due to frequent illnesses in children c. Higher cost to feed a lactating mother d. Loss of income through a parent’s absence from work to care for an ill child.
    36. 36. 9. Breastfeeding benefits for the hospital include all of the following EXCEPT: a. Warmer and calmer emotional environment b. No nurseries, more hospital space c. Fewer neonatal infections d. Less staff time needed e. Improved hospital image and prestige f. No free sponsorship from pharma, samples of formula and less earnings for hospital
    37. 37. 10. Breastfeeding benefits to family, EXCEPT: a. Better health, nutrition, and well-being of mother and child b. Costs less than artificial feeding c. Results in lower medical care costs d. Mother can do house works, can take care of sibling and save money
    38. 38. Benefits of Colostrum, EXCEPT a. Antibody-rich and has many white cells b. Has laxative effects c. Causes high incidence of jaundice d. Has growth factors e. Is vitamin-A rich
    39. 39. 12. Which of the following is TRUE for a Mom who uses milk formula… a. Does not get pregnant sooner b. Increased risk of ovarian and breast cancer c. Interferes with bonding d. Has higher hip fractures in older age e. All of the above f. None of the above
    40. 40. 13. AAP guidelines for breastfeeding advocates a. Exclusive breast feeding till 6 month b. Weaning after 4 months in exclusive breastfed infants c. Can feed water and juices after 4 months d. Use pacifier if breast milk is not enough and baby is hungry
    41. 41. 14. Harmful effects of breastfeeding are: a. Loss of mum’s figure b. High risk of post natal depression c. Low self-esteem in mother d. Baby gets too attached to mum e. Causes Iron deficiency anaemia in mother f. None of the above
    42. 42. 15. According to studies, breastfed babies are at lower risk of the following conditions EXCEPT: a. Respiratory and diarrhoea diseases b. Allergy disorder c. Obesity d. Schizophrenia
    43. 43. 16. Formula fed babies are constipated because a. Formula is low in thyroxin b. Cow’s milk iron do not absorb well in baby therefore more iron have been added into infant formula which increased the risk of baby having constipation. c. Formula increases water absorption in colon d. Formula has less fibre
    44. 44. 17. Which of the following is not an effect of breastfeeding? a. Provides superior nutrition for optimum growth. b. Protects against infection and allergies. c. Promotes bonding and development d. Incur more cost for the family
    45. 45. 18. All are true, EXCEPT: a. Iron is higher in breast milk b. Iron is better absorbed in breastfed infants c. Iron supplements are needed in all exclusively breastfed full term infants d. Iron in formula causes constipation
    46. 46. 19. TRUE of NEC, except: a. Exclusively formula fed infants were 6 to 10 times more likely to develop NEC than those who received breast milk. b. Although NEC is rare in babies over 30 week’s gestation, it was 20 times more common if the baby had received no breast milk. c. Infection from mothers milk cause NEC in preterm infection d. Breast milk is easy to digest and less osmolar
    47. 47. Answers 1. 1-T 2. 2-T 3. 3-F 4. 4-T 5. 5-F 6. 2-5 7. 3-5 8. 4-4 9. 5-6 10.6-4
    48. 48. Answers 11.7-3 12.8-1 13.9-1 14.10-6 15.11-4 16.12-2 17.13-5 18.14-1 19.15-3 20.BONUS
    49. 49. Thank You DO IT WITH PRIDE... BREASTFEED YOUR CHILD!
    50. 50. References: • Breastfeeding counselling: A training course. Geneva, World Health Organization, 1993(WHO/CDR/93.6). • Breastfeeding and the use of water and teas. Division of Child Health and Development UPDATE No.9, Geneva, World Health Organization, November 1997. (http://www.who.int/child-adolescenthealth/New_Publications/ NUTRITION/Water_Teas.pdf). • Popkin BM, Adair L, Akin JS, Black R, et al. Breastfeeding and diarrheal morbidity. Pediatrics, 1990,86(6): 874-882. • Scariati PD, Grummer-Strawn LM, Fein SB. A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States. Pediatrics, 1997, 99(6).von Kries R, Koletzko B, Sauerwald T et al. Breast feeding and obesity: cross sectional study. BMJ, 1999, 319:147-150. • Saarinen / Kajosaari M: Breastfeeding as prophylaxis against atopic disease :Prospective Follow up study until 17 years old:Lancet 346: 1065 – 9 , 1995
    51. 51. References: • Aniansson G,Alm B. Anderson B,Hakansson A, Larsson P.Nylen O,Peterson H,Rigner P.Svanborg M,Sabharnal Het al.A prospective study on breastfeeding and otitis media in Swedish infants:Pediatr.Infect Dis J,1994 Mar 13(3)183-8 • Lucas A & Cole TJ (1990). Breast milk and neonatal necrotising enterocolitis. Lancet 336: 1519-1522 • Rosenblatt KA, Thomas DB, and the WHO collaborative study of neoplasia and steroid contraceptives. Lactation and the risk of epithelial ovarian cancer. International J Epidemiol 1993;22:192-7.. • Cumming RG, Klineberg RJ. Breastfeeding and other reproductive factors and the risk of hip fractures in elderly women.Int J Epidemiol. 1993 Aug;22(4):684-91. Erratum in: Int J Epidemiol 1993 Oct;22(5):962. PMID: 8225744 [PubMed - indexed for MEDLINE] • Ravelli ACJ, van der Meulen JH, Osmond C, et al. Infant feeding and adult glucose tolerance, lipid profile, blood pressure, and obesity. Arch Dis Child 2000;82:248–52. • Newcomb, P.A. et al. 1994. "Lactation and a reduced risk of premenopausal breast cancer." The New England Journal of Medicine 330(2):81-87. • Ball TM, Wright AL. Health care costs of formula-feeding in the first year of life. • Pediatrics. 1999 Apr;103(4 Pt 2):870-6.PMID: 10103324 [PubMed - indexed for MEDLINE]
    52. 52. References: • Breastfeeding counselling: A training course. Geneva, World Health Organization, 1993(WHO/CDR/93.6). • Breastfeeding and the use of water and teas. Division of Child Health and Development UPDATE No.9, Geneva, World Health Organization, November 1997. (http://www.who.int/child-adolescenthealth/New_Publications/ NUTRITION/Water_Teas.pdf). • Fergusson DM, Beautrais AL, Silva PA. Breastfeeding and cognitive development in the first seven years of life. Social Science and Medicine, 1982, 16:1705-1708. Howie PW, Forsyth JS, Ogston SA,Clark A, Florey CV. Protective effect of breastfeeding against infection. BMJ, 1990, 300:11-15. • Popkin BM, Adair L, Akin JS, Black R, et al. Breastfeeding and diarrheal morbidity. Pediatrics, 1990,86(6): 874- 882. • Scariati PD, Grummer-Strawn LM, Fein SB. A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States. Pediatrics, 1997, 99(6).von Kries R, Koletzko B, Sauerwald T et al. Breast feeding and obesity: cross sectional study. BMJ, 1999, 319:147-150.
    53. 53. Breast cancer and breastfeeding: Analysis of data from 47 epidemiological studies in 30 countries (Beral V et al Lancet 2002) Longer you breastfeed-relative risk of breast cancer decreases Adapted from: Beral V et al. (Collaborative group on hormonal factors in breast cancer). Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries. Lancet 2002; 360: 187-95.
    54. 54. Risk of Ovarian cancer • This multinational study showed a 20-25% decrease in the risk of ovarian cancer among women who lactated for at least 2 months per pregnancy, compared to those who had not. Rosenblatt KA et al. (1993). Lactation and the risk of epithelial ovarian cancer - The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. Int J Epidemiol 22: 499-503
    55. 55. Breastfeeding Savings per year (2012) • For first 3 months of life baby needs average 2 tins of I kg powdered milk per month – Each tin costs $44.60 – 24 tins will cost $1070.40 • Savings for each year by breastfeeding is $1070.40 per year
    56. 56. Intelligence Quotient by Type of Feeding BF 2POINTS Higher than FF Study in 3-7 Years old 1982 BF 2.1 points higher than FF Study in 6 months to 2 years old, 1988 BF 12.9 points higher than FF Study in 9.5 year-olds 1996 BF 8.3 points higher than FF – Study in 7.5-8 year -olds 1992 BM 7.5 points higher than no BM Study in 7.5-8 years-old 1992 References: •Fergusson DM et al. Soc SciMed 1982 •Morrow-Tlucak M et al. SocSciMed,1988 • Lucas A et al. Lancet 1992 •Riva Eet al. Acta Paediatr 1996 Atleast 35 studies in the world show BF babies score 3 to 9 IQ points higher than FF babies
    57. 57. Duration of breastfeeding associated with higher IQ scores in young adults, Denmark Adapted from: Mortensen EL, Michaelsen KF, Sanders SA, Reinisch JM. The association between duration of breastfeeding and adult intelligence. JAMA, 2002, 287: 2365-2371. 99.4 101.7 102.3 106 104 96 97 98 99 100 101 102 103 104 105 106 Duration of breastfeeding in months <1 month 2-3 months 4-6 months 7-9 months >9 months LONGER U FEED = MORE BENEFIT
    58. 58. Breastfeeding Decreases the Risk of Allergic disorders - A Prospective Birth Cohort Study Type of feeding Asthma Atopic dermatitis Allergic rhinitis Children exclusively breastfed 4 months or more 7.7% 24% 6.5% Children breastfed for a shorter period 12% 27% 9% Adapted from Kull I. et al. Breastfeeding and allergic diseases in infants - a prospective birth cohort study. Archives of Disease in Childhood 2002: 87:478-481.
    59. 59. Lower risk of allergies. • It is generally agreed that allergies are less common in completely breastfed babies. A recent study in Sweden in which a birth cohort of 4089 infants was followed prospectively found that exclusive and partial breastfeeding reduced the risk of allergic disorders • Children exclusively breastfed during four months or more exhibited less asthma (7.7% vs. 12%), less atopic dermatitis (24% vs. 27%) and less allergic rhinitis (6.5% vs. 9%) Kull et al.
    60. 60. Risk of Allergy and Milk intolerance • Artificial milk has different proteins from human milk – slow and difficult to digest • Some babies develop intolerance to proteins in formula and develop rashes, diarrhea and other symptoms
    61. 61. Artificial Feeding and Risk of Allergy • Prospective study on Finnish infants of atopic parents for 17 years found that the prevalence of atopy was highest in the group of children not breastfed at all or were breastfed less than a month Saarinen UM,Kajosaeri M(1995) Breastfeeding as a prophylaxis against atopic disease: propsective follow up study until 17 years of age, Lancet 346:1065-1069
    62. 62. Increased Risk of Chronic Diseases • Study done in Amsterdam on 625 adults aged 48-53 years • Those who are bottle fed at hospital discharge had greater risk factors for cardiovascular disease than those who were exclusively breastfed Adapted from Ravelli AC et al(2000)infant feeding and adult glucose tolerance, lipid profile, blood pressure and obesity. Arch Dis Child 82:248-52
    63. 63. Risk of Otitis Media • A study in Sweden found that breastfed infants had less otitis media than artificially fed infants • At one to three months of age, 6 % of the weaned infants had otitis media, compared to only 1% of the breastfed infants Anaiansson et al
    64. 64. Necrotizing Enteritis in preterm infants • 926 preterm infants were studied, 51 of whom developed NEC. • Exclusively formula fed infants were 6 to 10 times more likely to develop NEC than those who received breast milk. • Although NEC is rare in babies over 30 weeks gestation, it was 20 times more common if the baby had received no breast milk. Adapted from Lucas A & Cole TJ (1990). Breast milk and neonatal necrotising enterocolitis,Lancet 336:1519-1522
    65. 65. Risk of Breast cancer • This multi-centre trial in the USA included more than 14000 pre- and post-menopausal women. It concluded that breast cancer risk was 22% lower among pre-menopausal women who have breastfed than among those who have never breastfed. Newcomb PA et al. (1994). Lactation and a reduced risk of premenopausal breast cancer. New Engl J Med 330: 81-87
    66. 66. Risk of hip fractures in elderly women • In one study of 311 cases of hip fractures in women over 65 years of age, it was found that parous women who had not breastfed had twice the risk of hip fractures as nulliparous women and those who did not breastfed Adapted from Cumming RG & Klineberg RJ(1993)Breastfeeding and other reproductive factors & the risk of hip fractures in elderly women.Int Epidermiol:022:684-691
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