A presentation on World Breast Feeding week 2021

1. WORLD
BREAST-FEEDING WEEK 2021
“EMPOWER PARENTS, ENABLE BREASTFEEDING:
NOW AND FOR THE FUTURE!”
NAME: MOHSIN AHMED ANSARI
DESIGNATION: III MBBS STUDENT
COLLEGE: TOMO RIBA INSTITUTE OF HEATH AND MEDICAL
SCIENCES
CITY: NAHARLAGUN
STATE: ARUNACHAL PRADESH

2. ABSTRACT
• IF BREASTFEEDING WERE SCALED UP TO
NEAR UNIVERSAL LEVELS, ABOUT 820 000
CHILD LIVES WOULD BE SAVED EVERY
YEAR.
• THOSE WHO BEGAN BREASTFEEDING
BETWEEN 2 AND 23 HOURS AFTER BIRTH
HAD A 33 PER CENT GREATER RISK OF
DYING COMPARED WITH THOSE WHO
BEGAN BREASTFEEDING WITHIN ONE
HOUR OF BIRTH.
• CHILDREN WHO ARE NOT PUT TO THE
BREAST WITHIN THE FIRST HOUR OF LIFE
ALSO FACE A HIGHER RISK OF COMMON

4. STATUS OF BREAST MILK FEEDING
GLOBALLY
• GLOBALLY IN 2020, 149 MILLION CHILDREN UNDER 5 WERE ESTIMATED TO BE
STUNTED (TOO SHORT FOR AGE), 45 MILLION WERE ESTIMATED TO BE
WASTED (TOO THIN FOR HEIGHT), AND 38.9 MILLION WERE OVERWEIGHT OR
OBESE.
• OVER 820 000 CHILDREN'S LIVES COULD BE SAVED EVERY YEAR AMONG
CHILDREN UNDER 5 YEARS, IF ALL CHILDREN 0–23 MONTHS WERE OPTIMALLY
BREASTFED. BREASTFEEDING IMPROVES IQ, SCHOOL ATTENDANCE, AND IS
ASSOCIATED WITH HIGHER INCOME IN ADULT LIFE.
• ABOUT 44% OF INFANTS 0–6 MONTHS OLD ARE EXCLUSIVELY BREASTFED.
• FEW CHILDREN RECEIVE NUTRITIONALLY ADEQUATE AND SAFE
COMPLEMENTARY FOODS; IN MANY COUNTRIES LESS THAN A FOURTH OF
INFANTS 6–23 MONTHS OF AGE MEET THE CRITERIA OF DIETARY DIVERSITY
AND FEEDING FREQUENCY THAT ARE APPROPRIATE FOR THEIR AGE.

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7. STATUS OF BREASTFEEDING IN INDIA
ACCORDING TO NATIONAL FAMILY HEALTH SURVEY:
• ONLY 24.5% OF CHILDREN ARE BREASTFED WITHIN THE
FIRST HOUR OF BIRTH
• ABOUT 50% INITIATE BREASTFEEDING WITHIN FIRST DAY
OF LIFE.
• MORE THAN HALF OF NEWBORN INFANTS RECEIVE
PRELACTEAL FEEDS, LIKE MILK OTHER THAN BREAST MILK,
HONEY, SUGAR OR GLUCOSE WATER, AND PLAINWATER.
• EXCLUSIVE BREASTFEEDING RATE UP TO THE AGE OF 6
MONTHS IS ONLY 46.3%; DECLINES RAPIDLY FROM FIRST
MONTH TO SIXTH MONTH WITH ONLY ABOUT 20%
CHILDREN CONTINUE IT BY 6 MONTHS.

8. WHO RECOMMENDATIONS
• MOTHERS INITIATE BREASTFEEDING WITHIN ONE HOUR OF BIRTH;
• INFANTS SHOULD BE EXCLUSIVELY BREASTFED FOR THE FIRST SIX MONTHS
OF LIFE TO ACHIEVE OPTIMAL GROWTH,
• DEVELOPMENT AND HEALTH, AND THEREAFTER, TO MEET THEIR EVOLVING
NUTRITIONAL REQUIREMENTS, INFANTS SHOULD RECEIVE NUTRITIONALLY
ADEQUATE AND SAFE COMPLEMENTARY FOODS, WHILE CONTINUING TO BE
BREASTFED; AND
• BREASTFEEDING SHOULD CONTINUE FOR UP TO TWO YEARS OR BEYOND.

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10. WHO RESPONSE
• THE PLAN INCLUDES 6 TARGETS, ONE OF WHICH IS TO INCREASE, BY 2025, THE RATE OF
EXCLUSIVE BREASTFEEDING FOR THE FIRST 6 MONTHS UP TO AT LEAST 50%
• UNICEF AND WHO CREATED THE GLOBAL BREASTFEEDING COLLECTIVE TO RALLY
POLITICAL, LEGAL, FINANCIAL, AND PUBLIC SUPPORT FOR BREASTFEEDING.
• IN ADDITION, WHO AND UNICEF HAVE DEVELOPED COURSES FOR TRAINING HEALTH
WORKERS TO PROVIDE SKILLED SUPPORT TO BREASTFEEDING MOTHERS, HELP THEM
OVERCOME PROBLEMS, AND MONITOR THE GROWTH OF CHILDREN
• WHO PROVIDES SIMPLE, COHERENT AND FEASIBLE GUIDANCE TO COUNTRIES FOR
PROMOTING AND SUPPORTING IMPROVED INFANT FEEDING BY HIV-INFECTED MOTHERS TO
PREVENT MOTHER-TO-CHILD TRANSMISSION, GOOD NUTRITION OF THE BABY, AND PROTECT
THE HEALTH OF THE MOTHER.

11. ANATOMY OF BREAST
• Aka - Mammary gland
• Provides nutrition and immunity to the
newborn in the form of milk
• Found in both sexes – functional in
female and rudimentary in males.
• Modified sweat gland
• Divided into 4 quadrants – UL, UM, LL
& LM. Axillary tail of Spence –
extension of UL quadrant
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12. STRUCTURE OF BREAST
Skin
• Nipple – conical projection; has muscles
which help to facilitate in sucking of milk for
baby.
• Areola – Pigmented circular area containing
sebaceous glands; forms tubercles of
Montgomery; lactiferous sinuses present
below it.
Parenchyma
• Compound tubuloalveolar gland; each lobe
has cluster of alveoli; drained by a
lactiferous duct.
Stroma:
• Supporting framework – fibrous and fatty
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13. PHYSIOLOGY OF LACTATION
Production of breast milk:
• Controlled by Prolactin (PRL)
• Prolactin reflex –
• Amount of milk secretion is proportional to suckling
strength.
• PRL present in blood for about 30 mins. 13
Suckling of nipple
Sensory impulse goes to
brain
Anterior pituitary
releases PRL
PRL reaches the breast
parenchyma via blood
Initiates secretion of milk
via milk producing cells

14. FACTORS AFFECTING PROLACTIN LEVELS
• EXERCISE; PHYSICAL
WORKOUTS
• BREASTFEEDING
• ESTROGEN
• OXYTOCIN
• VASOACTIVE INHIBITORY
PEPTIDE
• STRESS
• SLEEP
• DA ANTAGONISTS (ANTI-
PSYCHOTIC DRUGS)
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• DOPAMINE (DA)
• DA AGONISTS
(BROMOCRIPTINE)

15. PHYSIOLOGY OF LACTATION
Flow of milk:
• Regulated by Oxytocin hormone
• Works before or during feed to make milk flow
• Oxytocin reflex –
• Signs of active oxytocin secretion – tingling sensation in
breast; cry of baby; uterine pain
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Suckling impusles
goes to brain
Oxytocin released
from posterior pituitary
Reaches breast via
blood
Contracts the muscle
cells around alveolus
Milk flows along the
duct

16. PSYCHOLOGICAL FACTORS AFFECTING OXYTOCIN
REFLEX
 THINKING OF LOVE AND
AFFECTION TOWARDS
BABY
 SOUND OF BABY
 SIGHT OF BABY
 CONFIDENCE
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 WORRY
 STRESS
 PAIN
 DOUBT.
HELPING IN OXYTOCIN
REFLEX
HINDERING OXYTOCIN
REFLEX
That’s why Oxytocin is an emotional hormone

17. BREAST MILK INHIBITION
• Excess milk left in the breast inhibits
milk production.
• Mediated via a substance present in
the breast milk which inhibits the
cells from secreting more milk.
• Inhibitor is removed when breast
milk is removed by suckling or
expression leading to more milk
production.
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18. COMPOSITION OF BREAST MILK
CONTAINS ALL THE MACRO AND MICRO NUTRIENTS, ALSO SUPPLEMENTED BY
BIOACTIVE FACTORS
Nutrients Amount (per 100mL of milk)
FATS 3.2-3.8g
PROTEINS
• In colostrum
• In mature milk
2.3g
0.9g
Carbohydrates 7.1g
Vitamin C 6 mg
Vitamin D 5 IU
Calcium 0.03mg
Iron 0.1mg
Energy 65 kcal

19. GUIDELINES FOR GOOD POSITIONING AND
ATTACHMENT
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• MOTHER CAN BE IN ANY POSITION TO FEED HER BABY WHICHEVER IS
COMFORTABLE TO HER
• SOME RECOMMENDED SUITABLE POSITIONING FOR MOTHER -
Laid back Cross
cradle
Football
hold
Side lying

20. FOUR SIGNS OF PROPER POSITIONING
• HOLD THE INFANT’S HEAD, NECK AND BODY IN A STRAIGHT LINE
• BABY’S FACE SHOULD BE DIRECTLY INFRONT OF MOTHER’S BREAST (EN-FACE)
• HOLD THE INFANT’S BODY CLOSE TO HER BODY (WARM CHAIN IS MAINTAINED)
• SUPPORT INFANT’S WHOLE BODY AND NOT JUST THE HEAD AND NECK.
FOUR SIGNS OF GOOD ATTACHMENT:
• CHIN TOUCHING THE BREAST
• MOUTH WIDE OPEN
• LOWER LIP TURNED OUT
• MORE AREOLA VISIBLE ABOVE THE BABY’S MOUTH THAN BELOW.
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21. VIDEO ON PROPER ATTACHMENT OF
BABY
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22. GUIDELINES FOR COMPLEMENTARY
FEEDING AFTER 6 MONTHS
• MASHED SOLID FOODS SHOULD BE INTRODUCED AS A
COMPLEMENT TO CONTINUED BREASTFEEDING. FOODS
FOR THE BABY CAN BE SPECIALLY PREPARED OR
MODIFIED FROM FAMILY MEALS.
• WHO NOTES THAT:
• BREASTFEEDING SHOULD NOT BE DECREASED WHEN
STARTING ON SOLIDS;
• FOOD SHOULD BE GIVEN WITH A SPOON OR CUP, NOT IN A
BOTTLE;
• FOOD SHOULD BE CLEAN AND SAFE; AND
• AMPLE TIME IS NEEDED FOR YOUNG CHILDREN TO LEARN TO
EAT SOLID FOODS.

23. NUTRITION PROVIDED BY BREAST MILK IN SECOND YEAR
OF LIFE.

24. BENEFITS OF BREAST
FEEDING
• PROVIDES ALL THE NUTRIENTS A BABY NEEDS FOR THE FIRST 6 MONTHS OF LIFE
• BREAST MILK IS EASILY DIGESTED BY THE BABY
• BREAST MILK CONTAINS ANTIBODIES AND OTHER COFACTORS AND PROTECTS AGAINST DIARRHOEA AND
OTHER INFECTIONS. ALSO BABY IS LESS PRONE TO ILLNESS
• CONTAINS ENOUGH WATER SUFFICIENT FOR EVEN VERY DRY CLIMATE
• BREAST MILK IS CLEAN, SAFE AND CHEAP
• STRENGTHS THE BOND BETWEEN MOTHER AND BABY
• HELPS IN REDUCING POST DELIVERY BLEEDING
• BABIES ARE LESS PRONE TO HAVE DIABETES, HEART DISEASES, ECZEMA, ASTHMA, RHEUMATOID
ARTHRITIS AND OTHER DISORDERS IN LATER PART OF LIFE
• ENHANCES BRAIN DEVELOPMENT AND SENSES OF THE BABY
• HAS CONTRACEPTIVE EFFECT FOR THE MOTHER IF IN CASE OF EXCLUSIVE BREAST FEEDING (ALTHOUGH
FAILURE MAY HAPPEN)
• MOTHERS HAVE LOWER RISK OF BREAST AND OVARIAN CANCERS
• BREAST FEEDING PROTECTS THE ENVIRONMENT

25. ACTIONS THAT HELP PROTECT, PROMOTE
AND SUPPORT BREASTFEEDING
1. ADOPTION OF POLICIES SUCH AS THE INTERNATIONAL LABOUR ORGANIZATION’S "MATERNITY
PROTECTION CONVENTION 183" AND "RECOMMENDATION NO. 191", WHICH COMPLEMENTS "CONVENTION
NO. 183" BY SUGGESTING A LONGER DURATION OF LEAVE AND HIGHER BENEFITS;
2. ADOPTION OF THE "INTERNATIONAL CODE OF MARKETING OF BREAST-MILK SUBSTITUTES" AND
SUBSEQUENT RELEVANT WORLD HEALTH ASSEMBLY RESOLUTIONS;
3. IMPLEMENTATION OF THE "TEN STEPS TO SUCCESSFUL BREASTFEEDING" SPECIFIED IN THE BABY-
FRIENDLY HOSPITAL INITIATIVE, INCLUDING:
• SKIN-TO-SKIN CONTACT BETWEEN MOTHER AND BABY IMMEDIATELY AFTER BIRTH AND INITIATION OF
BREASTFEEDING WITHIN THE FIRST HOUR OF LIFE;
• BREASTFEEDING ON DEMAND (THAT IS, AS OFTEN AS THE CHILD WANTS, DAY AND NIGHT);
• ROOMING-IN (ALLOWING MOTHERS AND INFANTS TO REMAIN TOGETHER 24 HOURS A DAY);
• NOT GIVING BABIES ADDITIONAL FOOD OR DRINK, EVEN WATER, UNLESS MEDICALLY NECESSARY;
4. PROVISION OF SUPPORTIVE HEALTH SERVICES WITH INFANT AND YOUNG CHILD FEEDING COUNSELLING
DURING ALL CONTACTS WITH CAREGIVERS AND YOUNG CHILDREN, SUCH AS DURING ANTENATAL AND
POSTNATAL CARE, WELL-CHILD AND SICK CHILD VISITS, AND IMMUNIZATION; AND
5. COMMUNITY SUPPORT, INCLUDING MOTHER SUPPORT GROUPS AND COMMUNITY-BASED HEALTH
PROMOTION AND EDUCATION ACTIVITIES.

26. BREASTFEEDING PROMOTION NETWORK OF
INDIA (BPNI)
• REGISTERED, INDEPENDENT, NONPROFIT, NATIONAL ORGANIZATION LOCATED IN DELHI
• WORKS ON PROTECTING, PROMOTING AND SUPPORTING BREASTFEEDING AND
APPROPRIATE COMPLEMENTARY FEEDING OF INFANTS AND YOUNG CHILDREN.
• BPNI WORKS THROUGH ADVOCACY, SOCIAL MOBILIZATION, INFORMATION SHARING,
EDUCATION, RESEARCH, TRAINING AND MONITORING THE COMPANY COMPLIANCE
WITH THE IMS ACT.
• DOES NOT ACCEPT FUNDS OR SPONSORSHIP OF ANY KIND FROM THE COMPANIES
PRODUCING INFANT MILK SUBSTITUTES, FEEDING BOTTLES, RELATED EQUIPMENT OR
INFANT FOODS
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27. CONVENTIONS ON MARKETING OF BREAST
MILK SUBSTITUTES
AN INTERNATIONAL CODE TO REGULATE THE MARKETING OF BREAST-MILK
SUBSTITUTES WAS ADOPTED IN 1981. IT CALLS FOR:
• ALL FORMULA LABELS AND INFORMATION TO STATE THE BENEFITS OF
BREASTFEEDING AND THE HEALTH RISKS OF SUBSTITUTES;
• NO PROMOTION OF BREAST-MILK SUBSTITUTES;
• NO FREE SAMPLES OF SUBSTITUTES TO BE GIVEN TO PREGNANT WOMEN,
MOTHERS OR THEIR FAMILIES; AND
• NO DISTRIBUTION OF FREE OR SUBSIDIZED SUBSTITUTES TO HEALTH
WORKERS OR FACILITIES.

28. HOW TO PROMOTE BREASTFEEDING
• INCREASE FUNDING
• FULLY IMPLEMENT THE INTERNATIONAL CODE
OF MARKETING OF BREAST MILK
SUBSTITUTES
• ENHANCES THE QUALITY OF CARE IN
FACILITIES
• IMPROVE ACCESS TO SKILLED
BREASTFEEDING
• STRENGTHEN LINKS BETWEEN HEALTH
FACILITIES AND COMMUNITIES
• DEVELOP MONITORING SYSTEMS THAT TRACT
THE PROGRESS OF POLICIES PROGRAMMES
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29. BIBLIOGRAPHY
• HTTPS://WWW.WHO.INT/HEALTH-TOPICS/BREASTFEEDING
• HTTPS://WWW2.HSE.IE/WELLBEING/CHILD-HEALTH/GETTING-BREASTFEEDING-
OFF-TO-A-GOOD-START/POSITIONING-AND-ATTACHMENT.HTML
• MATERNAL AND CHILD HEALTH SERVICES – RECENT ADVANCES IN COMMUNITY
MEDICINE (A H SURYAKANTHA)
• BREASTFEEDING - IAP TEXTBOOK OF PAEDIATRICS
• “CAPTURE THE MOMENT” WHO UNICEF