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WHO and UNICEF jointly developed the Global Strategy for Infant and Young Child Feeding to revitalize world attention to the impact that feeding practices have on the nutritional status, growth and development, health, and thus the very survival of infants and young children
We strive for nature , here is is a baby who tries to lactch on…what do you think if she needs support !
As a global public health recommendation, breastfeeding should be started within one hour of birth. Infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods whilebreastfeeding continues for up to two years of age or beyond.
There has been enough scientific, research evidence to establish numerous benefits of exclusive breastfeeding and detrimental effects of formula feeding for the baby, the mother, the family, the society and the world.
A study from Ghana showed an association between timing of breastfeeding and newborn survival. The study showed that 22% of all neonatal deaths could be prevented if all women could initiate breastfeeding within one hour of birth. If the initiation of breastfeeding is delayed for more than three days, the risk of mortality increase six times.
In this slide you would see that out of deaths occurring during the first six months, 53% of pneumonia and 55% of diarrhea is because of suboptimal feeding practices. Similarly during the second six months these figures are 18 and 25% respectively. This is sufficient to say that human, financial and physical mechanisms and resources must be matched to achieve optimal feeding practices.
Large disease burden is attributed to suboptimum breastfeeding, it leads to 1.4 million I.e.12% of all under-five deaths and 43.55 million DALYs which is 10% of global Under-5 DALYs. Most of the deaths 1.06 million and 37 million DALYs are attributed to non exclusive breastfeeding during first six months.
Breastfeeding is also linked with childhood intelligence and better adult health. A meta-analysis of available evidences by WHO conclusivelyestablishes protective role of breastfeeding on obesity, diabetes, hypertension and resultant cardiovascular disease later in the life.
The new evidence arrives from S Africa first time such study has removed confusion on role of breastfeeding during HIV infection and points out that exclusive breastfeeding actually can reduce transmission , about 4 % of postnatal transmission occurs due to breastfeeding . Transmission is doubled with mixed feeding, i.e. breastfeeding plus other milk feeds, and it is 11 times higher if solids were used to feed babies along with breastfeeding during first is months. In a country of mixed feeders it becomes quite relevant to call for a national policy that is clear enough to provide skilled counselling and practical and physical support needed to begin breastfeeding within one hour, and maintain exclusive breastfeeding in all women, so that we can reduce the cohort of positive HIV babies. Of course in HIV positive women the consensus evolved at the 2006 WHO Technical consultation is to … “Exclusive breastfeeding is recommended for HIV-infected women for the first 6 months of life unless replacement feeding is acceptable, feasible, affordable, sustainable and safe for them and their infants before that time. Consistent messages, frequent, high quality counseling”
Please read the bullets one by one.
Women need support in every corner of the world. They need to be supported in their roles for caring their children, and breastfeeding comes as the first role, once they become mothers. YOU MAY LIKE TO USE FACES FROM YOUR REGION ALSO.
Working mothers needs support to achieve successful exclusive breastfeeding in the form of ensuring effective enforcement of maternity benefit services and provisions of supportive child care services like provision of crèche’, facility for expression and storage of breast milk etc.
For a mother to succeed in breastfeeding, she should be aware of the mechanism of breast milk production and also the transfer of the breast milk from mothers’ breasts to the baby.
Lets study a bit how breasts produce milk ! Anatomy and Physiology of this!!Nipple - The part of breast through which the milk flows is called nipple. When the baby suckles, the brain gets necessary message to produce the milk.Areola - Around the nipple there is a circle of dark skin called areola. Beneath the areola the milk is collected. Therefore areola must go inside the baby’s mouth in order to draw milk.Bunches of milk secreting cells - There are millions of bunches called \"alveloi\" made up of milk secreting cells inside the breasts. Different size breasts have same number of these cells. The diagram shows only a few of these bunches, the box shows three of them enlarged. A hormone makes these cells produce milk. Another hormone helps milk flow. These bunches of milk secreting cells are surrounded by supporting tissue and fat. It is the fat and other tissue which gives the breast its shape, and which makes most of the difference between large and small breasts. Different sized breasts produce milk in quantity that is sufficient for the child.
A correctly attached baby has her mouth wide open, with the lower lip turned outside, chin touching the breast, and large black portion of the breast and nipple in side her mouth.
Exactly opposite happens in case of an incorrect attachment
Please read out the bullets for describing the causes of poor attachment
(Production of breatsmilk - Prolactin reflex)We will now see how the breast milk is produced. As the baby suckles on the breast ,it provides a sensory stimulus through nerve endings in the nipple to the anterior pituitary gland situated in the brain,resulting in the release of hormone called prolactin. This hormone acts on glands in the breast for milk production. Thus, milk production is dependent on the sucking stimulus i.e. more the baby sucks more prolactin will be secreted and hence more milk will be produced …-click-…More prolactin is produced at night. Prolactin is helpful in producing next feed and in suppression of ovulation.
We will now see how the breast milk is transferred from the mothers’ breast to the baby’s mouth. As the baby suckles on the breast .it provides a sensory stimulus through nerve endings in the nipple to the posterior pituitary gland situated in the brain,resulting in the release of hormone called oxytocin. This hormone acts on the muscle cells surrounding the milk producing glands in the breast. It propels the milk from the milk producing glands towards the nipple. Thus, milk transfer is dependent on the sucking stimulus i.e. more the baby sucks more prolactin will be pushed towards the nipple and hence more milk will be available to the baby to suckle.More prolactin is produced at night. Prolactin is helpful in producing next feed and in suppression of ovulation.
The release of oxytocin is influenced by mothers’ psychological and physical condition. If mother is confident about her ability to breast feed and she thinks positively about the baby, the release of oxytocin increases. If reverse is the state of mind of the mother, less oxytocin is released even if frequent suckling is attempted. Also, if mother is having any pain, worry, stress or doubt; release of oxytocin decreases. Mother needs support to maintain her confidence. This tender requirement is exploited by the formula making companies who starts there communication by saying “ if you do not have enough milk….” there by negatively effecting the confidence of the mother.
Sometimes mothers complaint that “I do not have enough milk”. This is the most common reason given by the mother for introducing artificial feed. When the mother does not get cooperation and help from her family. She easily loses confidence in herself. She remains tense and due to this her milk flow is reduced. If by any reason baby does not suckle enough then the milk supply is reduced. This is the time when the mother needs help from a trained counselor to reinstate her confidence and to ensure frequent and effective suckling.
Mothers need space, friendly counselors to help them in expressing milk/breastfeeding and acceptance of breastfeeding as the societal norm as the ideal feeding for the infant.
The slide shows certain preconditions to make children health and developed, in yellow you see the preventive approaches, and in white is the curative one.
You may support the cause of breastfeeding by signing a petition on-line at .http://www.onemillioncampaign.org/en/Details_Petitions.aspx .
Celebrities endorsing breastfeeding may help in establishing breastfeeding in the society as the natural way of feeding the infant. Here you may se the first lady of Timor Leste’ breastfeeding her child and allowing to get her photographed to share it with others.
Women Need Support
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and Place here
Global Strategy for Infant
and Young Child Feeding
• Adopted by the
WHA and UNICEF
Executive board in
Optimal Infant and Young
• Starting breastfeeding
within one hour of birth
• Exclusive breastfeeding
for the first six months
• Introducing appropriate
after 6 months along
breastfeeding for two
years or beyond
Risk of neonatal mortality
according to time of
initiation of breastfeeding
4.5 Six times more risk of death 4.2
With in 1 From 1 hour Day 2 Day 3 After day 3
hour to end of day
Deaths attributed to sub-optimal
breastfeeding among children
20 0-6 months
Respiratory Diseases (DD)
Public Health Nutr. 2006 Sep; 9(6): 673-85
Impact of Suboptimum
breastfeeding on child mortality
(1.06 Due to Non- EBF
1.4 million deaths due to suboptimum breastfeeding
Due to Non- EBF
43.5 million DALYs due to suboptimum breastfeeding
Long term effects
• Subjects who were
lower mean blood
pressure and total
cholesterol, as well as
higher performance in
and type-2 diabetes
was lower among
• A 2007 WHO
Exclusive breastfeeding Reduces
HIV Transmission Risk
Exclusive Breastmilk + Breastmilk +
Breastfeeding Formula Solids
Lancet , 31 March 2007
What women need to
Breastfeeding education and support
• Accurate and un- biased information to all
family members, community
• One to one counselling during pregnancy
• At birth support to begin breastfeeding
• Counselling, home visits, and support to
maintain exclusive breastfeeding , like support
on positioning and nutrition
• Counselling for complementary feeding
• Counselling to prevent breastfeeding problems
and take care if they do arise
• Referral for breastfeeding problems like breast
engorgement, sore nipples, not enough milk,
and breast infection.
Breastfeeding in the Correct Position
• Milk producing
• Lactiferous canaliculi
• Lactiferous sinuses
• Myoepithelial tissue
• Adipose tissue
Anatomy of the Breast
Signs of Correct
• Mouth wide open
• Lower lip is turned
• Chin touching the breast
• Black part of the breast
not visible below the
• Large black portion of
breast and nipple
including milk collecting
ducts are inside baby’s
• Tongue under the teat
• Mouth is not wide
• Chin is away from
• Baby is sucking only
• Most black portion
of the breast is
outside the baby’s
• Tongue away from
Causes of Incorrect
• Use of feeding bottles. Leads to
• Inexperienced mother
• Functional difficulty with the
mother or the baby
• Lack of skilled support
The Prolactin reflex
Prolactin from nipple
• More prolactin
secreted at night
• Secreted after feed
to produce next
sucking • Suppresses
The Oxytocin reflex
• Works before or during
feed to make milk flow
sucking • Makes uterus contract
How does the mother’s
confidence play part
Thinks lovingly Doubt
Sound of baby
Sight of baby
The Feeling of “Not
Not true. Just a perception, this is not
a disease entity, just a symptom of
You need to know from the mother,
why she feels that her baby is not
getting enough, and can solve her
• Reinstating mother’s confidence
• Ensure frequent, effective suckling
Which children grow
healthy and achieve
• Well nourished mothers
• Exclusively breastfed for the first six months,
begin breastfeeding within an hour
• Enough and right food to eat later
– Complementary feeding ,continued breastfeeding
• Cared well
• Hygiene and sanitary environment
• Treated when sick