Breast milk is the ideal food for infants, providing all necessary nutrients for healthy growth. The WHO recommends exclusive breastfeeding for the first six months to achieve optimal infant health outcomes. Breastfeeding benefits both mother and child, protecting infants from illness and reducing risks for mothers. Supporting breastfeeding practices like early initiation and avoiding supplementation are important to establish and sustain breastfeeding.

1. EXCLUSIVE BREAST FEEDING

2. Wh othe ’s ilk???
The othe ’s ilk:
1. Always available – No preparation time.
2. Proper temperature.
3. Clean & Fresh.
4. Free of contaminating agents.
5. Cheap.

3. Exclusive breastfeeding within
one hour of birth saves
infant and mothers’ lives
Early initiation of breastfeeding
Only breast milk,
no other liquids or
solids, not even
water, with the
exception of
necessary
vitamins, mineral
supplements or
medicines.
Exclusive breastfeeding
0-<6 months

4. BREAST FEEDING
• Breastfeeding is the normal way of providing young
infants with the nutrients they need for healthy growth
and development. Virtually all mothers can breastfeed,
provided they have accurate information, and the
support of their family, the health care system and
society at large.
• Colostrum, the yellowish, sticky breast milk produced
at the end of pregnancy, is recommended by WHO as
the perfect food for the newborn, and feeding should
be initiated within the first hour after birth.

5. Exclusive breastfeeding
• Exclusive breastfeeding is the process of
feeding a newborn baby exclusively with
breast milk and no other supplement. The
duration of exclusive breastfeeding as given by
the WHO is 6 months after birth. Infants must
thereafter receive complementary baby food
along with breast milk for up to 2 years of age.

6. WHO recommendations on BF
• 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, while continuing to
breastfeed for up to two years or beyond.

7. Function of breast milk
• Breast milk is the natural first food for babies, it provides
all the energy and nutrients that the infant needs for the
first months of life, and it continues to provide up to half or
o e of a hild’s ut itio al eeds du i g the se o d half of
the first year, and up to one-third during the second year of
life.
• Breast milk promotes sensory and cognitive development,
and protects the infant against infectious and chronic
diseases. Exclusive breastfeeding reduces infant mortality
due to common childhood illnesses such as diarrhoea or
pneumonia, and helps for a quicker recovery during illness.
These effects can be measured in resource-poor and
affluent societies

8. Function of breast milk
• Breastfeeding contributes to the health and well-being of mothers; it
helps to space children, reduces the risk of ovarian cancer and breast
cancer, increases family and national resources, is a secure way of
feeding and is safe for the environment.
• While breastfeeding is a natural act, it is also a learned behaviour. An
extensive body of research has demonstrated that mothers and other
caregivers require active support for establishing and sustaining
appropriate breastfeeding practices.
• WHO and UNICEF launched the Baby-friendly Hospital Initiative in 1992,
to strengthen maternity practices to support breastfeeding. The
foundation for the BFHI are the Ten Steps to Successful Breastfeeding
described in Protecting, Promoting and Supporting Breastfeeding: a Joint
WHO/UNICEF Statement. The evidence for the effectiveness of the Ten
Steps has been summarized in a scientific review document.

9. • Advantages of Exclusive Breastfeeding
For the Mother
• The mother experiences a delay in the return of menstrual cycles.
• Exclusive breastfeeding can help the mother from becoming
pregnant again until she chooses to settle on weaning.
• Breastfeeding reduces the risk of developing breast and ovarian
cancer in the mother.
For the Baby
• An exclusively breastfed newborn baby has a lower risk of
gastrointestinal infection than a breast fed baby.
• It helps the baby to regain all the weight lost at birth.
• Exclusively breast fed babies quickly recover from infection and
cold. Moreover, exclusive breastfeeding protects the baby from
becoming sick

10. Psychological benefits of breastfeeding
• Emotional bonding
• close, loving relationship between mother and baby
• mother more emotionally satisfied
• baby cries less
• baby may be more emotionally secure
• Development
• children perform better on intelligence tests
2/9

11. Socio-economic benefits of breast
feeding
• Income savings
• Reduce risk of infection & diseases hence
reduced hospital visits & attendant medical
cost
• Mother are more economically productive
since they spent less time caring a caring for a
sick child

12. EXCLUSIVE BREASTFEEDING
• To enable mothers to establish and sustain
exclusive breastfeeding for 6 months, WHO and
UNICEF recommend:
• Initiation of breastfeeding within the first hour of
life
• Exclusive breastfeeding – that is the infant only
receives breast milk without any additional food
or drink, not even water
• Breastfeeding on demand – that is as often as the
child wants, day and night
• No use of bottles, teats or pacifiers

13. 10 Facts related to exclusive breast
feeding
• Breastfeeding is one of the most effective ways to ensure
child health and survival.
• If breastfeeding were scaled up to near universal levels,
about 820 000 child lives would be saved every year .
Globally, only 40% of infants under six months of age are
exclusively breastfed.
• WHO actively promotes breastfeeding as the best source of
nourishment for infants and young children. This fact file
explores the many benefits of the practice, and how strong
support to mothers can increase breastfeeding worldwide.

14. WHO recommends that:
• * 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.
Fact 1: Breastfeeding for the first six months is crucial

15. Fact 2: Breastfeeding protects infants
from childhood illnesses
• Breast milk is the ideal food for newborns and
infants. It gives infants all the nutrients they
need for healthy development. It is safe and
contains antibodies that help protect infants
from common childhood illnesses such as
diarrhoea and pneumonia, the two primary
causes of child mortality worldwide. Breast
milk is readily available and affordable, which
helps to ensure that infants get adequate
nutrition.

16. Fact 3: Breastfeeding also benefits
mothers
• Exclusive breastfeeding is associated with a
natural (though not fail-safe) method of birth
control (98% protection in the first six months
after birth). It reduces risks of breast and
ovarian cancer, type II diabetes, and
postpartum depression.

17. Fact 4: Breastfeeding has long-term
benefits for children
• Beyond the immediate benefits for children,
breastfeeding contributes to a lifetime of good
health. Adolescents and adults who were
breastfed as babies are less likely to be
overweight or obese. They are less likely to
have type-II diabetes and perform better in
intelligence tests.

18. Fact 5: Infant formula does not contain the
antibodies found in breast milk
• Infant formula does not contain the antibodies found in
breast milk. The long-term benefits of breastfeeding
for mothers and children cannot be replicated with
infant formula. When infant formula is not properly
prepared, there are risks arising from the use of unsafe
water and unsterilized equipment or the potential
presence of bacteria in powdered formula.
Malnutrition can result from over-diluting formula to
"stretch" supplies. While frequent feeding maintains
breast milk supply, if formula is used but becomes
unavailable, a return to breastfeeding may not be an
option due to diminished breast milk production.

19. • FACT 6 :Transmission of HIV through
breastfeeding can be reduced with drugs
• An HIV-infected mother can pass the infection to
her infant during pregnancy, delivery and through
breastfeeding. However, antiretroviral (ARV)
drugs given to either the mother or HIV-exposed
infant reduces the risk of transmission. Together,
breastfeeding and ARVs have the potential to
significantly improve infants' chances of surviving
while remaining HIV uninfected. WHO
recommends that when HIV-infected mothers
breastfeed, they should receive ARVs and follow
WHO guidance for infant feeding.

20. Fact 7: Marketing of breast-milk substitutes are
highly monitored
• 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.

21. • FACTS 8 : Support for mothers is essential
• Breastfeeding has to be learned and many women
encounter difficulties at the beginning. Many routine
practices, such as separation of mother and baby, use
of newborn nurseries, and supplementation with infant
formula, actually make it harder for mothers and
babies to breastfeed. Health facilities that support
breastfeeding by avoiding these practices and making
trained breastfeeding counsellors available to new
mothers encourage higher rates of the practice. To
provide this support and improve care for mothers and
newborns, there are "baby-friendly" facilities in about
152 countries thanks to the WHO-UNICEF Baby-friendly
Hospital Initiative.

22. • FACTS 9 : Mothers should continue
breastfeeding at work
• Many mothers who return to work abandon
breastfeeding partially or completely because
they do not have sufficient time, or a place to
breastfeed, express and store their milk. Mothers
need a safe, clean and private place in or near
their workplace to continue breastfeeding.
Enabling conditions at work, such as paid
maternity leave, part-time work arrangements,
on-site crèches, facilities for expressing and
storing breast milk, and breastfeeding breaks, can
help.

23. • Fact 10: Solid foods should be phased in at six months
• To meet the growing needs of babies at six months of
age, 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.

24. Ten Steps to Successful Breastfeeding
• Every facility providing maternity services and care for newborn infants should:
1. Have a written breastfeeding policy that is routinely communicated to all health care
staff.
2. Train all health care staff in skills necessary to implement this policy.
3. Inform all pregnant women about the benefits and management of breastfeeding.
4. Help mothers initiate breastfeeding within half an hour of birth.
5. Show mothers how to breastfeed, and how to maintain lactation even if they should be
separated from their infants.
6. Give newborn infants no food or drink other than breast milk, unless medically indicated.
7. Practise rooming-in - that is, allow mothers and infants to remain together - 24 hours a
day.
8. Encourage breastfeeding on demand.
9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding
infants.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on
discharge from the hospital or clinic.

25. Technique of Breast Feeding
• Feedings should be initiated as soon after
birth as possible
• Mothers who wish to initiate breast-feeding
in the delivery room should be supported in
doing so.
• the infant's desire for food will vary at
different times of the day(The time required
for an infant's stomach to empty may vary
from 1–4 hr or more during a single day)
• By the end of the 1st wk of life, most healthy
infants will be taking 60–90 mL/feeding and
want 6–9 feedings/24hr

26. Differences in the quality of proteins in
different milks
Co ’s ilk
Human milk
Whey protein
Curds
Easy to digest Difficult to digest
2/4

27. Summary of differences between
milks
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).
Slide 2.2

28. Nutrients Found In Breast Milk
• Breastmilk contains all the nutrients the infant needs for proper growth and development.
• These nutrients include:
 Free water
 Proteins – Protein accounts for 75% of the nitrogen-containing compounds and the non-protein
nitrogen substances include urea, nucleotides, peptides, free amino acids and DNA.
 Fats – Essential fatty acids and long-chain polyunsaturated fatty acids
 Carbohydrates – The principal carbohydrate of human milk is lactose.
 Minerals, vitamins, and trace elements.
 Anti-Allergenic Properties
 Anti-Parasitic Properties
 Anti-Viral Properties
 Anti-Bacterial Properties
 Hormones
 Growth Factors
 Enzymes

29. Major nutrients
• Protein
• Human milk contains two types of proteins: whey and
casein. Approximately 60% is whey, while 40% is
casein. This balance of the proteins allows for quick
and easy digestion. If artificial milk, also called
formula, has a greater percentage of casein, it will be
more difficult for the baby to digest. Approximately
60-80% of all protein in human milk is whey protein.
These proteins have great infection-protection
properties. Listed below are specific proteins that are
found in breast milk :Lactoferrin, Secretory
IgA,lysozyme inhibit growth of bacteria

30. • Vitamins
• The amount and types of vitamins in breast milk is directly
elated to the othe ’s ita i i take. This is h it is
essential that she gets adequate nutrition, including vitamins.
Fat-soluble vitamins, including vitamins A, D, E, and K, are all
ital to the i fa t’s health
• Water-soluble vitamins such as vitamin C, riboflavin, niacin,
and pantothenic acid are also essential. Because of the need
for these vitamins, many healthcare providers and lactation
consultants will have nursing mothers continue on prenatal
vitamins.

31. • Carbohydrates
• Lactose is the primary carbohydrate found in
human milk. It accounts for approximately 40%
of the total calories provided by breast milk.
Lactose helps to decrease a large number of
unhealthy bacteria in the stomach, which
improves the absorption of calcium, phosphorus,
and magnesium. It helps to fight disease and
promotes the growth of healthy bacteria in the
stomach.

32. Other components
• Breast milk also contains important non-nutritional components,
such as antimicrobial factors, digestive enzymes, hormones and
growth factors that are important for passive protection against
infections and immune-mediated diseases and modulate
immunological development.
• Immune-related components and growth factors include:
• Secretory IgA – Predominant immunoglobulin in breast milk
• Bioactive cytokines – Including transforming growth factor-b (TGF-
b) 1 and 2 and interleukin-10 (IL-10)]
• Others – leukocytes, oligosaccharides, lysozyme, lactoferrin,
adiponectin, interferon-g, epidermal growth factor (EGF) and
insulin-like growth factor (IGF)-1.

33. Composition of some of the key nutrients found in
breastmilk
Component
Mean value for mature breastmilk (per
100mL)
Energy (kJ) 280
Energy (kcal) 67
Protein (g) 1.3
Fat (g) 4.2
carbohydrate (g) 7.0
Sodium (mg) 15
Calcium (mg) 35
Phosphorus (mg) 15
Iron (mcg) 76
Vitamin A (mcg) 60
carbohydrate (g) 7.0

34. HOW LONG TO BREASTFEED
• Newborns can nurse for 5 to 10 minute per breast; every 2 to
3 hours. This comes to about 10 to 12 feedings per day. In the
beginning, there is only colostrum, and there’s not very much
of it, so be ready to feed often but for short durations.
• One month or more: as baby gets older, his stomach will get
larger. He will nurse less frequently but for a longer duration at
each feeding session. For example, he may nurse 20 to 40
minute per breast every 3 to 4 hours.
• By 6 months, Baby may breastfeed for 20 to 40 minutes per
breast; 3 to 5 times per day.

35. Colostrum in Human Milk
• Thick, yellow fluid
• Provides 58-70 cal/100 ml.
• High in protein, electrolytes, sodium,
potassium, chloride and vitamin A.
• Low in fat and carbohydrate.
• Lactobacillus bifidus factor.
• Contains antibodies immune system cells.

36. Colostrum
Benefits of colostrum feeding:
1. Perfect food for infants in initial days.
2. Laxative effect – lea s i fa t’s i testi es of
initial stools; prevents jaundice.
3. Contains leukocytes which prevent
infection.
4. Contains IgA which also provides immunity.

37. • 1–7 August 2016
World Breastfeeding Week

38. CONTRAINDICATION TO
BREASTFEEDING
 Active /untreated TB
 Mom takes radioactive compound(cancer for
chemo)
 Mom take illegal drug
 HIV infection

39. BREAST MILK STORAGE/THAWING:
 Unless being used immediately, refrigerate it within 1
hour.
 Thaw/warm the milk in container of lukewarm water or
running water.
 Once milk is thawed, it should be used within 24 hours.
 Once milk is warmed and not used for the feeding, it
should be discarded.

40. Place of storage Temperature Maximum storage time
In a room 25°C 77°F Six to eight hours
Insulated thermal bag with
ice packs
Up to 24 hours
In a refrigerator 4°C 39°F Up to five days
Freezer compartment
inside a refrigerator
-15°C 5°F Two weeks
A combined refrigerator
and freezer with separate
doors
-18°C 0°F Three to six months
Chest or upright manual
defrost deep freezer
-20°C -4°F Six to twelve months

41. HOW OFTEN TO BREASTFEED?
• After milk supply has increased
• Baby should have 5 to 6 wet diapers every day
• 3 to 4 dirty diapers every day

42. is a manufactured food designed and
marketed for feeding to babies and
infants under 12 months of age,
usually prepared for bottle-feeding or
cup-feeding from powder (mixed with
water) or liquid (with or without
additional water).
Formula feeding

43. Advantage & Disadvantage Artificial Feeding
Advantages of Artificial feeding
• If you bottle feed your baby, they may sleep for longer
between feeds.
• You can ask someone else to feed your baby, such as your
partner or a family member, if you need to take a break.
• Like breastfeeding, bottle feeding enables a strong bond
and a sense of closeness to develop between the baby
and parent.
• Formula milk has added vitamin K
• If you are bottle feeding your baby, you know exactly how
much milk your baby has had.
• Your social life does not need to be curtailed. You can
resume your normal life.

44. Indication of Artificial Feeding
• Baby’s mouth too small, nipple too big
• Baby’s mouth too large, nipple too small
• Socially more acceptable
•Maternal anxiety – baby not getting enough milk
• Maternal medication/infection
•Tried breast feeding, became exhausted
•Contraindication to breast-feedi g, su h as i fa t’s eta oli
disorders (galactocemia) and mothers who have cancer and under
radiation treatment
•Death of the mother.

45. Disadvantages of artificial feeding
• Interferes with bonding
• More diarrhoea and persistent diarrhoea
• More frequent respiratory infections
• Malnutrition; Vitamin A deficiency
• More allergy and milk intolerance
• Increased risk of some chronic diseases
• Obesity
• Lower scores on intelligence tests
• Mother may become pregnant sooner
• Increased risk of anaemia, ovarian cancer, and breast
cancer in mother
2/10

46. :Disadvantages of Breast Feeding
• Unknown intake-volume of milk.
• T a s issio of i fe tio -CMV, hepatitis, HIV,TB
• B east ilk Jau di e-mild self limiting
• T a s issio of d ugs-antithyroid, anti cancer
• Nut itio al i ade ua ies-prolong BF without
introduction of solids lead to poor weight gain,
rickets
• Vit K deficiency—hemorrhagic disease of newborn
• Less fle i le, e otio al upset if u su essful

47. NUTRITION WHILE BREASTFEEDING:
 Eat a well-balanced, varied diet
 Breastfeeding mothers burn 500+ calories daily
 Check with doctor about taking a multivitamin with iron
 Drink eight glasses of fluid (eight ounces each) daily
 Avoid or limit caffeinated drinks to one to two cups daily
 Avoid alcohol or limit to one serving (six ounces of wine or 12
ounces of beer) on a special occasion

49. • THANK YOU

50. human Milk production

52. Methods of
Feeding
1. Breast feeding
2. Formula feeding
3. Cup feeding
4. Finger feeding

53. Cup feeding (and similar vessels like spoon, etc)
is a method of feeding baby that has been
around for a very long period of time. It should
be used to feed a baby who is not yet taking the
breast and is better than a bottle . Usually be
about 4-6 weeks after baby birth.
Cup feeding

54. Finger-feeding, a substitute technique for
breastfeeding, has probably existed for
thousands of years as a way to keep a baby
fed who has difficulties going to breast or
who needs to be separated from mother for
any length of time.
Finger feeding