This document discusses the benefits of breastfeeding for both children and mothers. It summarizes that breastfeeding provides optimal nutrition for infant development, protects against infectious diseases, and lowers the risk of obesity and chronic diseases. Breastfeeding also benefits mothers by reducing risks of certain cancers, diabetes, and cardiovascular diseases. The economic analysis finds that increased breastfeeding rates could save billions of dollars annually in healthcare costs.
Breastfeeding is the most natural and normal way of providing all the required nutrients to the infants that are essential for their healthy development and growth. Almost all mothers have the capacity to breast feed their child, but in some cases lack of adequate information or misconceptions keep the baby deprived of his birthright, which is the breast milk.
[PDF]✔download⚡ Maternal and Child Nutrition The First 1 000 Days (74th Nestl...framvoksasntyuy
How to prevent and manage low birth weight Growth and nutrition during the fetal period and the first 24 months after birth are important determinants of development in early childhood. Optimal nutrition and health care of both the mother and infant during these first 1000 days of an infant's life are closely linked to growth learning potential and neurodevelopment in turn affecting longterm outcomes. Children with low birth weight do not only include premature babies but also those with intrauterine growth restrictions who consequently have a very high risk of developing metabolic syndrome in the future. Epidemiology epigenetic programming the correct nutrition strategy and monitoring of outcomes are thus looked at carefully in this book. More specifically two important nutritional issues are dealt with in depth The first being the prevention of low birth weight starting with the health
World Breastfeeding Week is an annual celebration marked from 1-7 August that highlights this essential practice. This year it is built around the theme of Breastfeeding Support for Mothers. More mothers breastfeed when they receive support, counselling and education in health centres and in their communities
Breastfeeding is the most natural and normal way of providing all the required nutrients to the infants that are essential for their healthy development and growth. Almost all mothers have the capacity to breast feed their child, but in some cases lack of adequate information or misconceptions keep the baby deprived of his birthright, which is the breast milk.
[PDF]✔download⚡ Maternal and Child Nutrition The First 1 000 Days (74th Nestl...framvoksasntyuy
How to prevent and manage low birth weight Growth and nutrition during the fetal period and the first 24 months after birth are important determinants of development in early childhood. Optimal nutrition and health care of both the mother and infant during these first 1000 days of an infant's life are closely linked to growth learning potential and neurodevelopment in turn affecting longterm outcomes. Children with low birth weight do not only include premature babies but also those with intrauterine growth restrictions who consequently have a very high risk of developing metabolic syndrome in the future. Epidemiology epigenetic programming the correct nutrition strategy and monitoring of outcomes are thus looked at carefully in this book. More specifically two important nutritional issues are dealt with in depth The first being the prevention of low birth weight starting with the health
World Breastfeeding Week is an annual celebration marked from 1-7 August that highlights this essential practice. This year it is built around the theme of Breastfeeding Support for Mothers. More mothers breastfeed when they receive support, counselling and education in health centres and in their communities
IT IS USED FOR PUBLIC AWARENESS AS A TOOL FOR THE MOTHERS . NO PROMOTIONAL DESIRE.IF ANY UNINTENTIONAL COPYING IS THERE FORGIVE ME AS IT IS FOR PUBLIC AWARENESS WITH NO BUSINESS MOTTO
Promoting breast feeding as a right of the childNaeem Zafar
In this presentation we will see how breast feeding,, a natural phenomenon and protector of human species has to be protected by Universal laws and legislation. Yet we have to fight for this right through awareness raising and advocacy to the government as well as lay public.
Breastfeeding is a precious moment comes in every mother's life. It nourishes both mother and her baby. Along with benefits, there are some myths also which are associated with breastfeeding.
Infant and young child feeding ppt describe the nutritional needs of infant and child. Exclusive breastfeeding for six months and complementary feeding for the child. avoid formula feeding for the child and continue breastfeeding for 24 months.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
IT IS USED FOR PUBLIC AWARENESS AS A TOOL FOR THE MOTHERS . NO PROMOTIONAL DESIRE.IF ANY UNINTENTIONAL COPYING IS THERE FORGIVE ME AS IT IS FOR PUBLIC AWARENESS WITH NO BUSINESS MOTTO
Promoting breast feeding as a right of the childNaeem Zafar
In this presentation we will see how breast feeding,, a natural phenomenon and protector of human species has to be protected by Universal laws and legislation. Yet we have to fight for this right through awareness raising and advocacy to the government as well as lay public.
Breastfeeding is a precious moment comes in every mother's life. It nourishes both mother and her baby. Along with benefits, there are some myths also which are associated with breastfeeding.
Infant and young child feeding ppt describe the nutritional needs of infant and child. Exclusive breastfeeding for six months and complementary feeding for the child. avoid formula feeding for the child and continue breastfeeding for 24 months.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Agenda
The magnitude of the problem.
Risk factors of growth failure in infants and children.
Effect of good nutrition on growth.
The proper time for an intervention.
What are the management goals?
Important nutrients for optimal growth: Arginine & Vitamin K2.
According to the WHO, malnutrition is by far the biggest contributor to child mortality
Under-weight births and IUGR (intra-uterine growth restrictions) cause 3 million child deaths a year.
According to the Lancet, consequences of malnutrition in the first two years is irreversible.
Malnourished children grow up with worse health and lower educational achievements.
Malnutrition can exacerbate the problem of diseases such as measles, pneumonia and diarrhoea.
But malnutrition can actually cause diseases itself , and can be fatal in its own right
The term 'faltering growth' is widely used in relation to infants and young children whose weight gain occurs more slowly than expected for their age and sex.
In the past, this was often described as a ‘failure to thrive’ but this is no longer the preferred term :-
partly because ‘failure’ could be perceived as negative,
but also because lesser degrees of faltering growth may not necessarily indicate a significant problem but merely represent variation from the usual pattern when measured against the standardized growth charts (WHO Growth Charts
The journey of low birth weight infant Khaled Saad
Previously known as ‘failure to thrive’ (FTT), also known as weight faltering
Infant or children whose current weight or rate of weight gain is significantly below that expected of similar children of the same age, sex and ethnicity
Can occur in both infants (< 1 year of age) and in children (> 1 year of age)
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
7. Breastfeeding and Maternal Infant Health
Outcomes in Developed Countries
Current evidence demonstrates breastfeeding associated
with reduction in risk of:
• Acute otitis media
• Non-specific gastroenteritis
• Severe lower respiratory tract infections
• Atopic dermatitis
• Asthma in young children
• Obesity
• Type 1 and type 2 diabetes
• Childhood leukemia
• Sudden infant death syndrome (SIDS)
• Necrotizing enterocolitis
Ip S, et al: Breastfeeding and Maternal and Infant Health Outcomes in
Developed Countries, April 2007. Agency for Healthcare Research
and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/brfouttp.htm
8. Benefits of Breastfeeding
“Dose Dependency”
• Acute otitis media 50% less with EBF > 3-6 months
• Atopic dermatitis 42% less with EBF > 3 months
• Gastroenteritis 64% less with any BF vs. none
• Lower respiratory tract disease and hospitalization 72% less with EBF
> 4 months
• Asthma 40% less with BF > 3 months with positive family history
• Obesity 24% less with any BF
• Type 1 DM 30% less with BF > 3 months
• Type 2 DM 40% less with any BF vs. None
• Cancer:
– Acute lymphocytic leukemia 20% less with BF >6 months
– Acute myelogenous leukemia 15% less with BF >6 months
• SIDS 36% less with any BF > 1 month
Ip S, Chung M, Raman G, et al. Breastfeeding and Maternal and Infant Health Outcomes in
Developed Countries. Rockville, MD: Agency for Healthcare Research and Quality, 2007.
http://www.ahrq.gov/clinic/tp/brfouttp.htm
AAP Pediatrics 2012;129;e827-41.
EBF=Exclusive breastfeeding
BF=Breastfeeding
10. Childhood Obesity
• One of the most significant childhood
health problems in the U.S.
• Affects 20% of children in the U.S., with up
to 30% classified as overweight for age
• Incidence decreased in the breastfed
population
Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries, Structured Abstract. April
2007. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/brfouttp.htm
AAP Section on Breastfeeding: Breastfeeding and the Use of Human Milk, Pediatrics 2005;115:496-506.
Evidence on the Long Term Effects of Breastfeeding: Systematic Reviews and Meta-analyses, World Health
Organization 2007, Geneva, Switzerland.
http://www.who.int/child-adolescent-health/publications/NUTRITION/ISBN_92_4_159523_0.htm
11. Breastfeeding and Obesity
• Obesity defined as a BMI > 95%ile for age
• Data from the Pediatric Nutrition Surveillance System
• 177,304 children followed up to 60 months
• Controlled for gender, ethnicity/race, BW
• Dose-responsive protective effect against obesity at age
4 years in non-Hispanic whites
• Greatest protection with breastfeeding for > 12 months
Grummer-Strawn LM, Mei Z: Does Breastfeeding Protect Against Pediatric Overweight?
Analysis of Longitudinal Data From the Centers for Disease Control and Prevention Pediatric
Nutrition Surveillance System. Pediatrics 2004;113:81-86.
12. Obesity Prevention
• Encourage breastfeeding
• “Extent and duration of breastfeeding have been
found to be inversely associated with risk of
obesity in later childhood, possibly mediated by
physiologic factors in human milk as well as by
the feeding and parenting patterns associated
with nursing.”
AAP Policy Statement, Committee on Nutrition, Pediatrics 2003; 112:424-430.
13. Cognitive Benefits
• Human milk
– Contains fatty acids, nucleotides,
oligosaccharides, and taurine
to enhance neural and retinal
development
– Enables child to reach full
developmental potential
• Human milk fat
– Provides essential fatty acids
– Provides long-chain polyunsaturated fatty acids,
including docosahexaenoic acid
(DHA) and arachidonic acid (ARA)
16. Maternal Benefits of
Breastfeeding
• Type 2 diabetes mellitus 4-12% less for each year of BF
for women w/out history gestational DM
• Pre-menopausal breast cancer 4.3-28% less for each
year of BF
• Ovarian cancer 21% less for any vs. no BF and evidence
for dose response
• Postpartum depression less for short term BF vs. no
breastfeeding
Ip S et al: Breastfeeding and Maternal and Infant Health Outcomes in
Developed Countries, April 2007. Agency for Healthcare Research and
Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/brfouttp.htm
BF=Breastfeeding
18. Lactational Amenorrhea Method
Have mother’s
menses returned?
Is mother supplementing
regularly or allowing long
periods without breastfeeding?
Is the baby older than
6 months?
There is a 1%–2% risk
of pregnancy.
Yes
Yes
Advise
another method
of family
planning.
No
Reprinted from Contraception. 1997;55:328, Multicenter study
of the Lactational Amenorrhea Method (LAM): I. Efficacy,
duration,and implications for clinical application,
Labbok MH et al, with permission from Elsevier
No
No
Yes
19. The Economic Benefits of
Breastfeeding
• U.S. Department of Agriculture
• $3.6 billion dollars would be saved annually if
US breastfeeding rates increased to that
recommended in Healthy People 2010
guidelines
• Projected figures were based on analysis of
decreased otitis media, gastroenteritis, and
necrotizing enterocolitis cost savings only
J Weimer: U.S.D.A., Food Assistance and Nutrition Research Report No. 13, March 2001
http://www.ers.usda.gov/publications/fanrr13
20. Burden of Suboptimal
Breastfeeding in the US
• Analyzed saving for those conditions validated by the
AHRQ report:
– necrotizing enterocolitis
– otitis media
– gastroenteritis
– hospitalization for lower respiratory tract infections
– atopic dermatitis
– sudden infant death syndrome
– childhood asthma
– childhood leukemia
– type 1 diabetes mellitus (type 2 DM excluded)
– childhood obesity
Bartick M: The Burden of Suboptimal Breastfeeding in the United
States: A Pediatric Cost Analysis. Pediatrics online April 2010.
21. Burden of Suboptimal
Breastfeeding in the US
• Results: If 90% of US families could comply with
medical recommendations to breastfeed exclusively
for 6 months, the United States would save $13 billion
per year and prevent an excess 911 deaths, nearly all
of which would be in infants ($10.5 billion and 741
deaths at 80% compliance).
• Conclusions: Current US breastfeeding rates are
suboptimal and result in significant excess costs and
preventable infant deaths. Investment in strategies to
promote longer breastfeeding duration and exclusivity
may be cost-effective.
Bartick M, Reinhold A. The Burden of Suboptimal Breastfeeding in the United
States: A Pediatric Cost Analysis. Pediatrics. 2010;125:e1048.
22. Community Benefits
• Breastfeeding is convenient, saves money, and
is “green”
• Reduced health care costs
• Lower employee absenteeism
• Convenient and cost effective
• Environmentally friendly
• Decreased energy demands for production
and transport of infant formula
23. Summary of Breastfeeding Benefits
• Promotes optimal health outcomes for
mothers and children
• Prevents infectious diseases for children
• Assures that children meet their full
developmental potential
• Reduces health care costs
• Is environmentally conscious
Editor's Notes
The American Academy of Pediatrics strongly supports breastfeeding for virtually all mothers and infants.
This presentation is designed to explain
Why breastfeeding is important for babies and their mothers and families and results in optimal health outcomes
How breastfeeding can be best be initiated and supported
The role every health care professional can play in promoting breastfeeding in hospitals, clinics, offices, and the community
The author would like to acknowledge members of the Section on Breastfeeding Executive Committee and Rachel Meek for their review of the material in this slide set. The slides may be used for educational purposes with credit to the original source.
This section will address the benefits of breastfeeding for children, mothers, and society at large.
Breastfeeding should be viewed as a natural extension of the nurturing and nourishing that the mother provides for the growing fetus in utero. During the pregnancy, the breasts prepare to nourish the young, whether the mother intends to breastfeed or not. Milk of different mammalian species is not interchangeable. Cow’s milk, even when altered in the form of commercially available infant formula, is not the optimal feeding to support infant growth and development. Breast milk is also the original “organic” feeding for babies—no processing, no unnecessary additives, and custom designed for each baby
Young infants may become sensitized to cow milk protein when it is incorporated into the diet at an early age. Human milk minimizes exposure to foreign proteins and provides virtually all of the nutrients most term infants require, with the exception of vitamin D, which will be discussed later. Although it is uncommon, some infants, while exclusively breastfeeding, can be sensitized by the mother’s consumption of cow milk based products.
Human milk is a complex substance that contains many compounds not provided in infant formula. Human milk is customized to most appropriately meet the growth and developmental needs of the baby. The production of human milk is quite sophisticated. The composition of the milk changes throughout the day, during the course of a feeding, and throughout the period of lactation.
Mothers who deliver their babies prematurely produce milk that is somewhat different than the milk that mothers produce for term infants.
Overall, the somatic growth pattern seen in breastfed infants seems to be more appropriate, resulting in a reduced risk for obesity later in life. Human milk contains a number of hormones and other factors that promote growth of the infant. As noted, the hormonal response in both mother and infant from the nursing relationship facilitates strong attachment of mother and infant, felt to be highly mediated by oxytocin.
Multiple factors have been identified in human milk that provide important immunologic benefits. These factors are not found in infant formula. Colostrum is a concentrated source of secretory immunoglobulin A (IgA), but other substances, such as, other immunoglobulins, lysozymes, and lactoferrin in human milk, help to prevent infection. Whole cells, such as macrophages and neutrophils, are transmitted in human milk. Highly reactive chemical compounds, such as cytokines, play a role in modulating the infant’s developing immune system.
When the breastfeeding mother encounters an infectious agent, either by inhaling or ingesting the agent, she produces specific immunoglobulins that are transmitted via the milk to provide specific protection for her baby. Enzymes aid in digestion of human milk and also provide anti-inflammatory effects. Nucleotides promote immune function and encourage the growth of favorable bacterial flora.
Human milk provides growth promoting factors. Breastfed babies also exhibit better satiety control, so the exclusively breastfed infant should be the norm for infant growth. All children should have growth parameters measured at each well child visit.
The Global Strategy for Infant and Young Child Feeding issued a joint 2002 WHO/UNICEF statement that breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants. These standards included the recommendation that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, they should receive adequate and safe complementary foods while breastfeeding continues up to 2 years or beyond. Nutrition plays a crucial role in the early months and years of life. The strategy indicates that lack of breastfeeding can increase risk for ill-health with life long effects, including poor school performance, impaired intellectual and social development, or chronic diseases
The World Health Organization growth standards establish breastfeeding as a biological “norm” and the breastfed infant as the standard for measuring healthy growth. Previous charts relied upon a random mixture of breastfed and artificially fed infants. The current standards are based upon a pooled sample from 6 participating countries including Brazil (South America), Ghana (Africa), India (Asia), Norway (Europe), Oman (Middle East), and USA (North America), instead of just children from one country, as was the case for the 2000 CDC charts.
The global standard shows how children should grow under optimal conditions, and is not just a description of how they do grow at a particular time and place. The WHO standards provide tools to recognize sub-optimal or excessive weight gain, demonstrate that children born in different regions of the world and given optimal conditions, have the potential to grow and develop within the same range of height and weight for age, and provide a tool to measure normal growth as an expression of health. They are currently available for children aged birth to 5 years and include weight, length, head circumference, and BMI (body mass index).
The full set of charts, as well as the methodology for their development, may be downloaded at www.who.int/nutrition. These growth standards have been recommended by the AAP and the CDC for monitoring growth of children birth-24 months of age in the US and are available on the CDC website.
The report published in April 2007 by the Agency for Healthcare Research and Quality, based upon research conducted by the Tufts-New England Medical Center Evidence-Based Practice Center and commissioned by the Office on Women’s Health of the Department of Health and Human Services, is summarized on the slide.
The report included systematic reviews/meta-analyses, randomized and non-randomized comparative trials, prospective cohort and case-control studies published in English and which had a comparative arm with formula feeding or different duration of breastfeeding. The report noted that the breastfeeding literature includes many observational studies, that there were limited randomized controlled clinical trials, that definitions of breastfeeding and “exclusive breastfeeding” were not consistent among the studies, that some studies failed to control for confounding factors, and that there was not always reliable data collection regarding other feeding behaviors. Using the rigorous criteria outlined, the study did identify sufficient evidence in the published literature to support the associations noted on the slide.
Breastfed infants have a lower incidence of many neonatal and infant infections than do formula-fed infants. Breastfed infants who are exposed to microorganisms that cause infectious diseases generally have a milder form of the infection and are less likely to require hospitalization.
For example, breastfed infants who encounter rotavirus infection, a common cause of gastroenteritis in infants, are less likely to require intravenous fluids and hospitalization than are artificially fed infants. Most breastfed infants with rotavirus can continue breastfeeding throughout the illness. Breastfed infants have decreased incidence and severity of otitis media, gastroenteritis, and respiratory syncytial virus (RSV) disease.
Many of the benefits of breastfeeding are dose dependent. The longer the child is breastfed, the greater the benefits. For some benefits, the greater the period of exclusive breastfeeding, the better the protection.
This slide summarizes the benefits which were published by the Agency for Healthcare Research and Quality and summarized in the AAP Policy Statement.
There are other benefits associated with breastfeeding as well, which may not appear until later childhood or adult life. Multiple studies have demonstrated a decreased incidence of the conditions noted on the slide. The explanations for these associations are multifactorial. Significant factors include the effect of human milk on the developing immune system and the lack of exposure to foreign protein to which the immune system must respond.
Several evidence-based reviews have identified breastfeeding as a preventative measure in reducing childhood overweight and obesity. Causes for obesity are multifactorial, including genetic factors, however, early infant feeding behaviors appears to play a role. Breastfed babies are better able to control their intake than are bottle fed infants, who are often encouraged to finish every last drop in the bottle. In addition, the way the baby metabolizes human milk, and the gut response to human milk is different than that seen with infant formula.
A large scale study published by Lawrence Grummer-Strawn, Ph.D., and colleagues demonstrated the protective effect of breastfeeding on childhood obesity, especially in the white population. The study showed that breastfeeding has a dose dependent effect on obesity, such that, the longer the breastfeeding, the greater the protection against obesity.
These statements from the Committee on Nutrition of the American Academy of Pediatrics highlight the important role of breastfeeding in obesity prevention.
This slide shows some of the many useful components and fat in human milk.
The fats in human milk, particularly the specific types of long-chain polyunsaturated fats, including preformed docosahexaenoic acid (commonly referred to as DHA), are deposited in high amounts in the nervous tissue of the brain and retina of the eye. Some studies have shown slightly better cognitive outcomes in infants who are breastfed versus those who are formula fed. These differences are particularly noted in premature infants.
There are significant short and long-term benefits of feeding human milk to premature infants, in addition to those seen for term infant. The premature infant is especially at risk for infectious complications. Premature infants breastfed, or fed mother’s expressed milk, have lower rates of bacterial sepsis and necrotizing enterocolitis.
Mothers also benefit from the breastfeeding experience.
Mothers who breastfeed are at decreased risk of excessive or prolonged bleeding postpartum. Suckling at the breast causes maternal release of oxytocin, which constricts the myoepithelial cells of the uterine wall. Mothers who breastfeed also experience decreased risk of developing ovarian cancer and have a lower incidence of breast cancer.
Women who breastfed their infants during their reproductive years seem to have a decreased risk of osteoporosis in the postmenopausal years, although some studies have shown conflicting results.
There is a dose dependent relationship between the maternal benefits of breastfeeding and the length and duration. The Agency for Healthcare Review and Quality review of the evidence indicated a decrease in type 2 diabetes, premenopausal breast cancer, ovarian cancer, and postpartum depression with breastfeeding.
Studies published since the AHRQ report indicate additional protective effects of breastfeeding for the lactating mother.
This slide illustrates the contraceptive contribution of breastfeeding. For the first 6 months after delivery, breastfeeding mothers are at very low risk of conceiving another child IF all three of the following conditions are met:
There are no long intervals between feedings
The mother continues exclusively breastfeeding during the daytime and throughout the night
The mother has not had the return of her menstrual cycles
When all 3 of these conditions are met, the protection against conception is at least 98%, equivalent to oral contraceptive agents. But a woman should begin use of another method of contraception IF
She has introduced formula or solids
Her baby is sleeping long intervals
Her menstrual periods have resumed
Her baby is older than 6 months
In addition to the health benefits, optimal breastfeeding rates would have significant economic benefits. These figures are based upon only the three conditions noted, otitis media, gastroenteritis, and necrotizing enterocolitis, which would be decreased significantly if the U.S. breastfeeding rates were equal to the recommended levels.
A more recent study was published in Pediatrics, using a similar method of cost analysis as was used in the 2001 study, and computing costs if 80-90% of US families breastfed exclusively for 6 months. For the calculation, the authors used 2005 Centers for Disease Control and Prevention breastfeeding rates and 2007 dollars.
Increasing the frequency and duration of breastfeeding benefits all members of society.
Breastfed infants require fewer visits to the doctor’s office for illness, antibiotic prescriptions, hospitalizations, and days of absence from work for employed parents.
Breastfeeding is more convenient for the mother—no bottles to prepare; no formula to purchase, transport, and refrigerate when traveling; and no diaper bags full of bottles, nipples, cans of formula, water, or warming equipment. Human milk is always available when mother is available and is always ready to feed at precisely the right temperature.
Breastfeeding is more environmentally friendly—fewer bottles, nipples, and cans of formula, all of which must be manufactured, distributed, and disposed of at an environmental cost.
