Breast Feeding Week Presentation

2. • Oxytocin release is facilitated by a
confident, tension-free mental state
of the mother.
• If the mother is in stress, the release
of oxytocin may be affected leading
to poor ejection of milk and decrease
in milk output.
Oxytocin Reflex (Milk Ejection Reflex/
Let-down Reflex)

3. Initiation of breast feeding
• Breast feeding should be initiated within first half an hour to one hour of birth.
• In cesarean section breast feeding should be given within 4 hour.
• Early sucking provides warmth security & colostrums the baby’s first
immunization.
• It helps in anti-infective factors & protects the baby from respiratory infection &
diarrheal disease.
• Mother should be advised for exclusive breast feeding up to 6 months & as
demand feeding.

4. Signs of Effective Breastfeeding in the Infant
• Wt loss <7% with no wt loss after day 3, wt gain by day 5, and back to
birth wt by day 10
• At least 3 bowel movements per 24hrs after day 1
• Bowel movements that go from black meconium on day 1
to seedy yellow by day 5
• At least 6 clear urinations per day by day 4
• Satisfied and content after feedings
• Audible swallowing during feedings
International Lactation Consultant Association, 2005

5. Signs of Effective Breastfeeding in the Mother
• Noticeable increase in firmness, weight and size of breasts and noticeable
increase in milk volume and composition by day 5
• Nipples show no evidence of damage
• Breast fullness relieved by breastfeeding
International Lactation Consultant Association, 2005

6. Early Formula Supplementation
• One study showed highest rates of formula supplementation occurring
between 7pm-9am, regardless of the time of birth, to allow the mother to
“get some rest”.*
• Another study showed that one or more formula feedings can adversely
affect breastfeeding duration.**
• Formula feedings decrease breastmilk supply because of reduced
demand
• Plastic nipples provide instant gratification of milk, may accustomize
infants to its texture and to suckle softer, making it difficult to go back to
the breast
*Gagnon et al, 2005; **Hill et al, 1997

7. Breastfeeding
• Exclusive breastfeeding for 6 months
• Important source of energy; less likely to develop
obesity.
• Benefits for the infant: Reduces GI infections/diarrhea
and confers immunity.
• Benefits to mother: reduces the risk of ovarian and
breast cancer and natural contraception (not fail safe)
due to lactation amenorrhoea

8. Important attributes of foods for complementary feeding
• •
•Start feeding with small amounts and gradually increase the quantity with
the increasing age of the child.
• ◻The consistency, frequency, and variety should change as the infant grows,
depending upon the requirements and the feeding abilities
• A variety of nutrient-rich foods shall be offered to ensure the body requirements.
• ◻During illness, the principle of more fluids including frequent breastfeeding and
encouragement to eat soft,
• favorite foods should be followed. After illness, promote feeding more often than
usual so as to replenish the deficient intake.

9. Intervention

10. IYCF Strategies
1. Breastfeeding Support:
• Adoption of policies like ILO’s "Maternity Protection Convention’’
• Adoption of the "International Code of Marketing of Breast-milk Substitutes" and subsequent
relevant World Health Assembly resolutions.
• Implementation of the "Ten Steps to Successful Breastfeeding" specified in the Baby-Friendly
Hospital Initiative.
• Provision of supportive health services with IYCF counselling during contacts with caregivers
and young children.
• Community support i.e. mother support groups and community-based health promotion and
education activities.

11. IYCF Strategies
• 2.Complementary feeding: Developmentally ready at 6
months.
• Continue frequent, on-demand breastfeeding until at least 2
years.
• Responsive feeding: Feed infants directly and assist older
children. Feed slowly and patiently, encourage but don’t force,
talk to child and maintain eye contact.
• Good hygiene and proper food handling.
• Start small amounts of food and increase gradually as child
gets older.

12. IYCF Strategies
2. Complementary feeding:
• Gradually increase consistency and variety.
• Increase feeding frequency: 2–3 meals to 3–4 meals
per day with 1–2 additional snacks.
• Use fortified complementary foods or vitamin-
mineral supplements as needed.
• During illness, increase fluid intake including more
breastfeeding, and offer soft, favourite foods.

13. IYCF Strategies
3. Feeding in exceptionally difficult
circumstances: Breastfeeding recommended
wherever possible.
• low-birth-weight or premature infants
• mothers living with HIV
• adolescent mothers
• Settings where diarrhoea, pneumonia and malnutrition are prevalent.
•infants and young children who are malnourished
•families suffering the consequences of complex emergencies.

14. Recommendations
1. Invest in proven, low-cost solutions to save children’s lives and
prevent stunting:
• Iron supplements prevents anaemia
• vit A prevents blindness and lowers risk of death from common dzs,
• zinc plus good hygiene can save a child from diarrhea,
• 6 months of exclusive breastfeeding.
Although not expensive it’s a tragedy that millions of mothers and
children don’t have access.

15. Recommendations
2. Invest in health workers:
• to reach the most vulnerable mothers and children.
• CHWs are critical to save lives and prevent stunting
3. Help more girls go to school and stay in school:
• one of the most effective
• educated women tend to have fewer, healthier and better nourished
children.

16. Recommendations cont’d
• education gives girls knowledge, self confidence, skills and hope for
bright future.
• It can also delay marriage, child bearing and improve spacing.
4. Increase private sector partnerships to improve nutrition for mothers
and children.
5. Improve laws, policies and actions that support families and
encourage breastfeeding.

17. Recommendations cont’d
6. Increase government support for proven solutions:
• to meet SDG, lifesaving services must be increased for women and
children who need them most.
• Nigeria should commit to and fund national nutrition plans that are
integrated with plans for maternal and child health.
• Donors should support these goals by keeping their funding
commitments to achieving the SDGs.
• Countries should endorse and support the Scaling Up Nutrition (SUN)
movement.

18. Minimum Dietary Diversity
Cereals
&
Tubers
Pulses, Nuts
&
Legumes
Vit A: Veg
& Fruits
Vegetables
& Fruits
Milk &
Milk
Products
Egg Meat Products
Vit C Iron Sunlight

19. Introduction
• Nutrition of pregnant/lactating woman critical to development of
child.
• Targeting the 1000 day period is one of the best investments to
improve health, nutrition and economic outcomes.
• Nutrition specific interventions will be most impactful when focusing
on this window of opportunity.
•A child’s, in fact nation’s future is determined
by the quality of nutrition in first 1,000 days.
•Optimal nutrition is critical for cognitive and
physical development at this stage.

20. Introduction cont’d
Why 1000 days?
• 1000 days from pregnancy to 2nd
birthday = 270+365+365 = 1000.
• Critical window when child’s brain and body are developing rapidly.
• Mothers and babies need good nutrition to lay the right foundation for the child's
future cognitive, motor and social skills.
• Good nutrition during pregnancy and infancy has profound impact on a child’s
ability to grow and learn.
• Poor nutrition during this window can lead to newborn and child morbidity,
mortality, poor fetal growth and stunting.

21. Introduction cont’d
Why 1000 days?
• Children with restricted development during this window are at risk of
neurological problems and poor school achievement.
• Consequently early school drop out, low-skilled employment and poor care of
their own children, thus intergenerational transmission of poverty and
malnutrition.
• Damage from poor nutrition during this period is often irreversible.
• Preventive efforts should focus on the 1,000 days; therapeutic efforts target
severe wasting.

22. Introduction cont’d
Key Facts
•Every infant and child has the right to good nutrition ("Convention on the Rights
of the Child“).
•Malnutrition is associated with 45% of children’s deaths.
•171 million (27%) of children stunted; 60 million children (10 %) wasted.
•Underweight and deficiencies linked with 19% and 10% of children’s deaths.
•About 40% of infants 0–6 months old are exclusively breastfed.
•In many countries less than 25% of infants 6–23 months meet criteria of safety,
diversity and frequency of diet appropriate for their age.

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Defination
“Breastfeeding is an unequalled way of providing ideal food for the healthy growth
and development of infants; it is also an integral part of the reproductive process
with important implications for the health of mothers. As a global public health
recommendation, 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 breastfeeding continues for upto two years
of age or beyond” – WHO, 2002.

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Nutritional superiority
The exceptional nutritional quality of human milk has been recognised for a long
time.
Mother’s milk is designed for easy digestion and assimilation. Fat and calcium in
human milk are also easily absorbable.
The milk sugar – lactose in mother’s milk provides ready energy.
In addition, a part of it is converted into lactic acid in the intestines which destroys
harmful bacteria present.

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The amount of vitamins such as thiamine, vitamin A and vitamin C found in
mother’s milk depends on the diet of the mother.
The human milk has inherent anti-infective properties which no other milk has.
This protective function of human milk is particularly important in developing
countries where there is much exposure to infection.

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• Breastfeeding helps parents to space their children.
• Breastfeeding helps a mother to shed extra weight
gained during pregnancy.

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Early initiation
• Early initiation of breastfeeding is extremely important for establishing successful
lactation as well as for providing ‘Colostrum’ (mother’s first milk) to the baby.
• Ideally, the baby should receive the first breastfeed as soon as possible and
preferably within one hour of birth.
• The new born baby is very active during the first half an hour and if the baby is
kept with the mother and effort is made to breastfeed, the infant learns sucking
very fast.

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• In case of caesarean deliveries, new born infants can be started with
breastfeeding within 4-6 hours with support to the mother.
• The mother, especially with the first birth, may need help in proper positioning
for breastfeeding. Breastfeeds should be given as often as the baby desires and
each feed should continue for as long as the infant wants to suckle.
• Newborn babies should be kept close to their mothers to provide warmth and
ensure frequent feeding.

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• During this period and later, the newborn should not be given any other fluid or
food like honey, animal or powdered milk, tea, water or glucose water, since
these are potentially harmful.

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The anti-infective substances protect the baby from infectious diseases such as
diarrhoea, to which the child might be exposed during the first few weeks after
birth. Colostrum is basically the first immunisation a child receives from the
mother.

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Exclusive breastfeeding
• Exclusive breastfeeding means that babies are given only breast milk and nothing
else – no other milk, food, drinks and not ever water.
• Breast milk provides best and complete nourishment to the baby during the first
six months..
• Breast milk meets the hydration requirements even under the extremely hot and
dry summer conditions prevailing in the country.

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Exclusive breastfeeding provides babies with the best start in life. It makes them
smarter with higher intelligence and helps in optimal development.
Exclusive breastfeeding is, therefore, extremely important to prevent infections
like diarrhoea and acute respiratory infections in early infancy and thus reduce
infant mortality.
Benefits of breastfeeding are reduced if it is not exclusive breastfeeding.

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Recommendation
• Breastfeeding should be promoted as the gold standard feeding options.
• Babies should be breastfed at least 8 to 10 times in 24 hours till lactation is
established (1 to 2 weeks) indicated by frequent urination, stooling and adequate
weight gain.
• Mothers who work outside should be assisted with obtaining adequate
Maternity/ Baby Care/Breastfeeding leave, should be encouraged to continue EBF
for 6 months by expressing milk while they are out at work.