Natural feeding. Advantages. Immune biological role. Rules. Extra feeding

1. Natural Feeding

2. Plan of the lecture:
 Definition of the notion “Natural Feeding.” 12
principles of natural feeding.
 Advantages of natural feeding of infants.
 Quantitative and qualitative composition of breast
milk.
 Immune biological role of breast milk.
 Notion about “free feeding”.
 Rules of putting a child on the breast.
 Extra feed. Rules of introduction.

3.  The best kind of feeding a child at the age up
to 6 months is exclusively breast feeding.
 Exclusively breast feeding - feeding only
with breast milk without including into a
ration of the child another food or liquid.
“Clinical Protocol of medical Care of a Healthy Child up
to 3 Years” (Order of MPH of Ukraine, N149,
20.03.2008).

4. 12 principles of breast feeding
according to WHO demands:
 To have a strict fixed in written form policy about the
practice of breast feeding and regularly give
information to medico-sanitary personnel.
 To teach the whole medico-sanitary personnel the
necessary skills for fulfilling this policy.
 Inform all pregnant women about advantages and
methods of breast feeding.
 Help the mothers to start breast feeding during the
first 30 min after the labor.

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6. 12 principles of breast
feeding according
to WHO demands:
 Show the mothers how to feed with the breasts and
how to save lactation .
 Don’t give the baby any other food or liquid besides
breast milk, if only on the doctor’s prescription.
 Practice a whole day being the mother with the baby
in one ward.
 It is good if breast feeding is the initiative of the
baby.

7. 12 principles of breast
feeding according
to WHO demands:
 Don’t give the babies anything imitating artificially
the breasts or calm down.
 Try to organize the groups of supporters of breast
feeding and direct the mothers to those groups after
leaving maternity home or the clinic.
 Hold the international combining the rules of
distribution of breast milk substitutes.
 Practice the family delivery.

8. Advantages of breast feeding
Breast milk - “a gold standard” of feeding.
Breast milk:
ideal nutrient, fully answering the demands of the
baby’s physiology;
promotes the neuro-psychic development of a
child;
improves adaptation to the extra uterine life;
promotes optimization psycho-social
interrelations;
improves reproductive possibilities of the mother;

9. Advantages of breast feeding
 supplies decrease of acute and chronic morbidity of
the baby;
 is specific in a form;
 decreases the risk of oncological diseases in the
mother;
 presence of specific and nonspecific factors of
defense;
 permanent temperature, sterility;
 economical advantages.

10. Composition of woman and cow milk
(g/l)
Kind of
milk
Proteins Fats Carboh
ydrates
Min.
salts
Kcal Correlation of
ingredients
Colostrum 80-11080-110 48-48-
8181
40-5340-53 4-84-8 150150 1:0,7:0,51:0,7:0,5
Breast
milk
12-1512-15 35-35-
3939
70-7570-75 2-32-3 70-70-
7575
1:3:61:3:6
Cow milk 30-3530-35 30-30-
3535
35-4035-40 7-87-8 65-65-
7070
1:1:11:1:1

11. Qualitative advantages of breast milk :
 Breast milk protein contains:
 more albumin, assimilated without digestion;
 less casein than the cow milk;
 indispensable aminoacids, fully satisfying the needs
of child’s organism;
 there are no analogues in correlation of methionine
and cystine;
 indispensable aminoacids taurine and cysteine, which
are of life necessity for the development of central
nervous system, for the eye retina, almost absent in
the cow milk;

12.  peptides, nucleotides, promoting growth and
increasing the mass of the body, 5 times more than in
cow milk:
 in breast milk there are more than 20 enzymes,
promoting digestion and increasing growth and the
body mass;
 breast milk has Ig A, which is fully absent in cow
milk.

13. Advantages of breast milk fat:
 Essential fatty acids (linole, linolene, arachidonic),
present in the fatty cells, influence exchange of
vitamins, immune reactivity. They are in larger
amount in breast milk than in the cow milk;
 omega-fatty acids and peptides, promoting the
development of CNS, are in larger amount in breast
milk than in the cow milk;
 three-chain fatty acids, such as docosagexenoid acid,
is present in breast milk and absolutely absent in milk
mixtures and in cow milk;

14. Advantages of breast milk fat:
 fat of breast milk is well emulsified, well promoting
absorption;
 50% of breast milk fat is assimilated by lipase, which
is present in it;
 carnitine, present in breast milk, takes part in
oxidation of fatty acids, promotes their penetration
through mitochondrial membrane.

15. Carbohydrates of the breast milk:
 are present in larger amount in breast milk, there is no
need in sweetening it;
 B-lactosa of breast milk is better assimilated than that
of a cow milk, which causes meteorism, abdominal
distension and colics;
 oligo-aminosugars of breast milk, influencing better
growth of bifidum-flora, acidophylic bacteria and
normalization of intestinal biocenosis, have the name
“bifidus-factor.”

16. Defense factors in the breast milk:
 secretory immunoglobulin A (SigA);
 immunoglobulins A, M. G; lysozyme;
 interferon; complement;
 macrophages; T- and B-lymphocytes;
 lactoferin; antistaphylococcus factor;
 neuramic acid; bifidus-factor;
 regulating peptides;
 Breast milk - unique natural complex immune
system, supplying a so called “lactation immunity” in
the most critical for the life of a child period, and the
first putting on the breast is supposed to be the first
immunization.

17.  The first putting of a baby to the breast:
after tighting the umbilical cord, while
appearing the seeking and sucking reflex
(the baby is lifting his head, opens widely
his mouth, is seeking the breasts of the
mother), the obstetrician helps to put a baby
 on the mother’s breast comfortably (during
the first hour after the birth).
Protocol of Medical Care of a Healthy Newborn Child
(Addition to Order of MPH of Ukraine, N152,
04.2005).

18.  Signs of correct putting a child to the mother’s
breast:
 the chin of the baby is attached to the breast
of the mother;
 the mouth of the child is widely opened;
 the lower lip of the baby is turned outside;
 the child is catching the lower part of the
areole.

19.  How to help the mother to put the child correctly
on the breast:
 The mother must lie or sit in comfortable position
and hold the baby with hands or put the him on a
pillow.
 You must sit down near the mother in comfortable
position. Show her how to hold the baby with face
turned to the mother.
 The head of the child must be on the same line as
the body, and the abdomen - against the mother’s
abdomen.

20.  If necessary, support the baby from outside on the
shoulders. The head must be turned back.
 The mother must lift the breast with a hand and give
the baby the whole breast, not only the nipple. Don’t
try to put the nipple in the baby’s mouth with force.
 The mother can touch with the nipple the lips of the
child for catching reflex stimulation.
 Wait a little when the baby opens his mouth
and wants to suck, then quickly put the baby
on the breast.

21.  Put the baby on the breast so, that the lower lip be
under the nipple, the chin will be close to the breast,
the nipple will be some higher than the centre of the
baby’s mouth and stimulate the palate.

22. The child is correctly put
on the mother’s breast.
The child is incorrectly put
on the mother’s breast.

23.
The main kinds of the baby’s position on the
breasts:

24. Another means of the baby’s position on the breasts
of the mother:
 the mother can feed the child by standing (if not
possible to lie or to sit);
 the mother can be in recumbent position, the baby on
the mother, it is good in case of lactostasis or when
there is too much milk in the breasts;
 sometimes there is a position, when the mother is on
her abdomen, the baby under the mother, held by the
mother’s hand, supported by the elbow.

25. The main methods of the baby’s position on the
breasts of the mother:

26. “Clinical protocol of the medical Care of a Healthy
Child at the Age up to 3 years” (Order of MPH of
Ukraine N149, 20.03.2008)
The child at the age up to 6 months does not need
additional liquid, because it leads to :
decrease of obtained calories ;
increase of the risk of arising acute intestinal
infections;
decrease the need of a child in breast milk;
decrease of the period of breast feeding.

27. Consulting the mothers in the questions of
exclusively breast feeding of a child at the age
up to 6 months:
The mother must feed the child 8-12 times a
day, “on the demand of the child”.
The child may be on the breasts as long as he
wants.
 The use of the baby’s dummy prevents
establishing the breast feeding.

28.  Assessment of feeding and nutrition of a child is
carried on during every obligatory medical
prophylactic examination of a child at the age up to 3
years and aimed at immunization. Assessment of
feeding and nutrition cane be carried out by the
doctor, as well as by the nurse, with the following
consultation of the mother and the family in the
questions of feeding and nutrition of a child.

29. Age periods when the child can need more breast
milk:
 3 weeks;
 66 weeks;;
 33 monthsmonths..
It is connected with the intensive growth of the child in these age
periods, demanding partial putting on the breasts, but not the
reason of introducing in the ration of the child milk mixtures.

30. The main rules of successful breast feeding:
Putting the child to the breasts during the first hour of
life, if there are no contraindications.
The whole day being the mother and the baby together.
Correct putting a child to the breasts of the mother.
Breast feeding of the child on his demand, even at the
night time.

31.  Not giving a child up to 6 months other food than
breast milk. The only exclusion is the doctor’s
administration.
 Not using the baby’s dummy or artifiicial nipple.
 Exclusively breast feeding up to the age of 6 months.
 Obligatory introduction of adequate extra food at 6
months.
 Continue breast feeding up to the age 1 year and, if
possible, longer.

32. Methods of calculation of a day need of a
child in milk:
 Zaitseva’s formula: V=2% of body mass on the
birth x n, (where V – a day volume of milk , n – the
day of life of a child.
 Finkelstein formula : V = 70 or 80 x n, where n –
the day of life of a baby.
 For calculating the need in milk for 1 feeding in first
8 days of life is used a formula: 10xn, where n – the
number of days of the baby’s life.

33. Volume method:
from 10 days to 2 months a day volume of milk
comprises- 1/5 of body mass;
from 2 to 4 months - 1/6 of the body mass;
from 4 to 6 months - 1/7 of the body mass;
from 6 to 9 months - 1/8 of the body mass;
from 9 to 12 months - 1/9 of the body mass.

34. Method of calory coefficient:
 Is based on the fact, that 1liter of breast milk has 700
kcal.
The calory need from the birth to 3 months comprises
125 kcal/kg;
from 3 to 6 months - 120-115 kcal/kg;
from 6 to 9 months - 110 kcal/kg;
from 9 to 12 months - 100 kcal/kg.
Calculate a day need in calories depending on the age
and compose a proportion:
700 kcal - 1000 ml
DNC – X ml, where DNC is the Day Need in Calories.

35.  At the age of 6 months breast milk continues
to be the main product for nutrition, but arises
the necessity in widened nutrition ration and
introduction of additional food. Breast milk
can not satisfy the necessary amount of
calories, micronutrients, first of all iron, for
providing normal development of a child.

36.  Extra feed – the products of nutrition, which
are introduced additionally to the breast milk
(milk mixtures in case of artificial feeding)
into the ration of a child of the 1st
year of life.
 The first product, proposed to use at this age
are cereals (rice, buckwheat, corn), vegetable
or fruit mash. These products can be given 1 or
2 times a day with gradual enlarging the
volume of the portion.

37. Rules of carrying out extra feed:
At first the baby is given only 1-2 teaspoonful and only
after that gradually enlarging the volume every day for 3-
4 tea spoonful. In 7-10 days the baby can have the first
full portion of additional food, i.e. 150-180 g.
- At first the extra feed is given, then the child is put on
the breasts. Gradually 1 feeding with breast milk is
excluded.
- It is preferable to give the 1st
extra feed at noon, for the
3rd
feeding. If this time the child is sick, it is better to wait
with extra feed up to the permission of the doctor.

38. The next extra feed may be introduced in 2-3 weeks after the first one.
One cannot give 2 different products at the same time.
- To every new product the child must be taught gradually.
- Extra food must be homogenized, not causing difficulties in
swallowing.
- The amount of food for 1 feeding must answer the age need (from 6
months to 12 months - 180-200 g). The caloricity is increased with
the concentration of the ingredients.
- Strictly following the regime of feeding is necessary.
- In anemia, rachitis, regurgitation extra feed can be introduced even
earlier. In the hot period of summer or when the child is sick, it is
better to wait with the new food products.

39. Juices or other drinks :
From 6 months some children can need water. You can
not give the baby gaseous, mineral or distilled water.
Juice can be given, when the baby takes extra feed
products. Don’t dissolve juices with water or add sugar.
Beginning with 6 months the baby must be gradually
taught to drink from the cup.
It is not recommended to give the child any kind of tea
(black, green) or coffee up to 2 years. These drinks
prevent absorption of iron.