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Lecture 8

Lecture 8 - Breastfeeding

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Health Sciences
Health Sciences 1001A/B
Shauna Burke

Breastfeeding Health and Nutrition for Infants  Formula: artificial milk for babies that is a substitute fro breast milk. It can be cow based or soy based Breastfeeding: The Basics  Human milk is species specific; mother makes milk that is perfectly suited to her baby‟s requirements for growth and development  Baby seal feeds once every 4 days but needs to quickly gain fat so the mother‟s milk is high in fat  Baby cow needs to gain muscle so mother‟s milk is high in protein  Baby human is born very immature (system-wise), so milk is high in lactose because it is good for brain development. It is low in protein. Babies brain will grow 3 times in size  Breast milk is the ultimate „super food‟ and the only single food for humans that can independently sustain life for the first 6 months after birth  WHO recommends: After 6 months introduce solid foods but still breastfeed for up to 2 years and beyond  Some cultures breastfeeding for up to four years is not uncommon Human Breast milk: The Basics  Breast milk provides all of the fluid and nutrients for optimal growth and development o Protects the infant from bacteria and viruses that the mother comes in contact with o Many mom‟s think that if they are sick they shouldn‟t breastfeed, but its actually the opposite. When she is sick she passes the antibodies to her infant and prevents them from getting sick.  Few reasons, medically speaking, for women not to breast feed o Reasons include: tuberculosis and HIV  Breast milk adapts to the infant o Constantly changes to meet the infant‟s nutritional needs  Composition changes in the early postpartum period, form colostrum to mature milk o Immediately after birth the women produces colostrum, called liquid gold, which contains all the nutrients the baby needs Hormones Involved in Breastfeeding  Estrogen  Progesterone  Prolactin: responsible for maintiningg milk supply  Oxytocin: is responsible for the feeling of bonding between mother and baby, as well as good feelings, releases anxiety, physiological behaviors during breastfeeding, temperature  When a women is pregnant the mlik production is under endocrine control (all hormones involved)  After the baby is born it switches to autocrine control (supply and demand) Benefits of Breastfeeding “The biological norm for infant feeding is breastfeeding. Any substitution can result in significant adverse consequences for both mother and baby.” Short-Term Benefits for Baby Infection  Does response relationship between duration and exclusivity of breastfeeding and protection from many types of infections noted in several studies o Dose response means the higher the dose the greater the protection o The longer a woman beastfeeds, the more she protects her infant  Even partial daily feedings decrease risk of infection in preterm infants by 50%  Pre term is any infant born before 37 weeks  Typically pregnant for 40 weeks Sudden Infant Death Syndrome (SIDS)  Not breastfeeding increases chances of infant dying from SIDS  2007 meta-analysis found that breastfeeding was associated with a 36% risk reduction of SIDS compared to not breastfeeding  Unexplained death of an infant between 0-1 years of age  Number of factors, but not breastfeeding is one of those  One of the theories is a breast fed baby digests milk very easily so it doesn‟t get into as deep of sleep as a formula fed baby, so they wake up more often which can be protective for the infant o For new mothers this can be exhausting, which is why they tend to use formula  Women who actually get better quality sleep than formula mothers because they just have to „pick up baby and feed‟, whereas formula mothers need to get bottle ready, sterilize, etc. Mortality  Not breastfeeding significantly increases a child‟s risk of dying in infancy  Developing countries infants who are not breastfed have increased rates of diarrhea and respiratory diseases (both main causes of infant death) o Don‟t have clean water to make formula o Formula is expensive, so mother‟s dilute it o Don‟t have ability to sterilize the bottles  United States: formula infants have increase risk of mortality Weight  Not breastfeeding increases a child‟s risk of being overweight and obese  Increase breastfeeding duration associated with decrease rats of childhood obesity  Most of this research looks at lifetime rates and lifetime duration  Breastfed babies have to work for the milk and they stop when they are full  Formula can be related to overweightness because they don‟t stop and don‟t work for milk, it is fed to them Temperature and Respiratory Regulation  Bottle feeding  increase risk for physiological instability  Oxygen saturation and body temperature found to be significantly decrease in preterm infants who were bottle fed vs. breastfed  Skin to skin contant is when a baby is born it is immediately placed on the mother‟s unclothed chest. This increases breastfeeding rate and both their body temperatures increase by a degree and allows for bonding. o Becoming more common procedure in the hospitals Pain  Not breastfeeding increase infants’ response to pain  Analysis of 11 studies showed that both breastfeeding and human milk are pain relieving  Breastfeeding is used as a pain reliever right after baby is given vaccinations or circumcised Long-Term Benefits for Baby Childhood Cancer  Several studies have found increase risk of childhood cancers including leukemia, lymphoma, and Hodgkin‟s disease when children have not been breastfed Asthma  Not breastfeeding increases the risk of asthma in childhood  No family history of asthma breastfeeding for at least 3 months associated with a 27% decrease in risk  Family history of asthma breastfeeding for at least 3 months associated with a 40% decrease in risk Cognitive and Brain Development  Not breastfeeding associated with decrease scores on developmental and cognitive screening tools  % of expressed human milk that infants receive correlates significantly with IQ scores (particularly strong for boys) Type 1 and Type 2 Diabetes  Children fed formula= increase risk of diabetes  Breastfeeding decreases risk of type 1 diabetes by 39% compared to infants who were not breastfed Benefits for Mother  Premature weaning or not breastfeeding are associated with health risks  Degree to which health outcomes are realized depends on duration, frequency, and exclusivity of breastfeeding  In many studies, associations are based on lifetime duration of breastfeeding Health Outcomes Associated with NOT Breastfeeding  Increase prevalence of hypertension, diabetes, hyperlipidemia, cardiovascular disease, metabolic syndrome  Increase risk of breast cancer, ovarian cancer, rheumatoid arthritis, postpartum depression  Reduction in bone health  Increase sleep disturbances  Decreased postpartum weight loss The Hazards of Formula and Bottle-Feeding  Milk-based powdered infant formula serves as an ideal substrate for bacterial growth  Pathogen contamination Enterobactersakazakii has been detected in commercially produced powedered infant formula  Recalls of formula can happen- last year there was a recall because a child died from contamination  Powder cannot be sterilized Adulteration of Formula (chemically modifying) Malamine  2008 Thousands of children in China, Taiwan, Vietnam, and Singapore affected by melamine added to 22 brands of infant formula; 50,000 hospitalized and at least 6 died from acute renal failure  Malamine added to disguise low protein content resulting from diluting formula; also increase nitrogen content, increase apparent protein content, and gave formula a milky appearance  U.S. FDA and WHO established guidelines for tolerable upper limits for melamine ingestion unclear how much is considered safe in young children  Phytoestrogens in soy formula effects on reproductive, immune, and thyroid function  Typically a public health nurse would advice against a soy product  Bisphenol A in bottles and formula acts as an endocrine disruptor with estrogenic properties  Heating a bottle with BPA can cause prob
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