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Lecture 12

Health Sciences 1001A/B Lecture Notes - Lecture 12: Canadian Paediatric Society, Breast Milk, Colostrum

Health Sciences
Course Code
HS 1001A/B
Shauna Burke

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The basics:
oHuman milk is species specific, mother makes milk perfectly suited to her baby’s
requirement for growth and development
oBreast milk is the ultimate ‘super food’, only single food for humans that can
independently sustain life for first 6 months after birth
oBreast milk provides all of the fluid and nutrients for optimal growth/development
Protects infant from bacteria and viruses that the mother comes in contact
oBreast milk adapts to the age of infant
Constantly changes to meet the infant’s nutritional needs
oComposition changes in early postpartum period, from colostrum to mature milk
“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” (WHO,
oHormones involved in breastfeeding: estrogen, progesterone, prolactin, oxytocin
oRecommendations: Breastfeeding – exclusively for the first six months, and
sustained for up to 2 years or longer with appropriate complementary feeding – is
important for nutrition, immunologic protection, growth/development of
infants/toddlers (WHO, Health Canada, Dietitians of Canada, Canadian Paediatric
Society 2012)
oBenefits: “breastfeeding is the normal way of providing young infants with the
nutrients they need for healthy growth/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.” (WHO 2015)
Short Term Benefits:
oInfection: reduced risk, dose response relationship between duration and
exclusivity of breastfeeding and protection from many types of infections
oSudden Infant Death Syndrome: reduced risk
oMortality: not breastfeeding increases child’s risk of dying in infancy, developing
countries – infants are not breastfed have higher rated of diarrhea/respiratory
diseases (both main causes of infant death). Estimated 800,000 lives could be
saved every year among children <5 years if all children 0-23 months were
optimally breastfed (WHO 2014)
oOverweight and Obesity: many studies show relationship between breastfeeding
and obesity prevention, an area of considerable debate, 2014 systemic review
suggest that the relationship is unclear, difficult to ‘prove’ due to confounding
maternal, genetic, cultural, child, environmental variables
oTemperature and Respiratory Regulation: bottle feeding has increased risk for
physiological instability, oxygen saturation & body temp found to be significantly
lower in preterm infants who were bottle fed vs. breastfed, importance of skin-to-
skin (“kangaroo care”)
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oPain: Not breastfeeding increases infants responses to pain, analysis of 11 studies
show that both breastfeeding & human milk are pain relieving
Long Term Benefits:
oReduced risk of some childhood cancers
Several studies have found increased risk of some childhood cancers
(leukemia, lymphoma, Hodgkin’s) when children have not been breastfed
Additional research needed
Reduced risk of asthma
Increased cognitive development
Debated issue
Breastfeeding associated with increased scores o
developmental/cognitive screening tools
2013 study – babies breastfed for 1 year were better able to
understand others at 3 years of age and had higher verbal and
nonverbal intelligence at 7 years
Reduced risk of type 1 and type 2 diabetes
Children fed formula appears to be associated with an increased
risk of diabetes
Benefits for Mother:
oPremature weaning or not breastfeeding are associated with health risks
oDegree to which health outcomes are realized depends on duration, frequency,
and exclusivity of breastfeeding
oIn many studies, associations are based on lifetime durations of breastfeeding
oHealth outcomes for NOT breastfeeding:
Increase prevalence of hypertension, diabetes, hyperlipidemia,
cardiovascular disease, metabolic syndrome
Increase risk breast cancer, ovarian cancer, rheumatoid arthritis,
postpartum depression
Reduction in bone health
Increased sleep disturbances
Decreased postpartum weight loss
Risks of Formula Feeding:
oIncreased risk for compromised nutritional status, growth/developmental and
overall health and survival
oMilk based powdered infant formula serves as an ideal substrate for bacterial
oPathogen contamination – Enterobacter sakazakii has been detected in
commercially produced powdered infant formula
oAdulteration of Formula
2008 – thousands of children in China, Taiwan, Vietnam, Singapore
affected by melamine added to 22 brands infant formula, 50,000
hospitalized and at least 6 died from acute renal failure
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