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Breastfeeding

Definition

Breastfeeding is the practice of feeding an infant milk through the mother’s breast. According to La Leche League International (LLLI), human milk is ‘a living fluid that protects babies from disease and actively contributes to the development of every system in baby’s body”’. Breastfeeding stimulates babies’ immune systems and protects against diarrhea and infection.

Description

The mother’s body prepares for breastfeeding while she is pregnant. The fatty tissue of the breast is replaced by glandular tissue that is necessary to produce milk. When baby suckles the breast the hormone oxytocin is released. This causes the muscle cells of the breast to squeeze milk from the milk ducts to the nipple.

History

Throughout time millions of mothers have breastfed their babies. During ancient times mothers breastfed their babies for 12-18 months or until the mother’s menstrual cycle returned.

For thousands of years breastfeeding was the only source of nutrition for the first part of a baby’s life. Before the invention of formula few alternatives were available. If a mother could not breastfeed a wet nurse was found or the baby was fed animal milk or “pap”, a mixture of flour, rice, and water In the early 1900’s most babies in America were still breastfed, and over half of them were breastfed for one year or longer. However, as more women entered the workforce and supplemental methods of feeding were introduced, breastfeeding rates in America decreased. According to a survey from Ross Labs, by 1971 only 24.7% of

Benefits of breastfeeding

Benefits for InfantBenefits for Mother
• Perfect food for infant• Promotes faster shrinking of the uterus
• Guarantees safe, fresh milk• Promotes less postpartum bleeding
• Enhances immune system• Promotes faster return to pre-pregnancy weight
• Protects against infectious and noninfectious diseases• Eliminates the need for preparing and mixing formula
• Protects against food allergies and intolerances• Saves money not spent on formula
• Decreases risk of diarrhea and respiratory infections• Decreases risk of breast and ovarian cancer
• Promotes correct development of jaw, teeth, and speech patterns• Increases bonding with infant
• Decreases risk of childhood obesity• Enhances self-esteem in the maternal role
• Increases cognitive function• Delays the menstrual cycle
• Increases bonding with mother 

(Illustration by GGS Information Services/Thomson Gale).

Breastfeeding rates around the world

CountryAt birthAt 4–6 months
Denmark98% 
Kenya98%12%
Nigeria97%1%
Sweden97% 
Haiti96%2%
Indonesia96%42%
Egypt95%56%
India95%43%
Turkey95%10%
Brazil93%29%
China93%64%
Australia87%48%
Canada72%31%
United States70.1%33.2%
United Kingdom69%21%
Scotland50–63%30%
France50% 
Ireland31–54%14%

Statistics developed by La Leche League International (LLLI) in 2003 revealed the percentage of women breastfeeding their infants at birth and at 2-4 months (Illustration by GGS Information Services/Thomson Gale.)

American babies were breastfed at birth, and of these babies, only 5.4% of them were still breastfed at 6 months.

Demographics

In 1982, the United States experienced resurgence in breastfeeding and rates have continued to increase. The National Immunization Survey conducted by the Center for Disease Control and Prevention (CDC) in 2005 revealed that 72% of American babies were breastfed at birth and 39% were still breastfed at 6 months.

The developing world has experienced a decline in breastfeeding rates as well due to urbanization, social change, and the promotion of formula. Mothers who choose to feed their babies formula often encounter unsafe hygienic conditions in which to prepare the bottles, or they cannot afford to purchase the fuel needed to heat the water. Two of the major causes of infant mortality in developing countries are diarrhea and acute respiratory infections. Both are conditions that breastfeeding can protect against.

The World Health Organization (WHO) and the United Nations Children Fund (UNICEF) are working together to bring about a change in the global breastfeeding culture. In 2002, they developed “The Global Strategy for Infant and Young Child Feeding”, which recommends that all babies are exclusively breastfed for the first 6 months of life with continued breastfeeding up to 2 years or beyond. Exclusive breastfeeding means that breast milk is the child’s only food source of nutrition for the first 6 months of life and that no other solids or liquids such as formula or water are introduced at this time, with the exception of liquid vitamins or medicines. Despite this recommendation, only one-third of all babies in the developing world were exclusively breastfed for 6 months in 2004. The highest rates of exclusive breastfeeding were in the East Asia/Pacific region (43%) and the lowest rates were in the Western/Central Africa region (20%).

Composition of Breast Milk

Breast milk is the perfect food for an infant. It contains all the nutrients a baby needs to grow and stay healthy:

  • Fats: Breast milk contains omega-3 fatty acids essential for the growth and development of the brain and nerve tissue. The amount of fat a baby receives depends on the length of the feeding. The milk at the beginning of the feeding is called the foremilk. It is the low fat milk. The hind milk that comes at the end of the feeding contains higher concentrations of

KEY TERMS

Exclusive breastfeeding—Breast milk is the child’s only food source of nutrition for the first 6 months of life. No other solids or liquids such as formula or water are introduced at this time, with the exception of liquid vitamins or medicines.

Oxytocin—A hormone that produces a calm, relaxed feeling.

Postpartum—This refers to the period of time after childbirth.

fat. Therefore, the longer the baby nurses the higher the fat content.

  • Proteins: The whey proteins found in breast milk are easier to digest than formula. Taurine, an amino acid that is important in the development of brain tissue, is found in breast milk but not in cow’s milk
  • Sugars: Breast milk contains lactose, a milk sugar that provides energy. Breast milk contains 20-30% more lactose than cows milk
  • Vitamins and minerals: Breast milk provides the most balanced source of vitamins and minerals for an infant.
  • Immune system boosters: White blood cells and immunoglobulins are responsible for fighting and destroying infection

The content of breast milk varies from feeding to feeding, at different times of day, and as the baby grows.

Benefits for Baby

There are a plethora of benefits for the breastfeeding baby, including:

  • Increased immunity: Breast milk contains antibodies that are relayed by the mother and help to protect the baby from bacteria and viruses. These immunoboos-ters are not found in formula.
  • Low incidence of ear infections and respiratory infections.
  • Higher intelligence: Several studies have found higher levels of brain-boosting DHA in the blood levels of breastfed babies than in formula-fed babies.
  • Improved digestion and less constipation.
  • Decreased risk of diarrhea, pneumonia, urinary tract infections, and certain types of spinal meningitis. Decrease in food allergies and eczema.
  • Promotes normal weight gain: Breastfed babies are less likely to be overweight than formula-fed babies.
  • Reduced risk of juvenile (Type 1) and adult onset (Type 2) diabetes, celiac disease, cancer, rheumatoid arthritis, multiple sclerosis, liver disease, and acute appendicitis.
  • Lower risk of Sudden Infant Death Syndrome (SIDS).
  • Reduced risk of breast cancer (in daughters who have been nursed).
  • Promotes development of jaw and facial structure.
  • Promotes bonding between mother and child.

Benefits for Mother

Breastfeeding women also enjoy many benefits:

  • Reduced risk of breast, ovarian, and uterine cancers.
  • Natural contraceptive: Many women who breastfeed exclusively for six months experience a delay of fertility.
  • Faster postpartum recovery: Breastfeeding uses up extra calories so it’s easier for moms to lose their pregnancy weight. Nursing also helps the uterus shrink back to its normal size faster.
  • Relaxation: When a mother is breastfeeding her body produces oxytocin, a hormone that induces a calm, content feeling.
  • Protection from osteoporosis.
  • Saves time and money: Breast milk is cheaper than formula and the mother doesn’t have to spend time preparing bottles.
  • Better for the environment as there are no bottles to wash or cans to dispose of.

Mother nutrition

The ideal diet of a breastfeeding woman is comprised of healthy and nutritious foods from the five basic food groups. The main concentration (50-55%) should be made up of carbohydrate foods such as pastas, grains, and fruits. Healthy fats such as fatty fish and avocados should be 30%, and proteins should equal 15-20% . Breastfeeding women should make sure to eat foods that contain lots of calcium, such as dairy products, broccoli, and beans, and make sure they eat plenty of iron-rich foods like lean red meat, fish and poultry.

In order to compensate for the energy they expend breastfeeding their babies, breastfeeding women should add 300-500 extra nutritious calories to their diet each day and drink extra fluids. Breastfeeding mothers should also continue to take a prenatal vitamin.

Breastfeeding concerns

Every substance that a breastfeeding mother puts into her body has the potential to pass to her baby through her breast milk. This includes food, medicine, alcohol, and cigarettes

  • Foods: Foods such as dairy products, caffeine, grains and nuts, gassy foods, and spicy foods may cause the baby to fuss if the food upsets the baby’s stomach. If this occurs, the mother should eliminate the suspect food from her diet for 10-14 days to see if the trouble stops.
  • Medications: Any medication taken while breastfeeding should be approved by a doctor.
  • Birth control pills: The high estrogen type of birth control pills may decrease a breastfeeding mother’s milk supply and are not recommended. A progestin-only pill such as the “mini-pill” is the least likely to cause milk supply issues.
  • Alcohol: Infants have a hard time detoxifying from the alcohol that passes through their mother’s breast milk to them. It is recommended to limit alcohol consumption while breastfeeding.
  • Cigarettes: Cigarettes contain toxins that can pass through to the baby and are not recommended for breastfeeding women.

When breastfeeding is not an option

Although breastfeeding is the optimal way to feed an infant, sometimes it is not possible or feasible. A small percentage of women have conditions that prevent breast milk production, such as insufficient development of milk production glands, and cannot breastfeed. Women with HIV are advised against breastfeeding as the virus may be passed to their babies. Women who are newly diagnosed with infectious tuberculosis should not breastfeed unless they are on medication. Babies with galactosemia, a rare genetic disorder where the infant cannot metabolize the sugar in breast milk, cannot breastfeed.

BOOKS

La Leche League International The Womanly Art of BreastfeedingNew York, NY: Penguin Group, 2004.

Meek, Joan Younger, MD American Academy of Pediatrics New Mother’s Guide to BreastfeedingNew York, NY: Bantam Dell, 2005.

Sears, William, MD and Sears, Martha, RN The Baby Book: everything you need to know about your baby from birth to age twoBoston, MA: Little, Brown and Company, 2003.

ORGANIZATIONS

The American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (847) 434-4000. <http://www.aap.org>.

Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA 30333. (800) 311-3435. <http://www.cdc.gov/>.

La Leche League International, PO Box 4079, Schaumburg, IL 60168-4079. (800) LALECHE. <http://www.lalecheleague.org>.

United Nations Children Fund (UNICEF), 3 United Nations Plaza, New York, NY 10017 (United States address). (212) 686-5522. <http://www.unicef.org>.

World Health Organization, Department of Child and Adolescent Health and Development (CAH), Avenue Appia 20, CH-1211 Geneva 27, Switzerland. (+00 41 22) 791 21 11. <http://www.who.int/child-adolescent-health/index.htm>.

Jennifer L. Byrnes


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