1. INFANT FEEDING: BREASTFEEDING Nutrition through the Lifespan

2. Topics  The History of breastfeeding  Society’s (and your) views of breastfeeding  Advantages and disadvantages for mother  Advantages for baby  Anatomy of the breast  The mechanics  Potential problems and complications  Breastfeeding in the news

3. KWL  What do you know about breastfeeding?  What do you want to know about breastfeeding?

4. The History of Breastfeeding  Until the 18 th century, breastfeeding was considered a “peasant” act. Wealthy families paid a “wet nurse” to breastfeed their babies.  In the late 1800s, commercially available artificial infant foods were introduced, and breastfeeding statistics nose- dived.  In 1910, one study shows that 90% of poor women breastfed. 17% of rich women did.  By the 50s, most women fed their babies formula.  The American Academy of Pediatrics, in 1997, released their recommendation to breastfeed babies for at least six months. This was not well-received.  Today, the CDC, WHO, AAP, and other agencies are strongly promoting breastfeeding.

6. Society’s View…  What Would You Do? What Would You Do?  Read the statements on your survey and rate your agreement with each on a scale of 1 to 5.  Why do you believe that Americans feel so uncomfortable with the concept of breastfeeding?  Do you believe that breastfeeding is “weird?”  Do you believe that women should Do you believe that women should be allowed to breastfeed in public?

7. Your thoughts…  Why are we, as a society, offended by this… and

8. …but not by this?

9. Advantages vs. Disadvantages for Mom AdvantagesDisadvantages Breast Feeding Free Burns 500 calories Builds immune system Nutrients Bonding Prevents food allergies Correct temperature Already prepared Shrinks uterus Gastrointestinal benefits Reduces risk for breast cancer by up to 59% Only mom can feed Eats every1 ½ to 2 ½ hours Pain Engorgement Production issues Do not know how much baby ate Modesty Formula Feeding Anyone can feed Eats every 2-4 hours Do not need to worry about medication/ alcohol/ etc. No concerns for modesty Preparation Cost Temperature Sanitation No colostrum More diarrhea

10. Breastfeeding Advantages for Baby  Ideal fat and protein percentages  Gradual, healthy weight gain for baby  Reduced risk of obesity  Higher IQ  Stronger immune system  Reduced risk of SIDS  Reduced risk of allergies (food and seasonal) and asthma  Reduces the incidence of childhood cancers like leukemia.  Protection from chronic illnesses like Crohn’s disease, diabetes, MS, and others  Many more…

11. Anatomy of the female breast 1. Chest wall 2. Pectoralis muscle 3. Alveoli (lobules) 4. Nipple 5. Areola 6. Milk ducts 7. Fatty tissue 8. Skin

12.  Milk is produced in the alveoli (which, in groups, are called lobules).  It drains to the nipple through the milk ducts.  Each nipple has 15-20 passages through which milk flows.

13. Care for Breastfeeding Mother  Sleep when baby sleeps.  Eat well balanced meals.  Drink plenty of fluids.  Refrain from alcohol, smoking, and medication.  Caffeine, chocolate, and cow’s milk may be likely to cause colicky baby: fussy, irritable (gas forming in abdomen causing pain)

14. Potential Problems  Engorgement- too much milk too quickly causes pain and swelling. Apply warm compresses or pump more often.  Leaking- breast pads and nursing bras will help  Sore nipples- air dry; do not use soap, cream, or ointment  Insufficient supply- Proper latch on will help baby get enough milk. The more often you feed the more milk you will produce. May need to supplement with formula so baby gets enough.  Infection- flu, mastitis, herpes, yeast infection, etc.  Maternal attitude may cause insufficient supply or issues with feeding.

15. The Mechanics of Breastfeeding  Position mother for comfort  Hold baby near breast  Brush baby’s lips or cheek with finger or breast  Rooting reflex  Sucking reflex (fades at 3 months)  Babies are born knowing how to nurse!  Offer both breasts at each feeding.

16. More info…  “Let down” occurs when milk drops from the milk ducts into the nipple – can be triggered by baby crying, proximity to baby, etc.  Babies should empty one breast before mom offers the other.  Babies’ noses are made the stick out so that they can still breathe while they nurse.  Expect 6-8 wet diapers per day and at least one dirty diaper per day to indicate that baby is getting enough to eat.

17. Pumping  Breast pumps can be bought or borrowed from the hospital.  It's important to pump if one wishes to store breast milk in the freezer.  Should not be boiled or heated in the microwave- defrost using tap water.

18. How to know if baby is hungry… Age Behaviors Established HungerSatiety Early InfancyFusses and cries, mouths the nipple; kicks; rooting reflex Draws away from nipple or falls asleep 16-24 weeksActively approaches breast or bottle, leans forward to spoon Releases nipple and withdraws head, fusses or cries, bites nipple, increases attention to surroundings. 28-36 weeksVocalizes eagerness for bottle or food. Changes position, shakes head, keeps mouth closed tight, hands become more active. 40-52 weeksPoints or touches spoon or feeders hand Behaviors as above, sputters with tongue and lips, hands bottle or cup to feeder.

19. The Composition of Breastmilk  Colostrom is produced for the first 2-5 days after birth.  Extremely rich in nutrients and antibodies  Very concentrated

20. The Composition of Breastmilk  Foremilk is produced early in the feeding.  Lower fat content  Higher sugar/carb content  Hindmilk is produced later in the feeding.  Higher fat content  Less sugar  Produced in back ducts Babies need both!

21. How much should a newborn eat???  To calculate the number of ounces of breast milk needed per day by the baby, use the following calculation:  Weight (kg) * 110 kcal/kg  Divided by 20 kcal/oz.  = total/ oz per day  1 kg = 2.2 lb.  Approximately how many ounces per day and per feeding does a 8 lb. baby need???

22. How long is breastfeeding recommended?  American Academy of Pediatrics (AAP) recommends breastfeeding exclusively for at least six months and supplementing with solids until one year.  World Health Organization (WHO) recommends “two years or beyond.”

23. What if mom smokes or drinks?  Breastfeeding mothers are encouraged to quit smoking, but even as a smoker, breast milk is still best for baby.  Mothers should not breastfeed while drinking alcohol. Alcohol is passed through breast milk.  Some prescription drugs are also incompatible with nursing. Ask your doctor.