“Step Up For Breastfeeding: Educate and Support”

WORLD BREASTFEEDING WEEK 2022

-Written by Sai Lavanya Patnala, Final year, Apollo Medical College, Hyderabad

Step Up for Breastfeeding: Educate and Support is this year’s World Breastfeeding Week theme. This issue seeks to raise breastfeeding awareness by pleading with governments and groups to put safeguards in place for nursing[1].

EDUCATE: What we need to learn?

Breastfeeding is an important part of a newborn’s life. Breastfeeding or lactation provides total nutritional and emotional dependency of the baby on the mother. The strong emotional bonding between the mother-child dyad is needed for successfully prolong breastfeeding[2].

Why is breastfeeding important?

-Colostrum produces mucosal immunity to the gastrointestinal (GI) tract via the secretory IgA (sIgA), IgM, and IgG which give barrier protection to the gut and play a vital role in fighting the germs.

– Early introduction of breastfeeding will help in establishing the naturally sterile gut of the baby to colonize with safe microbiota from the milk like Bifidobacterium and Lactobacillus, which along with the oligosaccharides confer anti-bacterial activity to the gut.

-Lactoferrin helps in increasing iron absorption and preventing its degradation by bacteria. 

-Breastfeeding lowers the risk of upper respiratory tract infections and diarrhea in the newborn. Other postulated benefits include a lower risk of developing asthma, type 1 diabetes, food allergies, and obesity[3].

What are the issues of concern?

Establishment of smooth bonding between the mother and baby is essential for successful breastfeeding. Skin-to-skin contact in the first 2 hours after birth is essential for successful initiation of lactation.

– The breast crawl, soon after birth, while the baby is alert will initiate the bonding, and it will be an assurance by giving comfort and calm to the mother. The breast crawl is when the baby is placed on the mother’s abdomen after birth; the baby finds its way to the breast to suckle

-Successful breastfeeding factors related to the baby include proper latching, alertness of the baby, rooting reflex, and active sucking reflex. Getting a correct latch on the nipple is important. If the latch is not correct due to issues such as lip tie or tongue tie, the mother can develop cracked nipples or pain while breastfeeding. 

-Although lactation is a natural process, the mother needs support and education for proper positioning and latching. The ability of the baby to empty the breast will determine the subsequent milk volume. 

-Maternal factors like pain, anxiety, emotional instability, among others should be addressed before and after delivery. 

-The use of medications needs to be addressed while the mother is breastfeeding. Women should not be told to stop breastfeeding, but careful attention needs to be placed to find alternatives that are safe to use while breastfeeding. 

– In general, breastfeeding can be stopped between 6 to 12 months, although some women breastfeeding until the child is 2 to 4 years. The use of alcohol, smoking, or coffee is not valid reasons to stop breastfeeding.

What are the benefits of breastfeeding for a woman’s health?

-Early suckling is one of the most important stimuli for the production of oxytocin, which is responsible for uterine involution and reducing occurrence of postpartum hemorrhage and anemia. 

-High levels of oxytocin can also increase the pain threshold, reducing maternal discomfort and thus contributing to an increased feeling of love for the baby.

-While the mother exclusively breastfeeds, her protection against pregnancy can reach 96% during the first 6 months, thus ensuring spacing between pregnancies. It has been estimated that, after the return of the menstrual cycles, the probability of conception is reduced by 7.4% for each additional month of breastfeeding.

-During pregnancy, the body of a woman accumulates a weight of ~ 3 kg of fat that will be utilized throughout the first 6 months of breastfeeding 

-A lower body mass index has been detected among mothers who breastfed for a period of 6–12 months, and those who exclusively breastfed were leaner than those who breastfed on a partial basis. This also provides a sensation of greater self- esteem and satisfaction with their body image among lactating women.

-Breastfeeding may also act on a mechanism of regulation of daytime cortisol secretion, with a stable concentration of the hormone possibly reducing the risk of postpartum depression.20 

-Suckling at the maternal breast preceded by skin to skin contact lowers the cortisol levels, consequently reducing the levels of anxiety.

-Breast feeding has a protective effect against the risk of breast cancer. According to UNICEF, a 16% increase in the proportion of mothers who breastfeed for 6 months can reduce the expected prevalence of breast cancer by 1.6% per year.

– Breast feeding not only lowers the risk of development of ovarian cancer among lactating women, it also increases the life- expectancy of women who have already developed the disease.

-According to Farland et al, the duration of total and exclusive BF was significantly associated with a decreased risk of endometriosis. 

-Breastfeeding can contribute to the reduction of the risk of osteoporosis in future life.

-Studies correlating BF with blood pressure have detected lower levels of both systolic and diastolic pressure among nursing mothers during the BF period. 

 -There is a 12% reduction in the risk of developing Metabolic syndrome observed for each year of lactation, which is associated with a reduced insulin resistance provided by BF.

SUPPORT: BABY FRIENDLY HOSPITAL INITIATIVE

-The BFHI is a global UNICEF/WHO-sponsored effort to promote breastfeeding by ensuring that all women are provided with sound information regarding their infant feeding choices and that those who elect to breastfeed their infants are given physiologically sound, evidence-based advice and skilled assistance prenatally and as they begin nursing their infants during their postpartum hospital or birth center stay. The initiative is based on ten policy or procedure statements, The Ten Steps[4].

REFERENCES

1.https://www.indiatoday.in/information/story/world-breastfeeding-week-2022-date-theme-and-significance-1983641-2022-08-04#:~:text=WORLD%20BREASTFEEDING%20WEEK%202022%3A%20THEME&text=Step%20Up%20for%20Breastfeeding%3A%20Educate,safeguards%20in%20place%20for%20nursing.

2. Alzaheb RA. A Review of the Factors Associated With the Timely Initiation of Breastfeeding and Exclusive Breastfeeding in the Middle East. Clin Med Insights Pediatr. 2017;11:1179556517748912. 

3. Kalarikkal SM, Pfleghaar JL. Breastfeeding. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534767/

4. Naylor AJ. Baby-Friendly Hospital Initiative. Protecting, promoting, and supporting breastfeeding in the twenty-first century. Pediatr Clin North Am. 2001 Apr;48(2):475-83. doi: 10.1016/s0031-3955(08)70039-7. PMID: 11339166.

5. https://www.who.int/multi-media/details/ten-steps-to-successful-breastfeeding

6. Del Ciampo LA, Del Ciampo IRL. Breastfeeding and the Benefits of Lactation for Women’s Health. Rev Bras Ginecol Obstet. 2018 Jun;40(6):354-359. English. doi: 10.1055/s-0038-1657766. Epub 2018 Jul 6. PMID: 29980160.7. https://medlineplus.gov/ency/article/002452.htm

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