breastfeeding give em ’ the breast breakfast!
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Breastfeeding Give em ’ the breast breakfast! . Mara Caris Courtney Klebe. Objectives. Discuss nutritional components and benefits in breast milk Discuss barriers and how to overcome barriers of breastfeeding Discuss recommended diet while breastfeeding - PowerPoint PPT PresentationTRANSCRIPT
MARA CARISCOURTNEY KLEBE
BreastfeedingGive em’ the breast breakfast!
Objectives
Discuss nutritional components and benefits in breast milk
Discuss barriers and how to overcome barriers of breastfeeding
Discuss recommended diet while breastfeeding
Bring awareness to breastfeeding in public Provide programs supporting breastfeeding
History of breastfeeding[1]
Wet nurses were used to breastfeed children of the royal families
Wet nursing began as early as 2000 BC and extended into the 20th century
By 1900 wet nursing was extinct
Breast Milk[2]
Colostrum “First Milk”: Thick yellow fluid Low in fat, and high in Carbohydrates, proteins, and
antibodies Laxative effect 20 kcal/oz Mature milk around day 3 or 4 Defends baby against harmful infections
Infant Stomach Capacity[2]
Components of breast milk:Fats [3,4,5]
“Hind milk” higher in fat
Amount and type related to maternal diet
Essential fatty acids, saturated fatty acids, triglycerides
LCFA(long chain fatty acids): -DHA- 1.3 g/day AI -Arachidonic acid- 13
g/day AI Contains 10-20 mg/dL
of cholesterol, and is not reflected in maternal diet
Components of breast milk:Protein:[3,4,5]
Low levels in breast milk
Mostly alpha-lactalbumin
Whey(60%) and Casein (40%): Ratio makes breast
milk more digestible Great infection-
protection properties
Other proteins:1. Lactoferrin2. Secretory IgA3. Lyzsozymes4. Bifidus Factor
DRI: 25g/day during lactation
Components of breast milk:Carbohydrates [3,4,5]
Lactose: Primary CHO in breast
milk Enhances Ca, P, and
Mg absorption Monosaccharide's:
galactose fructose
Oligosaccharides: Third most abundant
component; 130 types Protective properties
against respiratory and enteric diseases
Promotes growth of bifidobacterium and Bacteroides
Components to breast milk: Vitamins- Fat Soluble[5,6]
Vitamin A: gives colostrum yellow color (beta-carotene)
Vitamin E: Muscle integrity and resistance to RBC breakdown
Components to breast milk: Vitamins- Fat Soluble Cont.[5,6]
Vitamin D: content of milk is related to sun exposure and maternal vitamin D intake Recommended to take
supplementation- 400 IU/day
Vitamin K: very little content until normal gut bacteria start making it
Vitamin K shot at birth
Components of Breast MilkVitamins- Water Soluble
Vitamin CRiboflavinNiacinB6B12
Components of breast milk:Minerals[6]
Largely protein bound and balanced to enhance bioavailability
Sodium: low content
Calcium: content in breast milk not related to maternal intake
Components of breast milk: Minerals Cont. [6,7]
Magnesium: adequate amount for growth and development
Zinc: requirements during lactation are more than during pregnancy
Benefits of Breast Feeding:
Benefits to the Baby[6]
Optimal nutrition for infant Strong bonding with mother
Safe, fresh milk Enhanced immune system
Reduced risk for acute otitis media, severe lower respiratory tract infections, and asthma
Protection against allergies and intolerances
Promotion of correct development of jaw and teeth
Higher IQ and school performance through adolescence
Reduced risk for chronic diseases
Reduced risk for SIDS
Benefits to the Baby: A report by the Agency for Healthcare Research and Quality (AHRQ) [6]
23% reduction in the risk of otitis media in infants if ever breastfed; 50% if breastfed exclusively for 3 months
72% reduction hospitalization for a lower respiratory tract infection during first year of life
15-19% reduction in leukemia if breastfed for first 6 months
27 % reduction of asthma if breastfed for first 3 months without a family history of asthma, 40% reduction with family history
Benefits to the Baby Cont. [4,6]
Easier Digestion Lactose, whey & casein proteins, and fat are easily
digested
Antibodies in breast milk helps build the baby’s immune system
Benefits to the Baby Cont. [4,6]
Brain and growth development Promotes rapid formation of myelin
Possible role in prevention of obesity 4% reduction in adulthood obesity each month of
being breastfed
Benefits to the mother[6]
Strong bonding with infant Increased energy expenditure
Faster shrinking of the uterus Reduced postpartum bleeding and delays the menstrual cycle
Decreased risk for chronic diseases
Improved bone density
Decreased risk for postpartum depression
Enhances self-esteem in the maternal role
Time saved from preparing and mixing formula
Saves money
Benefits to the Mother Cont.[6]
Weight loss Pre-pregnancy weight + total pregnancy weight change +
parity = greatly impact postpartum weight loss Increase levels of oxytocin
stimulates uterine contractions, minimizes postpartum blood loss, and returns uterus to nonpregnant size
Lowers blood pressure before, during, and after sessions
Benefits to the Mother Cont. [6]
Fertility is delayed in most women when breast feeding ovulation is delayed
Increased Bone Health Reduced risk of hip fractures in postmenopausal
women Improved bone mineral density during you adulthood
in adolescent mothers
Benefits to the Mother Cont. [6]
Lowers risk of type II diabetes, breast cancer, ovarian cancer, BP, and rheumatoid arthritis 4.3 % reduction in risk of breast cancer development each year
woman breastfeeds Partial inhibition of ovulation results in decreased risk of
ovarian cancer >12 months decreased rheumatoid arthritis
Family Economy
Less prescriptionsLess illnessImproves
communication
Saves money reduces health care cost time off work
Less Bottles = less waste
No manufacturingEnvironmentally
friendly
Benefits [5,6]
Barriers to Breastfeeding
EmbarrassmentLack of supportLack of confidenceConcerns about
diet/health practicesFear of painInfections
Insufficient breastfeeding education
Disruptive hospital policies
Promotion of infant formula
Time
Barriers to Breastfeeding: Solutions
Do what makes you feel comfortable
Don’t judge others who choose to breastfeed
Educate yourself on breastfeeding
Use a breast pump
Wear clothes compatible with breastfeeding
Practice at home Find support
Breastfeeding Conditions[5]
Sore NipplesFlat or Inverted NipplesLet Down Failure Hyperactive LetdownHyperlactationEngorgementPlugged DuctMastitis
Sore Nipples Hyperlactation
Causes: Incorrect positing Suction trauma Poor latch Improper release
Treatment: Nurse on least sore breast Find comfortable position Pump to express milk
Breastfeeding Conditions[5]
Causes: milk volume of the
mother exceeds the intake of the baby
Treatment: Nurse on one breast
while mother expresses on other
Cabbage leaves or cold compresses to decrease production
Letdown Failure Hyperactive Letdown
Causes: Oxytocin is suppressed
and milk can’t be expressed
Treatment: Oxytocin nasal spray Decrease stress
Causes: Milk streams from the
breast as feeding begins
Treatment: Express milk till flow
stops Remove infant from
breast until flow stops
Breastfeeding Conditions[5]
Flat or Inverted Nipples
Breastfeeding Conditions[5,8]
Causes: naturally occurs
Treatment: Correct latch positioning Use breast pump prior to
feeding to draw out nipple
Engorgement
Causes: Milk building up in the
breasts Treatment:
Continue to nurse baby Nurse frequently Pump prior to nursing or
hand express
Breastfeeding Conditions[5,9]
Plugged Duct
Breastfeeding Conditions[5,10]
Causes: Milk duct does not
properly drain and becomes inflamed
Treatment: Correct position of baby
on the breast Wear lose nursing
garments Proper time span
between nursing
Mastitis
Causes: Inflammation, cracked
sore nipples, engorgement, restriction from tight bra or clothing
Treatment: Continue nursing Switch to unaffected side Apply wet or dry heat to
breast Adequate rest/ fluid
Breastfeeding Conditions[5,11]
Tips to ease pain[12]
Correct latching Over the counter breast lotionMassage breast before and after feedingWet or dry heat on breast before feedingHerbs to promote/reduce milk flowPositioning (demo/ pictures)
Position demonstration
Medications and Breastfeeding[5]
90-99% of women who breastfeed take some type of medication during their first week postpartum
Most medications are excreted in breast milkMedications contradicted during
breastfeeding include antineoplastic agents, drugs of abuse and drugs that suppress lactation
Not recommended: Approved with breastfeeding:
EchinaceaGinseng RootSt. John’s Wort
FenugreekGoat’s-Rue
Herbs and breastfeeding[5]
Alcohol and Breastfeeding[5]
Alcohol consumed is concentrated in breast milk and can inhibit milk production
Odor and volume of breast milk changes
Takes a 120 pound woman about 2-3 hours to clear one serving of beer or wine from her body
Sleep patterns and psychomotor development of infants change
Smoking and Breastfeeding[5]
Cigarettes Asthma, respiratory infections, colic, and acid reflux Results in lower milk output, lower fat content, and
slower growth of infant Marijuana
Possible decrease in infants motor development
Maternal Diet[13]
The U.S Department of Agriculture’s MyPyramid Food Guide has set guidelines
Healthy-weight women expend around 500 kcal/day in the first 6 months due to breastfeeding- 400 kcal after 6 months
Maternal Diet Cont.[13]
Well-nourished breastfeeding mothers do not need to take routine vitamin or mineral supplementation
Fluid needs and demands increase
Like pregnancy, should avoid fish high in mercury,
Maternal Diet cont.[5,13]
Caffeine Does not pose as much as a problem; around 5
oz. a day is okay Some symptoms do occur like infants being
wakeful and fussy No long-term effects have been documented
Maternal sample diet[14]
Breastfeeding: YesAge: 26Height: 5 ft. 7 in. Weight: 140 lbs. Baby birth date: Aug 28th, 2013 Physical activity: 30-60 minutes of moderate
activity per day
My SuperTracker Plan [14]
Breast milk Cow’s milk-based formula
7 % of calories from protein
38% of calories from carbohydrates
55% of calories from fats
9-12% of calories from protein
41-43% of calories from carbohydrates
48-50% of calories from fats
Breast milk vs. formula[4,5,6]
Formula[4,5,6]
Made under sterile conditions Babies who are formula-fed aren’t as hungry
as babies who are breastfed Some reasons as to why women choose to
formula feed:1.Convience 2.Flexibility3.Time and frequency of feedings4. Diet
Healthy People 2020 on breastfeeding[15]
42 focus areas, one of which is Maternal, infant, and Child Health
“New objectives will take on some of the most challenging barriers to breastfeeding success faced by U.S. mothers.” [4]
Healthy People 2020 Objectives[15]
Increase the proportion of infants who are ever breastfed.
Increase the proportion of infants who are breastfed at six months and one year
Increase the proportion of infants who are exclusively breastfed through three and six months
Healthy People 2020 Objectives Cont.[15]
Increase the proportion of employers that have worksite lactation support programs.
Reduce the proportion of breastfed newborns who receive formula supplementation within first two days of life
Programs promoting breastfeeding[16]
WICBaby Friendly Hospital InitiativeAcadamey of Pediatrics (AAP)WHOThe U.S. Department of Health and Human
Services (DHHS)Wellstart International
Conclusion
The American Academy of Pediatrics (AAP) recommends that mothers breastfeed exclusively for the first 6 months, followed by breastfeeding in combination with the introduction of complementary foods for at least 12 months.
Breastfeeding provides many benefits to the baby, mother, family, and community.
Questions???
References
1. Stevens E, Patrick T, Pickler R. A History of Infant Feeding. J Perinat Educ. 2009; 18(2): 32-39. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684040/pdf/jpe-18-032.pdf. Published Spring 2009. Accessed Sept 20 2013.
2. What is Colostrum? How does it benefit my baby? La Leche League International. http://www.llli.org/faq/colostrum.html. Updated Oct 2006. Accessed Oct 2013.
3. What’s in Breast Milk? American Pregnancy Association: Promoting Pregnancy Wellness. http://americanpregnancy.org/firstyearoflife/whatsinbreastmilk.html. Updated Jan 2013. Accessed Sept 20 2013.
4. Mahan K, Escott-Stump S, Raymond J. Krause’s Food and the Nutrition Care Process. 13th. St. Louis (MO): Elsevier Saunders; 2012.
5. Brown J, Isaacs J, Krinke B, Lechtenberg, Murtaugh M. CHAPTER. Nutrition Through the Life Cycle. 4th. Belmont (CA): Wadsworth; 2011.
6. Position of the American Dietetic Association: Promoting and Supporting Breastfeeding. J Am Diet Assoc. 2009 Nov;109 (11): 1926-942.
7. Naturalwellnessgirl. [image from the internet] [Updated 2013] Available from: http://www.naturalwellnessgirl.com/2011/10/mineral-monday-zinc/
8. Medela. [image from the internet] Available from: http://www.medela.com/CA/en/breastfeeding-consumer/breastmilk-information/flat-or-invert-nipples.html
9. Pretty Mom Guide. [image from the internet] [update 2011 Jan 05] Available from: http://prettymomguide.com/engorgement-if-youre-not-breastfeeding.html
10. Breastfeeding Challenges. [image from the internet] [Updated 2010 Dec 04] Available from: http://breastfeedingchallenges.wordpress.com/2010/12/04/plugged-milk-duct/.
11. Beliefnet. [image from the internet] [Updated 2007 Nov] Available from: http://www.beliefnet.com/healthandhealing/getcontent.aspx?cid=11684
12. Breastfeeding FAQs: Pain and Discomfort . Kids health. http://kidshealth.org/PageManager.jsp?lic=44&cat_id=161&article_set=44020. Accessed Sept 20 2013.
13. Lyn S, Khan P. Maternal Nutrition During Breastfeeding. NEW BEGINNINGS. 2004; 21(2): 44. http://www.llli.org/nb/nbmarapr04p44.html Published April-May 2009. Updated Aug 29 2006. Accessed Sept 20 2013.
14. ChooseMyPlate.gov. [internet] United States Department of Agriculture. [Cited Oct 15 2013]. Available from : http://www.choosemyplate.gov/pregnancy-breastfeeding.html
15. Healthy People 2020 Objectives Combat the Barriers to Breastfeeding. United States breastfeeding Committee. http://www.usbreastfeeding.org/NewsInfo/NewsRoom/201012HP2020andTJCToolkit/tabid/185/Default.aspx Published Dec 13 2013. Accessed Oct 8 2013.
16. Hospital Support for Breastfeeding: Preventing obesity begins in hospitals. Centers for Disease Control and Prevention. http://www.cdc.gov/VitalSigns/BreastFeeding/ Published Aug 2011. Accessed Sept 21.