Successful Early Initiation and Exclusive Breastfeeding up to Six

Months of Age

““AADIGURU” AADIGURU” Early Intervention CentreWright Town - Jabalpur

Worldwide distribution of child deaths

Each dot represents 5000 deaths Lancet 2003

India is epicenter of Childhood Mortality

9.7 million < 5 yrs deaths annually world over

India 2.1 million (21%)

1 million newborns die

1 million newborns die

annually in India

annually in India

Neonatal Resuscitation :6-42% Breastfeeding :55-87% Prevention and management of hypothermia

:18-42% Kangaroo Mother Care (LBW):incidence of infection

:51% (7-75%)

Post Neonatal interventions - efficacy for reducing all cause of neonatal mortality

Global and National Recommendations for Infant and Young Child Feeding

Initiate breastfeeding within one hour of birth

Exclusive breastfeeding for first 6 months of life

Introduce nutritionally adequate and safe complementary foods after the infant reaches 6 months of age

Continue to breastfeed for 2 years or beyond.

What is Exclusive Breastfeeding?

Giving an infant only breastmilk

No food or drink other than breastmilk— not even water

No Ghutti/Honey etc.

Benefits to the Baby

Complete food for the first six months Perfect nutrition Higher IQ Emotional bonding Prevents infections Prevents chronic diseases Easily digested

Benefits to the Mother

Reduces post delivery bleeding and anemia Helps delay next pregnancy - LAM Protective effect against breast and ovarian

cancer Helps to loose weight Emotional bonding Needs no preparation

Benefits to the Society

Reduces absenteeism of mothers from work as they are less prone to disease.

Economical Enhances Bonding

First year is critical!First year is critical!

Malnutrition strikes the most in infancy beginning in 3-4th month , 29-30 % at 6 months, goes up and peaks about 46% by 18 months, flat curve after that (NFHS 3).

Years of life

Brain development

Underweight (-2sd) NFHS-3

Over 60 million

10 lakh children

die during

first month,

14 lakhs by

1 year, and 20 lakhs

by 5 yrs. 2/3rd are related to poor feeding.

Successful Breastfeeding…

Exclusive breastfeeding for the first six months

U-5 deaths reduction by preventive Interventions

Source: Jones et al. LANCET 2003;362:65-71

0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

Breastfeeding

Complementary feeding

Clean delivery

Hib vaccine

Clean water, sanitation, hygiene

Zinc

Vitamin A

Antenatal steroids

Newborn temperature management

Tetanus toxoid

Antibiotics for PRM

Measles vaccine

Nivirapine and replacement feeding

Insecticide-treated materials

Antimalarial IPT in pregnancy

Inte

rven

tion

Percent

Breastfeeding is defined as exclusive

breastfeeding for first 6 months and

continued breastfeeding during

6-11 months

Successful Breastfeeding…

Major Hurdles Lack of family support Lack of support by health professionals Commercial influence Feeling of not enough milk among women

Successful Breastfeeding…

Important Do’s Initiate breastfeeding as early as possible within one

hour of birth. Do not give the baby any prelacteal feeds No bottles, artificial teats or pacifier Breastfeeding on demand at least 8-10 times in a

day and at night a Breastfeed in a correct position Build mother’s confidence to sustain good milk

supply and alleviate feeling of not enough milk.

Successful Breastfeeding…

Initiate Breastfeeding Within One Hour of Birth

Successful Breastfeeding…

No Prelacteal Feeds Replace colostrum Reduce baby’s desire for

breastfeeding Greater risk of infection Risk of intolerance,

allergy

Successful Breastfeeding…

No Bottles, Artificial Teats or Pacifiers for Breastfeeding Infants

It lead to nipple confusion

Successful Breastfeeding… Breastfeeding in the Correct Position

Milk producing glands Lactiferous canaliculi Lactiferous sinuses Myoepithelial tissue Adipose tissue

Anatomy of the BreastAnatomy of the Breast

Successful Breastfeeding…

Build Mother’s Confidence During prenatal period During antenatal Period During postnatal period

The Feeling of “Not Enough Milk”

Not true. Just a perception Reinstate mother’s confidence Ensure frequent, effective suckling

• More prolactin More prolactin secreted at nightsecreted at night

• Secreted after feed Secreted after feed to produce next feedto produce next feed

• Suppresses Suppresses ovulationovulation

The Prolactin reflexThe Prolactin reflex

Baby sucking

Sensory Impulses from nippleProlactin

in blood

Breastmilk Production

The Oxytocin reflexThe Oxytocin reflex

Breastmilk Transfer

• Works before or during Works before or during feed to make milk flowfeed to make milk flow

• Makes uterus contractBaby

sucking

Sensory Impulses from nipple

Oxytocin in blood

How does the mother’s How does the mother’s confidence play partconfidence play part

Breastmilk Transfer

Thinks lovingly of baby

CONFIDENCE Sound of baby Sight of baby

Pain Worry Stress Doubt

Mother learns to position baby

Baby learns to take breast

Rooting reflex

Swallowing reflex

Sucking reflex

Feeding reflexes in the baby

Signs of Correct Attachment

Mouth wide open Lower lip is turned outside Chin touching the breast Black part of the breast not

visible below the lower lip Large black portion of

breast and nipple including milk collecting ducts are inside baby’s mouth

Tongue under the teat

Incorrect Sucking Position

Mouth is not wide open Chin is away from the

breast Baby is sucking only

nipple Most black portion of

the breast is outside the baby’s mouth

Tongue away from the teat

Causes of Incorrect Attachment

Use of feeding bottles. Leads to nipple confusion

Inexperienced mother Functional difficulty with the mother or the

baby Lack of skilled support

Conclusion

Exclusive Breastfeeding for First Six Months

Being Successful- Initiate breastfeeding as early as possible within one hour of

birth. Do not give the baby any prelacteal feeds No bottles, artificial teats or pacifier Breastfeeding on demand at least 8-10 times in a day and at

night a Breastfeed in a correct position Build mother’s confidence to sustain good milk supply and

alleviate feeling of not enough milk.

Thanks