Women NeedWomen NeedSupport to Support to Breastfeed Breastfeed

SuccessfullySuccessfully

Women NeedWomen NeedSupport to Support to Breastfeed Breastfeed

SuccessfullySuccessfullyWrite your Name Write your Name

/Organisation date /Organisation date and Place hereand Place here

Write your Name Write your Name /Organisation date /Organisation date

and Place hereand Place here

Global Strategy for Infant Global Strategy for Infant and Young Child Feedingand Young Child Feeding

Global Strategy for Infant Global Strategy for Infant and Young Child Feedingand Young Child Feeding

• Adopted by the Adopted by the WHA and UNICEF WHA and UNICEF Executive board in Executive board in 20022002

• Adopted by the Adopted by the WHA and UNICEF WHA and UNICEF Executive board in Executive board in 20022002

Life begins here ….Life begins here ….Life begins here ….Life begins here ….

Optimal Infant and Young Child Feeding

Optimal Infant and Young Child Feeding

• Starting breastfeeding Starting breastfeeding within one hour of birthwithin one hour of birth

• Exclusive breastfeeding Exclusive breastfeeding for the first six monthsfor the first six months

• Introducing appropriate Introducing appropriate and adequate and adequate complementary feeding complementary feeding after 6 monthsafter 6 months along along with with Continued Continued breastfeeding for two breastfeeding for two years or beyondyears or beyond

• Starting breastfeeding Starting breastfeeding within one hour of birthwithin one hour of birth

• Exclusive breastfeeding Exclusive breastfeeding for the first six monthsfor the first six months

• Introducing appropriate Introducing appropriate and adequate and adequate complementary feeding complementary feeding after 6 monthsafter 6 months along along with with Continued Continued breastfeeding for two breastfeeding for two years or beyondyears or beyond

Science Science SupportSupportScience Science SupportSupport

Risk of neonatal mortality Risk of neonatal mortality according to time of according to time of

initiation of breastfeedinginitiation of breastfeeding

Risk of neonatal mortality Risk of neonatal mortality according to time of according to time of

initiation of breastfeedinginitiation of breastfeeding

0.71.2

2.32.6

4.2

00.5

11.5

22.5

33.5

44.5

With in 1hour

From 1 hourto end of day

1

Day 2 Day 3 After day 3

0.71.2

2.32.6

4.2

00.5

11.5

22.5

33.5

44.5

With in 1hour

From 1 hourto end of day

1

Day 2 Day 3 After day 3

Pediatrics 2006;117:380-386

Six times more risk of death

Deaths attributed to sub-Deaths attributed to sub-optimal breastfeeding among optimal breastfeeding among

childrenchildren

Deaths attributed to sub-Deaths attributed to sub-optimal breastfeeding among optimal breastfeeding among

childrenchildren

53

18

55

20

0

10

20

30

40

50

60

LowerRespiratoryTrach (LRT)

DiarrhoealDiseases (DD)

0-6 months6-12 months

53

18

55

20

0

10

20

30

40

50

60

LowerRespiratoryTrach (LRT)

DiarrhoealDiseases (DD)

0-6 months6-12 months

Public Health Nutr. 2006 Sep; 9(6): 673-85

Impact of Suboptimum Impact of Suboptimum breastfeeding on child mortality breastfeeding on child mortality

and DALYsand DALYs

Impact of Suboptimum Impact of Suboptimum breastfeeding on child mortality breastfeeding on child mortality

and DALYsand DALYs

77% (1.06

million)

77% (1.06

million)

Due to Non- EBFDue to Non- EBF

Due to Non- EBFDue to Non- EBF

85% (37 million)

1.4 million deaths due to suboptimum breastfeeding 1.4 million deaths due to suboptimum breastfeeding

43.5 million DALYs due to suboptimum breastfeeding 43.5 million DALYs due to suboptimum breastfeeding

Long term effectsLong term effectsLong term effectsLong term effects

• Subjects who were Subjects who were breastfed experienced breastfed experienced lower mean blood lower mean blood pressurepressure and total and total cholesterol, as well as cholesterol, as well as higher performance in higher performance in intelligenceintelligence tests. tests. Prevalence of Prevalence of overweight/obesity and overweight/obesity and type-2 diabetes was type-2 diabetes was lowerlower among breastfed among breastfed subjects.subjects.

• A 2007 WHO A 2007 WHO PublicationPublication

• Subjects who were Subjects who were breastfed experienced breastfed experienced lower mean blood lower mean blood pressurepressure and total and total cholesterol, as well as cholesterol, as well as higher performance in higher performance in intelligenceintelligence tests. tests. Prevalence of Prevalence of overweight/obesity and overweight/obesity and type-2 diabetes was type-2 diabetes was lowerlower among breastfed among breastfed subjects.subjects.

• A 2007 WHO A 2007 WHO PublicationPublication

Exclusive breastfeeding Reduces Exclusive breastfeeding Reduces HIV Transmission RiskHIV Transmission Risk

Exclusive breastfeeding Reduces Exclusive breastfeeding Reduces HIV Transmission RiskHIV Transmission Risk

12

11

0

2

4

6

8

10

12

Ha

zard

Ra

tio

ExclusiveBreastfeeding

Breastmilk +Formula

Breastmilk +Solids

12

11

0

2

4

6

8

10

12

Ha

zard

Ra

tio

ExclusiveBreastfeeding

Breastmilk +Formula

Breastmilk +Solids

Lancet , 31 March 2007

What women need to What women need to succeed?succeed?

What women need to What women need to succeed?succeed?

Breastfeeding education and support Breastfeeding education and support • Accurate and un- biased information to all family Accurate and un- biased information to all family

members, communitymembers, community• One to one counselling during pregnancyOne to one counselling during pregnancy• At birth support to begin breastfeeding At birth support to begin breastfeeding • Counselling, home visits, and support to maintain Counselling, home visits, and support to maintain

exclusive breastfeeding , like support on exclusive breastfeeding , like support on positioning and nutritionpositioning and nutrition

• Counselling for complementary feeding Counselling for complementary feeding • Counselling to prevent breastfeeding problems and Counselling to prevent breastfeeding problems and

take care if they do arisetake care if they do arise• Referral for breastfeeding problems like breast Referral for breastfeeding problems like breast

engorgement, sore nipples, not enough milk, and engorgement, sore nipples, not enough milk, and breast infection.breast infection.

Breastfeeding education and support Breastfeeding education and support • Accurate and un- biased information to all family Accurate and un- biased information to all family

members, communitymembers, community• One to one counselling during pregnancyOne to one counselling during pregnancy• At birth support to begin breastfeeding At birth support to begin breastfeeding • Counselling, home visits, and support to maintain Counselling, home visits, and support to maintain

exclusive breastfeeding , like support on exclusive breastfeeding , like support on positioning and nutritionpositioning and nutrition

• Counselling for complementary feeding Counselling for complementary feeding • Counselling to prevent breastfeeding problems and Counselling to prevent breastfeeding problems and

take care if they do arisetake care if they do arise• Referral for breastfeeding problems like breast Referral for breastfeeding problems like breast

engorgement, sore nipples, not enough milk, and engorgement, sore nipples, not enough milk, and breast infection.breast infection.

Women All Over the World Need SupportWomen All Over the World Need Support

Women at work …need Women at work …need support Crèches etc.support Crèches etc.

Women at work …need Women at work …need support Crèches etc.support Crèches etc.

What matters What matters to succeed to succeed

What matters What matters to succeed to succeed

Successful Breastfeeding…Successful Breastfeeding…Successful Breastfeeding…Successful Breastfeeding…Breastfeeding in the Correct PositionBreastfeeding in the Correct Position

Anatomy of the BreastAnatomy of the Breast

• Milk producing Milk producing glandsglands

• Lactiferous Lactiferous canaliculicanaliculi

• Lactiferous sinusesLactiferous sinuses

• Myoepithelial Myoepithelial tissuetissue

• Adipose tissueAdipose tissue

Signs of Correct Signs of Correct AttachmentAttachment

Signs of Correct Signs of Correct AttachmentAttachment• Mouth wide open Mouth wide open • Lower lip is turned Lower lip is turned

outsideoutside• Chin touching the breast Chin touching the breast • Black part of the breast Black part of the breast

not visible below the not visible below the lower liplower lip

• Large black portion of Large black portion of breast and nipple breast and nipple including milk collecting including milk collecting ducts are inside baby’s ducts are inside baby’s mouthmouth

• Tongue under the teatTongue under the teat

• Mouth wide open Mouth wide open • Lower lip is turned Lower lip is turned

outsideoutside• Chin touching the breast Chin touching the breast • Black part of the breast Black part of the breast

not visible below the not visible below the lower liplower lip

• Large black portion of Large black portion of breast and nipple breast and nipple including milk collecting including milk collecting ducts are inside baby’s ducts are inside baby’s mouthmouth

• Tongue under the teatTongue under the teat

Incorrect Sucking Incorrect Sucking PositionPosition

Incorrect Sucking Incorrect Sucking PositionPosition

• Mouth is not wide Mouth is not wide openopen

• Chin is away from Chin is away from the breastthe breast

• Baby is sucking only Baby is sucking only nipplenipple

• Most black portion of Most black portion of the breast is outside the breast is outside the baby’s mouththe baby’s mouth

• Tongue away from Tongue away from the teatthe teat

• Mouth is not wide Mouth is not wide openopen

• Chin is away from Chin is away from the breastthe breast

• Baby is sucking only Baby is sucking only nipplenipple

• Most black portion of Most black portion of the breast is outside the breast is outside the baby’s mouththe baby’s mouth

• Tongue away from Tongue away from the teatthe teat

Causes of Incorrect Causes of Incorrect AttachmentAttachment

Causes of Incorrect Causes of Incorrect AttachmentAttachment

• Use of feeding bottles. Leads Use of feeding bottles. Leads to nipple confusionto nipple confusion

• Inexperienced motherInexperienced mother• Functional difficulty with the Functional difficulty with the

mother or the babymother or the baby• Lack of skilled supportLack of skilled support

• Use of feeding bottles. Leads Use of feeding bottles. Leads to nipple confusionto nipple confusion

• Inexperienced motherInexperienced mother• Functional difficulty with the Functional difficulty with the

mother or the babymother or the baby• Lack of skilled supportLack of skilled support

• More prolactin More prolactin secreted at nightsecreted at night

• Secreted after feed Secreted after feed to produce next to produce next feedfeed

• Suppresses Suppresses ovulationovulation

The Prolactin reflexThe Prolactin reflex

Baby Baby suckingsucking

Sensory Impulses Sensory Impulses from nipplefrom nippleProlactin Prolactin

in bloodin blood

Breastmilk Production

The Oxytocin reflexThe Oxytocin reflex

Breastmilk TransferBreastmilk Transfer

• Works before or during feed 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 TransferBreastmilk Transfer

Thinks lovingly of baby

CONFIDENCE Sound of baby Sight of baby

Pain Worry Stress Doubt

The Feeling of “Not The Feeling of “Not Enough Milk”Enough Milk”

The Feeling of “Not The Feeling of “Not Enough Milk”Enough Milk”

Not true. Just a perception, this is Not true. Just a perception, this is not a disease entity, just a not a disease entity, just a symptom of underlying problem.symptom of underlying problem.You need to know from the mother, You need to know from the mother,

why she feels that her baby is not why she feels that her baby is not getting enough, and can solve her getting enough, and can solve her

problems byproblems by

• Reinstating mother’s confidence Reinstating mother’s confidence • Ensure frequent, effective sucklingEnsure frequent, effective suckling

Not true. Just a perception, this is Not true. Just a perception, this is not a disease entity, just a not a disease entity, just a symptom of underlying problem.symptom of underlying problem.You need to know from the mother, You need to know from the mother,

why she feels that her baby is not why she feels that her baby is not getting enough, and can solve her getting enough, and can solve her

problems byproblems by

• Reinstating mother’s confidence Reinstating mother’s confidence • Ensure frequent, effective sucklingEnsure frequent, effective suckling

Women need help of Women need help of this kind…this kind…

Women need help of Women need help of this kind…this kind…

Which children grow Which children grow healthy and achieve healthy and achieve

development potential?development potential?

Which children grow Which children grow healthy and achieve healthy and achieve

development potential?development potential?

• Well nourished mothersWell nourished mothers• Exclusively breastfed for the first six months, Exclusively breastfed for the first six months,

begin breastfeeding within an hourbegin breastfeeding within an hour• Enough and right food to eat laterEnough and right food to eat later

– Complementary feeding ,continued breastfeeding Complementary feeding ,continued breastfeeding

• Cared wellCared well• Hygiene and sanitary environmentHygiene and sanitary environment• Treated when sickTreated when sick

• Well nourished mothersWell nourished mothers• Exclusively breastfed for the first six months, Exclusively breastfed for the first six months,

begin breastfeeding within an hourbegin breastfeeding within an hour• Enough and right food to eat laterEnough and right food to eat later

– Complementary feeding ,continued breastfeeding Complementary feeding ,continued breastfeeding

• Cared wellCared well• Hygiene and sanitary environmentHygiene and sanitary environment• Treated when sickTreated when sick

One way to Support is One way to Support is to Sign up to Sign up

One way to Support is One way to Support is to Sign up to Sign up

Mum power: The friends from ante-natal Mum power: The friends from ante-natal class converge on McDonald's for the feed-class converge on McDonald's for the feed-in. Maddie Reynolds is fourth from the left in. Maddie Reynolds is fourth from the left

Mum power: The friends from ante-natal Mum power: The friends from ante-natal class converge on McDonald's for the feed-class converge on McDonald's for the feed-in. Maddie Reynolds is fourth from the left in. Maddie Reynolds is fourth from the left

Make Make breastfeedinbreastfeedin

g visible, and g visible, and more widely more widely available !!available !!

Make Make breastfeedinbreastfeedin

g visible, and g visible, and more widely more widely available !!available !!

The First Lady of Timor Leste at 7th Ministerial Consultation on Children

Thank you