Breastfeeding & weaning Tips For New Mothers

Dr. Adil El Hamamsy

Specialist Pediatrician

Medcare-Sharjah

The American Academy of Pediatrics (AAP)&The World Health Organization(WHO); currently recommends:

• Infants should be fed breast milk exclusively for the first 6 months after birth. Exclusive breastfeeding means that the infant does not receive any additional foods (except vitamin D) or fluids unless medically recommended.
• After the first 6 months and until the infant is 1 year old, the AAP recommends that the mother continue breastfeeding while gradually introducing solid foods into the infant’s diet.
• After 1 year, breastfeeding can be continued if mutually desired by the mother and her infant.

Child Health Benefits

Human milk is species-specific, and all substitute
feeding preparations differ markedly from it, making
human milk uniquely superior for infant feeding.
Exclusive breastfeeding is the reference or normative
model against which all alternative feeding methods
must be measured with regard to growth, health,
development, and all other short- and long-term outcomes. In addition, human milk-fed premature infants receive significant benefits with respect to host
protection and improved developmental outcomes
compared with formula-fed premature infants.
From studies in preterm and term infants, the following outcomes have been documented.
Infectious Diseases
Research in developed and developing countries
of the world, including middle-class populations in
developed countries, provides strong evidence that
human milk feeding decreases the incidence and/or
severity of a wide range of infectious diseases including bacterial meningitis, bacteremia; diarrhea, respiratory tract infection, necrotizing enterocolitis otitis media, urinary
tract infection, and late-onset sepsis in preterm
infants. In addition, post neonatal infant mortality rates in the United States are reduced by 21% in
breastfed infants.
Other Health Outcomes
Some studies suggest decreased rates of sudden
infant death syndrome in the first year of life and
reduction in incidence of insulin-dependent (type 1)
and non–insulin-dependent (type 2) diabetes tus, lymphoma, leukemia, and Hodgkin disease, overweight and obesity,hypercholesterolemia,and asthma in older children and
adults who were breastfed, compared with individuals who were not breastfed. Additional research in
this area is warranted.
Neurodevelopment
Breastfeeding has been associated with slightly enhanced performance on tests of cognitive development. Breastfeeding during a painful procedure such as a heel-stick for newborn screening
provides analgesia to infants.
Maternal Health Benefits
Important health benefits of breastfeeding and lactation are also described for mothers. The benefits
include decreased postpartum bleeding and more
rapid uterine involution attributable to increased
concentrations of oxytocin,84 decreased menstrual
blood loss and increased child spacing attributable to
lactational amenorrhea, earlier return to prepregnancy weight, decreased risk of breast cancer,
decreased risk of ovarian cancer,93 and possibly decreased risk of hip fractures and osteoporosis in the
postmenopausal period.
Community Benefits
In addition to specific health advantages for infants and mothers, economic, family, and environmental benefits have been described. These benefits
include the potential for decreased annual health
care costs of $3.6 billion in the United States, decreased costs for public health programs such as the
Special Supplemental Nutrition Program for Women,
Infants, and Children (WIC); decreased parental employee absenteeism and associated loss of family income; more time for attention to siblings and other
family matters as a result of decreased infant illness;
decreased environmental burden for disposal of formula cans and bottles; and decreased energy demands
for production and transport of artificial feeding products. These savings for the country and for families would be offset to some unknown extent by increased costs for physician and lactation consultations,
increased office-visit time, and cost of breast pumps
and other equipment, all of which should be covered
by insurance payments to providers and families.

CONTRAINDICATIONS TO BREASTFEEDING
Although breastfeeding is optimal for infants,
there are a few conditions under which breastfeeding
may not be in the best interest of the infant. Breastfeeding is contraindicated in infants with classic
galactosemia (galactose 1-phosphate uridyltransferase deficiency); mothers who have active untreated tuberculosis disease or are human T-cell lymphotropic virus type I– or II–positive; mothers
who are receiving diagnostic or therapeutic radioactive isotopes or have had exposure to radioactive
materials (for as long as there is radioactivity in the
milk); mothers who are receiving antimetabolites or chemotherapeutic agents or a small number
of other medications until they clear the milk

CONDITIONS THAT ARE NOT
CONTRAINDICATIONS TO BREASTFEEDING

Certain conditions have been shown to be compatible with breastfeeding. Breastfeeding is not contraindicated for infants born to mothers who are hepatitis B surface antigen–positive, mothers who are
infected with hepatitis C virus (persons with hepatitis C virus antibody or hepatitis C virus-RNA–positive blood),111 mothers who are febrile (unless cause is a contraindication outlined in the previous section), mothers who have been exposed to low level environmental chemical agents, and
mothers who are seropositive carriers of cytomegalovirus (CMV) (not recent converters if the infant is
term).111 Decisions about breastfeeding of very low
birth weight infants (birth weight
1500 g) by mothers known to be CMV-seropositive should be made
with consideration of the potential benefits of human
milk versus the risk of CMV transmission.
Freezing and pasteurization can significantly decrease the CMV viral load in milk.
Tobacco smoking by mothers is not a contraindication to breastfeeding, but health care professionals
should advise all tobacco-using mothers to avoid
smoking within the home and to make every effort to
wean themselves from tobacco as rapidly as possible.
Breastfeeding mothers should avoid the use of
alcoholic beverages, because alcohol is concentrated
in breast milk and its use can inhibit milk production. An occasional celebratory single, small alcoholic
drink is acceptable, but breastfeeding should be
avoided for 2 hours after the drink.
For the great majority of newborns with jaundice
and hyperbilirubinemia, breastfeeding can and
should be continued without interruption. In rare
instances of severe hyperbilirubinemia, breastfeeding may need to be interrupted temporarily for a
brief period

Breastfeeding Benefits Your Baby’s Immune System

Breast milk is the food naturally designed to best meet the needs of human babies. It has all the necessary nutrients, in just the right amounts, and is easy to digest. Beyond the nutritional benefits, here’s a great bonus: Breastmilk also helps build and support your baby’s immune system:

Breast milk: food & infection fighter

Breast milk contains antibodies that can fight infection. Those antibodies are present in high amounts in ,colostrum the first milk that comes out of the breasts after birth. However, there are antibodies in breastmilk the entire time a mother continues to nurse. Through these antibodies, the mother can pass on some protection from infectious illness she had in the past, and those she gets while breastfeeding. Breast milk can literally give babies a head start in preventing and fighting infections.

Breast milk also is made up of other proteins, fats, sugars and even white blood cells that work to fight infection in many different ways. They are especially helpful in fighting gastrointestinal infections, since breast milk heads right to the stomach and intestine when your baby eats. The different factors in breast milk work directly within the intestine before being absorbed and reaching the entire body. This also sets the stage for a protective and balanced immune system that helps recognize and fight infections and other diseases even after breastfeeding ends.

Other factors in breast milk directly stimulate and support the immune system. These include lactoferrin and interleukin-6, -8 and -10. These proteins help to balance the immune system inflammatory response, which is needed for immune function but can be damaging in excess.

Is breastmilk probiotic?

Breast milk has “probiotic” factors, too.  Some support the immune system and others serve as a nutrient source for healthy bacteria in the body, called the human microbiome. The healthy microbiome can play a lifelong role in not only preventing infection, but also in decreasing the risk of     allergies ;asthma ;obesity and other chronic diseases. ​

With all these immunity-boosting factors in breast milk, it is not surprising that breastfed babies are less likely to suffer from ear infections, vomiting, diarrhea, pneumonia, urinary tract infections, and certain types of meningitis .

Research also shows that children who nurse for more than six months are less likely to develop childhood leukemia and lymphoma than those who receive formula. This may be in part because these types of cancer are affected by disruptions to the immune system.

The transition from exclusive breastfeeding to full use of family foods is a very vulnerable period. It is the time when many infants become malnourished, contributing significantly to the high prevalence of malnutrition in children under five years of age worldwide. It is essential therefore that infants receive appropriate, adequate and safe complementary foods to ensure the right transition from the breastfeeding period to the full use of family foods.

Amounts of foods to offer