Breastfeeding—An Essential Newborn Nutrient

Abstract

Breastfeeding is an art/skill. Globally, it is gaining a steady prominence as World Health Organization (WHO) and United Nations International Children's Emergency Fund (UNICEF) have specified exclusive breastfeeding for the initial half year. They have likewise offered significance to initiation of breastfeeding within half an hour to 1 hour after birth that has a critical effect on the developing infant as the colostrum in the breast milk supports immunity in the developing baby and newborn child, following birth helps in invigorating the posterior pituitary, release of Oxytocin and thus helps in uterine contraction and forestalls postpartum hemorrhage in postnatal mothers.

Analysis of data from 123 countries shows that babies are breastfed at some point in their lives. However, the rate shifts between low-income, middle-income and high-income countries. It is evaluated that in low- and middle-income countries, approximately 4% of children are never breastfed, while in high-income countries it is 21%. As indicated by the WHO, in excess of 20 million infants are born weighing under 2.5 kg and unfortunately developing nations are facing the brunt of this.

One of the WHO Global Targets 2025 is to increase the rate of exclusive breastfeeding in the first 6 months up to at least 50% to improve maternal, infant, and young child nutrition. Unfortunately, only 38% of infants aged 0 to 6 months are exclusively breastfed globally.

Numerous factors contribute to produce a positive situation for breastfeeding. Within the health care organizations, mothers need information and support to breastfeed immediately after birth and beyond. Indeed, studies have discovered that implementation of breastfeeding interventions within the health care organizations and community can possibly expand the rates by 2.5 times.

In India, government has implemented 6 months maternity leave that benefit many working mothers to exclusive breast feed their newborns.

Breastfed children perform better intelligence tests, and are less likely to be overweight and diabetic in later life. If the breastfeeding rate improves in compared to the current rates, then additional 20,000 deaths can be prevented due to breast and ovarian cancer. Studies have found that exclusive breastfeeding can have influence on development of milestones. An ability that a child must achieve by a certain age is developmental milestone. The milestones can be physical, social, emotional, cognitive and communication skills like walking, sharing, expressing emotions, identifying familiar sounds, and talking.·

Keywords

breastfeeding - health - postpartum - newborn - nutrient - nutrition

Introduction

Breastfeeding is a natural act. Virtually all mothers can breastfeed provided they have an accurate knowledge and support within the families and communities and also from the health care system.

Breast milk contains all the nutrients that a baby needs for 6 months and it is easily digested. It has an anti-infective property that prevents the baby from infection. A newborn baby needs 110 to 120 kcal/kg body weight/day, while an average newborn weighing 3.4 kg requires 45 to 75 mL every 2 to 3 hours. The infant requires 40 to 60 mL/kg during the initial 2 days of life and 100 to 150 mL/kg/day before the finish of the first week.

Breast milk provides 67 kcal/100 mL or 20 kcal/OZ. Iron from breast milk is better absorbed than from artificial feeds because of high lactose and vitamin C that facilitate in iron absorption. Lactose increases acidity of the intestine, which decreases undesirable bacteria and improves absorption of calcium, potassium, and magnesium. Also, the enzyme produced primarily by the pancreas known as pancreatic amylase helps to digest carbohydrates.

As per the World Health Organization (WHO), exclusive breastfeeding should be initiated within half an hour to 1 hour after birth for 6 months. This practice is highly recommended and implemented by all health care organizations, in the labor unit and postnatal wards.[1] [2] [3] [4]

A recent report by The Prime Minister's Overarching for Holistic Nourishment(POSHAN) shows that, over the last decade, the percentage of infants who were exclusively breastfed for 6 months in India increased from 46.4 to 54.9%. National Family Health Survey (NHFS) revealed that among the South Indian Sates, Karnataka has reported the compliance with 54.2% children who have been exclusively breastfed till 6 months that is against 58.6% in the previous survey.[5] [6]

Due to lack of education and knowledge on breastfeeding, some women may be unable to breastfeed, while improving pregnant women's knowledge of breastfeeding may help them to breastfeed longer. Mothers need help and support for successful breastfeeding. Counselling has been shown to be effective intervention to increase rates of early initiation of breastfeeding, reduce rates of prolateral feeding, and increase rates of exclusive breastfeeding.[7] Primiparous mothers may have some anxiety because they are not quite sure how to breastfeed. Rather than becoming anxious about it, the mothers need to learn all things about breastfeeding process. Inadequate preparation is given to antenatal mothers regarding breastfeeding in regular antenatal clinics. Mainly counselling should focus on exclusive breastfeeding and its importance, immediate initiation of breastfeeding, techniques and positioning, importance of colostrum, indicators of adequacy of successful breastfeeding, expression, and storage of breast milk.[8]

It is the responsibility of the midwife to make sure that the newborn is put to the breast at the earliest and assist the mother with utmost care. In the community area, public health nurses can play a vital role in educating the women and empowering them to lead them to a path for successful feeding.

A consistent series of counselling and assistance is required even in the delivery room as well as in the immediate postnatal period for a successful attainment of breastfeeding skills.[9] Despite strong evidences in support of exclusive breast feeding for the first 6 months of life, its prevalence has remained low worldwide and it is estimated that only about one-third of infants were exclusively breastfed for the first 6 months of life.[2] [10]

Lack of proper information, lack of counselling on feeding, lack of proper feeding skills, inadequate health care support, aggressive promotion of baby foods by commercial industries, and lack of proper support structures at community and work place may be the cause of failure to exclusive breastfeeding.[11]

Mothers should be made aware that:

• All mothers will have sufficient amount of milk for their babies.

• They should be made known that the more the infant is put to the breast, the milk production escalates.

• They need to be confident that they can feed.

• They need to be taught the proper technique/latch of breastfeeding.

• They need to be comfortable, relaxed, and above all, patience in breastfeeding works wonders among all mothers and thus infants will get adequate feed.

Breastfeeding should be encouraged among all mothers. Nursing professionals play a major role in creating awareness among mothers as well as assisting first time mothers. Patience is the key to latch the baby properly on to the breast and above all joy in feeding the newborn.

Diet of the mother should be nutritious that is rich in proteins, vitamins, and minerals. Carbohydrates and fats are also required in moderate amount as they are a source of energy.

There are various positions adopted for breastfeeding. Mothers can adopt any comfortable position to feed. The best position is cradle hold.

The four key points in proper positioning are as follows:

• a) Baby's head and body should be in straight line.

• b) Baby's face should be facing breast with nose opposite the nipple.

• c) Baby's body should be close to mothers.

• d) Mother should support baby's bottom and not just the head and shoulders ([Fig. 1]).[12] [13]

Fig. 1 Breastfeeding techniques and Burping Positions.

Why Do You Need to Burp the Baby after Every Feeds?

A crucial part of feeding a baby is burping. Burping technique helps in getting rid of colicky pain in the abdomen as some of the air that babies tend to swallow during feeding. Not being burped often and swallowing too much air can make a baby spit up.

Do All Mothers Have Enough Milk?

More than 90% of mothers will have sufficient amount of milk for the baby. It depends mainly on the healthy diet of the mother. Protein-rich diet along with minerals and vitamins along with the right technique of feeding will have a huge impact on breast milk production.

How Does the Mother Know That Baby Has Enough Feed?

• Baby comes off breast solitary.

• Baby stops crying.

• Baby passes stool and urine.

• Baby is active.

• Sleeps well.

• Steady gain in weight.

How Long and How often a Mother Needs to Feed?

The length of time a mother needs to feed varies in each baby. It mainly depends upon the correct latch and also on the sucking potential of the newborn. Initially, the mother might need to demand feed on every second hourly. When feeding has established, most babies feed from both the breasts. But sometimes babies may have got enough feed from one breast. Always offer second breast and let the baby decide. In the next feed, try to alternate the breast to feed that will increase the production and so also it will prevent engorgement. Each baby's demands vary, but most babies wake up during the night. It is ideal to keep the baby close to you and be relaxed at night during feeding.

Benefits of Breastfeeding to the Newborn

• It contains all the required nutrients and enzymes for the ideal growth and development of the newborn.[14]

• It is free from contamination and has anti-infective properties.

• It boosts immunity and increases the intelligent quotient of the baby.[15]

• It increases an emotional bonding with the mother.

Benefits of Breastfeeding to the Mother

• Post-delivery bleeding and anemia are reduced.

• It provides protective effect against reproductive organ cancers.[16]

• It increases an emotional bonding with the newborn.

Benefits of Breastfeeding to the Society

• It lowers heath care costs by reducing illness and deaths of children less than 5 years of age.[9]

• It reduces absenteeism in working mothers.

Conclusion

Breast milk for the newborn is considered to be the best and a natural nutrient for lifelong health. It is the best possible start in life the newborn can avail from the mothers.[9] It is important that the latch and breastfeeding techniques are rightly attained by the mother so that the newborn gets adequate amount of feed and this in turn will help the mother also get adequate rest.

The mother needs a good support and encouragement from their family, health care team, as well as society at large for successful breastfeeding. In this regard, child birth education units in the hospitals with nurse led clinics would be favorable. It should be a collaborative effort by all the health team members to make breastfeeding a global success by giving a wide awareness.

Conflict of Interest

None declared.

• References

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Publication History

Article published online:
10 October 2022