Breastfeeding

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Breastfeeding

• Laura Plachta, M.D.

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American Academy of PediatricsPolicy on
Breastfeeding
Human milk is uniquely superior for infant
feeding and is species-specific all substitute
feeding options differ markedly from it. The
breastfed infant 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.
American Academy of Pediatrics, Work Group on
Breastfeeding and the use of Human
Milk. Pediatrics December 1997 100(6) 1035-1041
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History - Infant Feeding

• maternal feeding
• wet nursing

• Ancient
• Middle ages
• Renaissance
• Modern

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History - Infant Feeding

• maternal feeding
• wet nursing
• artificial feeding - animal milk, pap

• Ancient
• Middle ages
• Renaissance
• Modern

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History - Infant Feeding

• maternal feeding
• wet nursing
• artificial feeding - animal milk, pap

• Ancient
• Middle ages
• Renaissance
• Modern

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History of Infant Feeding
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History of Infant FeedingInfant Food
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History of Infant FeedingInfant Food
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History of Infant FeedingPercentage Methods
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Trends in Infant FeedingRoss Mothers Survey

• breastfeeding rates doubled 1970-1982
• rates stable since
• now
• in-hospital 62
• _at_ 6 mo. 26

todays resident born this year
Ross Mothers Survey - Updated Breastfeeding
Trend Through 1997. Ross Laboratories,
Columbus, Ohio.
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Trends in Infant FeedingRoss Mothers Survey -
Demographics

• Rates increase with maternal age and level of
  education.
• Geographic variability - highest rates in Pacific
  and Mountain regions, lowest in South
• White 29, Hispanic 25, Black 15

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Nutrition

• Protein
• 70 whey/30 casein also secretory IgA,
  lactoferrin. Higher concentrations of AA taurine
  in human milk.
• Lipids
• 50 of calories fatty acids and triglyceride with
  heat-labile lipase
• Carbohydrate
• lactose, oligosaccharides
• Minerals
• Na, K, Cl, Ca and Mg

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Milk Composition
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Host Defense

• Secretory IgA
• lactoferrin
• lysozyme
• oligosaccharides
• growth factors
• cellular components

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Gastrointestinal Function

• Faster gastric emptying with breastmilk.
• Avoids formula intolerances.
• Trophic/developmental stimulation for infant gut.

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Economic Benefit

• Formula cost for first year of life estimated at
  855.
• Indirect economic benefits may include
• reduced health care costs
• reduced employee absenteeism.

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Environmental Benefit

• cows - land use, fertilizer, antibiotics
• glass bottles, plastic nipples
• plastic/paper packaging
• gas-powered distribution, exhaust
• marketing

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Anatomy - Mammary Gland
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Anatomy - Mammary Gland
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Physiology of Lactation

• Embryogenesis
• Mammogenesis
• pubertal
• pregnancy
• Lactogenesis
• Stage I
• Stage II
• Lactation
• Involution

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Physiology Gestation
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PhysiologyPostpartum
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PhysiologyLactation
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PhysiologyLactogenesis

• first 50 hours50 ml/day typical
• 2nd 50 hours500 ml/day
• later 600 ml/day

Adapted from Jensen RG Handbook of Milk
Composition. San Diego, Academic Press, 1995, p
88.