Breast Feeding Overview

Breast feeding  is  the  feeding  of  the  Infant or  child  with breast  milk directly from  the  mother breast .The  mechanism  develops  when the  child  comes in  contacts    with the  mother  nipple  develops   a sucking  reflex  result in sucking  and  swallowing  the milk. Experts recommends that child within   first hour should be breast fed.

Breast feeding  promotes  the  health of  both the  mother and  infant  and  prevent  the disease .The  individuals who are breast fed for  longer duration  develops  in  stable  and  healthy personalities.  Breast feeding is considered as more beneficial as compared to artificial fed. In exceptional cases artificial feed has to be given  to the  infant  when mother is  infected  by T-lymphocyte virus, HIV Virus,  or under medication  for  the  purpose  of  treatment of tuberculosis. It is better to adapt to artificial feed practice in child whose mother is suffering from AIDs.

Types of Breast Feeding

Breast feeding is defined as “the child has received breast milk direct from the breast or expressed”. Types of Breast Feeding are as follows:-

• Exclusive breastfeeding: The infant has received only breast milk from the mother or a wet nurse, or expressed breast milk, and no other liquids or solids with the exception of drops or syrups consisting of vitamins, mineral supplements, or medicines.
• Predominant breastfeeding: The infant’s predominant source of nourishment has been breast milk. However, the infant may also have received water and water-based drinks (sweetened and flavored water, teas, infusions, etc.), fruit juice; oral rehydration salts solution (ORS), drop and syrup forms of vitamins, minerals and medicines, and ritual fluids (in limited quantities). With the exception of fruit juice and sugar water, no food-based fluid is allowed under this definition.
• Full breastfeeding: Exclusive breastfeeding and predominant breastfeeding together constitute full breastfeeding.
• Complementary feeding: The child has received both breast milk and solid or semi-solid food.

Bottle-feeding: The child has received liquid or semi-solid food from a bottle with a nipple/teat. 

Composition of Breast Milk

Breast milk is made of nutrients from the bloodstream and bodily stores. It has a right amount of fat, sugar, proteins and water which is needed for the development of the infants. The composition of the milk changes depends upon how long the baby was nursed at each session. Then nutrient  in  Human  Milk contain  fat which provides  much of  the energy, a young  human  or animal needs protein  for  growth , special milk sugar lactose which produces  energy.

• The mean mature macronutrient composition of mature term milk is estimated to 0.9to 1.2g/dL for protein, 3.2 to 3.6 g/dL for Fat and 6.7 to 7.8g/dL for lactose.
• Energy estimates ranges from 65 to 75k cal/dL and are highly correlated with fat content with human milk.
• The protein of human milk have  specific protein, Casein  which forms  softer curd easy to digest lactalbumin, actoferrin, secretary IgA,  lysozyme  and  serum albumin.
• The  Fat content  Human milk consist of  essential fatty acid  ,which is  characterized of high content  of  Palmatic  acid  oleic  acid  ,which are needed  for  the  baby’s  brain, eyes, and  blood  vessels. Lipase in human milk helps to digest fat as baby’s gut has not developed.
• Lactose : The  Breast milk contains  more  lactose  than other milk ,which is  energy source  of  brain  development.
• Vitamin and  iron: Human milk contains  more of  some  important  vitamin than  cow’s  milk like  Vitamin A and  Vitamin C .10% of  Iron  is  absorbed from Cow milk where 50% of  Iron  is  absorbed by human milk.

Comparison  of  Milk  of Human ,Cow  and  Goat

Comparing  the  basic  macro nutrient,  the  concentration of  Lactose  is  more  in human milk as compared to the  goat and  cow respectively. The protein content in Human milk is low as compared to Cow and Goat milk. Fat content of goat milk is more as compared to human and cow milk respectively.

Types of Human Milk

• Colostrum. First day after delivery, the breast secretes colostrums. Colostrums is yellow thicker than later milk and it secreted in small amount. It is enough for a normal baby which is exactly needed for the baby for the first few days. The Colostrums contains more antibodies and more white blood cells than later milk. It provides a baby the first immunization to protect against most bacteria and Viruses. Colostrums is rich in growth factor, which stimulates the   intestine to become    mature.  The growth factor prepares the intestine to digest and absorb milk and prevent the absorption of undigested protein. If  the  baby has  cow’s milk or  other foods  before  having  Colostrums ,the  foods can damage  the  intestine  and  can cause  allergies. Besides this it acts as laxative and help the baby to pass meconium.
• Mature Milk:  After 1-2 weeks of parturition the constituent of milk increases in quantity.
• Foremilk: comes from the beginning of a feed .It look greyish white and watery in consistency. It is rich in proteins, lactose, vitamins, minerals, and water.
• Hind  Milk: come  at the  end of a feed , it look whiter than hind  milk because  it  contain  more  fat . The  content  of  fat make  the hind  milk more  rich in energy. Fat  supplies more  than half the  energy in breast milk .A baby needs both the hind  and  the  foremilk for  growth and  development. It  is  important  not  to take  a slow  feed  or her off the breast before it  has finished or he  may  not  get  enough hind  milk.   

Advantages of Breast Feeding  

There are numerous benefits which are listed as

1. General Growth Pattern:  The infants who are breastfed show advantages regarding their general health and growth.
2. Mental health: If the child  is  exclusively  breast fed for  more  than six month ,he  may be better predictor  of  better mental health in childhood and  adolescent  and  his   cognitive and Motor functions will be  better developed.
3. CHILD HOOD OBESITY is lower in the children who are breast feed.
4. Infection: The infants who are not breast fed are significantly  prone  to develop large  number of  acute  and  chronic  diseases including  lower respiratory tract infections, ear infection ,bacteremia, bacterial meningitis  botulism, urinary tract infection. The infants who are breastfed are less prone to diseases like sudden death syndrome, insulin dependent diabetes mellitus, Crohn’s disease and ulcerative colitis.
5. Immunity:  During breast feeding 0.25-0.5 grams per day of Secretory IgA passes to the baby via milk. This  one  of  the  most import function of  Colostrum .The  antibodies  mainly  act in small intestine  but  certain  amount  antibodies  are moved to  other parts of  the  body. Besides this  the  breast milk contains  anti-infective  factors  like bile salts stimulated  lipases  and  lacto ferrin  which binds  to irons  and  inhibit  the  growth of  intestinal bacteria . Women who are vaccinated against  tetanus  ,whooping  cough ,influenza   within  the  breastfeeding  period  are like  to pass through milk when nursing  their  infants.Allergic  Diseases: The  infants  who are exclusively  breast fed are less likely to developed  allergic diseases like  atopic  dermatitis ,necrotizing  entercolitis.  In long term health effects it will protect the child against respiratory tract infection.
6. Cardiovascular System: Breastfed children has  lower cholesterol level and  C-reactive  proteins  due  to which risk of cardiovascular diseases  is lessened in later life  and  they  may also expressed lower blood  pressure  as compared to bottle feed infants.
7. Role  of  Genetic and  Environment Factors: The IQ of  the  individuals were   warranted better  who were fed  on breast milk as compared to   those individuals  who were  fed on Infant  Formula milk. Breast milk having increase content of essential unsaturated poly fatty acid and the infants having gene FADS2 which plays a vital role in polyunsaturated metabolism augmented with better environmental conditions enhanced into better personalities.

Benefits to Mother

1. Cost Effectiveness:  Breast feeding  is  cost effective way of  feeding  to an infant  ,it  provides  maximum  nourishment  to the  infant  with less cost.
2. Bonding effect: Skin to Skin contact also called as kangaroo care develops breast feeding behavior in the newborn. When  the  new born  placed  on the  mother skin have  a natural instinct  to latch on the  breast and  start nursing.
3. Hormone Released: Breast feeding releases oxytocin and a prolactin hormone that relaxes the mother and make her feel better towards baby. Immediately after  birth level of Oxytocin hormone  in the  blood  increases  results in  the  secretion of  milk ,  contraction  of  the  uterus and  bleeding  stops  immediately.
4. Weight Loss:  The  mother who are breast feeding  their  newborn has shown  reduction in  their  weight  loss.

Long term effect of lactation on mother:

1. The mother who continuously breast feeding their infants has shown reduced risk in chronic  diseases like  diabetes mellitus-type-2 ,Heart  Diseases  carcinoma  of  breast,  endometrial cancer, ovarian cancer, Breast fed mother suffering from diabetes requires less insulin, reduces risk of post partum bleedings.
2. Natural post partum infertility, Breast feeding may delay in return the fertility for some women by suppressing ovulation. The breastfeeding women may not ovulate or have regular periods during the entire lactation period.

Impact of Breast Feeding on Community

Financial benefits: Breast feeding has reduced the health care cost. Due to  lower incidence  of  illness   in breastfed infants  allows the  parent  to give  more  attention to others  children .By encouraging  breast feeding  practices in  infants the  government  has  to import less infant  formula milk. Sociological Factors: The choice of mother to breast fed her children depends upon the socioeconomic status, race, ethnicity, and CULTURE. The women who have breast fed their infants   for longer duration; children have shown to attain better educational achievement. The employment pattern in women has changed the attitude of Women to feed their infants. The  African  women  immediately after delivery rejoins  the  employment   due  to which    she  has  to  discontinue to breastfed    her child     as  compared  to the  white  women who join the  organization   a bit later on employment  after delivery   results in

• Establishing   a better bondage   by breastfeeding  her child ,develops  into better personalities as compared  to the  African woman child.
• Supportive work ENVIRONMENT plays a vital role in encouraging breast feeding.
• The level of  education  in women  play a vital role  in continuing  or  discontinue  breast  feeding. Educated women can easily interpret the  advantages  and  disadvantages  of  breast feeding  in light  of access to information  by she   can make  better decision.
• The  women  of   higher  status  has  an access  to the  lactation room and  suffer less social stigma  for  having  breastfed or expressed milk.
• Women of low income   Due  to nature  of work  leave cannot  be  extended  to women of  low  income    due  to which they have  to discontinue breastfeeding  and  unintended pregnancies  may increased.

Psychological Effects: Breast feeding    provided  an opportunities  for  toddler to developed   comforting bonding  moment  with their  mother and the  security obtained through extended  breastfeeding helped the toddler  to strengthened their    abilities  to become  confident     independent balanced    individual . Massive   industrialization has improved health care and sanitation  facilities ,and has    provided better  employment  opportunities to women   these opportunities disassociated the  women  from  breastfeeding their toddler thus  depriving  the  infant  from  physical  cognitive  and  emotional needs.

Disadvantages of Artificial Feed

1.  Contamination:  Artificial feeds are often contaminated with bacteria especially if the mother is using feeding bottle. Bottles are difficult to clean and need to be boiled after every feed. Bacteria grow in artificial feed very quickly, especially in feeding   bottle.
2. Infections:  Artificial feed do not have any anti infective factor. Artificially fed babies are ill more often with diarrhoea    other infections will take place if the feeds are not hygienically prepared.
3. Persistent  Diarrhoea : In artificial fed babies ,diarrhoea  is  more  likely to become  persistent ,that is  to continuous  for  more than two weeks. Persistent diarrhoea is difficult to treat and it may lead to severe under nutrition. It is sometimes necessary to stop giving the baby artificial milk feeds to cure the conditions.
4. Lack of  Iron: The  iron  from the  cow ‘s milk is  not  absorbed completely as it  is absorbed from  breast milk. An artificial fed baby may develop iron deficiency, but added iron may increase the risk of infection in the baby.
5. Too much Salt: Cow’s milk contains too much of salts which may sometimes cause hypernatraemia and fits, especially in child who is suffering from diarrhoea.
6. Unsuitable fat: Cow’s milk contains more saturated fatty acid s than breast milk. For healthy growth, a baby needs more unsaturated fatty acids. Cow’s milk does not contain enough of the essential fatty acid like  linoleic acid, they contain enough cholesterol .Dried skim milk contains no fat so it should never be used for infants.
7. Unsuitable  Protein: Cow’s milk contains  too much of  Casein  protein ,casein contains  an  unsuitable  mixture  of amino acids which are difficult for  the  baby’s immature kidneys  to excrete. However   diluted milk may not contain enough of   the essential amino acids, cystine and taurine which needed for baby’s growing brain.
8. Indigestion: Cow’s milk is more difficult to digest. It does not contain the enzyme lipase to digest the fat. Casein form  thick indigestible  curds, because cow milk digest slowly, it  fills  the  stomach for  longer duration   than the  breast milk ,so that the baby does not become  hungry again as quickly as he  should .The  baby stool becomes  thicker and  harder and  he become  constipated.
9. Allergy: Babies who are fed on cow’s milk are more likely to develop allergic problems, example asthma and eczema and cow milk intolerance.
10. Sucking problems: baby who learns to suck from the breast may refuse to take Cow milk. A few bottle feeds can cause breastfeeding failure.
11. Expense: Poor mothers may be unable to buy enough Infant Formula Milk for their babies. They can give too few feeds and sometime they may place little milk or milk powder into each bottle. Bottle fed babies can also become malnourished.

History of Breastfeeding

In ancient time’s infants were accompanied along with their mother for the purpose of feeding.

1. In Egyptians, Greeks and Roman Empires, women usually feed their own children.
2. Royal Family employed the nurses to feed their infants .The concept of Wet nurses were introduced. With the passage of time in certain countries employed noble women instead of wet nurses to nurse their infants. But the lower-class women fed their infants and used wet nurse only if they are unable to feed their own baby.
3. In 15th Century use of  Cow or Goat milk, but these attempts were not successful.
4. In 18th Century ,flour and  Cereal were used as substitute  of  Breast feeding  which did  not  have  the  favorable  outcome.
5. 18th and 19th Century during   Industrialization revolution women workers   were employed in the  workforce due  to their  work requirement    urban centre were created where  mother breastfed their  infants.
6. In 1900 to 1960 Breast feeding decline due to development of artificial infant formula, this created negative impact towards breastfeeding in the community.
7. In MID 19TH CENTURY Affluent societies of Canada and USA started developing negativeapproach regarding practice of breastfeeding. To breast fed the infants   was more popular among lower class. The affluent class considered as uncultured approach and looked to this problem as disgust. To coincide with the problem, extended infant formula was introduced in mid 19^th Century, and the use was accelerated during World War II.
8. From 1960 to 2000 Efforts were made to revive the importance of breast feeding practices, but still the negative attitude prevails in the society.
9. On April 28, 1988, a meeting was held on definitions related to breastfeeding. The meeting was sponsored by the Interagency Group for Action on Breastfeeding (IGAB), an ad hoc working group of representatives from UNICEF, United States Agency for International Development (USAID), SIDA, and WHO. In addition to these organizations, the meeting was attended by or input and review were received from the International Lactation Consultants Association (ILCA), LLLI, the Population Council, the International Baby Food Action Network (IBFAN), Johns Hopkins School of Hygiene and Public Health, Well start International, Family Health International, and the technical secretariat, Georgetown IRH/Breastfeeding Division.