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Breast Development
Milk Glorious Milk
Initial Milk - Colostrum
Lasting for approx 1 week
40 ml/ day
High in protein and IgA
Less water, fat and sugar
Thick yellow/ cream colour
Mature Milk
Develops over the first few weeks
Decline in Igs and Protein
Increase in Fat and Sugar
90% Water; 7% Sugar (Lactose)
2% Fat; Minerals & Vitamins
Foremilk and Hindmilk
Develops as baby grows to cater for individual needs
Let Down Reflex – A Neuroendocrine Reflex
NB: Prolactin is controlled by Dopamine via tonic inhibition
CessationTwo primary reasons for cessation of milk production:
Weaning onto solids
Unable to breastfeed
Weaning onto solids
To maintain production, accumulated milk needs to be removed regularly (via nursing or expressing)
If not prolactin levels fall as does milk production.
As babies are weaned onto solids demand for milk naturally reduces .
Unable to BF
Most women can breast feed, but some should not. Alcohol misusers
Certain drugs – methotrexate, cyclosporine, lithium
Active TB
HIV
Breast Cancer Tx
Infant with Galactosemia
If not BF, do not bind, but wear supportive bra, and use ice packs and NSAIDS to ease pain. It will pass in 7-10 days when the body produces PIF (prolactin inhibiting factor
Breast Feeding Difficulties
2 in 3 women have difficulties with BF; Breast Feeding is not easy!!!
Cracked Nipples
Mastitis
S. Aureus
Thrush
Leaky boobs – not a problem as such, but irritating and embarrassing.
There are dedicated breastfeeding support groups run by hospitals to give advice and support to breastfeeding mums.
Breast Feeding Statistics 81% BF at Birth, falling to 69% at 1 week and 55% at 6 weeks
1 in 3 BF to 6 months compared to 1 in 4 in 2005
However… only 1 in 100 EBF at 6 months
Breast feeding levels highest in certain demographic groups: Mothers in Managerial/ professional occupations
Leaving education aged over 18
Aged over 30
Living in less deprived areas
From a minority ethnic group (Chinese and Black in particular)
BF levels are lowest in Under 20’s and those in the lowest socio-economic groups.
http://www.hscic.gov.uk/catalogue/PUB08694/Infant-Feeding-Survey-2010-Consolidated-Report.pdf
Advantages of BF
For Baby:
Lower Risk of…
Infection (GI, Resp, UTI, Ear)
Necrotising enterocolitis
Allergic disease
Insulin dependent DM
SIDS
Childhood Leukaemia
Likely to…
Have higher IQ
For Mum:
Promotes attachment
Involution of the Uterus
Prevention of RA
Lower risk of Breast and Ovarian Ca
Lower risk of hip fractures
Aids weight loss?
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)70002-1/abstract
For the Country:
£45 million could be saved by across the board increases in BF resulting in medical interventions necessary for both mother and child.http://adc.bmj.com/content/early/2014/11/12/archdischild-2014-306701.abstract
Weaning Not recommended before 6 months unless necessary; reduces
risk of infection and allergies.
Allows for optimal development of the GI tract and certain developmental miles stones before hand to make it safer. Able to sit up (S) and hold head up
Can bring things to mouth
Shows interest in food
Makes chewing motions
No Cow’s milk until 1 year then Full Fat Milk until 2 years
Slowly introduce potential allergens one at a time … eggs, wheat, nuts etc.
Balanced diet with plenty of Vitamins and Minerals (particularly iron and Vit D)
Food is for fun before one
Spoon Feeding
Using pureed and mashed foods fed to the child
Slowly introduce lumps and texture
Baby Led
Finger food
Small portions of your adult meal (without salt etc)
Let’s them discover with all their senses
Weaning
Obesity In a recently published study
94% of parents to overweight children did not recognise them as such… they were “Just about right”
Obese child (2-19 years) defined as a child with a BMI for age percentile above 95th
Approx 70% of toddlers regularly consume sweetened beverages
National Child monitoring programme BMI measured in reception
and year 6
