Breast Feeding
The World Health Organization and the American
Academy of Pediatrics recommend human milk as the exclusive
nutrient source for the first 6 months of life, and indicates that
breastfeeding be continued at least through the first 12 months
of life, and thereafter as long as mother and baby mutually
desire.
The scientific rationale for recommending breastfeeding as the
preferred feeding choice for infants stems from its
acknowledged benefits to infant nutrition; gastrointestinal
function; host defense; neurodevelopment; and psychological,
economic, and environmental well-being
Infant Feeding
The first decision that parents make regarding infant nutrition is
the decision to breast feed or bottle feed their newborn.
Although the composition of infant formula is similar to that of
breast milk, breast milk is still considered to be the best option
for optimal health promotion and disease prevention in the
newborn. Research provides good evidence that breastfeeding
decreases the rate of postneonatal infant mortality (21%), and
reduces the incidence 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 rates in preterm infants.
Benefits of breastfeeding:
 Decreased incidence of bacterial and viral infections as a
result of passive immunity, acquired via the transfer of
maternal antibodies.
 Breastfed infants are less likely to develop allergies,
gastrointestinal tract diseases, respiratory tract diseases,
ear infections, UTI, RTI, and childhood obesity.
 The maternal transfer of antibodies and immune factors
enhances development of the immune system and
facilitates the neonate’s immune system response. The
longer the time that an infant is breastfed, the stronger the
protection against infection and the earlier the maturation
of the infant’s immune system.
 In addition, some studies have indicated that breastfed
infants experience lower rates of diabetes, lymphoma,
leukemia, Hodgkin’s disease, and sudden infant death
syndrome
 Human breast milk contains more carbohydrates, less
protein, and less casein than cow’s milk or infant
formulas; which facilitates its digestion
 At 1 year of age, breastfed infants are leaner than their
formula-fed counterparts and obesity in later life.
 Infants who have been breastfed have a lower incidence of
OM than those who have been bottle fed. The number of
episodes of OM decreases significantly with increased
duration and exclusive breastfeeding.
 Breast milk contains immunoglobulin A (IgA), which
offers protection against allergies and viruses.
 Breastfeeding is also associated with slight improvements
in cognitive development in both term-born and
prematurely born infants, although the benefits appear to
be greatest for the latter group of infants
Mother:
 The total energy cost to a woman who is exclusively breastfeeding
an infant 0 to 6 months is estimated to be 500 kcal/day; could
result in 0.5 kg/week of wt loss.
 Breastfeeding results in a faster rate of postpartum weight loss than
formula feeding; 0.6–2.0 kg /12 months.
 Breastfeeding facilitates changes in body composition; fat is
mobilized from the trunk and thigh areas
Table 4-2 Infant Feeding Patterns
Birth–1 month
Breast every 2–3 hours----Bottle every 3–4 hours
2–3 oz. per feeding
2–4 months
Breast or bottle every 3–4 hours
3–4 oz. per feeding
4-6 months
Breast or bottle 4-6 times per day
4-5 oz. per feeding
Iron-fortifi ed rice cereal
Breast or bottle 4 times per day
6–8 oz. per feeding
6–8 months
8–10 months
Finger foods
Chopped or mashed foods
Sippy cup with formula, breast milk, juice or water
Breast or bottle 4 times per day
6–8 oz. per feeding
10–12 months
Self-feeds with fi ngers and spoon
Most table foods are allowed
Breast or bottle 4 times per day
6–8 oz. per feeding