BREASTFEEDING
SEMINAR
PALMERSTON NORTH
1 9 TH S E P T E M B E R
DAWN HUNTER I BCLC
THE WORLD HEALTH
ORGANIZATION RECOMMENDS:
For OPTIMAL health:
• Exclusive breastfeeding for six months
• Continue breastfeeding up to two years and
beyond
This is the Gold Standard for infant feeding
Colostrum: the first milk. Various
colours: white, clear, yellow, pink,
brown to name some.
Formula
Breastmilk
An example: the yellowish colour is
attributed to beta-carotene a precursor
of vitamin A. The presence of this is
important for protection against infection
and eye development.
Amount produced in the first 24
hours 7 – 123mls with the average
production as 35mls.
Photo: Courtesy Rebecca Behre Idaho
The average amount a baby drinks in
the first 24hrs = 15+/-11g (Santoro
W Jr, Martinez FE, Ricco RG, Jorge
SM 2009)
Breastmilk is a dynamic fluid:
• ‘preterm’ milk,
• colostrum,
• transitional milk,
• mature milk,
• weaning milk,
• foremilk and
• hindmilk
Breastmilk
 Species specific
 Changes depending on stage of




lactation
Preterm
Colostrum
• Transitional
• Mature
• Weaning
• Foremilk and hindmilk
Flavours variable – similar to
amniotic fluid
Contains antibodies
Colostrum can be several colours:
bright yellow, clear, white, light
brown or pink (bloody) as in the case
of ‘rusty pipes’
Breastmilk
 Human milk stimulates the maturation








of the GI tract and stimulates the
baby’s own immune protection
Enzymes, hormones and growth factors
are higher in human milk than in other
species
Many influences on gut maturation and
protection e.g. enzymes, lipases,
pancreatic amylase
Low in casein; higher whey
Low protein compared to other species
Contains growth hormones, antibodies,
leucocytes and other cellular
components
Matches 50% of infant’s genetic
makeup!
Fresh and ready to use
100% natural
Foremilk & Hindmilk showing
different fat content
Breastmilk








Free
300+ components
Soft curds
Gastric ½ emptying time = 48mins
Breastfeeding = 645kcals/day=117,390kcals/6months =13kgms fat!
Nutritionally optimal until around 6 months of age
Contains contaminants:
 Chemicals in human milk may mean that 1: 1,000,000 may have an
increased risk of cancer (avoid contact contaminants if possible; for
example solvents in paint, dry cleaners, hair dye)
Contains stem cells
Breastfeeding is a relationship
Formula (A Breastmilk Substitute)
 Derived from a different species or plant base
 Higher in casein than breastmilk
 Genetically different from infant
 Easily contaminated (eg. enterobacter sakazakii)
 Has expiry date
 Manmade





Inert. Highly processed
Fed by bottle – risk of contamination
Shelf life affects ingredients
Same taste every feed, every day
Less than five long chain polyunsaturated fatty acids!
Formula




<100 components
Gastric ½ emptying time = 78 minutes
Tough less digestible curds
Costs money = ±$2000 per year
 No cellular component
 More illness = more absenteeism from work place
 Controlled by large multi-billion dollar companies
 Nutritional role only
 More alkaline pH
 Alters gut flora
Risks Associated with Formula Feeding for the Baby
Risks Include:
Asthma (Silvers K et al 2012, Gold M, Kemp A. 2005)
Atopic diseases (Oddy, W 2004, Matheson MC, Balasuriya
A et al 2007)
Lower cognitive function (Lucas, A et al 2001, Michaelson KF,
Lauritzen L et al 2009)
Obesity (Miralles O et al 2006, Weyermann M, Brenner H et al
2007, Huus K, Ludvigsson JF, 2008)
Types 1 & 2 Diabetes (Ip S, Chung M, Raman G et al. 2007)
Lymphoid malignancies (Bener et al 2008)
Rheumatoid Arthritis (Lankarani-Fard et al 2001)
Dental caries (Valaitis R, Hesch R, et al 2000)
Gastroenteritis (Talayero JMP, Lizán-Garcia M et al 2006)
Crohns disease (Klement E et al. 2004)
Coeliac disease (Akobeng AK et al. 2006)
Necrotising Enterocolitis (Sisk P, Lovelady C et al. 2007)
Appendicitis (Pisacane A. et al. 1995)
Risks Associated with Formula Feeding for the Baby
SIDS (Venneman MM, Bajanowski T et al. 2009)
Hypertension (Martin RM, Gunnell D et al. 2005)
Heart disease (Martin RM et al. 2005)
Leukaemia/childhood cancers (Ortega-Garcia JA,
Ferris-Tortajada et al 2007, Bener et al 2008)
Otitis media (Hetzner NM, Razza RA et al. 2008)
Bacterial meningitis (Silfverdal S, Bodin L, Olcén
P 1999)
Botulism (Heinig MJ 2001)
Ulcerative colitis (Rigas A, Rigas B, Blassman M.
et al. 1993)
Diarrhoea (Meinzen-Derr JK, Farkas T et al 2004)
Urinary tract infections (Marild S, Hansson S et
al 2004)
Risks Associated with Formula Feeding for the Mother
By not breastfeeding the mother has an increased risk of:
Bleeding following birth (Chua S et al. 1994)
Uterine Cancer (Rosenblatt KA et al. 1995)
Ovarian Cancer (Ip S, Chung M, Raman G et al. 2007)
Osteoporosis (Ip S, Chung M, Raman G et al. 2007)
Breast Cancer (Ip S, Chung M, Raman G et al. 2007)
Rheumatoid arthritis (Pikwer M, Bergström U et al. 2008)
Risks to infant health
…….. we know that artificial feeding is ‘risky for any baby’ (Minchin 1998)
A formula fed baby is:

five times more likely to go to hospital with diarrhoea

twice as likely to go into hospital with a chest infection

five times more likely to suffer from a middle ear infection

five times as likely to have an infection of their urine

twice as likely to develop eczema or a wheeze if they come from
an atopic family

if premature, twenty times more likely to suffer a rare but serious
condition, neonatal necrotising enterocolitis. A hundred lives per
year could be saved if all babies were fed their mother’s own milk
or donor milk

more at risk of sudden infant death syndrome

more likely to have reduced cognitive development and decreased
visual acuity
Kramer & Kakuma
Exclusive Breastfeeding
“When comparisons are being made with
breastmilk, an appeal of ‘no contest’ should be
recognised. Natural selection is an optimising
process, and the controlled trial for breastmilk,
with human survivability as the outcome
measure, has been in progress for a minimum of
240,000 years – or 8000 generations”
Dr Mike Woolridge
(Senior Lecturer in Infant Feeding at the School of Healthcare, Faculty of
Medicine & Health, University of Leeds)
References
1.
‘Optimal duration of exclusive breastfeeding (Review)’ Kramer MS and Kakuma R. The Cochrane
Collaboration. 2009
2.
‘The Optimal Duration of Exclusive Breastfeeding’ Report of an Expert Consultation. Geneva, Switzerland.
28-30 March 2001
3.
‘Weaning as a Natural Process’ Brylin Highton; LEAVEN, Vol 36, No 6. Dec/Jan 2001, p.112-114
4.
‘Influence of breast feeding on subsequent reactivity to a related renal allograft’ Kois WE, Campbell DA
Jr, Lorber MI, Sweeton JC, Dafoe DC. J Surg Res 1984 Aug;37(2):89-93
5.
‘The Effect of Breast-milk on Newborn Gut Maturation’ Marie Bosco. Fitgerald Health Education Assoc Inc
6.
‘Supplementation of the Breastfed Baby “Just One Bottle Won’t Hurt” – or Will It?’ Marsha Walker
7.
‘Volume and Frequency of Breastfeedings and Fat Content of Breast Milk Throughout the day’ Kent JC,
Mitoulas LR, Cregan MD, Ramsay DT, Doherty DA, Hartmann PE. Pediatrics 2006;117;e387
8.
‘Premature Delivery Influences the Immunological Composition of Colostrum and Transitional and Mature
Human Milk’ Castellote C, Casillas R, Ramírez-Santana, Pérez-Cano FJ, Castell M, Moretones MG, LópezSabater, Franch À. American Society for Nutrition 2011.
9.
‘Differential transfer of dietary flavour compounds into human breast milk’ Hausner H, Bredie WL,
Mølgaard C, Petersen MA, Møller P. Physiol Behav. 2008 Sep 3;95(1-2):118-24
10. ‘Bacterial Imprinting of the Neonatal Immune System: Lessons From Maternal Cells?’ Perez PF, Dorè J,
Leclere M, Levenez F, Benyacoub J, Serrant P, Segura-Roggero I, Schiffrin EJ, Donnet-Hughes A.
Pediatrics 2007; 119;e724
11. ‘The genome sequence of Bifidobacterium longum subsp. infantis reveals adaptions for milk utilization
within the infant microbiome’ Sela DA, Chapman J, Adeuya A, Kim JH, Chen F, Whitehead TR, Lapidus A,
Rokhsar DS et al. PNAS; Dec 2; 2008,Vol 105,No 48: pp.18964-18969
12. ‘Bioactive factors in human milk’ Margit Hamosh (2004)
13. ‘Human Breast Milk as a Source of DNA for Amplification’ Haas DM, Daum M, Skaar T, Philips S, Miracle
D, Renbarger. Clinical Pharmacology April 2011 51 (4)
References
14. ‘Breast milk: an unappreciated source of stem cells’ McGregor JA, Rogo LJ. Journ of Human Lactation
22(3) 2006
15. ‘The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis’ Bartick M and
Reinhold A. Pediatrics 2010;125;e1048.
16. ‘Breastfeeding Protects against Current Asthma up to six years of age’ Silvers KM, Frampton CM,
Wickens K et al. The Journal of Pediatrics 30 Jan 2012.
17. ‘Breastfeeding protects against adverse respiratory outcomes at 15 months of age’ Silvers KM, Frampton
CM, Wickens K, Epton MJ, Pattemore PK, et al. Maternal and Child Nutrition (2009),5,pp.243-250
18. ‘Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries’ Evidence
Report/Technology Assessment No. 153. April 2007.
19. ‘Does prolonged breastfeeding reduce the risk for childhood leukemia and lymphomas?’ Bener A,
Hoffmann GF, Afify Z, Rasul J, Tewfik I. Minerva Pediatr. 2008 Apr;60(2):155-61
20. ‘Association between infant feeding patterns and diarrhoeal and respiratory illness: A cohort study in
Chittagong, Bangladesh’ Mihrshahi S, Oddy W, Peat JK, Kabir I. International Breastfeeding Journal
2008; 3:28.
21. ‘Breast feeding and acute appendicitis’ Pisacane A, de Luca U, Impagliazzo N, Russo M, De Caprio C,
Caracciolo G. 1995 BMJ Volume 310
22. ‘Breastfeeding and Health Outcomes’ David Meyers. Breastfeeding Medicine Vol 4 2009
23. ‘Evidence on the long-term effects of breastfeeding: Systematic Reviews and Meta-analysis’ WHO 2007
24. ‘Early menopause is an independent predictor of rheumatoid arthritis’ Mitra Pikwer, Ulf Bergström, JanÅke Nilsson, Lennart Jacobsson, Carl Turesson. Ann Rheum Dis Oct 2011.
25. ‘A formula fed baby is ….’ Kramer & Kakuma (2002) Midwifery Digest 14:2 (2004)
26. ‘Did you ever wonder what’s in ……?’ Cecily Heslett, Sherri Hedberg and Haley Rumble 2007