Breastfeeding

last authored: Oct 2009, David LaPierre

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What is breast milk?

Breast milk composition is species-specific.

 

Colostrum

Colostrum is the first milk present for the first~3 days. It is thick and yellowish due to beta carotene. Volume is 2-20 ml. It has a high protein, low fat content.

High ash content, higher sodium, chloride, magnesium, protein, fat-soluble vitamins, immunoglobulins, mononuclear cells.

Lower potassium, calcium, lactose, glucose, urea, and fats.

 

 

Transitional milk

Colostrum is progressively mixed with newly produced milk during days 7-14.

 

Mature breast milk

Water is the biggest constituent. It is a complex collection of lipids and fatty acids - over 160 of them. These fats provide 50% of caloric intake, provide EFAs, help with absorption of fatty acids and fat-soluble vitamins, and provide cholesterol.

Proteins make up ~0.9%, including casein....

Immunoglobulins...

Iron and zinc is more efficiently absorbed.

Enzymes aid in absorption and preventing infection.

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Supplementation

Breastfeeding needs o be supplemented with:

• vitamin K
• vitamin D 400 IU/d
• fluoride
• iron

 

 

Benefits of breastfeeding

Enhanced maternal-infant bonding

Economical and convenient

Easily digested, with lower renal solute load

More rapid uterine involution

 

• Decreased risk of necrotizing enterocolitis
• protects against SIDS
• reduces risks of IDDM

 

 

 

Risks of Formula Feeding

• inadequate micro-nutrients and essential fatty acids
• risk of contaminated formulations and water
• decreased neurodevelopment and lower IQ
• higher incidence of allergic disorders
• higher overall morbidity and mortality

 

Learning to Breastfeed

coming soon

 

 

Difficulties Breastfeeding

Mastitis is not a contraindication for breastfeeding from that breast.

Babies initially latch first, then decide to take a break.

Give parents permission to mix with formula first.

The stress of meeting expectations can be very difficult.

Breast feeding jaundice: first 1-2 weeks due to a lack of adequate feeding and dehydration

Signs of inadequate breastfeeding include:

• <6 wet diapers daily after first week
• very sleepy or lethargic infants
• <7 feeds per day
• weight loss >10% birth weight
• jaundice

 

Contraindications

• maternal chemotherapy or radiotherapy
• HIV/AIDS
• active, untreated TB
• local varicella lesions
• increased alcohol/drug use
• relative contraindicated medications: bromocriptine, chloramphenicol, high dose diazepam, ergots, gold, metronidazole, tetracycline, lithium, cyclophosphamide

Resources and References

Public Health Agency of Canada - Ten Tips for Successful Breastfeeding

UK National Health Services - Supporting Breastfeeding Moms