IMCI Bulletin #7- Breastfeeding

Use the following link
to download this document:
full text in PDF (390Kb)

Excerpt

Breastfeeding in the Americas

Evidence shows that breastmilk protects against infant diarrheal and respiratory infections, has positive effects on the motor and cognitive development of preschool and school aged children, and protects against chronic diseases such as diabetes mellitus, obesity and high blood pressure in the adolescent and adult years.

Breastmilk also has a positive effect on family economics since it provides all the energy and nutrients that an infant needs for the first 6 months of life, half of all energy and nutrients between 6 and 12 months and one-third of all energy and nutrients from 12 to 24 months. Breastfeeding has been associated with reduced risk of maternal breast and ovarian cancers, and faster return to pre-pregnancy weight. Women who exclusively breastfeed for 6 months and who have not yet resumed menstruation are also protected from pregnancy.

In spite of all the benefits and although the initiation of breastfeeding in Latin America is high (above 95%), the vast majority of women do not practice exclusive breastfeeding (EBF). Exclusive breastfeeding, defined as breastmilk being the only source of infant food and liquid, is more protective of health than partial breastfeeding and is critical to the health and survival of younger highly vulnerable infants. The WHO/PAHO recommendation is to exclusively breastfeed infants for the first 6 months of life and, after this age, introduce complementary foods and continue breastfeeding until their second birthday or beyond (WHA54.2, 2001)

WHO/PAHO recommends that:

• 1. Infants be exclusively breastfed for the first 6 months of life.
• 2. Infants be put to the breast within the first hour after birth.
• 3. Women give colostrum (the first milk of the breast, which a different texture and color and numerous immunological and developmental properties).
• 4. Complementary foods be introduced starting at 6 months of age.
• 5. Breastfeeding be continued into the second year of life and beyond.

Successful breastfeeding results from the interplay of a complex series of physiological and behavioral interactions between a mother and her infant (Figure 1). However, whether or not an infant is put to the breast and breastfed in a manner considered optimal depends on the interaction between two factors, a woman’s choice to breastfeed and her ability to act upon this choice. Maternal choice is influenced by the breastfeeding information the woman receives, as well as by the physical and social support provided to her during pregnancy, childbirth, and post-partum. Familial, medical and cultural attitudes and norms, demographic and economical conditions, legislation regarding infant and young child feeding and maternal/paternal employment, and national and international policies and norms are other factors that influence breastfeeding behavior.

The first month of life is the time when the protective effects of EBF on infant health and survival are the greatest; however, it is during this time that women are most likely to discontinue EBF. Although breastfeeding is a natural event, it is also a learned behavior, and unfortunately, in Latin America exclusive breastfeeding is not a cultural norm. Women who exclusively breastfeed their infants for 6 months have little support from their families and/or communities and are exposed to contradicting health system messages, and commercial and media messages. This, coupled with the challenges of everyday urban life, which often separate mothers from their infants within the first months after birth, limit their ability and discourage them from exclusively breastfeeding. As a result, the vast majority of women introduce liquids and/or other foods prior to 6 months (Figure 2).