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Breastfeeding the Turning Point in 2010

By etavares On 30 November, 2010 Open Space | 2010 Comments Off on Breastfeeding the Turning Point in 2010 No tags

Breastfeeding is the Gold Standard of infant nutrition. Given the indisputable evidence of advantages for the mother, child, and community health in general, all health professionals should promote, and support it by taking a strong and clear position in favour of breastfeeding.
It is recommended that, except in rare individual circumstances which may be unfavourable, all children should be feed exclusively with breast milk for a period never less than six months that may be extended after the start of food diversification until 24 months of age.
Recent studies show that exclusive breastfeeding during a period of 6 months is associated with less infections with a less severe level during the first 12 months of life.

Multiple international organizations including WHO and UNICEF recommend a goal for the health programme in 2010 that 50% of infants worldwide would exclusively be breastfeed during the first 6 months of age and 25% during 12 months.

In 1990 WHO and UNICEF, launched the challenge called “The Friend’s Baby Hospital” in order to promote breastfeeding worldwide. To achieve this accreditation it has been established a set of measures called “Ten Steps to Succeed in Breastfeeding”. To be approved each hospital must achieve a rate of 80% of the overall criteria established for each step. In Portugal, the first hospital to be approved was Hospital Garcia de Orta, at Almada, in 2000. Since then many other hospitals have been approved.

Hospital de Santa Maria-CHLN is presently preparing its application to be approved by the referred international programme, which is considered as a quality certificate of health care services to the community.

Although natural, breastfeeding must be learned and promoted by health care professionals.

So, decision about breastfeeding should be done on a conscious and well reasoned basis, due to its importance.

The decision about breastfeeding should be properly supported and well planned in order to avoid some problems that may happen.
Breast milk is a living food, plain and natural, with benefits for the baby and mother, giving socio-economic benefits to the community.

Advantages of breast milk for the child are nutritional, anti-infectious, immune and cognitive.

Several studies show a higher intelligence quotient in children who have been breastfed. It also has an important role in language development due to stimulation of facial muscles.

Breastfeeding provides significant social and economic benefits by having people living on a better health basis. Related costs due to the increase in calories given to the mother mean 50% of the amount spent in purchasing artificial milk.

The non-use of non-biodegradable products nipples, bottles, milk cans, etc, also protects the planet.

There are very few contraindications on breastfeeding, only on newborn with metabolic disease, or due to maternal causes as drug addiction, HIV infection, active untreated tuberculosis, treatment with anticancer drugs, immunosuppressants, and drugs with new action and use absolutely unknown to the mother.

Hepatitis B or C, maternal fever, hyperbilirubinaemia breastfeeding and cleft palate are not considered as contraindications.

It is crucial that the mother has empathy with the baby and feel confident in her ability to breastfeed.

Pleasant feelings like having fun with her baby, touch him, look at him or even hear him promote the ejection of milk. Unpleasant feelings such as pain during breastfeeding, doubts, insecurities or stress inhibit this reflex.

The confidence and pleasure during lactation are critical to the production and ejection of milk.

To make this process in a harmonious way is vital to have a good fit between the baby’s mouth and the breast.

There are three main reflections of the baby for breastfeeding: rooting reflex and grasping, sucking reflex and swallowing reflex.

These reflexes are automatic and do not have to be learned by the baby.

The success of breast-feeding does not mean only a good fit between the breast and the baby’s mouth, but also to breastfeed in a free time concept, or whenever the baby wants. In general the frequency of feedings varies from 8 to 10 feedings per day on the first four week s to 7-9 feedings a day after the 1st month.

Until the establishment of lactation (4-6 weeks old) there should be an interval of more than three hours during both day and night.
Also, the duration depends on the effectiveness of breastfeeding in general it takes about 10 to 15 minutes post partum and after the first month, most babies feel satisfied after a 8 to 10 minutes breastfeed.

The more the baby nurses, the more milk is produced

A proper assessment of the effectiveness of breastfeeding is essential for growth and development of the baby preventing situations of insufficient intake leading to dehydration and malnutrition which in severe cases can lead to hospitalization.
It is a clinical assessment based on breastfeeding history and elimination pattern, physical examination including signs of dehydration and jaundice; physical examination of mother’s breasts, observation of feeding (sucking pattern).
Graça Oliveira
Neonatology Service – Children and Family’s Department HSM-CHLN
oligraca@hotmail.com

_______________
Bibliography

1 Albuquerque M., Oliveira G., Abrantes M, Cunha A., Oliveira B. Aleitamento materno; A prática hospitalar e o sucesso do aleitamento até aos 6 meses de vida. Nascer e Crescer 1996;5:107-11.
2 Branco AS., Bastardo C., Albuquerque M., Oliveira G. Aleitamento materno: A prática e o e o sucesso das medidas de implementação do aleitamento materno até aos 6 meses de vida. Acta Pediatra. Porá., 2004; Nº5/6; Vol.35:441-445.
3 Poling G., Lathe C. Breastfeeding: The Essential Principles. Paediatrics in Review Vol.27 No.11 November 2006 409-417.
4 Garner LM., Morton J., Lawrence RA., et al. Breastfeeding and the use of human milk. Paediatrics 2005; 115:496.

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Index - News # 17 | out/nov. 2010
 Editorial Note
 Hospital for Small Children
 Recorded interview with Professor Gomes-Pedro
 Interview Professor Paulo Ramalho 
 T. Berry Brazelton, MD – João Carlos Gomes Pedro Homage
 Cultural Soirée of the 100th anniversary of FMUL
 Last Lecture by Professor João Carlos Gomes-Pedro
 Opening of the 2010/2011 Academic Year Ceremony – University of Lisbon
 Medicine Evening 2010
 Medical Students Street Party
 Facilities, Equipments, and Information Technologies Unit
 Invitation to Participate in the 13th “Education for Science” Workshop
 Publications FMUL/HSM/IMM
 Lecturers’ Participation in Academic Examination Panels in other institutions(by 31 October 2010)
 FMUL students awarded prizes at the 5th YES Meeting
 IMM Seminars
 An ongoing PhD thesis in Pediatric Research: Interventions and Outcomes in Clinical Trials of Bronchiolitis
 Words to Professor J. Gomes-Pedro
 Bags and Rucksacks: “weights” today and “burdens” tomorrow (PART I)
 Feeding newborn babies at risk
 Valuing Differences
 Sexual education in schools
 Health at Schools Programme
 Cardio-pneumologists at the Paediatric Laboratory For Respiratory Function Studies
 Neonatology, The perspective of a neonatologist at Santa Maria Hospital 
 Introduction to Medicine – Subject Development and Episodes in the Life of a Member of Staff
 Paediatric Origins of Chronic Pulmonary Disease in Adults
 Breastfeeding the Turning Point in 2010
 The importance of a multidisciplinary team in child development
 Science and Health Research 
 Hospital Indicators of the Pediatric University Unity
 Social Values Stock Exchange: “Is Laughing the Best Therapy?” Project
 Swine Flu (H1N1) Pandemics in Portugal (1918-2009): echoes and schisms of the past in the present
 Course “ABC of Clinical Genetics” 2010
 14th Annual Meeting of the Portuguese Society of Human Genetics – 18-20 November 2010
 Workshop “Looking for the Clown Inside You” – 20 November
 Food Bank Against Hunger – 27 and 28 November
 Caminho Book Market – From 29 of November to 17 of December
 ENJOY Med’10 – Deadline for submitting abstracts: 30 November
 Grande Prémio Fundação AstraZeneca 2010
 Obituary
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100 AnosPropriedade e Edição: Faculdade de Medicina da Universidade de Lisboa NIPC: 502662875  Periodicidade: Mensal  Diretor: Prof. Doutor Fausto J. Pinto Conselho Editorial: Prof. Doutor Fausto J. Pinto, Profª. Doutora Ana Sebastião, Prof. Doutor Mamede de Carvalho, Prof. Doutor António Vaz Carneiro, Prof. Doutor Miguel Castanho, Dr. Luís Pereira  Equipa Editorial:  Ana Raquel Moreira, Cristina Bastos, Isabel Varela, Joana Sousa, Maria de Lurdes Barata, Rui Gomes, Sónia Teixeira  Colaboração:  Gabinete de Relações Públicas, Internacionais e Comunicação  Versão Inglesa: AP|PORTUGAL- Language Services  Conceção: Metatexto, Lda. e-mail: news@medicina.ulisboa.pt  Sede do Editor e Sede da Redação: Avenida Prof. Egas Moniz, 1649-028 Lisboa Estatuto Editorial Anotado na ERC 

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