Exclusive Breastfeeding WHY AND HOW WE SHOULD SUPPORT

Exclusive Breastfeeding WHY AND HOW WE SHOULD SUPPORT THE PATIENTS SUCCESS IN THIS INITIATIVE KELLY GUTTENBERG RNC

Breast feeding is well recognized as the best source of nutrition for newborns.

World Health Organization The World Health Organization (WHO) (2011) recommends: • Exclusive breastfeeding for six months. • At six months, foods may be introduced with continuation of breast feeding for up to two years of age. Breastfeeding “promotes sensory and cognitive development, and protects the infant against infections and chronic diseases” (WHO, 2011) Breastfeeding can “reduce infant mortality due to common childhood illnesses such as diarrhea or pneumonia”, and speed up recovery from an illness. (WHO, 2011)

Benefits of Exclusive Breastfeeding BENEFITS TO NEURAL DEVELOPMENT • Increases in cognitive scores • Increases in fine motor skills • Increases in gross motor skills • Increases in problem solving • Increases in personal-social skills & Murray, 2012) (MCCrory

Benefits of Exclusive Breastfeeding SOURCE OF IMPORTANT Ig. A IMMUNOGLOBULIN Adheres to mucosal surface to help prevent diseases that enter through the mucosa (such as rotavirus and E. Coli), causing diarrhea and pneumonia Enhances immune response of infant, particularly to those antigens present in mothers and thus infants environment. (Brandtzaeg, 2010; Van de Perre, 2003)

Benefits of Exclusive Breastfeeding DEVELOPMENT OF HEALTHY GUT MICROBES Breast milk is the source of two prevalent probiotics, Lactobacillus and Bifidobacterium. They assist in the proper processing of nutrients and setting up a healthy gut microbiota. This healthy gut can have an effect on health processes throughout ones life. The microbes found in breast milk are unique in that the mammary glands ordinarily do not have microbes; only during lactation do they present. (Fernandez et al. , 2013)

Disruption of Infant Gut Microbes Delivery by Cesarean Section � With a vaginal birth, infant is exposed to its mothers’ flora, through the birth canal. � Cesarean born, infant exposed to hospital environment and the people and the microbes there, setting up different flora. (Azad et al. , 2013) Formula Feeding � Sets up more alkaline environment � The ‘good’ bacteria, prefers the more acidic environment. � The disease causing bacteria prefer the more alkaline environment and are more prevalent in the formula fed infant. ( Walker, n. d. )

• Inflammatory bowel disease • Necrotizing enterocolitis • Diabetes • Obesity • Cancer • Allergies • Asthma Disruption of these healthy microbes “has been linked to an increasing number of diseases” (Azad et al. , 2013, p. 1)

Non Exclusive Breastfeeding MEDICAL ISSUES • PRETERM – Admission to the NICU, separation from mother • LATE PRETERM – Delayed sucking, hypoglycemia, hypothermia • HYPOGLYCEMIA – Symptomatic, treat Asymptomatic, safe to breastfeed (Ayton 2012) et al. ,

Non Exclusive Breastfeeding PSYCHOSOCIAL ISSUES • Personal Preference • Breasts Perceived as Sexual • Family Tradition • Discomfort • Time Costly(Smith & Forrester, 2014)

Non Exclusive Breastfeeding • Women who choose not to breast feed should not be made to feel guilty • It is the nurses responsibility to make sure the woman is educated on breast versus formula feeding

Support of Exclusive Breastfeeding NEED FOR SUPPORT FROM Hospital staff Home and Family Community Workplace

Support from Hospital Staff Women who felt their Care Providers were supportive of breastfeeding were more likely at one and three months postpartum, to still be exclusively breastfeeding. (Ramakrishnan et al. , 2014)

Written Policy 2. Trained Staff 3. Educated Mothers 4. Initiate Breastfeeding Within a Half Hour of Birth 5. Demonstrate How to Mothers, Even with Separation 6. Nothing Other Than Breast Milk, Unless Medically Indicated 7. Rooming In 8. Breastfeeding On Demand 9. Give No Artificial Teats or Pacifiers 10. Establish Breastfeeding Support Groups and Refer Mothers to Them at Discharge 1. Ten Steps to Successful Breastfeeding Attaining the baby friendly status (WHO, 2010)

Your support in initiating early breastfeeding, assisting new mothers with breastfeeding, educating new mothers about the benefits of exclusive breastfeeding along with the effects of formula feeding will help establish and support exclusive breastfeeding success. Exclusive Breastfeeding Initiative Success