COMMUNITY
BREASTFEEDING: OUR DUTY AS HCPS TO GIVE THE BALANCED PICTURE In the UK, breastfeeding rates are lower than most of Europe. Whilst almost three quarters of women started breastfeeding at birth,1 only a third were still breastfeeding at six months.2 Breastfeeding can be a highly emotive topic. Mums want to give their babies the best start in life and nutritionally speaking we know that breastmilk is the best option. “Breast is best”, not only for the infant but for the mother too: breastmilk provides the infant with protective factors that resist gastrointestinal, respiratory and ear infections.3 Breastfeeding is also associated with higher scores on intelligence tests in later life3 and it is also shown to protect the mother from breast cancer, improve birth spacing and it may even reduce ovarian cancer and Type 2 diabetes.3 Not only does breast milk supply nutrients, but the act of breastfeeding is calming for the baby and supports their mouth and jaw development.4 RECOMMENDATIONS
It is recommended that infants should be exclusively breastfed for the first six months of life, as breastmilk supplies all the nutrients the infant requires to develop and grow.4 Colostrum, the milk produced in the first few days after giving birth, is a concentrated source of nutrients for those early days when baby cannot take much in their tummy. Beyond six months, solids should be introduced to support the infant’s additional requirements and breastfeeding should be continued up to two years or beyond.4 It is tricky to make recommendations at this stage, as each mother and baby are variable in when and how much they wean, so some intuition and adjustment is required.
Mothers need to be in positive energy balance whilst breastfeeding, to account for meeting her own needs, plus the needs of the infant, as well as taking into consideration the extra energy that the body needs to produce breastmilk, and how efficient mum is at converting what she eats into breastmilk.
Priya Tew Freelance Dietitian, Dietitian UK Priya runs Dietitian UK, a freelance dietetic service that specialises in social media and media work, consultancy for food companies and private patient work.
NUTRIENT DEFICIENCIES
It is understandable that a mother may be concerned about providing enough nutrition for her baby. However, it should be reassuring that milk composition is very resistant to marginal deficiencies in maternal diet and micronutrient deficiencies are rare in breastfed infants, except if the mother is severely depleted pre/postnatally. Table 1 overleaf provides more detail on specific recommendations for maternal diets to ensure breastmilk volume and composition is adequate. Every baby is unique and whilst breastfeeding may come quite naturally to some mums and babies, to others it can bring its own set of complications and problems. There is the potential to over-simplify breastfeeding, leaving mums who find breastfeeding difficult, feeling that they are failing their baby. As healthcare professionals, we have a role to encourage and support breastfeeding, but also need to be aware of when to allow mums to know it is ok to stop.
Naomi Leppitt Dietitian Naomi is newly qualified, working as a Community Dietitian in Windsor.
REFERENCES Please visit the Subscriber zone at NHDmag.com
BREASTFEEDING SUPPORT
Breastfeeding support groups and counsellors can play a key role in www.NHDmag.com October 2019 - Issue 148
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