Feed to Thrive - English Version (Primary module)

Feed to thrive

Your guide to breastfeeding

Contents Breastfeeding - A comprehensive guide 4

Why should you breast feed your child?

6

When to start?

7

Advantages of breastfeeding for mother

11

Origin of Breastfeeding Skin-to-Skin Kangaroo Care

12

Breastfeeding Positions

14

Breastfeeding Problems

17

Myths vs Facts

Nutrition and Breastfeeding 21

Colostrum - The Golden Liquid

23

Artificial Foods

24

WHEN BREAST FEEDING ENDS TOO EARLY...

25

Weaning : NO RUSH TO MUSH

28

Use of Pacifiers

Vulnerable groups and Breastfeeding 29

Breastfeeding at Workplace

31

Breastfeeding in HIV

32 34

Breastfeeding after Cancer Breastfeeding in Non-Binary Parents

Breastfeeding - Role of the community 36

Baby Friendly Hospitals

It is an unsentimental metaphor for how love works in a way- you don't decide how much and how deeply to love, you respond to the beloved and give with joy exactly as much as they want....

-Marni Jackson

Why should you breast feed your child?

Breast milk contains all the essential nutrients necessary for the first 6 months of an infant's life.

Breast milk also helps maintain immunity for the first 6 months and protects your child against infections.

It could also save your child from non communicable diseases like asthma, diabetes and also reduce incidence of obesity in the future.

Advantages of breastfeeding for baby OPTIMAL BRAIN DEVELOPMENT Studies suggest that breastfeeding in linked with increased cognitive development.

REDUCED RISK FROM VARIOUS DISEASES Breastfed infants have a 60% less chance of dying from SIDS. They're also less affected by ear infections and allergens. (due to colostrum). Breastfeeding also increases positive response to immunization.

OPTIMAL ORAL DEVELOPMENT Breastfeeding facilitates optimal oral development due to various jaw movements. Nutrients in breast milk decrease risk of tooth decay.

LOVE, AFFECTION AND COMFORT Comfort nursing is a natural way to calm an upset baby Sucking releases the hormone cholecystokinin in both parent and baby, which results in a sleepy feeling.

When to start?

WHO and UNICEF suggest to start breastfeeding within 1 hour of birth EXCLUSIVE BREAST FEEDING (Only breast milk- no additional food or water) First 6 months of life

After 6 months, Breastfeeding should be continued.

Complementary foods that are nutritionally adequate should also be given.

Advantages of breastfeeding for mother BREASTFEEDING IS A NATURAL ANTICANCER MECHANISM Breast feeding for more than 12 months reduces the risk of breast cancer by 26% and ovarian cancer by 13%.

BREASTFEEDING ALSO ACTS AS A NATURAL CONTRACETPIVE MECHANISM Continued breast feeding could delay returning back to fertility contributing to longer birth intervals even in absence of contraceptives

BREASTFEEDING IS ALSO BENEFICIAL RIGHT AFTER BIRTH Breastfeeding releases a hormone called oxytocin,which helps the uterus contract back to prepregnancy size, decreasing postpartum bleeding. It also reduces the risk of infections after birth.

BREASTFEEDING IS BENEFICIAL FOR BONE STRENGTH It helps reduce the risk of osteoporosis in the mother, due to the release of hormones!

Does Breastfeeding protect Parent's Mental health?

New research shows how breastfeeding lowers parent's risk of depression, helps them get more sleep, and overcome past adversity.

Breastfeeding does not deplete parents, nor does it cause depression.

Breastfeeding problems certainly can do both of these things – all the more reason why women need good support and accurate information. But it does not make sense for something so critical to the survival of our species to be harmful for parents. And it is not.

Comparison between feeds Research reports that breastfeeding parents had a significantly higher energy level throughout the day, in comparison to mixed fed and formula fed infants.

When a parent is depressed--or even at risk, she is often advised to supplement with formula so that they can get more sleep. However, recent studies suggest that breastfeeding actually lowers parent's risk for postpartum depression.

Despite popular belief, Results of recent studies suggest that exclusively breastfeeding parents actually get more sleep than their mixed- or formulafeeding counterparts.

Origin of Breastfeeding Skin-to-Skin Kangaroo Care

Immediate skin-to-skin contact after birth helps initiate breastfeeding. When the baby suckles, beneficial bacteria from the parent and their environment will colonize the infant’s microbiome and may help the infant digest food, while training the immune system to recognize bacterial allies and enemies.

"Kangaroo Care" Infants are held upright, skin-to-skin on the parent's bare chest.

Researchers found that babies who were held close to their parents' bodies for large portions of the day not only survived, but thrived.

Mortality rates plunged from 70 percent to 30 percent.

Benefits of Kangaroo Care Healthier Heart Rate and Respiration

Reduced Fetal Stress and Pain & Better Sleep for Baby

Prevention of Postpartum Depression

Boosted Mental Development

Promotion of Healthy Weight

improves bond between parent and infant

Increase supply of breast milk

Maintains appropriate temperature of infant

Better Adaptability Outside the Womb

Breastfeeding Positions For just about every new parent and baby, the first attempts at breastfeeding are haphazard, at best.

But proper positioning is essential in helping your newborn latch on the right way, as well as preventing nipple soreness and other problems.

POSTIONS FOR BREASTFEEDING: LAID-BACK BREASTFEEDING OR BIOLOGICAL NURTURING Encouraging baby’s natural breastfeeding instincts.

Particularly helpful for parents who have smaller breasts, for newborns and for babies with super sensitive tummies or excess gas.

CRADLE POSITION

The cradle position is most commonly used after the first few weeks. The cross-cradle position gives you more control.

FOOTBALL HOLD POSITION It also helps when a after a forceful milk ejection reflex.

Useful if you Had a C-section, have Large breasts or Twins

SIDE-LYING POSITION Many parents find lying down to nurse a comfortable position, especially at night.

Breastfeeding Positions For just about every new mom and baby, the first attempts at breastfeeding are haphazard and hapless, at best. But proper positioning is essential in helping your newborn latch on the right way, as well as preventing nipple soreness and other breastfeeding problems.

POSTIONS FOR BREASTFEEDING: 1.

LAID-BACK BREASTFEEDING OR BIOLOGICAL NURTURING Encouraging baby’s natural breastfeeding instincts.

Particularly helpful for moms who have smaller breasts, for newborns and for babies with super sensitive tummies or excess gas.

2.

CRADLE POSITION The cradle position is most commonly used after the first few weeks. The cross-cradle position gives you more control.

3.

FOOTBALL HOLD POSITION It also helps when a mother has a forceful milk ejection reflex.

Useful if you Had a C-section, have Large breasts or Twins

Breastfeeding Problems and solutions-1

Latching On

Baby's Mouth should cover the lower areola, while the upper part should be slightly visible.

Clogged Ducts

Get plenty of rest Massage the breasts Apply a warm compress Mastitis

Treat with antibiotics Empty your breasts as often as you can

Breastfeeding Problems and solutions-2

Low milk supply

Nurse your breasts and pump as often as possible

High milk supply

Breastfeed more frequently Baby sleeping on breast

Start feeding baby when breasts are more full Tick;e the feet of your baby

Breastfeeding Problems and solutions-3

Painful let-down of breasts

Check for infection Feed on one breast and shift only if necessary

Cracked nipples

Breastfeed more often at shorter intervals Moisten nipples with breastmilk after feeding Oral thrush in baby

Associated with sore and cracked nipples Anti-fungal cream Treat sore nipples

MYTHS VS

FACTS

MYTH

FACT

Feeding usually hurts and leads to sore nipples and is painful

With the right positioning and nipple attachment, breastfeeding is a joyful experience

MYTH

FACT

It isn't necessary wash them You should tobefore always wash feed. The each nipples your nipples secrete a before chemical which breastfeeding keeps them clean and safe for the baby.

MYTH

FACT

Parent must consume only simple foods when breastfeeding

A nutritious balanced diet should be consumed. There is no need to make a drastic change in diet. In cases of any allergy, consult a specialist.

Colostrum - The Golden Liquid

Colostrum is the first stage of breast milk.

Colostrum is yellow and thick in consistency or can appear clear and runny.

It contains:

Fat – Low amount for easy digestion (also lower in lactose than mature milk) Antibodies leukocytes, IgA, IgG, IgM – Protects baby against disease (these are high in concentrations) Protein – High in protein, which supplies rapid growth Lactoferrin – Protects baby from infection, is antiinflammatory and aids with iron absorption WHY IS COLOSTRUM IMPORTANT?

Colostrum delivers its nutrients in a very concentrated low-volume form.

It has a mild laxative effect, encouraging the passing of the baby's first stool, which is called meconium. This further aids in jaundice prevention.

Ingesting colostrum establishes beneficial bacteria in the digestive tract.

Adding water to the feed

During the period of exclusive breastfeeding- it is not necessary to give water to infants; provided the quantity of breast milk is sufficient

Contaminated water may lead to diarrhea and other infections in the infant.

Adding water to the feeds can also decrease consumption of breast milk, thereby leading to early weaning.

Artificial foods as feeds

MORE CHANCES OF DIARRHOEA

INCREASED CHANCES OF LUNG INFECTIONS

MORE PRONE TO EAR INFECTIONS

IINCREASED RATES OF HOSPITALISATION

WHEN BREAST FEEDING ENDS TOO EARLY...

You are likely replacing the feed with a nutritionally weaker supplement.

Increased risk of malnutrition

DECREASED CONTRACEPTIVE ACTION AND INCREASED CHANCES OF CONCEPTION

Hindered intellectual development

Weaning : No rush to mush

STARTING AT AROUND 6 MONTHS

A recent research by the World Health Organization (WHO), shows that babies can get all the nutrients they need from breast milk or infant formula until they are around 6 months old. This gives a baby’s digestive system time to develop so that they can cope fully with solid foods.

Your baby is ready for weaning if they can:

Sit without support Baby should be able to sit without support and hold their neck steady Co-ordinate their eyes, hand and mouth So that they can look at the food, pick it up and put it in their mouth without help.

Swallow food

Babies who are not ready will push their food back out, so they get more round their face than they do in their mouths!

Weaning : NO RUSH TO MUSH FOOD INTRODUCTION: AROUND 6 MONTHS OF AGE

Start with Soft foods No added salt or sugar, and no honey.

Offer one meal a day. Offer only 1 or 2 pieces of food at a time Milk should be the main source of nutrition Create a habit of drinking water from an open cup Examples : Meat, tuna patties, peanut butter toast, fish, cooked eggs (all are great sources of iron), ripe fruits, cooked veggies, and avocados.

7-8 MONTHS: GAINING SKILLS, CONFIDENCE AND APPETITE

At 7 months of age, start introducing iron-rich foods.

Create a habit of using cutlery. Aim for 2 meals per day.

Try to offer soft finger foods at this stage to give your baby plenty of practice chewing.

Foods rich in iron include red meat such as beef, lamb or pork and dark poultry meat, as well as oily fish.

Vegetarian sources include beans, lentils, chickpeas and hummus, dal, fortified breakfast cereals, ground nuts or nut butters and green leafy vegetables.

Weaning : NO RUSH TO MUSH PINCER GRASP STAGE- 9 TO 12 MONTHS

Solid food is now the main source of nutrients.

Offer milk during mealtime or breastfeed on demand.

Offer smaller pieces of bite-sized food for baby to grab. Mix things up to expose baby to various textures. Serve dairy products as-is.

Examples : Starchy foods, like potatoes, pasta rice, bread/toast or breakfast cereal. Fruit and vegetables. Meat, tofu, fish, eggs, pulses or nut butters –to give your baby plenty of iron. Full-fat dairy products like cheese and yogurt are packed with calcium, which is ideal for strong bones and teeth.

12+ MONTHS: BABY IS A PRO BUT MIGHT LEARN THAT BEING MESSY GETS YOUR ATTENTION!

Baby eats like a pro and likely has more and more teeth, helping with the chewing.

Offer 3 meals and snacks every day. Baby should eat like the family.

Low fat foods are not recommended for babies.

Examples : Full-fat, unsweetened or plain yoghurts are a good choice because they don't contain added sugars.

Bread and butter, ham sandwich, carrot and cucumber sticks with some bread sticks, crackers with cheese, bananas, iron fortified cereals, ground and crushed nuts, nut butters and pulses –dal, lentils and chickpeas.

Use of Pacifiers Pros

Cons

CAN CALM DOWN A CRYING BABY

PACIFIER MAY CAUSE DENTAL MALFORMATIONS

HELPS BABY TO FALL ALSEEP

BABY BECOMES TOO DEPENDENT ON PACIFIER

HELPS DISTRACT THE BABY AT TIME OF SHOTS, BLOOD TESTS ETC.

Baby might become used to the pacifier, thereby reducing suckling reflex and breastfeeding

Breastfeeding at the workplace Breast milk has bio-active components which cannot be reproduced. It is therefore very important that, once a parent returns to work, her child continues to be breastfed.

Breastfeeding rooms at work not only reduce absentees, but also increase the retention of employees who are breastfeeding, thereby benefiting the company as well.

The child receives all the necessary nutrients from breast milk, at the right temperature in the correct quantity- adapting to it's needs of the baby throughout their growth and devlopment.

Breastfeeding room at the workplace Paper towel Power Outlet

Wash Basin Garbage can

Comfortable chair

Storage box at least 20 cm above the ground

Private space

Breastfeeding in HIV Can Parents with HIV breastfeed their children?

Yes. WHO recommends that all parents living with HIV should receive life-long Antiretroviral Therapy (ART) to support their health and to ensure the wellbeing of their infants. parents living with HIV who are on ART and adherent to therapy should breastfeed exclusively for the first 6 months, and then add complementary feeding until 12 months of age. Breastfeeding with complementary feeding may continue until 24 months of age or beyond.

What can be done to support Breastfeeding parents with HIV? Governments and local authorities should actively promote and implement services to create a supportive environment for parents living with HIV to remain adherent to treatment and to breastfeed their infants in all settings: at work, at community centers, in health clinics, and in their homes

Breastfeeding after Cancer Can you breastfeed after or during Hormone Therapy?

After a mastectomy, the breast involved may not be able to produce much milk, if any at all. It depends on how much of the breast tissue was removed.

Radiation therapy, which often follows a mastectomy, can cause damage to any remaining breast tissue, decreasing your chances of breastfeeding. Breastfeeding is not possible while undergoing chemotherapy.

Unilateral mastectomy (Removal of single breast)- Many women produce enough – or nearly enough – milk for their baby with just one breast. .

Can you breastfeed after or during Hormone Therapy? parents on hormone therapy, such as Tamoxifen, are advised not to breastfeed while on this medication as it may pass to their baby in their breastmilk.

Some parents might offer initial feeds of colostrum for a day or two before resuming hormone therapy. For parents whose overall risk of breast cancer is lower, a break of a few months might be a possibility.

COVID-19 And Breastfeeding COVID 19 SUSPECTED OR CONFIRMED PARENTS CAN ALSO BREASTFEED FOLLOWING THESE GIVEN MEASURES

WASH HANDS BEFORE BREAST FEEDING

COUGH/SNEEZE INTO A TISSUE AND DISPOSE IT

WEAR A MASK (EVEN IF MASK IS UNAVAILABLE YOU CAN BREASTFEED)

CLEAN ALL THE SURFACES YOU HAVE TOUCHED

Breastfeeding in non-binary parents Transwomen and Breastfeeding Yes. People who were assigned female at birth and who have nipples may be able to produce milk.

Requirements : Hormone replacement therapy Inducing lactation Breastfeeding goals

Transmen and Chestfeeding

Yes. People who were assigned male at birth can usually breastfeed.

Requirements : Language Gender dysphoria Testosterone use Top surgery Chestfeeding goals Supporting the decision not to nurse

Breastfeeding in non-binary parents It is not necessary to be fertile—or even to have ovaries or a uterus—to breastfeed.

WHY WOULD A NON-BINARY PARENT CHOOSE TO BREASTFEED OR CHESTFEED?

Attachment Breastfeeding helps the parent and baby form a secure attachment.

Nutrition Human milk provides the optimal nutrition and necessary immunity for human babies.

Healing Breastfeeding can help heal the heartache of infertility, and provides a biological connection between mother/parent and baby.

BABY FRIENDLY HOSPITALS

Hospital Policies

Do not promote infant formula, bottles and teats.

Adopting standard practices conducive to breastfeeding.

Maintaining proper supportive resources for feeding

Staff Competency Training staff to support parents during breastfeeding

ANTENATAL CARE Training the parent on the proper methods of breastfeeding.

It is important to guide the parent through the process, and prepare them for what's to come.

Care right after birth Encourage Skin-to-skin contact immediately after birth and breastfeeding within 30 mins.

Facilitate proper latching and attachment of the baby to the mother's breast.

Support parents with breastfeeding

PROVIDING PRACTICAL BREASTFEEDING SUPPORT

HELPING PARENTS WITH COMMON BREASTFEEDING PROBLEMS

ENSURING CORRECT POSITIONING, ATTACHMENT AND SUCKLING

Supplementing PRIORITISING DONOR HUIMAN MILK WHEN SUPPLEMENT IS NEEDED.

GIVING ONLY BREASTMILK UNLESS MEDICALLY CONTRAINDICATED.

GUIDING PARENTS THROUGH FORMULA FEEDS, IF NEEDED.

ROOMING IN LETTING PARENT AND BABY STAY IN CLOSE PROXIMITY FOR LONGER DURATIONS.

IF THE BABY IS SICK, ENSURE THAT THE PARENT IS AS CLOSE TO THE CHILD AS POSSIBLE AND AID FEEDING.

Responsive feeding

HELPING PARENTS IDENTIFY SIGNS OF HUNGER AND FEED THE INFANT ACCORDINGLY. NOT LIMITING FEEDS; AND COMPLETING EACH FEED.

Bottles, teats, and pacifiers SUPPORT EQUIPMENT HAS IT'S OWN SET OF PROS AND CONS. COUNSEL PARENTS ON USE AND RISKS OF FEEDING BOTTLES, TEATS, AND PACIFIERS

Discharge REFERRING PARENTS TO COMMUNITY RESOURCES FOR BREAST FEEDING SUPPORT AND WORKING WITH THESE COMMUNITIES TO IMPROVE SUPPORT SERVICES.

Credits Coordinators

Vishnu Bharadwaja (Chair 2020-21) Chetana Rajesh (Chair 2021-22) Shreya Durve (Vice Chair 2021-22) Content

Pooja Koormachalam Satwik Kuppili Design Coordinator

Shreya Durve

Translators

Chetana Rajesh & Shreya Durve (Hindi) Satwik Kupilli (Telugu) Zubeidaa Fathima (Tamil) Sijin Wilson (Malayalam) Sushith (Kannada)

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