Nome: Letícia Silva Belasco R.A:
Medicine
Breastfeeding,
also known as nursing, is the feeding of babies and young children with milk from a woman's breast Health professionals recommend that
breastfeeding begin within the first hour of a baby's life and continue as
often and as much as the baby wants. During the first few weeks of life babies
may nurse roughly every two to three hours and the duration of a feeding is
usually ten to fifteen minutes on each breast. Older children feed less
often. Mothers may pump milk so that it can be used later when
breastfeeding is not possible. Breastfeeding has a number of benefits to both
mother and baby, which infant formula lacks.
Deaths of an
estimated 820,000 children under the age of five could be prevented globally
every year with increased breastfeeding. Breastfeeding decreases the risk
of respiratory tract infections and diarrhea, both in developing and developed countries. Other
benefits include lower risks of asthma, food allergies, type 1 diabetes, and leukemia. Breastfeeding may also
improve cognitive development and decrease the risk of obesity in adulthood. Mothers may feel pressure to
breastfeed, but in the developed world children generally grow up normally when
bottle fed.
Benefits for
the mother include less blood loss following delivery, better uterus shrinkage, and less postpartum depression.
Breastfeeding delays the return of menstruation and fertility, a
phenomenon known as lactational amenorrhea. Long
term benefits for the mother include decreased risk of breast cancer, cardiovascular disease, and rheumatoid arthritis.
Breastfeeding is less expensive than infant formula.
Health
organizations, including the World Health Organization (WHO),
recommend breastfeeding exclusively for six months. This means that no other
foods or drinks other than possibly vitamin D are
typically given. After the introduction of foods at six months of age,
recommendations include continued breastfeeding until one to two years of age
or more. Globally about 38% of infants are only breastfed during their first
six months of life. In the United States, about 75% of women begin
breastfeeding and about 13% only breastfeed until the age of six months.
Medical conditions that do not allow breastfeeding are rare. Mothers who take
certain recreational drugs and
medications should not breastfeed Smoking, limited amounts of alcohol, or
coffee are not reasons to avoid breastfeeding.
Lactation
Changes early in pregnancy prepare the breast for lactation. Before
pregnancy the breast is largely composed of adipose (fat) tissue but under the influence of the
hormones estrogen, progesterone, prolactin, and other hormones, the breasts prepare for
production of milk for the baby. There is an increase in blood flow to the
breasts. Pigmentation of the nipples and areola also increases. Size increases as well, but
breast size is not related to the amount of milk that the mother will be able
to produce after the baby is born. By the second trimester of pregnancy colostrum, a thick yellowish fluid, begins to be produced in
the alveoli and continues to be produced for the first few days until the milk
"comes in", around 30 to 40 hours after delivery. Oxytocin contracts the smooth muscle of the uterus during birth and following delivery, called
the postpartum period, while breastfeeding. Oxytocin also
contracts the smooth muscle layer of band-like cells surrounding the alveoli to
squeeze the newly produced milk into the duct system. Oxytocin is necessary for
the milk ejection reflex,
or let-down, in response to
suckling, to occur.
Breast milk
Not all of
breast milk's properties are understood, but its nutrient content is relatively
consistent. Breast milk is made from nutrients in the mother's bloodstream and
bodily stores. It has an optimal balance of fat, sugar, water, and protein that is needed for a baby's growth and
development. Breastfeeding triggers biochemical reactions which allows
for the enzymes, hormones, growth factors and immunologic
substances to effectively defend against infectious diseases for the infant. The breast
milk also has long-chain polyunsaturated fatty acids which help
with normal retinal
and neural development.
The
composition of breast milk changes depending on how long the baby nurses at
each session, as well as on the child's age. The first type, produced
during the first days after childbirth, is called colostrum. Colostrum
is easy to digest although it is more concentrated than mature milk. It has a
laxative effect that helps the infant to pass early stools, aiding in the
excretion of excess bilirubin, which
helps to prevent jaundice. It also helps to seal the infants
gastrointestional tract from foreign substances, which may sensitize the baby
to foods that the mother has eaten. Although the baby has received some
antibodies through the placenta, colostrum contains a substance which is new to
the newborn, secretory immunoglobulin A (IgA).
IgA works to attack germs in the mucous membranes of the throat, lungs, and
intestines, which are most likely to come under attack from germs.
Breasts
begin producing mature milk around the third or fourth day after birth. Early
in a nursing session, the breasts produce foremilk, a thinner milk containing many proteins and vitamins. If
the baby keeps nursing, then hindmilk is
produced. Hindmilk has a creamier color and texture because it contains more
fat.
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