Breast Is Best for Babies: WHEN AND HOW TO BREASTFEED
Breastfeeding should be initiated as soon after delivery as possible, preferably within the first half-hour after birth. Delaying breastfeeding for four hours or more results in a lower incidence of successful breastfeeding. Mothers should be encouraged to nurse on cue, usually 10-12 times a day, including during the night, for as long as the infant seems interested. Frequent feeding is important in establishing a good milk supply. Supplementary feeding of water, glucose water or formula should be avoided, as these fluids tend to mute the appetite and interfere with lactation. Proper positioning pro vides comfort for the mother and the infant and is important in the establishment of an effective latch-on and adequate milk intake for the infant. The most frequently used positions that work well are the cradle position, football position and side-lying position. Enough of the areola should be in the infant’s mouth to permit the tongue to compress the areola overlying the collecting ducts against the hard palate. The time for suckling should be unrestricted as time for complete milk transfer varies. Signs of successful breastfeeding are listed in Table 2. While it is possible that a healthy, breastfed infant may not meet all these criteria, failure to do so warrants a careful assessment of the situation.
Ideally, infants should be exclusively breastfed for the first six months of life. Breastfeeding should be continued with the addition of complementary food, at least through the first 12 months and breastfeeding continued for as long as the mother and infant mutually desire. Breastfeeding for the first two year of life should be encouraged. viagra jelly online
PROMOTING AND SUPPORTING BREASTFEEDING
To promote, protect, and support breastfeeding, the WHO and UNICEF developed the Babyfriendly® Hospital Initiative (BFHI) 10 Steps to Successful Breastfeeding. The suggested 10 steps are listed in Table 3. A Babyfriendly® hospital should adhere to the WHO/UNICEF International Code of Marketing of Breast-Milk Substitutes and subsequent World Health Assembly (WHA) resolutions (Table 4). The code seeks to protect breastfeeding by preventing inappropriate marketing of breast milk substitutes, feeding bottles, soothers and complimentary foods when used to replace breast milk. Interventions, such as antepartum structured educational programs, postpartum support, rooming-in, proper advice to overcome breast-related problems, and peer counseling and encouragement have been shown to improve the initiation and duration of breastfeeding. Physicians should provide encouragement, advice and support to help mothers to continue breastfeeding after they return to work. Physicians should promote adoption of international, national and local policies that clearly support breastfeeding. Breastfeeding-mothers should be given the names of breastfeeding resources or support groups and information about legislation affecting breastfeeding in their area. Working mothers may consider the use of breast pumps or arrange to have the infant brought to the workplace to be breastfed there. Working part-time, job-sharing or arranging to do some work at home are other possibilities. The role of pediatricians in promoting and protecting breastfeeding has been outlined by the American Academy of Pediatrics (Table 5). Pediatricians/family physicians are urged to follow the recommendations so as to provide an optimal environment for breastfeeding. Physicians should be encouraged to have their offices breastfeeding-ftiendly. generic revatio
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