Encourage breastfeeding for infants
Encourage breastfeeding for infants: Excerpt from Avoiding Common Pediatric Errors
Author:
Esther Forrester, MD
What to Do - Make a Decision, Take Action
It is widely accepted that human breast milk is the optimum food for infants. Not only does it provide essential nutrients for the developing infant,
it changes in composition both during the lactation period and the lactation
session to supply ideal nutrition according to the respective stages of development and hourly demand. For example, the fat content of breast milk is
lowest early in the morning and highest in the afternoon. The amount of fat
in breast milk also increases substantially towards the end of a session. The
vitamin and mineral content of breast milk varies during the postpartum
period, throughout nursing, and during weaning.
The mineral content of breast milk is highest immediately postpartum
and decreases over time. During the first few days postpartum, colostrum
is high in vitamin E, protein, zinc, magnesium, and antibodies. From day
3 to day 6 postpartum, colostrum enters a transitional form with increasing amounts of fat, lactose, and calories, while protein and immune factors
gradually decrease. Magnesium levels begin to decrease after 18 months of
lactation. Unlike other minerals, magnesium secretion is unaffected by constitutional variables such as adolescent motherhood, maternal malnutrition,
smoking, gestation length, environment or stage of lactation.
The vitamin content transitions according to the fat-and water-
solubility of vitamins and may vary according to the mother's diet and genetic makeup. However, if a mother is deficient, the volume of milk produced
varies morethan the vitamin composition. Generally, water-soluble vitamins
(e.g., B, C, B6) increase over time except for vitamins C and B6. Fat-soluble
vitamins (e.g., A, D, E, K) generally decrease over time.
There is a strong correlation between vitamin D content in breast
milk and the 25-hydroxycalciferol (25-OH-D) concentration in serum of
exclusively breastfed infants. However, there is no correlation between the
concentration of vitamin D in mothers' serum and breast milk. Exclusively
breastfed infants 0 to 12 months of age should receive at least 200 IU
(5 ”g) of vitamin D to prevent rickets. For infants not exposed to sunlight,
up to 400 IU (10 ”g) may be required.
Although the amounts of calcium and iron in breast milk are less than
those found in cows' milk, the bioavailability is greater. Fifty percent of iron
in human breast milk is absorbed, whereas only 4% to 10 % is absorbed from
cows' milk or commercial infant formulas. The large amount of lactose in
breast milk is believed to help absorb calcium, phosphorus, and magnesium.
Lactose also nourishes intestinal bacteria, which in turn produce B vitamins
for the infant.
These naturalvariationsin breast milkrepresent afew of thereasons the
American Academy of Pediatrics and the American Dietetic Association's
recommend breast feeding for the first 4 to 6 months of life. As the nutritional and dietary demands of the infant increase, breastfeeding should be
supplemented with solid foods for at least 12 months. Considering the impact that maternal nutrition status has on the quality and quantity of breast
milk, breastfeeding mothers must also make conscious efforts to supplement
their diets with vitamins and minerals and increase their caloric intake to
adequately provide for breastfeeding infants.
Suggested Readings
DŽorea JG. Magnesium in human milk. J Am Coll Nutr. 2000;19:210–219.
Cancela L, Le Boulch N, Miravet L. Relationship between the vitamin D content of maternal milk and the vitamin D status of nursing women and breastfed infants. J Endocrinol.
1986;110:43–50.
Karra MV, Udipi SA, Kirksey A, et al. Changes in specific nutrients in breast milk during
extended lactation. Am J Clin Nutr. 1986;43:495–503.
Meyer L. Breast Milk. CD written February 21, 2000. Available at: http://uimc.
discoveryhospital.com/main.php?id=1875. Accessed March 1, 2007.
Schuster E. Oregon State University Extension Family and Community Development.
Breast Milk Changes. Available at: http://72.14.209.104/search?q=cache:f5-6HRiU0GsJ:
extension.oregonstate.edu/fcd/nutrition/publications/nutrifocus/breastmilkchanges.pdf
+vitamins+in+breast+milk&hl=en&ct=clnk&cd=35&gl=us. Accessed March 1, 2007.
Vitamin D Supplementation for Breastfed Infants—2004 Health Canada Recommendation.
Available at: http://www.hc-sc.gc.ca/fn-an/nutrition/child-enfant/infant-nourisson/
vita d supp e.html. Accessed March 1, 2007.
Book Source Details
- Book Title: Avoiding Common Pediatric Errors
- Author(s): Anthony D Slonim MD, DrPH; Lisa Marcucci MD
- Year of Publication: 2008
- Copyright Details: Avoiding Common Pediatric Errors, Copyright © 2008 Lippincott Williams & Wilkins.
More About Congenital Toxoplasmosis
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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More About This Book:
Title: Avoiding Common Pediatric Errors
Authors: Anthony D Slonim MD, DrPH; Lisa Marcucci MD
Publisher: Lippincott Williams & Wilkins
Copyright: 2008
ISBN: 0-7817-7489-6
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