Dr Shabbir Ahmed Assistant professor pediatrics ANMC MBBS,MCPS,FCPS

Breastfeeding  Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development  All mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system

 Colostrum, the yellowish, sticky breast milk produced at the end of pregnancy, is recommended by WHO as the perfect food for the newborn

 Feeding should be initiated within the first hour after birth.  Exclusive breastfeeding is recommended up to 6 months of age  Continued breastfeeding along with appropriate complementary foods up to two years of age

What Are the Benefits of Breastfeeding for Baby?  Breast milk provides the ideal nutrition for infants  It has a nearly perfect mix of vitamins, protein, and fat – everything baby needs to grow  And it's all provided in a form more easily digested than infant formula  Breast milk contains antibodies that help baby fight off viruses and bacteria

 Breastfeeding lowers baby's risk of having asthma or allergies  Babies who are breastfed exclusively for the first 6 months, without any formula, have fewer ear infections, respiratory illnesses, and bouts of diarrhea  They also have fewer hospitalizations and visits to the doctor

 Breastfeeding has been linked to higher IQ scores in later childhood  What's more, the physical closeness, skin-to-skin touching, and eye contact all help baby bond with mother and feel secure  Breastfed infants are more likely to gain the right amount of weight as they grow rather than become overweight children

 Breastfeeding also plays a role in the prevention of SIDS (sudden infant death syndrome)  It also lower the risk of diabetes, obesity, and certain cancers as well

Are There Breastfeeding Benefits for the Mother?  Breastfeeding burns extra calories, so it can help you lose pregnancy weight faster  It releases the hormone oxytocin, which helps uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth  Breastfeeding also lowers risk of breast and ovarian cancer  It may lower risk of osteoporosis

 Since you don't have to buy and measure formula, sterilize nipples, or warm bottles, breast feeding saves time and money

Contraindications of breast feeding  Infants with Special Dietary Requirements  Galatosemia  Phenylketonuria – may be partially breastfed  Maternal Infectious Disease  Cytomegalovirus – may or may not breastfeed depending on individual circumstances  Herpes – if active on breast, may use other breast if not affected

 HIV – may or may not breastfeed depending on individual circumstances  Human T-Lymphotropic Virus type 1 or 2 infection  Tuberculosis – if not contagious or may resume feeding after two weeks of treatment

 Maternal Drugs –  Chemotherapy agents – certain agents, discontinue breastfeeding for as long as they remain in the milk  Drugs of abuse – discontinue breastfeeding until drugs are out of maternal system  Primaquine and Quinine – contraindicated if either infant or mother has G6PD  Metronidazole – discontinue breastfeeding until at least hours after medication

Sulfa drugs – may be a problem in infants with jaundice or G6PD, stressed or premature Radioactive isotope – discontinue breastfeeding for as long as the radioactivity is in the milk

Immunization  A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence  A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen

 Many vaccines require multiple doses for maximum effectiveness, either to produce sufficient initial immune response or to boost response that fades over time

Oral rehydration  Acute diarrhoeal diseases are among the leading causes of mortality in infants and young children in many developing countries  In most cases, death is caused by dehydration.  Dehydration from diarrhoea can be prevented by giving extra fluids at home

 Dehydration can be treated simply, effectively, and cheaply in all age-groups  In all but the most severe cases by giving patients by mouth an adequate glucose-electrolyte solution called Oral Rehydration Salts (ORS) solution

 ORS is a sodium and glucose solution which is prepared by diluting 1 sachet of ORS in 1 litre of safe water  It is important to administer the solution in small amounts at regular intervals on a continuous basis

Make ors at home  Measure and combine the ingredients in a container  Combine ¼-teaspoon real salt  ¼-teaspoon (potassium chloride)  ¼-teaspoon baking soda  with 2½-tablespoons granulated sugar  Use a spoon to quickly incorporate these dry ingredients together