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April O. Buchanan and Maria L. Marquez
Proper nutrition in infancy is essential for normal growth, resistance to infections, long-term adult health, and optimal neurologic and cognitive development. Healthy nutrition is especially important during the first 6 months, a period of exceptionally accelerated growth and high nutrient requirements relative to body weight (see Chapter 5). Breastfeeding is associated with a reduced risk of many diseases in infants, children, and mothers (for more details visit http://www.nutrition.gov/
Human milk and breastfeeding are the ideal and normative standards for infant feeding and nutrition. The American Academy of Pediatrics (AAP) recommends human milk as the sole source of nutrition for the first 6 months of life, with continued intake for the first year, and as long as desired thereafter. Breastfeeding has shortand long-term advantages for infant neurodevelopment. Pediatric health care providers should approach breastfeeding at multiple levels (individual, community, social, and political) to reach the goals of “Healthy People in 2020”; its targets include 82% of infants with any breastfeeding, 23.7% of infants with exclusive breastfeeding for the first 6 months of life, and lactation support at work of 38%. In collaboration with national and global organizations, including the AAP, World Health Organization (WHO), UNICEF, the Centers for Disease Control and Prevention (CDC), and the Joint Commission, hospitals are asked to promote and facilitate breastfeeding.
The first 2 days of breastfeeding, and perhaps the first hour of life, may determine the success of breastfeeding. The current rate of breastfeeding initiation for the total U.S. population is 75% (Figure 27-1). There is greater emphasis to improve and standardize hospital practices with “Baby Friendly” programs for breastfeeding support.
The Department of Health and Human Services and theCDC recognize that breastfeeding offers infants, mothers,and society compelling advantages in industrialized and developing countries. Human milk feeding decreases the incidence and severity of diarrhea, respiratory illnesses, otitis media, bacteremia, bacterial meningitis, and necrotizingenterocolitis.
There are beneficial effects of feeding preterm infants with human milk on long-term neurodevelopment (IQ) in preterm infants. Preterm breastfed infants also have a lower readmission rate in the first year of life.
Mothers who breastfeed experience both shortand longterm health benefits. Decreased risk of postpartum hemorrhages, more rapid uterine involution, longer period of amenorrhea, and decreased postpartum depression have been observed. Similarly, there is an association between a long lactation of 12 to 23 months (cumulative lactation of all pregnancies) and a significant reduction of hypertension, hyperlipidemia, cardiovascular disease, and diabetes in the mother. Cumulative lactation of more than 12 months also correlates with reduced risk of ovarian and breast cancer.