Breast feeding
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Task 1 and Task 2 are both part of just one coursework for the module Food and Nutrition.
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SAMPLE ANSWER
Task 1: Breast feeding
None of the existing breast milk substitutes are as effective as breast feeding. World health Organization (WHO) recommendations are exclusive breastfeeding for infants for at least six months and continued breastfeeding for at least two years. This implies that the infant should not be given any other food or drink. However, this does not exclude the vitamins and minerals they get during vaccination clinic. Breast milk is linked with increased immune system especially the gastrointestinal, allergies and atopic disorders. This paper explores the current breast feeding trends in the UK; and using relevant evidence based arguments, an evaluation on the benefits for increased breast feeding initiation and duration will be conducted.
Fall and colleagues (2011) indicated that breast milk has an array of bioactive components responsible for innate immunity and adaptive immunity. This includes the soluble IgA. Additionally, it also has glycan’s such as mucins, glycolipids, proteins and complex carbohydrates. These components give innate and adaptive protection to the infant especially from cardiovascular diseases. Hill and colleagues (2013) argues that the induction of breast milk oligosaccharides modulates the glycan’s on the epithelial cells; thereby enhancing protection from microorganisms such as Escherichia coli. According to Arenz et al (2004) diarrhea in infants is 5times common in bottle-fed infants that the breast fed babies. The cost of treating these gastrointestinal disorders is 12 folds that of breast fed infants.
Richard et al (2005) encourages exclusive breast feeding for diabetic mothers in order to protect the infant from suffering hypoglycemia. Additionally, Park and colleagues (2014) recognized that breast feeding enhances the intimate relationship between the mother and the infant. This relationship has been associated with cognitive behavior and emotional stability of the infant during growth. Yan et al (2014) associates exclusive breast-feeding with reduced risks of overweight and obesity. Breastfed infants gain weight gradually than the formula fed babies. McCrory and Layte (2012) argue that breast milk protein content is low as compared to the formula milk. Formula feeding results to increase plasma –insulin levels; and is often associated to high concentrations of insulin growth factor I. Exclusive breastfeeding closely correlates with high socioeconomic status; which is also associated with decreased childhood obesity incidences. HHSSP (2013) approximates that 1.5 million lives are lost due to inadequate of breastfeeding. Breast fed infants have lower cancer incidences. They are less susceptible to lymphomas and leukemia. Breast feeding is also associated as a means of family planning in some settings. Biologically, this can be linked to the delaying of ovulation and enhances proper child spacing.
Mcneal (2014) indicates that a 5% increment in breastfeeding could save £2.5 million UK health care cost. Investigations estimate that the use of breast milk substitute costs USA $331-$475 per baby. In Australia, exclusive breast feeding could save more than £435 million. It is estimated that the total cost of purchasing breast milk substitutes and the equipment necessary for feeding is about £250. Breast milk is natural, renewable with no packaging or delivery costs. Exclusive breastfeeding saves health care costs. A study conducted in Glasgow indicated that 15% higher medical consultations for infants fed on formula than exclusively breastfed babies. UNICEF UK studies estimated £17million saving if 45% women breast fed exclusively and 75% babies were breastfed at discharge.
Evidently, breast feeding is beneficial both to the infant and the mother. Why do mothers still choose not to breast feed? Karen and colleagues (2014) identifies the obstacles which hinder exclusive breastfeeding including short maternal leaves; lack of information on how to breastfeed and the benefits; inadequate support from the family; inadequate information on how to handle breastfeeding complications such as sore nipples (especially for first time mothers) and embarrassment. Breast feeding initiation programs have doubled in the last two decades i.e. from 36% to 64% from 1990 to 2010 respectively. However, breast feeding rates are stagnant in the last 5 years. In UK, 12% of mothers stop breast feeding within the first week of birth; 22% by two weeks and only 36% exclusively breast feed their infants for the first two months. In Scotland, the trend is contrary with rates increase by 4% in a span of 5years (36% in 1995 and 40% in 2000). Dyson and Et al (2005) argues that the rates of breast feeding are lowest in Europe. Currently, only 25% of infants in UK are exclusively breastfed during the first two months; and only 16% are exclusively breastfed for first six months. The figure is projected to decrease in the next decade. Of importance, cultural background determined the initiation duration for breast feeding. Studies indicated that Women from certain ethnic communities (Asian and Black) had lower breastfeeding rates. The low duration breast feeding rates are also prevalent among the white women. Irfan and Oguz (2013) findings indicates that infants from this community are less privileged in terms of breastfeeding initiation and duration. Moreover, teenage mothers are also likely to delay breast feeding initiation .Duration rates in families of low socioeconomic status were found to be the lowest. However, little efforts have been made to reduce the health disparities between the underprivileged backgrounds in the past two decades.
According to Mona and colleagues (2014) inherent health disparity will continue to increase if no strategic interventions are put in place. Strategic interventions should be tailored to meet the needs of cultural and socioeconomic groups. Stake holders should collaborate on multifaceted strategies/programs to increase breast feeding initiation and duration. Five studies in the US on 582 expectant mothers indicated that breastfeeding educative program during pregnancy increase breast feeding initiation and duration in low social-economic mothers. However, there lacks an evidence based education program intervention for overall expectant mothers. In hospital, mothers who are trained on positioning of the infant when breastfeeding increase the chances of longer breastfeeding duration. Haider (2014) reports that postnatal NICE guidelines is supported by several evidence based studies; thereby indicating the role and importance postnatal training intervention. Keiko and colleagues (2013) advices that Health practitioners should take lead and actively promote breastfeeding; in fact, every health institution should have a designated person who is held responsible for breast feeding program leadership and co-ordination. This intervention will ensure that various stake holders have adequate information and a strong framework to ensure quality health care services for both mothers and infants. The interventions efforts should be doubled when dealing with the underprivileged mothers.
Despite the underprivileged parental leaves, two thirds of the global labor forces are mothers (Boris, 2011). According to Rossin-Slater Et al (2013), lengthier maternity leave is associated with less depressive symptoms among mothers. Increasing the leave by one week indicated up to 7% reduction in depression symptoms. Lengthier paid leaves are also associated with significant reduction in infant mortality. A 10 week paid leave extension led to a 4.1% decrease on infant mortality. In 2010, study conducted in US, only 43% babies are exclusively breastfed at six months. The study indicated that nearly 900 infant’s death could be prevented if 90% of working mothers breastfed exclusively. This could save $13billion dollars annually.
Some mothers may not breastfeed due to mother-health related issues or the infant’s circumstances. In this case, the health professionals attending should provide the best evidence based advice. Most of the voluntary agencies have up to date information, and could be in apposition to give health practitioners useful information for particular circumstance. Hoddinott et al (2008) studies supports preterm infants and those born with several medical disorders should be breastfed. However, if the birth weight for the preterm babies is very low, then supplementary calories may be used. The main advantage of feeding preterm with breast milk is that breast milk is more tolerated better by the immature gastrointestinal system. This reduces the incidences of life threatening complications such as Necrotizing enterocolitis. The major challenge in this situation is the inaccessibility of breast pumps once these mothers leave the hospital premises. In some cases, they are forced to hire the facility from their own pockets (Horta Et al., 2007).
According to Christy (2014), there are increased concerns in UK on the level of mother-baby HIV transmission. The transmission can occur during birth or later via breastfeeding. Therefore, breast feeding HIV positive mothers should be informed on the contexts and risks of breastfeeding. The UK National Assembly has guidelines for guidance on both antenatal and postnatal care for HIV positive mothers. There should be easy access to breast feeding information at community level through local programs. For instance, nurses could provide breastfeeding advices during the immunization sessions. Community psychiatrists handling mothers with mental disorders such as postnatal depression should be armed with appropriate breast feeding information. This ensures that the mothers are adequately supported. Moreover, community pharmacists should be informed on appropriate medication for breastfeeding mothers especially on contraceptives matters. Despite the experience, education and wage gap differences; mothers experience significant wage penalty per child in terms of reduced working hours, unprecedented shifts to family friendly time and the numerous interruptions for child-bearing unprecedented-leave. There is increased need to set of policies geared towards maternity policy, job protection and supplementary income during pregnancy among the industrialized countries (Jing &Jae-ho, 2014).
References
Arenz, S., Et al. (2004) Breastfeeding and childhood obesity- a systematic review. International journal of obesity 28, p1247-1256
Boris, Eileen. (2011) “No Right to Layettes or Nursing Time”: Maternity Leave the Question of U.S. Exception. Workers across the Americas: the Transnational Turn in Labor History. N.P., 71-193. Print.
Christy BN. (2014) Breast feeding: A holistic concept analysis. Public Health nursing 31:1 p88-96
Dyson, L. Et al. (2005) “Promotion of Breast feeding initiation and Duration.” Retrieved on January 26th 2015 from [www.dh.gov.uk/assetRoot/04/07/16/96/04071696.pdf]
Fall, HD. Et al. (2011) Infant feeding patters and cardiovascular risk factors in young adulthood: data from five cohorts in low and middle income countries. International journal of epidemiology, 40; p47-62
Haider, SJ. (2014) An evaluation of the effects of breast feeding support program on health outcomes. Health Services research 49; 6, p2017-2034
Hill, DR. Et al. (2013) Human milk Hyaluronic Enhances Innate Defense of the intestinal epithelium. The journal of Biological chemistry 288; 40, p29090-29104
Hoddinott, P. Et al. (2008) Clinical review: Breast feeding. BMJ336, P881-887
Horta, BL. Et al. (2007) Evidence of the long term effects of breast feeding. Geneva, WHO Retrieved on January 26th 2015 from [http://whqlibdoc.who.int/publications/2007/9789241595230_eng.pdf]
HSSP. (2013) “Breast feeding: A great start.” Retrieved on January 26th 2015 from [http://www.unicef.org.uk/Documents/Baby_Friendly/Research/Preventing_disease_saving_resources.pdfhttp://www.unicef.org.uk/Documents/Baby_Friendly/Research/Preventing_disease_saving_resources.pdf]
Irfan, S &Oguz, T. (2013) Factors influencing breastfeeding duration: a survey in a Turkish population. Journal of pediatrics, 172; 11, p1459-1466
Jing, KM& Jae –Ho, K. (2013) Factors affecting exclusive breast feeding during the firth 6 months in Korea. Pediatrics international 55; 5, p177-180
Karen, W. Et al (2014) Understanding infant feeding practices of new mothers: findings from the healthy beginning trial. Australian journal of advanced nursing 32, 1, p6-15
Keiko, O. Et al. (2014) Effectiveness of a breast feeding self-efficacy intervention: Do hospital practices make a difference. Maternal & child health journal 18; 1, p296-306
McCrory, C& Layte, R (2012) Breast feeding and risk of overweight and obesity at nine years age. Social Science & Medicine 75:323-330
Mcneal, M. (2014) The business of breast feeding. Marketing health services 34:4, p22-27
Mona, N. Et al. (2014). A complex breastfeeding promotion and support intervention in a developing country: study protocol for a randomized clinical trial. BMC public health, 14; 1, p1-20
Park, S. Et al. (2014) Protective effect of breast feeding with regard to children’s behavioral and cognitive problems. Nutritional journal 13; 1 p84-95
Richard, MM. Et al. (2005) Breast feeding in infancy and blood pressure in later life: systematic review and meta-analysis. American journal of epidemiology 161; 1, p15-26
Rossin-Slater, Et al. (2013) “The Effect of California’s Paid Family Leave Program on Mothers’ Leave-Taking and Subsequent Labor Market Outcomes.” Journal of Policy Analysis & Management 2: 224-245. Print.
Yan, J. Et al. (2014). The association between breastfeeding and childhood obesity: a meta-analysis BMC public health 14:1, p467-490
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