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-HIV positive mother
-Mother is infected with human T-cell
lymphotropic virus type 1 or type 2
contraindications for breastfeeding (HTLV-1/2)
-Mother has untreated ebola virus
-Drug abuse by mother
-Infant galactosemia
BF became recognized as a public
1990
health priority in the US in what year?
Nursing a baby for a year or more de-
creases the risk of hypertension, dia-
betes, hyperlipidemia, and cardiovascu- 10-15%
lar disease when postmenopausal by
____%.
Women who do NOT BF are at greater
breast, ovarian, endometrial
risk for these 3 cancers
United Nations International Children's
UNICEF stands for
Emergency Fund
The WHO and UNICEF have set out 3
breastfeeding protection, breastfeeding
strategies needed for increasing BF initi-
promotion, breastfeeding support
ation and duration in every country
government, manufacturer and social
responsibility to assure breastfeeding's
Breastfeeding protection focuses on
ability to compete with commercial inter-
ests
advantages of breastfeeding on a per-
Breastfeeding promotion focuses on
sonal, community, country or global level
addressing improper marketing prac-
Breastfeeding protection also includes tices as described in "The international
code"
In the US, state and local BF legislation
addresses BF in public, employment is-
breastfeeding protection
sues, jury duty, family law, mothers in
prison etc. is an example of
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focuses on interaction of helpers with
Breastfeeding support family, as well as program development
and implementation.
This forms the basis of the Baby-Friendly The Ten Steps to Successful Breastfeed-
Hospital Initiative ing
1a. comply with the International code
of marketing of breast-milk substitutes &
relevant world health assembly resolu-
tions
1b. have a written infant feeding policy
that is routinely communicated to staff &
The Ten Steps to Successful Breastfeed-
parents
ing (critical management procedures)
1c. est. ongoing monitoring & data-man-
agement systems
2. ensure that staff have sufficient knowl-
edge, competence, and skills to support
BF
3. discuss the importance & mgmt of BF
w/ pregnant women and families
4. facilitate immediate STS contact &
support mother's to initiate BF as soon
as possible after birth
5. support mothers to initiate & maintain
The Ten Steps to Successful Breastfeed- BF and manage common difficulties
ing (key clinical practices )
6. do NOT provide breastfed newborns
any food or fluids other than breastmilk
unless medically indicated
7. enable mothers & their infants to re-
main together and practice rooming-in
24 hr/day
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8. support mother's to recognize & re-
spond to feeding cues
9. counsel mother's on use & risk of bot-
tles, teats & pacifiers
10. coordinate d/c so families have timely
access to ongoing support & care
Highest level of evidence meta-analysis an systematic review
An international health policy framework
to regulate the marketing of breastmilk The International Code of Marketing of
substitutes in order to protect breast- Breastmilk Substitutes (The code)
feeding, published by the WHO in 1981
regulates the marketing of BM substi-
The code tutes which includes formulas, teats and
bottles
track, assess and monitor the implemen-
The World Breastfeeding Trends Initia-
tation of the "Global Strategy" at the
tive is intended to
country and sub-country level
-expand the baby-friendly hospital initia-
tive
-provide community-based strategies
-strengthen monitoring and enforcement
How to support exclusive BFing of "the code"
-enact at least 6 months of paid maternity
leave
-invest in protection, promotion and sup-
port
_________ levels go down in b/t nurs-
prolactin
ing's and rise during nursing
Infrequent nursing leads to lower lev-
els of this hormone even with the same prolactin
amount of nipple contact
progesterone goes down and prolactin
after delivery of the placenta
goes up