Breastfeeding,
how...
Hattevig
G, Sigurs N, Kjellman. Effects of maternal dietary
avoidance during lactation on allergy in children at
10 years of age. Acta Paediatrica, 88: 7-12,
1999.
In order
to reduce the risk of food allergy in children, mothers
are sometimes advised to avoid eating certain foods
during lactation. In a 10 year follow-up study researchers
in Sweden studied the rate of allergies in children
whose mothers had followed different eating regimes
during lacation. In one group the mothers had not eaten
eggs, cow's milk or fish during the first three months
of lactation. In the other group the mothers had not
restrictied their diets.
Results showed
that a high rate of allergic symptoms occurred in both
groups. However, there was no significant difference
between the two groups. This was true for both food
and inhaled allergens. Also there was no difference
in the immunoglobin E levels in the blood of the children
in the two groups. It was concluded that the results
did not support the general recommendation to avoid
allergy-causing foods during lacation.
Morrow
AL, Guerrero ML, Shults J, Calva JJ, Lutter C, Bravo
J, Ruiz-Palacios G, Morrow RC, Butterfoss FD. Efficacy
of home-based peer counselling to promote exclusive
breastfeeding: a randomised controlled trial, The
Lancet: 353: 1226-1231, 1999.
Exclusive
breastfeeding for about 6 months is the optimal method
of infant feeding. However, it is uncommon even in cultures
of high breastfeeding rates. In order to assess the
effect of peer counselling on the rates of exclusive
breastfeeding, researchers in Mexico City carried out
a study in which mothers were randomly assigned to groups
with different frequency of peer counselling. One group
received three counselling visits, another received
6 visits and the control group had no visits. Counselling
for pregnant women consisted of the benefits of breastfeeding,
positioning, problems and solutions. Counselling of
new mothers included establishing a good breastfeeding
pattern, maternal concerns, and providing information
and social support.
Results showed
that at 3 months after birth 67% of mothers of the 6
visit group, 50% of the 3 visit group and 12% of the
control group were exclusively breastfeeding. Increased
duration of any breastfeeding was also seen in the visited
groups at 6 months with 87% visited mothers still breastfeeding
versus 76% of the control group. Another outcome of
the study showed that the control group of infants had
twice as many episodes of diarrhea compared with the
visited group.
Howard
C, Howard F, Lawrence R, Andresen E, DeBlieck E. Office
prenatal formula advertising and its effect on breastfeeding
patterns, Obstetrics and Gynecology, 95: 296-303,
2000.
Researchers
in Rochester, New York, USA compared the effect of prenatal
distribution of baby food industry-sponsored educational
packs with non-commercial educational packs on mothers'
infant feeding choices. The distribution of promotional
material and formula samples to families is prohibited
by the International
Code of Marketing of Breast-milk Substitutes. The
results of the study of 547 mothers showed that a mother's
choice to breastfeed or bottle-feed was not affected
by the type of educational materials she received before
the birth of her baby. 61% of mothers had already decided
to breastfeed before pregnancy while 11% changed their
minds during pregnancy. However, receiving commercially-sponsored
packs did affect breastfeeding duration. These packs
contained a baby milk company nappy bag, educational
materials, a can of infant fomula and a business reply
card. The non-commercial packs contained a generic nappy
bag, non-commercial educational material about pregnancy,
and a $5 coupon for baby items. Both groups of mothers
were offered help with breastfeeding concerns.
By the end
of the second week after birth 24% of the mothers who
had received commercial packs stopped breastfeeding
while only 15% of mothers who had received non-commercial
materials had stopped. Mothers who had received commercial
packs were five times more likely to stop breastfeeding
in hospital.
Gupta
A, Khanna K. Economic value of breastfeeding in India,
The National Medical Journal of India, 12(3):123-127,
1999.
Breastmilk
is an important national resource and breastfeeding
saves health care costs. Two doctors in India calculated
the value of breastmilk and breastfeeding for this country
of 24.4 million annual births. Based on the national
breastfeeding patterns they calculated that over the
usual 2 year lactation period mothers produced a total
of 3944 million liters of breastmilk. If this milk were
to be replaced by tinned cow's milk it would cost $3
billion. This amount is three times more than the government
spending for the Departments of Education, Health and
Family Welfare, and Science and Technology. At the household
level the cost of artificially feeding an infant is
43% of the minimum wage of a skilled urban worker.
With regards
to the reduction of health care costs by breastfeeding,
increasing breastfeeding could save $180 million by
reducing episodes of diarrhea. Saving from reduction
of acute otitis media costs would be $131 million if
breastfeeding was increased. Breastfeeding also leads
to lower fertility. At current rates in India breastfeeding
saves $123.7 million in contraception costs.
Rea
MA, Venancio SI, Martines JC, Savage F. Counselling
on breastfeeding: assessing knowledge and skills,
Bulletin of the World Health Organization, 77:
492-498, 1999.
Health care
workers have an important role to play in supporting
mothers' decision to continue to breastfeed or to introduce
breast-milk substitutes. WHO and UNICEF have developed
several counselling courses to teach heath workers appropriate
knowledge and skills. In order to analyze the effectiveness
of the WHO course, Breastfeeding counselling: a training
course, researchers carried out a randomized study of
60 health professionals in Sao Paulo, Brazil. One group
followed the course which included training in theoretical
and clinical aspects of breastfeeding, listening skills,
helpful non-verbal communication, empathizing, building
confidence and giving practical help among other skills.
The second group did not follow the course. The knowledge
level and quality of counselling skills of both groups
was tested before and after the course. Three months
later a further evaluation was given to the course group.
The results
showed that out of a possible score of 10 for breastfeeding
knowledge the course group scored an average of 8.35
and the control group 6.23. Post-course testing also
showed that the course significantly improved counselling
skills. Three months later testing showed that the level
of knowledge and skills were maintained at a high level.
Prepared
by GIFA-The Geneva
Infant Feeding Association, a member of the International
Baby Food Action Network-IBFAN
Editors Nancy-Jo
Peck, Eva Hansen.
Copies
of Breastfeeding Briefs sent upon request to GIFA,
Avenue de la Paix
11, 1202 Geneva, Switzerland
or to UNICEF country offices.
Available
also in French, Spanish, Portuguese and Arabic.
A contribution of Sfr. 10- for a subscription to
industrialized countries is gratefully accepted
and can be sent by international postal order to
no. 12-17653-5.
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