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, Box
157, 1211 Geneva 19, 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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