Breastfeeding
The best way of feeding an infant is with breastmilk. It contains maternal antibodies to support the baby's immune system, a range of dietary factors to promote growth and development and it naturally adapts to meet the changing nutritional needs of the child. Encouraging mothers to breastfeed for at least the first six months of life is a high priority for NHS maternity services and the WHO recommends exclusive breastfeeding for the first six months, after which other food and drink can be introduced (weaning). Expectant mothers are given lots of advice and support throughout pregnancy to encourage breastfeeding and this should continue postpartum until both mother and baby are comfortable and feeding well. Despite this, a DoH survey in 2011 showed that 22% of infants had never been breastfed and of those who had, 57% were not breastfed past three months of age.1
There are a number of reasons for this; not least of which is the personal choice of the mother, but there are also medical conditions and various medicines that contra-indicate breastfeeding or make it very difficult to persevere. Whenever a parent presents in the pharmacy for advice on switching to infant formulas they should be referred to the pharmacist who can reinforce the benefits of breastfeeding but also identify the barriers to it and provide solutions.
A full discussion on breastfeeding is outside the scope of this module. Some of the benefits are listed below but you may need to carry out additional learning to improve or refresh your knowledge. There is a section on breastfeeding in the Counter Excellence module 'Infant Feeding'.
Why breast is best
Breastmilk:
- Provides all nutritional needs in a form that is readily absorbed by the immature GI tract.
- Changes over time to meet the nutritional needs of the growing infant.
- Contains antibodies that prime the immature immune system.
- Contains digestive enzymes.
- Promotes the growth of intestinal microflora.
- Can reduce the risk of developing allergies such as asthma and eczema.
- Can reduce the risk of ear infections and respiratory tract infections.
- Can reduce the risk of GI infections and Crohn's disease.
- Is free.
Breastfeeding:
- Causes the release of hormones such as oxytocin and the endorphins.
- Promotes bonding between mother and child.
- Helps the mother lose pregnancy weight.
- Can reduce the risk of ovarian and breast cancer.
- Is convenient and doesn't require additional equipment such as bottles and sterilisers.
In all cases, expectant mothers must be given support and encouragement to initiate and continue breastfeeding. However, for the purposes of this module it will be assumed that the decision to move away from breastfeeding to formula feeding has already been taken by the parent. This leaves the role of the healthcare professional to advise on the appropriate use of formulae and in particular, the use of specialist formulae to manage dietary problems.
Scientific research has led to a much better understanding of the constituents and characteristics of breastmilk and this in turn has led to a number of advances in infant and follow-on formulae.