Chest cart. Akev - breastfeeding consultants - WHO. Breastfeeding consultant

Every mother wants to give her newborn baby only the best. And if the choice of a suitable stroller, crib and high-quality useful toys is a difficult question, but still not critical, then the issue of feeding plays a huge role.

Many of them face difficulties along the way due to lack of information or widespread prejudices. And in this case, WHO recommendations on breastfeeding can come to the aid of such mothers. But first, it's worth mentioning the benefits of this choice.

Manufacturers of infant formula convince customers that their products contain all the necessary complex of vitamins and nutrients for the child’s body. However, no formula can provide a baby with the benefits that breast milk brings. Among them:

• the ability to change the composition of milk depending on the age and needs of the child. No artificial formula is tailored to the needs of a specific child;
• the presence in milk of elements that help build immunity and increase protection against colds, reduce the risk of allergies and dysbacteriosis;
• presence of necessary antibodies in case of illness;
• ensuring close emotional contact between mother and baby;
• facilitating the process of falling asleep for a child;
• high digestibility of all vitamins and microelements contained in milk. It has long been known that, despite the high iron content in artificial formulas, it is practically not absorbed in the child’s body, as a result of which formula-fed children often experience;
• formation of correct bite;
• normalization of intestinal microflora, as a result of which in most breastfed children the process of establishing the functioning of the digestive system as a whole is even easier.

In addition to the undoubted health benefits of the newborn, it also carries many benefits for the mother. Thanks to it, after childbirth, hormonal levels and the body as a whole are restored faster, and the duration of postpartum discharge is reduced due to more intense contractions of the uterus.

Natural feeding

Women who had the opportunity to compare the experience of natural and artificial feeding note that when breastfeeding it is much easier for them to establish psychological contact with the child, it is easier to guess his needs. Breastfeeding reduces the risk of breast and ovarian cancer.

In addition to the health benefits for mother and baby, breastfeeding has another undeniable advantage over artificial formula - simplicity and convenience. Breast milk does not need to be cooled or heated; its temperature is optimal at any time. Parents don’t have to carry bottles of formula, a sterilizer, and a lot of other things everywhere.

In case of forced absence of the mother next to the child, all that needs to be done is to create a “bank” of milk. Once decanted, it stores well in the freezer.

Unfortunately, despite all the obvious benefits of breast milk, not all mothers know how to properly establish this natural process. In many developed countries, as well as in the post-Soviet space, advertising of formulas, agitation for feeding by the hour and many common misconceptions have led to the fact that a rare woman can start feeding her child without resorting to anyone’s help and advice.

To help new mothers, the World Health Organization has published the following recommendations:

• It is extremely important that the baby receives the first drops of milk as early as possible, ideally immediately after birth. A few drops of colostrum ensure the colonization of the intestines with beneficial microflora from the first minutes of life.
• Mother and baby, except in isolated cases related to health and life safety, should be in the same room in order to be able to immediately establish physical and psychological contact.
• It is necessary from the very beginning to ensure that the baby latches onto the breast correctly - this will help avoid cracks and other unpleasant sensations. In addition, if the latch is incorrect, the baby may swallow a lot of air during feeding or not receive the required amount of milk. The baby's lips should tightly clasp not only the nipple itself, but also most of the areola; during feeding, the mother should not experience any unpleasant or painful sensations. If such sensations appear during feeding, you should carefully remove the breast from the baby and offer it again, carefully monitoring the correct grasp.
• Until your baby learns to latch on correctly, bottle feeding should be avoided as much as possible, and you should also avoid giving your baby a pacifier. Attempts to satisfy the sucking reflex with their help often lead to the formation of an incorrect grip. In addition, there are often cases when, even after one bottle feeding, a child refuses to latch on to the breast - this is due to the fact that it is much easier for the baby to obtain milk in this way. As a last resort, if you need to feed the baby in the absence of the mother, you should use a spoon or syringe. It must be remembered that in case of any doubts regarding the correct latch of the breast, every mother can seek help from a lactation consultant. The specialist will not only answer all your questions, but also show you how to properly latch on to your baby and advise which feeding position is most suitable for this particular mother and baby. There is no need to be afraid to ask for help in such an important matter.
• Supplemental feeding should be avoided - the baby can get all the fluid he needs from mother's milk. If you give your child water, juices or milk of animal origin, the stomach will be full, but the body will not be satisfied and will not receive the necessary nutrients.
• You need to feed your baby solely on demand - firstly, all children are different, and each of them has their own diet. Secondly, feeding by the hour inevitably leads to a decrease in milk supply. Feeding on demand also means that the baby himself feels when he is full. There is no need to take the breast from the baby before he releases it himself.
• There is no need to wash your nipples with soap before each feeding! Constant washing, as well as the use of hard towels, can cause dry skin and, as a result, lead to cracked nipples. To maintain breast hygiene, a daily shower is enough.
• It is strictly not recommended to administer before 6 months. Up to six months, mother's milk satisfies all the baby's nutritional needs in full.
• The amount of milk in the breast is regulated according to the supply and demand system. The more often and more the baby eats, the more milk is produced. Therefore, in order to avoid lactostasis, you should not express unless absolutely necessary - otherwise, more milk will be produced than required, which will inevitably lead to stagnation.
• It is extremely important to provide your baby with night feedings. Firstly, night milk is considered the most nutritious. Secondly, in the pre-dawn hours the production of a hormone responsible for the amount of milk occurs. If the baby is bottle-fed at night, the mother’s body concludes that the need for milk has decreased and, accordingly, reduces its production.
• You need to make sure that the baby completely empties one breast before taking the other - otherwise he will not be provided with the most nutritious, “hind” milk.
• Avoid frequent weighing - each child gains weight differently, and the well-known weight gain tables that pediatricians are accustomed to relying on are primarily a guide for bottle-fed children. They were created to monitor possible overweight, and not at all underweight. Frequent weighings will only lead to increased nervousness in the mother, which will inevitably affect the quantity and quality of milk. What to do if it seems that the child is not gaining weight well, but doctors or others convince him that milk is “non-nutritive”? First of all, the mother needs to focus on her subjective feelings. Is the child healthy, alert, and developing according to schedule? It can be said with a high degree of probability that it has enough nutrients for full development. If there are still doubts, you can conduct the so-called “wet diaper” test. You should stop for a day and count the number of bowel movements. A child who has enough milk will have time to wet about 10-12 diapers during this time.
• A child should be breastfed until at least two years of age - even with adequate complementary feeding with regular foods, the child continues to receive antibodies and other useful substances from the mother in case of illness. Weaning should be done gradually, reducing the number of feedings. Night feedings are one of the last to be removed. In addition, such a recommendation is important for those mothers who are worried about the shape of their breasts. It is gradual involution (completion of feeding) that allows the mammary gland to gradually return to its original appearance.

The benefits of breastfeeding over artificial feeding are completely obvious, and every mother who is concerned about the health of her baby should delve into all the intricacies of this process and provide him with the most necessary things from birth.

The most common problems on the path to successful feeding are fears and prejudices, but in the modern world every mother can find the necessary information or seek help to dispel doubts. Good luck on this journey!

1. Early breastfeeding - within the first 12 hours after birth!
2. Avoiding bottle feeding of a newborn or in some other way before the mother puts him to the breast. This is necessary so that the child does not develop a mindset for any other feeding than breastfeeding.
3. Joint maintenance of mother and child in the maternity hospital in one ward.
4. Correct position of the baby at the breast allows the mother to avoid many problems and complications with the breast. If the mother was not taught this in the maternity hospital, she should invite a lactation consultant and learn this specifically.
5. Feeding on demand. It is necessary to put the baby to the breast for any reason, to give him the opportunity to suckle when he wants and as much as he wants. This is important not only for satiating the child, but also for his psycho-emotional comfort. To feel comfortable, the baby can be attached to the breast up to 4 times per hour.
6. The duration of feeding is regulated by the child: do not take your baby off the breast before he releases the nipple on his own!
7. Night feedings the baby is provided with stable lactation. In addition, it is night feedings that are the most complete and nutritious.
8. No additional soldering and the introduction of any foreign liquids or products. If the baby is thirsty, he should be put to the breast more often.
9. Complete refusal of pacifiers, pacifiers and bottle feeding. If it is necessary to introduce complementary foods, it should be given only from a cup, spoon or pipette.
10. Transferring the baby to the second breast only when he has suckled the first breast. If the mother rushes to offer the baby the second breast, he will not receive additional “late milk” rich in fats. As a result, the baby may experience digestive problems: lactose intolerance, foamy stools. Prolonged sucking on one breast will ensure proper bowel function.
11. Avoiding nipple washing before and after feeding. Frequent breast washing leads to the removal of the protective layer of fat from the areola and nipple, which leads to the formation of cracks. Breasts should be washed no more than once a day during a hygienic shower. If a woman showers less often, then in this case there is no need for additional breast washing.
12. Refusal from control weighing of the child, carried out more than once a month. This procedure does not provide objective information about the nutritional status of the infant. It only irritates the mother, leads to a decrease in lactation and the unreasonable introduction of supplementary feeding.
13. Elimination of additional milk expression. With properly organized breastfeeding, milk is produced exactly as much as the baby needs, so there is no need to pump after each feeding. Pumping is necessary in case of forced separation of mother and child, mother going to work, etc.
14. Only breastfeeding up to 6 months- the child does not need additional nutrition and complementary feeding. According to some studies, a child can be exclusively breastfed for up to 1 year without harming his health.
15. Support for mothers who breastfed their children before2-3 or more years. Communicating with women who have had positive experiences with breastfeeding helps a new mother gain confidence in her abilities and receive practical advice to help establish breastfeeding. Therefore, new mothers are advised to contact maternal breastfeeding support groups as early as possible.
16. Training in baby care and breastfeeding techniques necessary for a modern mother so that she can raise him up to 1 year without unnecessary hassle and comfortably for herself and her baby. Lactation consultants will help you arrange care for your newborn and teach your mother breastfeeding techniques. The sooner a mother learns motherhood, the fewer disappointments and unpleasant moments she and her baby will endure.
17. Breastfeeding until the child is 2-3 or more years old. Breastfeeding for up to one year is not a physiological period for cessation of lactation, so both mother and child suffer during weaning.
18. Breastfeeding increases the risk of another pregnancy, regardless of whether your period has arrived or not.
19. Menstruation is not a reason to stop breastfeeding, feed as usual.

“The first 2-3 years of a child’s life are critical for physical and mental development. However, current feeding practices in some countries may be doing more harm than good for young children's development. Children under three years of age are especially sensitive to the effects of poor nutrition; since during this period growth occurs more intensively than at any other time ... "

Poor nutrition can lead to: irreversible growth retardation, frequent severe infections, cardiovascular diseases, as well as various defects (delayed motor and cognitive development, behavioral problems, underdeveloped social skills, short attention span, poor learning abilities ).
“There is evidence... that infant nutrition has long-term health consequences and plays a role in preventing the development of some chronic non-communicable diseases in adults.”

Breastfeeding children up to two years of age significantly reduces infant morbidity and mortality. This is especially important for the period from birth to 6 months.

It is important to note that by “breastfeeding” the WHO means “the baby receiving breast milk directly from the breast”, and not just breastfeeding.

“WHO and UNICEF currently recommend continuing breastfeeding for up to 2 years, and possibly longer.” At the same time, it is specifically stated that “all children should be exclusively breastfed from the moment of birth until the age of approximately 6 months, but in any case during the first 4 months of life.”

“In the first few hours of life outside the womb, the baby is lively, active and ready to feed, so ideally breastfeeding should begin within the first hour.” “Colostrum, released in the first few days of life, is especially rich in immunoprotective factors and several vitamins and minerals...”
The necessary introduction of complementary foods from 6 months “does not mean stopping breastfeeding. On the contrary, in the first year of life, breast milk should remain one of the main sources of nutrition...” “The purpose of complementary feeding is to provide additional energy and nutrients, but ideally it should not replace breast milk during the first 12 months. To…stimulate milk production, mothers should continue to breastfeed their babies frequently while complementary feeding is introduced.”

When a breastfeeding woman is forced to go to work and can no longer adhere to the feeding schedule at the request of the child, then to maintain breastfeeding, she should express during the day. The expressed milk is then given to the baby. And to support lactation, night feedings should be maintained. In addition, WHO recommends that working women feed two to three times a day.

How to support lactation

Application. In the matter of sufficient lactation, correct attachment plays an important role. Therefore, first of all, you should pay attention to ensuring that the child takes the nipple into his mouth correctly.

The baby is attached to the mother's breast correctly (left) and incorrectly (right).

Regularity. “The key to establishing and maintaining optimal lactation is breastfeeding on demand. As long as the baby is positioned correctly at the breast and the mother breastfeeds frequently (8-12 times per day), he will likely consume adequate amounts of breast milk.” Rigid feeding schedules are not recommended because different babies have different needs.

Duration. “Baby-led feeding, in which the infant is allowed to voluntarily move away from the breast if he is satisfied and decides not to take the breast again when it is offered to him after a few minutes, will provide the best milk production. Weaning a baby prematurely...can reduce the amount of milk consumed, make babies hungry and needlessly cause mothers to doubt their milk supply is adequate.” It is also important not to rush to offer the baby another breast in order to give him the opportunity to suck the so-called later (highest calorie) milk from the first.
Supplementation and additional feeding. Up to 6 months, the child must be exclusively breastfed (drops and syrups - vitamins, minerals, medicines) are allowed. Additional fluids and food before 6 months “displaces richer, more nutrient-dense breast milk and interferes with the baby's ability to breastfeed, thereby compromising the establishment and continuation of breastfeeding. Even in hot climates, provided they are exclusively breastfed, children can retain fluid without supplementation.

Flexibility. “Exclusive breastfeeding provides the baby with milk in sufficient quantity and quality” until about 6 months. Until this age, “even mothers of twins are able to exclusively breastfeed their children.” “As the baby's needs increase and the mother responds by breastfeeding more frequently and for longer periods of time, the mother's milk supply can increase in a matter of days, even hours.”
Confidence. “Irreversible milk deficiency is rare in the first few months of life.” But mothers do not always have enough confidence that they are able to produce enough milk. And this fear can inhibit lactation. It is important to remember that insufficient weight gain in the child primarily means that the mother needs qualified breastfeeding advice, and not that the child should be transferred to artificial formula.
If your pediatrician indicates that your child is not gaining enough weight, check which physical development charts he/she is using. Unfortunately, many of these plans are outdated and based on data from American formula-fed children. “Breastfed children have different physical development patterns than their bottle-fed peers...”

Bottles, pacifiers and pacifiers. Their complete exclusion ensures that the mother will react correctly to the child’s tension - that is, she will offer him the breast to calm him down. Otherwise, the principle of feeding on demand is violated.

Harmful recommendations preserved from the times of the Soviet Union

• late initiation of breastfeeding (6-12 hours after birth), especially for sick women, including women suffering from anemia;
• feeding with a 5% glucose solution until breast milk production is established;
• exclusive breastfeeding only for the first month;
• breast milk as the main food for the first 4-4.5 months;
• complete cessation of breastfeeding by the age of 10-11 months;
• breastfeeding strictly according to schedule (with a deviation of no more than 15 minutes).

In addition, the importance of a long break at night was indicated - from 6.5 to 8 hours.
We started feeding them already from the second month:

• vegetable and fruit “juices” (jam with water) – 1 month;
• fruits – 2 months;
• cow's milk diluted with a decoction of cereals - 2-3 months;
• pure kefir, hard-boiled egg yolk – 3 months;
• tea and water with sugar, cow's milk, cottage cheese, porridge, butter, sugar and salt - 4 months.

What’s even worse is that “if anemia (and rickets) was diagnosed, it was recommended to introduce porridge and other solid foods before 4 months.”

When preparing the article, materials from the site were used

Breast milk is the most beneficial source of nutrition for a baby. It provides the baby with the necessary substances. And this truth does not need proof. WHO (World Health Organization) is seriously concerned about breastfeeding issues and advises a number of rules for the successful establishment of this process. WHO breastfeeding recommendations are widely used by many breastfeeding consultants in many countries around the world.

Rules for successful feeding

The WHO issued its recommendations not just “for show.” They really help many mothers to properly establish the process of breastfeeding and provide their baby with the necessary nutrition. Especially in the first 6 months of his life.

1. Put your baby to the breast as early as possible. It is advisable to do this in the first hour after birth. Colostrum, which is formed at the end of pregnancy, has a beneficial effect on the child’s immunity.
2. Do not bottle feed your newborn. Bottles can be addictive, and then the baby simply will not latch onto his mother’s breast. If there is a need for supplementary feeding, give it from a spoon or pipette. Avoid pacifiers as well.
3. Shared “living” in the same room with mom.
4. Learn how to put your baby to your breast correctly. You both need this. With the correct position, the baby will not take in excess air and will not bite your chest.
5. Feed your baby on demand. Breastfeeding by the clock is a relic of Soviet times. Give your child the opportunity to eat when he needs it.
6. Leave the duration of feeding up to the baby's discretion. Believe me, he will eat exactly as much as his body needs. No more and no less.
7. Pay great attention to night feedings. They are especially nutritious and guarantee stable lactation.
8. There is no need to supplement and introduce various juices and compotes into the diet. The baby only needs the fluid that comes with breast milk.
9. Do not offer your toddler a second breast if he has not sucked everything from the first. Late milk is the highest in calories.
10. There is no need to wash your breasts before and after feeding. This way you will only “earn” cracked nipples. A daily shower is enough for hygiene.
11. Don't stress yourself and your baby out with frequent weighings. They still will not give a complete picture of what is happening. Weigh your baby once a month, not more often.
12. You don't need to pump after every breastfeeding. If you have properly organized breastfeeding, milk will be released strictly “on demand.” Nothing extra. You need to pump if you are forced to part with your baby for a short time.
13. Try not to introduce complementary foods until 6 months of age. Studies have shown that babies of this age have enough breast milk. No additional nutrition is required at all.
14. WHO experts believe that a nursing mother needs to communicate with more experienced mothers. It may be helpful to contact lactation consultants or various support groups.
15. Try not to wean your baby until at least 1.5 years of age.

And most importantly, don’t be shy about learning how to be a mom. In today's world, there are many ways to learn baby care techniques and the basics of breastfeeding. This experience will help you avoid many troubles.

Breastfeeding rules:

Alternative opinion

There will always be someone who will express the opposite opinion. British scientists criticized the WHO recommendations.

They believe that children need complementary feeding as early as four months. However, UK pediatricians agree that these standards may differ for developing and developed countries. One of the London scientists said that there is no need to blindly follow any recommendations. A balanced look at the pros and cons is needed.

But this opinion of scientists was criticized. Representatives of the UK Ministry of Health believe that the researchers have put forward a groundless version and are simply helping baby food manufacturers make money.

However, in Russia, official recommendations include the introduction of complementary foods from 3-4 months.

So many people, so many opinions. Any mother has the right to choose a course of action. After all, the health of a small creature is in her hands.

Over the past decades, evidence and recommendations for breastfeeding have continued to grow. WHO can now say with complete confidence that breastfeeding reduces child mortality and has health benefits that extend into adulthood. For the general population, exclusive breastfeeding for the first six months of life, followed by breastfeeding with adequate complementary feeding for two or more years, is recommended for infant feeding.

To ensure that mothers can initiate and maintain exclusive breastfeeding for six months, WHO and UNICEF recommend:

• Conduct the first breastfeeding within the first hour of life;
• Carry out exclusive breastfeeding, that is, do not give the child anything other than breast milk - no other food or drink, not even water;
• Breastfeed on demand, that is, as often as the baby wants, both day and night.
• Do not use bottles, nipples or pacifiers.

Breast milk is the natural first food product for newborns. It contains all the nutrients and energy a baby needs during the first months of life and continues to meet half or more of a baby's nutritional needs during the second half of the first year and one-third during the second year.

Breast milk promotes sensory and cognitive development and protects the baby from infectious and chronic diseases. Exclusive breastfeeding helps reduce infant mortality from common childhood illnesses, such as diarrhea and pneumonia, and improves recovery from illness.

Breastfeeding is beneficial for the health and well-being of mothers. It allows for spacing of children, reduces the risk of ovarian and breast cancer, increases family and national resources, is a reliable feeding method and is environmentally friendly.

While breastfeeding is a natural behavior, it is also a learned behavior. Numerous scientific studies have demonstrated that mothers and other caregivers need active support in establishing and maintaining good breastfeeding practices. In 1992, WHO and UNICEF announced the Breastfeeding Friendly Hospital Initiative (BHII) to strengthen maternity ward practices to support breastfeeding. IBIV ​​is helping to improve the implementation of exclusive breastfeeding worldwide and, with support across the health system, can help mothers maintain exclusive breastfeeding.

WHO and UNICEF developed the 40-hour “Breastfeeding Counselling: A Training Course” and later the five-day “Infant and Young Child Feeding Counselling: A Comprehensive Course” to train health workers to provide skilled support to breastfeeding mothers and help them overcome problems. Basic breastfeeding support skills are also part of the Integrated Management of Childhood Illness Training Course for first-level health workers.

The Global Strategy for Infant and Young Child Feeding describes key actions to protect, promote and support breastfeeding.