1. Breastfeeding vs
artificial feeding
&Types of milk and
their use

2. Breastfeeding
Breastfeeding is the feeding of an infant or young
child with breast milk directly from female human
breasts (i.e., via lactation) rather than using infant
formula from a baby bottle or other container.
Babies have a sucking reflex that enables them to
suck and swallow milk.
Experts recommend that children be breastfed within
one hour of birth, exclusively breastfed for the first 6
months, and then breastfed until age two.

3. Benefits of
Breastfeeding to Infants
Immunity
 During breastfeeding, approximately 0.25-0.5 grams per day of
secretory IgA antibodies pass to the baby via the milk. This is one of
the most important features of colostrum.
 Main target for these antibodies are probably microorganisms in the
baby's intestine.
 There is some uptake of IgA to the rest of the body, but this amount is
relatively small.
 Also, breast milk contains several anti-infective factors such as bile
salt stimulated lipase (protecting against amoebic infections)
and lactoferrin (which binds to iron and inhibits the growth
of intestinal bacteria).

4. Infections
 Among the studies showing that non-breastfed infants have a
higher risk of infection than breastfed infants are:
 In a 1993 University of Texas Medical Branch study, a longer
period of breastfeeding was associated with a shorter
duration of some middle ear infections (otitis media with
effusion) in the first two years of life.
 A 2004 case-control study found that breastfeeding reduced
the risk of acquiring urinary tract infections in infants up to
seven months of age, with the protection strongest
immediately after birth.
 The 2007 review for AHRQ found that breastfeeding reduced
the risk of acute otitis media, non-specific gastroenteritis, and
severe lower respiratory tract infections.

5. Sudden infant death syndrome
 Non-breastfed babies have worse arousal from sleep at
2–3 months.
 This coincides with the peak incidence of sudden infant
death syndrome.
 A study conducted at the University of Münster found
that not breastfeeding doubled the risk of sudden infant
death syndrome in children up to the age of 1.

6. Diabetes
Infants exclusively breastfed have less chance of
developing diabetes mellitus type 1 than peers with a
shorter duration of breastfeeding and an earlier exposure
to cow milk and solid foods.
Breastfeeding also appears to protect against diabetes
mellitus type 2, at least in part due to its effects on the
child's weight.

7. Mental health
 Breastfeeding for more than 6 months is an independent
predictor of better mental health through childhood and
adolescence.
 The more months children were breastfed the less likely they
were to suffer from depression, delinquent behavior, attention
issues and other psychological problems. Breastfeeding also
improves cognitive development.
 The beneficial effects seem to stem in large part from the
unique composition of human milk which, compared to formula
milk, has been shown to lead to improved motor and cognitive
development in pre-term babies as well.

8. Allergic diseases (atopy)
 In children who are at risk for developing allergic diseases
(defined as at least one parent or sibling having atopy),
atopic syndrome can be prevented or delayed through
exclusive breastfeeding for four months, though these
benefits may not be present after four months of age.
However, the key factor may be the age at which non-breastmilk
is introduced rather than duration of breastfeeding.
 Atopic dermatitis, the most common form of eczema, can be
reduced through exclusive breastfeeding beyond 12 weeks in
individuals with a family history of atopy, but when
breastfeeding beyond 12 weeks is combined with other foods
incidents of eczema rise irrespective of family history.

9. Benefits of Breastfeeding to Mothers
Bonding
 Skin-to-skin contact (also called kangaroo care) of mother and
baby stimulates breast feeding behavior in the baby. Newborn
infants who are immediately placed on their mother’s skin have
a natural instinct to latch on to the breast and start nursing,
typically within one hour of being born. It is thought that
immediate skin-to-skin contact provides a form of imprinting
that makes subsequent feeding significantly easier.
 The World Health Organization reports that in addition to more
successful breastfeeding, skin-to-skin contact between a
mother and her newborn baby immediately after delivery also
reduces crying, improves mother to infant interaction, and
keeps baby warm.
 Hormones released during breastfeeding help to strengthen
the maternal bond.

10. Hormone release
 Breastfeeding releases oxytocin and prolactin, hormones
that relax the mother and make her feel more nurturing
toward her baby.
This hormone release can help to enable sleep even
where a mother may otherwise be having difficulty
sleeping.
 Breastfeeding soon after giving birth increases the
mother's oxytocin levels, making her uterus contract more
quickly and reducing bleeding.
 Pitocin, a synthetic hormone used to make the uterus
contract during and after labour, is structurally modelled on
oxytocin.

11. Weight loss
As the fat accumulated during pregnancy is used to
produce milk, extended breastfeeding—at least 6
months—can help mothers lose weight.
However, weight loss is highly variable among
lactating women; monitoring the diet and increasing
the amount/intensity of exercise are more reliable
ways of losing weight.
The 2007 review for the AHRQ found "The effect of
breastfeeding in mothers on return-to-pre-pregnancy
weight was negligible, and the effect of breastfeeding
on postpartum weight loss was unclear.

12. Gestational changes
 Dramatic changes occur in a pregnant woman’s metabolism
and body composition as she accommodates the demands of
providing for the nutritional needs of the growing fetus, and
metabolizing for two.
 In anticipation of lactation, the mother accumulates some
stores of visceral fat, but most of it is stored as subcutaneous
fat in the thighs, arms, buttocks, and breasts. This shift in fat
content leads to increased Insulin production, insulin
resistance, and circulating lipid levels in the mother.
 Studies have indicated that gestational weight gain (GWG) may
contribute to complications during labor and delivery and it is
the most reliable factor in predicting postpartum weight
retention (PPWR). In general, the more weight that women put
on during pregnancy, the more weight that they retain
afterward.

13. Long-term health effects
 For breastfeeding women, long-term health benefits include:
 Less risk of breast cancer, ovarian cancer, and endometrial cancer.
 A 2009 study indicated that lactation for at least 24 months is
associated with a 23% lower risk of coronary heart disease.
 Although the 2007 review for the AHRQ found "no relationship
between a history of lactation and the risk of osteoporosis", mothers
who breastfeed longer than eight months benefit from bone re-mineralisation.
 Breastfeeding diabetic mothers require less insulin.
 Reduced risk of metabolic syndrome
 Reduced risk of post-partum bleeding.
 women who breast fed for a longer duration have a lower risk for
contracting rheumatoid arthritis than women who breast fed for a
shorter duration or who had never breast fed.

14. Milk
Milk is a white liquid produced by
the mammary glands of
mammals.
Primary source of nutrition for
young mammals before they are
able to digest other types of food.
It also contains many other
nutrients.

15. Breast milk
 Breastmilk is the best source of nutrients for infant
to meet his needs for growth and development.
 It contains many valuable ingredients, such as
antibodies, living immune cells and enzymes.
 It helps baby to build up immunity, and reduce the
chances of having diarrhea, chest infection and
hospital admissions.
 It contains substances, which cannot be obtained
from infant formula, that help both the digestion and
absorption of nutrients.

16. Comparison of human milk with cow’s & buffalo’s
milk(values per 100g)
Nutrient Human milk Cow’s
milk
Buffalo’s
milk
Water(g) 88 87.5 81
Energy (kcal) 65 67 117
Protein(g) 1.1 3.2 4.3
Carbohydrate(g) 7.4 4.4 5
Fat(g) 3.4 4.1 6.5
Calcium(mg) 28 120 210
Phosphorus(mg) 11 90 130
Iron(mg) - 0.2 0.2
Carotene(mcg) 137 174 160
Thiamine(mcg) 0.02 0.05 0.04
Riboflavin(mcg) 0.02 0.19 0.1
Vitamin C(mg) 3 2 1
Caseinogen/ Lactalbumin
1:2 3:1 -
ratio
Source: National Institute of Nutrition ICMR, Hyderabad

17. TYPES OF BREAST MILK
 Colostrum or Early Milk
 Transitional Milk
 Fore milk
 Hind milk

18. COLOSTRUM
During the first two or three days after delivery thick
and yellowish fluid is secreted from the mammary gland.
 This differs from the regular milk and is called
colostrum.
 It is secreted in small quantity of about 10-40 ml.
 it is rich in protein.
 The total fat content of colostrum is less than mature
milk.
Concentration of arachiodonic acid and docosa
hexaenoic acid (DHA) as percent of total fatty acids is
higher in colostrum than mature milk.

19. COMPOSITION OF COLOSTRUM
NUTRIENT AMOUNT
Energy, kcal
58
Fat, g
2.9
Calcium, mg
31
Phosphorus, mg
14
Iron, mg
0.09
Protein, g
2.7
Lactose, g
5.3
Carotene, IU
186
Vitamin A, IU
296

20. Colostrum - immunization to
the infant
colostrum contains
 Interferon like substance which possesses strong antiviral
activity.
 B12 binding protein which inhibits growth of E- Coli and
other bacteria.
 It also contains antibodies against viral diaseses such as
small pox, polio, measles and influenza.
 Enzymes like lysozyme, peroxidase and xanthine oxidase
that promotes cell maturation
 protective substances and enhances the development
and maturation of the baby’s gastrointestinal tract.
 Colostrum help’s a baby to pass his or her first stool.

21.  TRANSITION MILK
During the next two weeks, the milk increases in quantity
and changes in appearance and composition is called
transition milk.
The immunoglobin and protein content decreases while
the fat and sugar content increases.
Exclusive breast feeding of colostrum and transition milk
minimizes infection related to neonatal death.
The composition of milk changes even during the length
of a single feed to exactly suit the need of a particular
baby.

22. FOREMILK- The milk that comes at the start of a
feed is called foremilk. Foremilk which is watery has a
low level of fat and is high in lactose sugar, protein,
vitamins, minerals and water. It satisfies the baby
thirst.
HIND MILK: Hind milk which comes later in a feed
is richer in fat, it satisfies the baby’s hunger and
supplies more energy than foremilk. Babies who are
fed fore and hind milk sleep well and grow healthy.

23. ADVANTAGES
OF BREAST
FEEDING

24. Carbohydrates
High amount of lactose facilitates absorption of magnesium,
calcium, amino acid and nitrogen
retention
Galactose formation of myelin which is
essential for normal nerve function
Galacto lipids promote rapid brain growth

25. Protein
Whey Energy source (lactalbumin
predominant protein)
Casein Energy source ( low content relative
to cow’s milk) ; carrier of Ca, Fe,Zn
Cu andPhosphate
Lactalbumin amino acid pattern that provides
more essential amino acids
lactalbumin forms a soft flocculent
curd

26. Conti..
Rich in sulfur containing amino
acid
For brain development
High tryptophan to neutral
amino acids ratio
controls brain serotonin synthesis
contains binding proteins Increase absorption of thyroxine,
corticosterol, vitamin D, folate and
B12.

27. Lipids
 Essential fatty acids 6 % EPA / DHA
 High carnitine content oxidation and transport of essential
fatty acid
MINERALS
 Minerals are largely protein
bound
 Calcium phosphorus ratio
Enhance bioavailability
2:1

28. Vitamins
 Vitamin A, C and E
 Water soluble Vitamin D
 Low in vitamin K
 B1 and Vitamin C
More then cow’s milk
Protects from rickets
Need K supplement
Completely absorb

29. HORMONE AND GROWTH FACTOR
BENEFITS
Rich source of hormones
like thyroid stimulating
hormone (TSH),
thyroxine, parathyroid
hormone,
corticosteroids,
calcitonin,
erythropoietin, oxytocin,
growth hormone
releasing factor, insulin
and prolactin
Enhance growth and
modulators

30. Components of Breast Milk
IMMUNOLOGICAL BENEFITS
Immunoglobulins (IgA ,IgM, IgE,
EgD)
Protective against bacterial and
virus infections
Bifidus Factors Promotes formation of healthy
bacterial colonization in infant’s
lower GI
Lactoferrin Iron binding protein that reduces the
availability of iron to bacteria in the
GIT
Lacto peroxidase Destroys bacteria
Lysozyme Kills bacteria by destroying the cell
wall

31. Enzymes
like amylase, lipoprotein lipase, oxidases,
lactoperxidases and leucocyte
mycloperoxidase
Increases digestibility and also act as
defense against microbes.
Macrophages Destroy bacteria by phagocytosis,
synthesizes lactoferin and lyzozyme
Interferon Interferes with viral replication in host cells
Lymphocytes Synthesizes IgA
Antistaphylococcus factor Inhibits the growth of staphylococcal
bacteria

32. Artificial
feeding

33. Reasons and benefits of formula feeding
 The mother's health: The mother is infected with HIV or
has active tuberculosis. She is malnourished, extremely ill or
has had certain kinds of breast surgery. She is taking any
kind of drug that could harm the baby, or drinks unsafe levels
of alcohol.
 The baby is unable to breastfeed: The child has a birth
defect or inborn error of metabolism such
as galactosemia that makes breastfeeding difficult or
impossible.
 The baby is considered at risk for malnutrition: In certain
circumstances infants may be at risk for malnutrition, such
as due to iron deficiency, vitamin deficiencies (e.g. vitamin
D which may be less present in breast milk than needed at
high latitudes where there is less sun exposure), or
inadequate nutrition during transition to solid foods.

34.  Personal preferences, beliefs, and experiences: The
mother may dislike breast-feeding or think it inconvenient. In
addition, breastfeeding can be difficult for victims of rape or
sexual abuse; for example, it may be a trigger for post
traumatic stress disorder.
 Absence of the mother: The child is adopted, orphaned,
abandoned, or in the sole custody of a man. The mother is
separated from her child by being in prison or a mental
hospital. The mother has left the child in the care of another
person for an extended period of time, such as while traveling
or working abroad.
 Food allergies: The mother eats foods that may provoke an
allergic reaction in the infant.

35.  Societal structure: Breastfeeding may be forbidden at the
mother's job, school, place of worship or in other public places,
or the mother may feel that breastfeeding in these places or
around other people is immodest, unsanitary, or inappropriate.
 Social pressures: Family members, such as mother's
husband, friends or other members of society may encourage
the use of infant formula. For example, they may believe that
breastfeeding will decrease the mother's energy, health, or
attractiveness.
 Lack of training: The mother is not trained sufficiently to
breastfeed without pain and to produce enough milk.
 Lactation insufficiency: The mother is unable to produce
sufficient milk

36.  Financial pressures: Maternity leave is unpaid,
insufficient, or lacking. The mother's employment
interferes with breastfeeding.
 Fear of exposure to environmental
contaminants: Certain environmental pollutants,
such as polychlorinated biphenyls, can bio
accumulate in the food chain and may be found in
humans including mothers' breast milk.
 Lack of other sources of breast milk:
 Lack of wet nurses
 Lack of milk banks

37. Formula feeding
 Infant formula is a manufactured food designed
and marketed for feeding to babies and infants
under 12 months of age, usually prepared for bottle-feeding
or cup-feeding from powder (mixed with
water) or liquid (with or without additional water).

38.  The composition of infant formula is designed to be
roughly based on a human mother's milk at
approximately one to three months postpartum, although
there are significant differences in the nutrient content of
these products.
 The most commonly used infant formulas contain
purified cow's milk whey and casein as a protein source,
a blend of vegetable oils as a fat source, lactose as
a carbohydrate source, a vitamin-mineral mix, and other
ingredients depending on the manufacturer.

39. Formula milk
 Cows milk is diluted to provide a concentration
of protein similar to human milk
 This lead to the formation of a softer more
flocculent curd that can be more easily
digested by infant’s enzymes
 Advantage of diluted milk to creating a calcium
concentration more near to human milk but
reduces calorie concentration
 During the first 2 weeks about 15 g sugar is
added to the formula milk thereafter 30 g is
sufficient.

40. Standard infant formula
 Standard infant formula have cow’s milk as a
base.
In making infant formula first remove the milk fat
and replace it with vegetable oil.
Fortified with all essential vitamins and minerals.
Available with or without added iron.
Several brands of infant formula now contain three
fatty acids that are prevalent in human milk:
arachidonic acid(ARA), eicosapentaenoic(EPA)
acid and docosahexaenoic acid(DHA).
Studies show that supplemental ARA & EPA may
benefit infant’s visual function and cognitive
development.

41. Soy- based formula
Soy is the source of protein.
To compensate for the inferior digestibility
of soy protein, soy formula contain more
protein than formula based on cow’s milk.
Lactose free and iron fortified.
Corn syrup and sucrose are the
carbohydrate sources.

42. Other type of formula
Special formula are available for infant who
are allergic to both cow’s milk and soy
protein, those who are premature and rare
defects in metabolic pathways.
Theses special formulas often have their
protein content modified in either its
digestibility or its amino acid composition.
Many special formula contain medium-chain
triglycerides as the major fat source.

43. Some other advantages of formula
feeding includes:
 Formula feeding gives the mother greater flexibility
with her schedule. The father and other caretakers can
easily step in, give a bottle, and establish their own
bonding routines.
 It is easy to tell how much the baby is getting.
 Babies digest formula slower than breast milk. As a
result, formula-fed babies typically go longer between
feedings during the day and especially the night.

44.  Convenience.
 Flexibility.
 Because formula is less digestible than
breast milk, formula-fed babies usually need
to eat less often than do breastfed babies.

45. Disadvatage of formula feeding
 Use of infant formula has been cited for numerous
increased health risks.
 Infants fed on formula are at increased risk for
acute otitis media, gastroenteritis, severe lower
respiratory tract infections,
atopic dermatitis, asthma, obesity, type 1 and
2 diabetes, sudden infant death
syndrome (SIDS), eczema, necrotizing
enterocolitis and autism when compared to infants
who are breastfed.

46.  Some studies have found an association between infant
formula and lower cognitive development, including iron
supplementation in baby formula being linked to
lowered I.Q. and other neurodevelopmental delays.
 In addition, mothers who forego breastfeeding in favour of
formula feeding are reported more likely to develop certain
types of cancer.
 Lack of antibodies. None of the antibodies found in breast
milk are found in manufactured formula, which means that
formula doesn't provide the baby with the added protection
against infection and illness that breast milk does.
 Expense. Formula can be costly.

47. • Possibility of producing gas and constipation. Formula-fed
babies may have more gas and firmer bowel
movements than breastfed babies.
• Can't match the complexity of breast milk.
Manufactured formulas have yet to duplicate the
complexity of breast milk, which changes as the baby's
needs change.
• Babies often cannot digest formula as easily as breast
milk, so it could give cause gas and other gastric irritations.
• Because it takes babies longer to digest formula, it has just
enough time to ferment -- making for some really stinky
diaper changes.

48. RISKS OF ARTIFICIAL FEEDING
 Interferes with bonding.
 More diarrhoea & respiratory infections.
 Malnutrition; vitamin A deficiency.
 Mother may become pregnant sooner.
 More allergy & milk intolerance.
 Increased risk of chronic diseases.
 Over feeding may take place.
 Lower scores on intelligence scale.
 Increased risk of anaemia, ovarian cancer &
breast cancer.