LactoGenesis Breast Feeding: The Global Overview

1. LactoGenesis
Breast Feeding:
The Global
Overview
Dr Sharda Jain
Dr Jyoti Agarwal

3. World Breast Feeding Week

4. बच्चे क
े लिए म ाँ क दू ध अमृत है

6. Lactogenesis क्य है ?
Lactogenesis is the onset of milk secretion
and includes all of the changes in
the mammary epithelium necessary to go
from the undifferentiated mammary gland
in early pregnancy to full lactation in PPP

7. Stages
Stage I
occurs during pregnancy, when the gland becomes sufficiently
differentiated to secrete small quantities of specific milk
components, such as casein and lactose.(this occurs in Mid
pregnancy)…..ie Preterm birth
Stage II
from late pregnancy to day 8 is the onset of copious milk secretion
associated with parturition.(with Decrease in Progesterone levels )

8. Stage III
of Lactogenesis the breast Feeding now has local autocrine
control rather than endocrine control. There's a maintenance of
milk secretion and mature milk production is established. This
usually takes place at around day 10 postpartum and lasts until
weaning begins.
Stage iv
The maturation of alveolar cells. It takes place in 2
stages: secretory initiation and secretory activation.

9. Endocrine Control to Autocrine Control

10. Breast Feeding is the Gold Standard of
Infant Feeding

11. Lets Talk about the history
.
1.https://pubmed.ncbi.nlm.nih.gov/26869575/ Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect Cesar G Victora 1, Rajiv Bahl 2, PMID: 26869575 DOI:
10.1016/S01406736(15)01024-7
HISTORY
BF
UNIVERSAL
GOLDEN
HOUR
Concept
Was missing
???
DHAI
Wet Nurse
Human have
breast fed their
children 3-4 years
Human Milk banks

12. Decrease in Breast feeding is
Civilization
Problem

13. The Golden hour of
Breast Feeding

14. Skin to Skin Contact + Breast Feeding
• Skin-to-skin contact is vital for baby
• It satisfies baby’s need - comforting or calming
• Can help boost a mother's milk supply.
• It increase anti-fight/ flight response in the infant – calm
,strong ,intelligent.
• Skin-to-skin contact is vital in neonatal units for preterm
infant where it is often known as 'kangaroo care

15. kangaroo
mother
care

16. WIDE VERIATION
Luckily India is
BF country

17. http://data.unicef.org/nutrition/iycf
India
40%
100%

18. Global Trends
Golden Hour Feeding is 40%
Exclusive breast feeding is just
over 63.7% for 6 months
Ref NFHS 5 19-21
Ever Breastfed – 83%
Breast Feeding 6months – 57.6%
BF 12months – 35.9%
Golden hour feeding 26%
Exclusive BF for 3 months – 47%
Exclusive BF for 6 months – 25%
Lactation Facility at work place – 50%
Formula feeding for 2 days – 18%
INDIA USA 2015

19. What are the statistics for NFHS 5
breastfeeding?
The latest National Family Health Survey (NFHS-5; 2019-21) statistics
have recorded the largest improvement in the percentage of children
who were exclusively breastfed under six months of age, from 55% in
NFHS-4 to 64% in NFHS-5.
03-Aug-2022 MOH

20. Breastfeeding Statistics of India
Children under 3 years breasfed
Golden hour of birth (%) in last three surveys
6 months exclusively breastfed (%)
(64%)
(55%)
(40%)

21. Importance of Antenatal Counseling on BF CDC US + FDA(IFPSII)
GROUP A
Counselling done in
3rd trimester
GROUP B
Counseling Not Done
7.8 months
Feeding
Dedication session on counselling on breast feeding & details of BF are of vital importance
3.8 months

22. Breastfeeding is Good Obstetric Practice
Breastfeeding is recognized as COMPLETE nutrition for infants,
providing numerous benefits to both mother and child such as:
 Makes them STRONG by giving Protection against child
infections ., increases intelligence, and probable future
reductions in NCD – obesity , diabetes.& stroke
 Beside SHAPING her ,It gives protection against breast cancer
and improved birth spacing, and also protect against ovarian
cancer and type 2 diabetes.
1.https://pubmed.ncbi.nlm.nih.gov/26869575/ Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect Cesar G Victora 1, Rajiv Bahl 2, PMID: 26869575 DOI:
10.1016/S01406736(15)01024-7

23. Lessons learnt : Facts about Breastfeeding
 Breastfeeding for the first 6 months is crucial.
 Protects infants from childhood illnesses.
 Mothers should continue breastfeeding at work
 Benefits mothers as it reduces risks of breast and ovarian
cancer, type II diabetes, and postpartum depression..
 Infant formula does not contain the antibodies found in breast
milk  not to be promoted..
Breastfeeding (who.int) (https://www.who.int/health-topics/breastfeeding#tab=tab_1)
Dr Sharda Jain

24. Breast feeding & Breast Milk
• Optimal somatic growth
• Metabolic competence
• Optimal cognitive development
• Increase infant response to infection & modulate
inflammatory responses
• Increase Mother to Child bonding

25. Lessons learnt : Facts about Breastfeeding
 Transmission of HIV through breastfeeding can
be reduced with drugs (Antiretrovirals).
Zero viral load – Zero Mother to Child Transfer.
 Solid foods should be started at six months or after.
 Long-term benefits for children such as the reduced risk of
obesity and type-II diabetes. Along with, better performance in
intelligence tests.
Breastfeeding (who.int) (https://www.who.int/health-topics/breastfeeding#tab=tab_1)
Dr Sharda Jain

26. Improved rated of breast feeding lead to…

28. TIME has come for Obstetrician plays a
Critical role in supporting BREASTFEEDING 
should not miss this COUNSELLING SESSION for
GOLDEN HOUR .ie FIRST ONE HOUR

29. Biggest Myth in public / Nurses / Doctor
Mind that formula feed is = breast milk
 Breastfeeding is easy.
 You should
wash your
nipples before
breastfeeding.
 It’s usual for
breastfeeding to hurt
– sore nipples are
inevitable.
 You should separate
a newborn and
mother to let the
mother rest.
 Only eat plain food.
 You can never
use formula if
you want to
breastfeed.
 Shouldn't
breastfeed if you’re
sick
 Exercise will affect
the taste of your
milk.
.
 Can’t take any
medication.
 Breastfeeding
causes sagging
breasts.
 Breastfed babies
are clingy.
 It’s hard to wean a
baby if you
breastfeed for more
than a year.
Myths about Breastfeeding

30. Challenges faced
1. Common challenges include the following:
Lack of experience or information to mothers
Pain
Too little or too much milk
Depression or anxiety
No facilities of accommodating breastfeeding or
pumping at the workplace

31. Challenges :
Lack of knowledge and training:
NO knowledge given in School & Colleges curricula about BF
OBSTETRICIANS and NURSES may not have received adequate training
in breastfeeding support and management, leading to a lack of confidence
and competence in providing effective support to breastfeeding mothers.
School & Colleges
NIL
Doctors & Nurses
is very patchy
7 days exclusive training on
bf is must during MBBS
Course
Basic Nursing Course

32. Challenges

33. Challenges:
Medical interventions may negatively
impact breastfeeding outcomes.
C – Section
Lack of support from family and community: nuclear family
Formula Feed

34. Other Challenges
Maternity leave policies: Maternity leave policies can impact the
ability of mothers to breastfeed, as returning to work too soon
after delivery can make it difficult to continue breastfeeding.
Lack of support from family and community: eg
Lack of access to lactation support team: Many mothers may not
have access to lactation consultants or other breastfeeding
support resources, which can limit their ability to overcome
breastfeeding challenges and achieve their breastfeeding goals.

35. The World Health Organization (WHO) + MOH recommends:
 Exclusive breastfeeding for the first six months of life.
 Continued breastfeeding alongside complementary foods for up to two
years or beyond.
 They emphasize the importance of early initiation of breastfeeding 
Golden hour
 Skin-to-skin contact between mother and infant.
 Supportive hospital practices, such as rooming-in and avoiding the use of
artificial nipples or pacifiers.

36. III. The Baby-Friendly Hospital Initiative (BFHI) is a global program that aims to promote and support
breastfeeding in healthcare facilities. The BFHI provides:
 Evidence-based guidelines and training for healthcare professionals to optimize breastfeeding
support
 Ten steps to successful breastfeeding and the international code of marketing of breastmilk
substitutes.
IV. The Centers for Disease Control and Prevention (CDC) + ministry of Health also provide
guidelines for optimizing breastfeeding support in healthcare settings. They recommend that:
 Healthcare professionals offer education and support for breastfeeding mothers.
 Provide breastfeeding-friendly environments.
 Collaborate with community resources to promote continued breastfeeding after discharge.
Baby-Friendly Hospital Initiative (BFHI)

37. Financial aspect of
Universal Breast Feeding as a AIM
Saves Billions &
Billions
of Dollar
Improves
Health of the
Mother
& Child