Breastfeeding Best Practices for Filipinos

See below for some of the Breastfeeding Best Practices for Filipinos that we have collated:

Why is early initiation of breastfeeding very important?
Some babies die after birth because they were not breastfed immediately. Breastfeeding should be initiated at once – about 30 minutes after normal delivery and about 3-4 hours after delivery by caesarian section. Providing breastmilk within the first hour after delivery can save up to 22% of infants from death and about 16% when they are breastfed within the first day thus, decreasing the rate of infant mortality significantly. Infants who were given early breastfeeding will have the opportunity to be more successful and sustain exclusive breastfeeding.

In addition, babies who are breastfed immediately can help avoid the risj of hypothermia as the warmth of the mother’s breast helps regulate the baby’s body temperature and avoiding the risj of death due to cold. Also, babies that were placed on the mother’s chest will be calmer as it reduces stress and stabilizesx the heartbeat and breathing.

On the other hand, the baby’s touch and suckle can help stimulate the production of oxytocin by the mother which causes uterine contractions that help reduce bleeding; stimulates other hormones, which makes the mother calm and relaxed and stimulates the production of breastmilk.

Early initiation of breastfeeding is part of the Essential Newborn Care Protocol adopted by the Department of Health. The four key elements of the protocol are:
• Immediate and thorough drying up of the newborn for 30 seconds to one minute warms the newborn and stimulates breathing.
• Early skin-to-skin contact between newborn and mother and delayed washing for at least 6 hours prevents hypothermia, infection and hypoglycemia.
• Properly timed cord clamping and cutting prevents the newborn from having anemia and protects against brain hemorrhage in premature newborns.
• Continuous non-separation of newborn and mother for early breastfeeding protects newborns from dying due to infections.

What are the disadvantages of exclusive breastfeeding for the mother?
a. Physiological benefits
• Breastfeeding promotes uterine involution, decreases risk of postpartum hemorrhage and increases period of postpartum anovulation (having periods without ovulating)
• Mothers can also practice natural child spacing since breastfeeding delays ovulation. This is called Lactation Amenorrhea Method (LAM). A lactating woman has at least 98% protection from pregnancy for six (6) months when she remains without her period (ammenorrheic) and fully or nearly fully breastfeeds/
• Breastfeeding also decreases the risk of breast cancer, ovarian cancer and hip and bone fractures.
• Breastfeeding also makes it easier for night feeds.
b. Psychological benefit
• Breastfeeding promotes attachment between the mother and child, increases self-esteem to mothers and allows daily rests for mothers. It is important for the optimal health and development of the baby. Breastmilk provides every single essential nutrient in the development of the baby, and the bonding element (mother’s thoughts, emotions and vibrations) that helps mother and baby to bond for life.
c. Financial benefit
• Breastfeeding can save as much as Php2,000.00 a month when compared to using other milks.
• Reduces time lost from work. Mothers do not have to absent themselves from work because breastfed babies are less likely to get sick.
• Reduces cost for medicines for sick baby because breastfed infants do not get sick easily.

What are the advantages of exclusive breastfeeding for the baby?
a. The human milk is naturally designed for human consumption. It is nutritionally superior to any alternatives, bacteriologically safe and always fresh. Breastfeeding promotes proper jaw, teeth and speech development. Suckling at the breast is comforting to fussy, overtired, ill or hurt baby. It also promotes bonding. Some of the other benefits of breastfeeding babies are:
b. Provides protection against infection. Breastmilk reduces the risk of acute infections such as diarrhea, pneumonia, ear infection, influenza, meningtitis and urinary tract infections.
c. Protects against illnesses. It protects against chronic disease in children such as allergies, diabetes, ulcerative colitis and chron’s disease. Breastfeeding promotes child development and is associated with lower risk factors for cardiovascular diseases including high blood pressure and obesity in later life.
d. Protects from allergies. Breastfed babies are exposed to fewer allergens in the first hour of life and the first feedings of colostrums literally ‘seal the gut’ (the porous lining of the intestine), providing a barrier to the absorption of allergy-producing agents. Both colostrums and mother’s mature milk are rich in antibodies, providing the baby the benefit of being immune for about 6 months of age.
e. Enhances intelligence. Human breast milk enhances brain development and improves cognitive development. According to the study by the American Academy of Pediatricians among the extremely low birth weight infants that a 10/ml per day increase in breast milk intake of infants increased the mental development index by 0.59 points, the psychomotor developmental index by 0.56pts and total behavior percentile score by 0.99 points using the Bayley Mental Developmental Score. The risk of rehospitalization of babies from discharge to 30 months decreased by 5%. World Alliance for Breastfeeding Action (WABA) says that the average I.Q. oif 7 and 8 year old children who were breastfed as infants was 10 points higher than their bottle-fed counterparts.

Why do exclusively breastfed babies need no additional water?
Healthy infants need about 80-100ml of water per kilogram of body weight in the first week of life and increases to 140-160 ml per kilogram between 3-6 months of age. The water requirements of the infant are all available from breast milk.

Eighty-eight (88) percent of breastmilk is made-up of water. Even though a newborn gets little water in colostrum, no additional water is needed because a baby is born with extra water. The breastmilk with higher water content is usually available in mothers about the third or fourth day from birth.

Beast milk is also low in solutes or dissolved substances such sodium, potassium, nitrogen and chloride. Thus, less water is needed to flush out these solutes. With less solutes, the baby’s kidneys which are still immature are not overworked.

How can a pregnant woman prepare for breastfeeding?
a. During pregnancy, women should eat an extra meal a day for adequate weight gain to support fetal growth and future lactation; and take iron/folate supplements.
b. During lactation, women should eat the equivalent of an additional nutritionally-balanced meal a day. She needs also high-dose vitamin A supplements within one month after delivery to build stores and to improve the vitamin A content of breastmilk.
c. Pregnant women should prepare their breast and nipples for breastfeeding. For those with inverted nipples, use the Hoffman’s maneuver. This is a simple stretching exercise that pulls the skin back and away from the nipple with fingertips. For those with no nipple problems, the expectant mother can prepare her breasts during the last six weeks of pregnancy. She can pull the nipple gently in all directions; grasp the nipples with two fingers and pull and roll them back and forth; and gently massage her breasts.

What are some breastfeeding techniques?
There are some techniques that make breastfeeding more effective:
a. Put the baby to the breast immediately after birth and allow baby to remain with the mother.
b. Mother could either sit down or lie down when breastfeeding. The position while breastfeeding should not make the mother feel tired.
c. Mothers should hold the baby close enough to her body, supporting the baby’s neck and shoulder.
d. Mothers could place the nipple on the baby’s cheek. This will make the baby turn and look for the nipple and grasp it by the mouth.
e. Mother could help the baby get enough milk by placing the baby’s lower lip toward the base of the areola. This assures that the nipple is at the center of the baby’s mouth.
f. Mothers should offer both breasts to the baby one after the other at each feeding time, allowing the baby to suckle on each breast for about 5-15 minutes. For the next feeding time, mother should start feeding on the breast last used by the baby. If the baby is satisfied after feeding from only one breast, mother should express the milk from the other breast. She should start feeding on this breast at the next feeding. This will ensure equal suckling and emptying of both breasts.
g. Breastfeed frequently, as often as the baby wants, day and night. The signs when the baby is hungry are: when baby turns towards the breast and searches for the nipple, licking movements, flexing arms, clenching fists, tensing body and kicking legs. Crying is the last sign of hunger.
h. Continue breastfeeding even if the mother or the baby becomes ill. Mothers suffering from headaches, backaches, colds, diarrhea or any other common illness, should continue to breastfeed her baby. Sick mothers need to rest and drink plenty of fluids to help her recover. If the mother does not get better, she should consult a health worker and say that she is breastfeeding. If the baby has diarrhea or fever, the mother should continue to exclusively breastfeed and frequently to avoid dehydration and malnutrition. Breastmilk contains water, sugar, and salts in adequate quantities to help the baby recover quickly. In cases of severe diarrhea, the mother should continue to breastfeed and provide oral rehydration solution using a spoon or a cup. Medical help should be sought.
i. Avoid using bottles, pacifiers (dummies), or other artificial nipples.

How can working mothers continue to breastfeed their baby?
Mothers can continue breastfeeding even when they have to return to work. Working mothers can breastfeed their baby before leaving work, after returning from work, at night and day-off or on weekends. While at work, mothers can express their milk to relieve pain due to full breasts, to ensure continuous milk production and prevent breasts from drying up. While the mother is away, the expressed breastmilk can be fed to the baby using a clean cup.

What are the policies and programs that promote, protect and support breastfeeding?
• Executive order 51 or the “National Code of Marketing of Breastmilk substitutes, Breastmilk supplements and other related products, penalizing violation thereof, and for other purposes”, otherwise known as the Milk Code. It aims to promote, protect and support breastfeeding through intensified dissemination of information on breastfeeding and the regulation of advertising, marketing and distribution of breastmilk substitute and other related products, including bottles and teats.
• RA 7600 or “The Rooming-In and Breastfeeding Act of 1992”. This law aims to create an environment where basic physical, emotional and psychological needs of mothers and infants are fulfilled after birth through the practice of rooming-in and breastfeeding. Health institutions must provide facilities or rooming-in and breastfeeding expenses incurred, in this regard, it shall be deductible expenses for income tax purposes.
• RA 10028 or “Expanded Breastfeeding Promotion Act of 2009”. The law provides for the necessary support services to enable breastfeeding mothers to combine family obligations with work responsibilities. The law provides for the establishment of lactation stations in workplaces, provision of breastfeeding breaks for working breastfeeding mothers, establishment of human milk banks in health institutions, inclusion of breastfeeding in curriculums of schools and declaring August of each year as Breastfeeding Awareness Month.
• DOH Administrative Order (AO) 2005-0014- “National Policies on Infant and Young Child Feeding”. The policy provides the guidelines for improving the survival of infants and young children by improving their nutritional status, growth and development through optimal feeding anchored on exclusive breastfeeding, early initiation within one hour after birth, provision of timely adequate and safe complementary food at six months while continuing breastfeeding up to two years and beyond. The AO is supported with the National Plan of Action for Infant and Young Child Feeding.
• DOH AO 2007-0026 or the “Revitalization of Mother-Baby Friendly Hospital Initiative in Health Facilities with maternity and Newborn Care services”. The AO aims to transform these health institutions into facilities that protect, promote and support rooming-In, breastfeeding and mother-baby friendly practices.
• DOH AO 2009-0025 or “Adopting New Policies and Protocol on Essential Newborn Care”. It provides guidelines on evidence-based essential newborn care for health workers and medical practitioners. The protocol entails four key elements including: 1) immediate and thorough drying of the newborn; 2) early skin-to-skin contact of the newborn to mother’s skin 3) properly-timed cord clamping and cutting; and 4) non-separation of the newborn from the mother for early breastfeeding initiation and rooming-In.
• Philippine Plan of Action for Nutrition. The country’s framework for nutrition identifies as priority action the promotion, protection and support of breastfeeding and complementary feeding and the other necessary conditions to promote infant and young child feeding practices.

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