Rosalee Brown
THE THEME of this year's breast-feeding week focuses on continuing breastfeeding for two years or beyond. It also seeks to remind us of the risk and cost of introducing foods other than breast milk to a child before six months old. There are a few medical conditions where replacement feeding, which includes infant formula, is advised.
The age from birth to two years old is a critical period for both physical and mental development and also a vulnerable period for the young child as it relates to many nutrition- related disorders such as micronutrient deficiencies. These are many times exacerbated by illnesses such as diarrhoea and acute respiratory infections.
Children at this age are at risk for inappropriate amounts of energy in their diets, in some cases inadequate amounts, but in many cases excessive amounts. Unfortunately, many of the meals offered are not dense in vital nutrients and this often leads to insufficient weight gain, growth faltering and at the other end of the spectrum, a child who is often times very large for his or her age.
BREASTFEEDING TO SIX MONTHS
A woman should start planning for breastfeeding, as soon as she is pregnant, by educating herself. Women who visit public clinics are educated about the importance of breastfeeding and how to successfully breastfeed. Jamaica has for many years been promoting exclusive breastfeeding to six months and, being a signatory to the International Code of Marketing Breast Milk Substitutes, has adopted the Mother/ Baby Friendly Initiative and developed the National Infant Feeding Policy. Public Health Centres provide information on expressing and storing breast milk, which is especially useful for mothers who return to work after two to three months.
BEYOND SIX MONTHS
Beyond six months, exclusive breastfeeding is inadequate for the growing child and complementary foods are necessary to support growth and development. Breastfeeding is still appropriate at this stage and still forms a large percentage of caloric and nutrient intake.
Many children who were exclusively or partially breastfed are again at risk at this stage, because of the nature of the complementary foods given to them. Many times they are not nutrient dense and often times there is a cessation of breastfeeding. Sugary, high-water content juices may be energy dense, but will not provide necessary nutrients. Also, consumption of large amounts of milk drinks will not provide all the nutrients, energy and opportunity for developing the skills necessary for learning how to consume foods from the family pot.
Complementary foods should be dense in nutrients as well as calories. Children will consume small amounts so it should be nourishing and these amounts should increase incrementally with age and growth.
BREASTFEEDING TO TWO YEARS
This ensures the continual provision of wholesome foods for this critical period and the continuation of bonding and love as the child seeks to increase the consumption of family foods to support growth and development.
RELACTATION IN A CRISIS
Relactation is restarting breastfeeding after it has stopped for some time; breast milk is produced on demand so if the child is put to the breast and sucks repeatedly for some time, lactation can restart but this is often a challenging task. This is important to note because in a crisis, like that which resulted from 'Katrina' in the U.S. Golf Coast where infants were dying because of dehydration, this is a possible option. Research has shown that women who have never been pregnant can induce lactation. Many times the mother will have to consume the limited ration and then breastfeed the infant or older child.
Rosalee Brown is a registered dietitian/nutritionist who operates Integrated Nutrition and Health Services; email: yourhealth@gleanerjm.com.
