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Natural feeding of a child. Natural feeding of children. Rules and stages of breastfeeding a newborn baby

Natural feeding of a child. Natural feeding of children. Rules and stages of breastfeeding a newborn baby

NATURAL FEEDING.

Feeding a baby with breast milk is called natural.

¨ Human milk is a unique and most balanced food product for a child of the first year of life;

¨ The composition of each mother’s breast milk exactly corresponds to the needs of her baby for various substances: proteins, fats, carbohydrates, vitamins and minerals;

¨ Mother's milk contains special substances - enzymes that promote the digestion and absorption of proteins, fats and carbohydrates;

¨ Mother’s milk contains immunoglobulins and immune cells that protect the child from most infectious diseases: intestinal infections, infectious hepatitis, diphtheria, tetanus and others;

¨ Breast milk contains substances that regulate the growth and development of the child and ensure the correct formation of his brain and intellect (hormones, growth factors, taurine, zinc, iodine, etc.);

¨ In the process of breastfeeding, a special, very close relationship arises between mother and child, the warmth of which remains throughout the rest of life;

¨ Breastfeeding is good for the mother's health because... it promotes contraction of the uterus after childbirth, helps restore the figure and is the best prevention of mastopathy and breast cancer.

Natural feeding is a physiological phenomenon for mother and child and therefore cases of true lack of milk are rare. The most responsible period for restoring lactation in the mother is the first 3-4 months after birth. We can recommend the following rules necessary for successful feeding:

¨ early attachment of the baby to the breast (in the delivery room);

¨ in the first weeks, it is advisable to provide the child with a free feeding regime (at the child’s request) and only later transfer the child to feeding according to the hour, which he himself chose;

¨ when introducing complementary foods, to prevent the extinction of lactation, it is recommended to put the baby to the breast at the end of each feeding;

¨ if there is not enough milk, it is necessary to put the baby to the breast often. We must remember that every drop of mother’s milk is priceless for an infant. At the same time, frequent breastfeeding can increase milk production in the mammary gland.

NUTRITION FOR A NURSING MOTHER.

A nursing mother must receive a complete, balanced diet, since a woman spends additional energy and nutrients to produce milk, and, therefore, it is necessary to replenish these costs.

The calorie content of the mother's diet during lactation should be increased by an average of 30-40% and amount to 2500-3000 kcal/day. The amount of protein should be about 100 g (60-70% of animal origin), fat - 85-90 g (15-20 g - vegetable fat), carbohydrates - 300-400 g. This amount of nutrients corresponds to that developed by the Institute of Nutrition RAMS is an approximate daily set of products, which includes: 200 g of meat or poultry, 70 g of fish, up to 600 ml. milk in any form (it is advisable to consume fermented milk products, 50 g of cottage cheese, 20 g of cheese, 400 g of various vegetables, 200 g of potatoes and 200-300 g of fruits and berries.

The amount of liquid (including soups, vegetables, etc.) should average 2 liters.

During breastfeeding, mothers should take some kind of multivitamin preparation containing vitamin D (for example, Gendevit - 2 tablets per day).

LURE. KINDS. INTRODUCTION RULES.

Complementary feeding is an independent type of nutrition, replacing one and then several feedings with breast milk or formula. Talk to your pediatrician about prescribing complementary foods. The introduction of complementary foods is due to:

¨ increasing the growing baby’s need for energy and basic food ingredients (P.ZH.U.);

¨ increasing the child’s body’s need for minerals (iron, calcium, magnesium) and vitamins;

¨ the need to train the masticatory apparatus;

¨ the need to stimulate the digestive glands and their gradual adaptation to the digestion of adult food;

¨ the need to introduce plant fibers, which play an important role in the proper functioning of the child’s gastrointestinal tract;

¨ the need to educate the child in the skills of consuming new types of food, including thicker consistency, which prepares him for weaning.

BASIC RULES FOR INTRODUCTION OF COMPLETE FEEDINGS.

¨ Start introducing complementary foods only to a healthy child or, as a last resort, during the recovery period, with normal stool;

¨ complementary foods are introduced warm before breastfeeding or formula feeding;

¨ complementary foods are given from a spoon, vegetable puree can be first added to a bottle of milk so that the child gets used to the new taste more easily;

¨ each complementary food is introduced gradually, from small quantities (1-2 teaspoons) and is brought up to the age dose within two weeks;

¨ a new type of complementary feeding is switched to 1.5-2 weeks after the introduction of the previous one;

¨ the density of complementary foods should gradually increase;

¨ second complementary food - cereal porridges - you need to start introducing them with gluten-free porridges (rice, corn, buckwheat) and cook them with the milk or formula that the child receives;

¨ Baby food in jars contains the optimal amount of salt and sugar and therefore should not be added.

DIFFERENT PERIODS OF CHILD NUTRITION.

The processes of assimilation of food in the human body are quite complex, and in children of the first year of life, given their intensive growth and insufficient maturation of the formations of all organs and systems, they proceed with a particularly heavy load.

We can roughly distinguish several periods of feeding children:

1. from 0 to 3-6 months when the child receives only milk;

2. from 3-6 months to 1 year– transitions, during which complementary foods are gradually introduced into the child’s diet;

3. from 1 year to 3 years– early childhood, when the child gradually and carefully becomes accustomed to traditional family dishes;

4.5. preschool ( from 3 to 6 years) and school ( from 7 to 14 years), characterized by a wide range of foods and dishes used in nutrition, basically no different from those received by adults.

1st period. If the child is breastfed naturally, then up to 3 months It is inappropriate and even harmful to include other products in the diet in addition to milk. It may be necessary to include vitamin D. In the absence of human milk, commercially produced substitutes should serve as the main food product.

2nd period. Breast milk or breast milk substitutes continue to be the mainstay of a child's diet. The recommended daily dose, depending on the age of the child, is from 400 to 800 ml. milk.

The number of products that are primarily included in the diet of children as a supplement to breast milk or its substitutes are fruit juices. This is primarily due to the fact that they have the same liquid consistency familiar to a baby as milk. At the same time, the introduction of juice allows you to provide the child with a number of new nutrients that he needs; sugars new to the baby (glucose, fructose), organic acids (citric, malic); promotes the absorption of milk nutrients, as well as additional amounts of vitamin C, potassium, and iron. Taking into account the unfavorable environmental situation, it is most advisable to introduce natural industrial juices into the diet of children. Juices should be introduced into the diet gradually, starting with two teaspoons, and increased over 2-3 weeks to 30-40 ml, and then by 8-10 months to 80-100 ml. in a day.

When breastfeeding, juices should be introduced into the child’s diet no earlier than 3 months of age.

It is advisable to introduce regular juice first into the child’s diet, which is characterized by low acidity and low potential allergenicity, then pear, plum, apricot, peach, raspberry, cherry, blackcurrant, orange, tangerine, strawberry juices, which are among the products with potentially high allergenicity, can be recommended. that should not be given earlier 6-7 months. This also applies to tropical juices and juices from other exotic fruits (papaya, mango). The introduction of juices should be made from one type of fruit (to exclude its possible allergenic effect) and only after getting used to it, mixed fruit juices can be introduced into the baby’s diet.

3rd period, 4th period, 5th period. Starting from the age of one year, the child, as a rule, no longer receives breast milk and can consume the same foods as an adult. However, one should avoid giving dried fruits, which can only be administered after 18 months. Pancake week fruits (peanuts, almonds and others) are practically prohibited up to 5 years. Sausages can be given in very small quantities. Chocolate and chocolate candies are best given to children after 5 years, but before this age, give the child marshmallows, marmalade, marshmallows, honey, jam, jam. To instill healthy habits in a future adult, you should not add too much sugar and salt to your food, and you should limit your consumption of fatty foods and sauces. It is better to use eggs no more than twice a week, boiled or fried.

Proper feeding of young children is not only the harmonious development and growth of the baby, but also laying the foundation for his health and resistance to infectious diseases and adverse environmental factors. Parents should pay the greatest attention to the nutrition of children in the first year of life. This is mainly due to the characteristics of their body (lack of nutrient reserves, unformed metabolic processes and an undeveloped defense mechanism), which complicates the process of assimilation of nutrients coming from food. A conversation about the nutrition of children in the first year of life must begin with a consideration of 3 main types of feeding: natural, artificial and mixed.

2.Natural feeding

Natural (breast) feeding is a form of nutrition for a newborn child and is the only physiologically adequate nutrition for a newborn and infant.

Feeding a baby with breast milk is called natural. Human milk is a unique and most balanced food product for a child of the first year of life; The composition of each mother's breast milk exactly corresponds to the needs of her baby for various substances: proteins, fats, carbohydrates, vitamins and minerals; Mother's milk contains special substances - enzymes that promote the digestion and absorption of proteins, fats and carbohydrates; Mother's milk contains immunoglobulins and immune cells that protect the child from most infectious diseases: intestinal infections, infectious hepatitis, diphtheria, tetanus and others;

2.1. Benefits of human milk:

1. Women's milk is completely devoid of antigenic properties, while cow's milk proteins have pronounced antigenic activity, which contributes to the appearance and intensification of allergic reactions in infants.

2. The total amount of protein in breast milk is significantly less than in cow's milk; its structure is similar to the proteins of the baby's cells. It is dominated by finely dispersed fractions, the particles of coarse casein protein are several times smaller than in cow's milk, which ensures that breast milk curdles in the stomach into more delicate flakes and thereby more completely digests it.

3. Human milk contains such a unique substance as taurine - a sulfur-containing amino acid that has neuro-active properties. With artificial feeding, protein overloads inevitably occur, since cow's milk contains three times more amino acids. These overloads are accompanied by intoxication and kidney damage due to metabolic disorders.

4. Human milk, especially colostrum, released in the first 3-4 days, is very rich in immunoglobulins, especially class A, with 90% being secretory IgA, which plays a fundamental role in the local immunity of the gastrointestinal tract of newborns. Leukocytes in breast milk synthesize interferon: it contains a large number of macrophages and lymphocytes. The level of lysozyme is 300 times higher than in cow's milk. It contains the antibiotic lactofelicin. Thanks to this, natural feeding ensures the development of immuno-biological protection of the infant, and therefore the morbidity and mortality of breastfed children is significantly lower than with artificial feeding.

5. The amount of fat in human and cow's milk is almost the same, but there is a significant difference in its composition: breast milk contains several times more unsaturated fatty acids. The breakdown of fat in infants begins in the stomach under the influence of breast milk lipase; it stimulates the appearance of active acidity in the stomach, promotes the regulation of the evacuation function of the stomach and the earlier release of pancreatic juice. All this facilitates the digestion and assimilation of fat, the individual components of which are included in the cells of all tissues and biologically active substances, are spent on the myelination of nerve fibers, providing an increased need for fats in a child of the 1st year of life.

6. Breast milk contains carbohydrates in relatively large quantities. They largely determine the microbial flora of the intestine. They contain B-lactose (up to 90%), which, together with oligoaminosaccharides, stimulates the growth of normal flora with a predominance of bifidobacteria, thereby suppressing the proliferation of pathogenic microorganisms and E. coli. In addition, B-lactose is involved in the synthesis of B vitamins.

7. Human milk is exceptionally rich in various enzymes: amylase, trypsin, lipase (there is almost 15 times more lipase in breast milk than in cow’s milk, and 100 times more amylase). This compensates for the child’s temporary low enzymatic activity and ensures the absorption of a fairly large volume of food.

8. The mineral composition of food and the content of bioelements in it are important for a growing organism. The concentration of calcium and phosphorus in breast milk is lower, but their absorption is two times better than from cow's milk. Therefore, with natural feeding, children suffer from rickets much easier and less often. The content of bioelements (sodium, magnesium, chlorine, iron, copper, zinc, cobalt, sulfur, etc.) in breast milk is optimal and meets the baby’s needs. Breast milk contains four times less sodium than cow's milk. Excessive sodium loads can cause vegetative-vascular dystonia with fluctuations in blood pressure during puberty, as well as more severe and more frequent crises in adult hypertension.

9. Breast milk differs from cow's milk in its higher content and higher activity of vitamins, in particular vitamin D, which also helps prevent rickets.

10. It has been shown that with natural feeding, sexual potency and fertility are higher in the future.

11. With natural feeding, a lifelong relationship with the mother is established, its subsequent influence on the child’s behavior, and future parental behavior is also formed.

Lactation in its natural development goes through a number of periods.
With the birth of a child comes adaptation period. It begins with the appearance of the first drops of colostrum in the mother's mammary gland and ends with a steadily increasing production of mature milk and the formation of a certain rhythm - from irregular latching to the breast to the formation of a stable feeding regimen with alternating rhythms of hunger and satiety. The duration of the adaptation period is on average 2–3 weeks.
Main period - successful feeding with gradually increasing or constant intervals between feedings, consistent with free feeding of the infant.
The normal lactation process is characterized by lactation crises. This is a short-term decrease in lactation, accompanied by anxiety in the child and a decrease in the number of urinations. Crises occur periodically - at 3-6 weeks, 3rd, 4th, 7th, 8th months. lactation. Their duration is on average 3–4 days, and they do not pose a danger to the child’s health. If the mother is instructed by the doctor about this possibility and promptly increases the frequency of breastfeeding, then she successfully increases the volume of lactation.

Definition of the concept of “natural feeding” and its varieties

Natural feeding This is feeding a child with breast milk while attaching it to the breast of the biological mother. From the standpoint of delimiting the volume of nutrition, according to the traditional domestic classification, with breastfeeding, the daily volume of nutrition is 80% or more represented by breast milk.
According to WHO terminology (1993), there are several types of natural feeding:
Exclusive breastfeeding - breastfeeding without supplementing with other food or drink. It is allowed to take vitamins, mineral salts, and medications.
Predominantly breastfeeding - when a child, in addition to mother's milk, receives a small amount of water or a drink containing water (tea).
Predominantly breastfeeding allows the use of “educational” thick complementary foods (no more than 30 g from a spoon) or the child irregularly receives limited quantities of adapted formulas (no more than 100 g per day).
Supplemented breastfeeding - mother's breast and regular feeding with formulas of more than 100 ml per day or the introduction of complementary foods of more than 30 g per day.
Optimal breastfeeding - This is exclusive breastfeeding with no intervals between feedings of more than 4–6 hours, a complete absence of the use of horns and nipples, and continued attachment to the breast for 6 months.
Natural feeding is optimal if the nursing mother is well-nourished.

10 principles, or steps, for successful breastfeeding, developed by UNICEF (1991)

1. Strictly adhere to the established rules of breastfeeding and regularly bring these rules to the attention of medical personnel and women in labor.
2. Train medical personnel in the necessary skills to practice breastfeeding.
3. Inform all pregnant women about the benefits and techniques of breastfeeding.
4. Help mothers initiate breastfeeding within the first half hour after birth. This provision applies only to healthy children and mothers.
5. Show mothers how to breastfeed and how to maintain lactation, even if they are temporarily separated from their children.
6. Do not give newborns any other food or drink other than breast milk, except for medical reasons.
7. Practice keeping the mother and newborn side by side in the same room around the clock.
8. Encourage breastfeeding on demand rather than on a schedule.
9. Do not give breastfed newborns any sedatives or devices that imitate the mother's breast (pacifiers, etc.).
10. Encourage the organization of breastfeeding support groups and refer mothers to these groups after discharge from the maternity hospital or hospital.

Absolute contraindications to breastfeeding

Contraindications to breastfeeding are very limited and are divided into 2 groups: contraindications from the child and from the mother.
1. From the child's side.
♦ Congenital metabolic diseases – phenylketonuria, galactosemia, “urine with the smell of maple syrup” disease.
♦ Congenital lactase deficiency.
In these cases, it is necessary to feed the child with artificial formulas, including medicinal ones.
2. From the mother's side.
♦ State of decompensation in chronic diseases of the heart, liver, kidneys.
♦ Acute mental illness.
♦ Malignant neoplasms.
♦ HIV infection, particularly dangerous infections (smallpox, anthrax), tetanus.
♦ Open form of tuberculosis with bacilli excretion. For tuberculosis, the child is vaccinated, the mother must receive courses of anti-tuberculosis drugs. Breastfeeding is possible after 1.5–2 months.
♦ Syphilis with infection of the mother after 6–7 months. pregnancy.

Absolute contraindications to early breastfeeding are limited. They should be considered as temporary restrictions on breastfeeding. In these cases, the mother should express milk to maintain the breast's ability to lactate.

Contraindications to early breastfeeding

1. From the child's side.
♦ Severe cerebrovascular accident.
♦ Birth trauma with central nervous system depression.
♦ Absence of sucking and swallowing reflex in prematurely born (premature) children.
♦ Hemolytic disease due to incompatibility of maternal and fetal red blood cells according to the Rh factor or the ABO system.
♦ The assessment of the newborn’s condition on the Apgar scale is below 7 points.
♦ Severe malformations (maxillofacial apparatus, heart, gastrointestinal tract).
2. From the mother's side.
♦ Surgical delivery, postpartum hemorrhage, severe forms of gestosis.
♦ Lack of consciousness.
♦ Infectious diseases of the mother (Appendix 1).
The presence of a number of infectious diseases in the mother requires the use of various feeding options, including “subnatural” bottle feeding, as well as options for sterilization and pasteurization of breast milk.
Relative contraindication early attachment of the child to the breast is the use of a number of drugs in the treatment of the mother: antibiotics (chloramphenicol, tetracycline), isoniazides, nalidixic acid, sulfonamides, estrogens, cytostatics, antithyroid drugs, diazepam, seduxen, lithium salts, meprobamate, phenyline, reserpine, atropine , ergotamine, iodine preparations, hexamidine.

Breastfeeding rules

1. Immediately after transfer from the delivery room, mother and child should be provided living together in one ward, where the baby’s crib is placed directly next to the mother’s bed. In such conditions, the mother has unlimited access to the baby at any time of the day and can feed on demand, that is, adhere to free feeding regime. An important advantage of mother and child being together is minimizing the risk of infection in the newborn. If a child is cared for by a mother, his body is populated by the mother’s microbes, and the milk contains specific antibodies to them. If a child is in a neonatal ward, his body becomes colonized with microbes from “strangers.” Although safe for them, they may turn out to be pathogenic for the newborn, and the mother’s milk may not contain the corresponding antibodies.
2. Feeding the baby on demand. From the first day of life, putting a baby to the breast should be based on any sign of discomfort and hunger. Signs of hunger There may be rotational movements of the head, active sucking movements of the lips, smacking lips, loud, persistent crying. The experience of the mother is very important, she must be able to differentiate the “hungry” cry of the child. However, you should know that a child may cry and worry for other reasons (discomfort due to heat, cold, wet diapers, fatigue, illness). In such cases, the mother’s attempts to eliminate the cause of crying by frequently putting the baby to the breast can lead to an overload of nutrition, which can serve as a risk factor for the development of gastrointestinal dysfunction and excessive weight gain. In some cases (colic), frequent feedings will increase the baby's discomfort.
3. One of the key factors in the formation and provision of full lactation is free feeding mode, in which children themselves set the intervals between feedings. In the first days and weeks (stage of colostrum and transitional milk) can be 12–20 or more times a day and determined by need child. The break between daytime feedings may not reach 2 hours, and between nighttime feedings should be no more than 3–4 hours. Night feedings are especially important, since the peak of prolactin production occurs in the evening and at night. However, it should be noted that the interval between feedings should not exceed 4 hours.
4. The duration of feeding is not limited, and this is important even when the child no longer sucks out practically anything, but is simply dozing. The need for contact and sucking can often be of an independent nature, relatively independent of the child’s eating behavior. Most children are satiated within 5-10 minutes, some take 20-30 minutes. Lazy suckers eat the same amount of milk as other babies. If they are taken away from the breast prematurely, they will not receive the hindmilk they need to develop normally and will go hungry. Sometimes breastfed babies are overweight. These are, as a rule, children with lymphatic-hypoplastic constitutional anomaly. It is often recommended to remove such babies from the breast a few minutes after the start of feeding, so that they do not “overeat”. However, this cannot be done, since they gain excess body weight not due to overeating, but precisely due to their constitution.
These children are characterized by an increased allergic mood, which, on the contrary, requires continued breastfeeding. If the child is overweight, the mother supplements him with something, then this supplement must be removed.
5. With sufficient lactation, the baby receives milk from only one breast, and at the next feeding - from another. With prolonged sucking of the breast and its active emptying, the baby should be offered a second breast, that is, during feeding, the baby can be applied to both mammary glands. Such feeding contributes to better development of lactation and more complete mutual adaptation of mother and child. The next feeding begins with the second breast. However, using two breasts when feeding carries the risk that the baby will not receive part of the difficult-to-extract hindmilk from the first breast. Therefore, under no circumstances You can't change breasts quickly when feeding.
6. Child do not give a pacifier or pacifier, since the mechanisms for squeezing milk out of the breast and nipple are different. In the first case, the child acts with his tongue, in the second - with the help of his cheeks. Having learned one method, he will not be able to switch to another.
7. It is important not to relieve the child’s anxiety caused by fasting, supplementation between feedings, especially with formula milk. A healthy newborn who is breastfed should not receive any nutritional supplements - glucose solution, saline solution, boiled water. This is unacceptable for two reasons: drinking liquid from a bottle increases the risk of infection, and drinking sweet drinks creates other pathways for carbohydrate metabolism that are different from physiological ones. If the mother has enough milk, the baby's fluid needs are fully satisfied, even in hot climates.
8. During the period of lactation formation (stage of colostrum and transitional milk) breasts are not expressed this is carried out only if there are indications (lactostasis, etc.). During the period of established lactation, the breasts should be emptied after feeding. The breast is expressed if after feeding there is a lot of milk in it and it is dense. Manual expression requires skill, time and certain training, so the most optimal is to use simple, convenient and atraumatic breast pumps (for example, the Avent.Isis manual breast pump or the Avent. Isis Uno electronic breast pump - see below).

Feeding regimen

The period of formation of the child's diet after discharge requires a certain flexibility. If the child was in a maternity hospital with the mother and child staying separately, then from birth he was fed according to a schedule (6-7 times a day). In this case, 2 feeding options are possible.
1. Maintain the existing feeding regimen. This is possible if the mother’s lactation is sufficient and the baby is developing well and easily maintains the intervals between feedings. Night feedings are possible if the baby has a need for them.
2. Feed the child on demand when the child cannot maintain the intervals between feedings or his rate of weight gain lags behind. This period will continue until sufficient, stable lactation occurs in the mother and until the child’s weight and height increase.
The number of feedings, including night feedings, can vary widely depending on the state of lactation at the moment, the degree of motor activity, the child’s energy expenditure, his well-being and mood.
In the first days and weeks (stage of colostrum and transitional milk) frequency of breastfeeding can be 12–20 or more times a day and is determined by the child’s needs.
After the mother has established lactation and the baby is growing well, the need for such frequent feedings disappears. The child, as a rule, suckles less frequently, and the frequency of feedings decreases from 10–15 in the first days and weeks to 7–6–5 in subsequent periods. The transition from an uncertain feeding rhythm to a relatively regular regimen takes from 10–15 days to 1–1.5 months. Free feeding does not exclude the possibility of reasonable regulation of the regime.
With good lactation in the mother, a healthy child by 1–1.5 months of age, as a rule, can withstand three-hour intervals well (since at about this time milk is retained in the stomach for 2.5–3 hours) and feeds 7 times during the day, adhering to certain feeding hours (6-9-12-15-18-21-24 hours). This does not exclude the possibility of night feedings or deviations of 30–60 minutes. from feeding time, depending on the baby's needs.
In general, a reasonable feeding schedule is preferable to erratic feedings, both for the baby and for the mother. Moreover, if a child develops well after the neonatal period and “sleeps through” night feedings, then they should not be considered strictly obligatory. A good night's sleep and adequate rest are also important for the mother, as they contribute to good lactation. If the child does not need night feedings, he will refuse them himself; he should not be prevented from doing so.
By 2 months, if the baby maintains a 3.5-hour interval, he can feed 6 times. With a 6-time regimen, the recommended feeding time is: 6–9 30 -13-16 30 -20-23 30 .
From 4.5–5 months. (1–2 weeks before the introduction of complementary foods) the child is transferred to 5 feedings a day with an interval between feedings of 4 hours.

Breastfeeding nutrition assessment

One of the main indicators of the sufficiency of milk received by a child is his behavior. If after feeding the baby calmly lets go of the breast, looks contented, and sleeps well until the next feeding, then he has enough milk.
For the vast majority of children, nutritional control is based on clinical health assessment child: correspondence of body length and weight to the age reached, adequate weight gain, age-appropriate psychomotor development, good skin condition, elastic turgor of soft tissues, adequate frequency of urination and stool, good functioning of all organs and systems. This state of child nutrition corresponds to the concept of normotrophy or more optimal - eutrophic development of the child (G. N. Speransky, A. F. Tur).
If there is a lack of milk received by the baby, the number of urinations decreases (less than 6 times), so the simplest test is for wet diapers.
If you suspect malnutrition(lactation crisis, hypogalactia) it is necessary to be able to assess the dynamics of physical development and the daily volume of milk received by the child in accordance with age standards. To do this, evaluate the length and, above all, the weight of the child’s body. Body weight responds most quickly to feeding disturbances and is considered a reliable indicator of “current” nutritional status, whereas stunting indicates chronic nutritional deficiencies.
Weighing is necessary for accounting for daily body weight gain. A decrease in these indicators below standard age values, and even more so when they approach the 10th centile, indicates malnutrition (Appendix 2). Taking into account the fact that the child does not always gain weight evenly, frequent, especially daily weighing only disorients parents. Therefore, for the first three months of life, if the child is in good health, it is enough to weigh him once every 2 weeks, then in the first year - once a month. If there is a suspicion of a lack of milk, weighing can be carried out once a week. followed by calculation of daily increases.
Having established the fact of malnutrition, to solve practical problems it is necessary estimation of daily milk volume, received by the child through “control feedings”. By themselves, “control feedings” are not sufficient to judge a lack of milk and “hypogalactia,” especially during the period of lactation formation or during its natural course during lactation crises. With individual feedings, the amount of milk varies so much that it is difficult to determine the amount of milk sucked per day from one or two weighings.
To assess the volume of milk a child receives, “control” feedings are carried out throughout the day, preferably at home. The daily data obtained during control weighings are compared with the calculated values. With breastfeeding, if the baby is in good health and has adequately gained length and body weight, no nutritional calculations need to be made.
The calculations below are focused only on those situations where there is inadequate development of the child or when feeding him, in addition to breast milk received during sucking, other types of nutrition are used (expressed milk, donor milk, infant formula) - that is, options for “subnatural” feeding or situation of supplementary feeding with hypogalactia of the 2-3rd degree.

Power calculation methods

The amount of milk a newborn needs for the first 10 days can be calculated:
1. According to the Finkelstein formula modified by A.F. Tour

Amount of milk per day (ml) = n × 70 or 80,

Where n is the day of life;
70 – with birth weight below 3200 g;
80 – with a birth weight of more than 3200 g.

2. According to the formula of N. F. Filatov, modified by G. I. Zaitseva

Amount of milk per day (ml) = 2% of body weight × n,

Where n is the day of life.

3. Based on the functional capacity of the stomach - according to the formula of N.P. Shabalov:
Amount of milk per 1 feeding = 3.0 x day of life × body weight (kg).

As an example, the following calculation of food volumes can be given.
Child 7 days old, body weight 3500 g.
According to Finkelyptein's formula: 80 × 7 = 560 ml;
according to the formula of N. F. Filatov and G. I. Zaitseva:

according to the formula of N.P. Shabalov, the volume of one feeding: 3 × 7 × 3.5 = 73.5 ml.
With 7 feedings a day (73.5 × 7), the daily volume will be 514 ml.
When calculating each of the proposed methods, the volume of food is slightly different. In actual feeding practice, these differences cannot be considered significant. In our opinion, only the Filatov-Zaitseva formula and the N.P. Shabalov formula take into account the individual body weight of the child, therefore these calculation methods are preferable.
In children older than the 10th day of life The following methods are used to calculate the daily amount of food:

1. “Volume” method according to Geibner - Cherny.
The daily amount of food is:
from 10 days to 6 weeks. – 1/5 of actual body weight;
from 6 weeks up to 4 months – 1/6 of actual body weight;
from 4 to 6 months. – 1/7 of actual body weight;
over 6 months – 1/8 of actual body weight.
This method has some limitations, since in many healthy children after six months or even earlier, the calculated volume of nutrition is more than 1000 ml. However, a child in the first year of life should not receive more than 1000–1100 ml of food per day.

2. “Calorie” method by M. S. Maslov.
According to this method per day the child should receive per 1 kg of body weight:
1st quarter of the year – 120 kcal;
2nd quarter – 115 kcal;
3rd quarter – 110 kcal;
4th quarter – 100 kcal.

3. Calculation of volume based on the child’s protein needs.
The most reasonable calculation of nutrition is based on taking into account the need for basic food ingredients (Order of the Ministry of Health of the Russian Federation, 1991, Appendix 3).
With an optimal ratio of proteins, fats and carbohydrates in breast milk, the calculation is carried out only on protein. It is known that with natural feeding before the introduction of complementary foods, the child’s need for protein is 2–2.2 g/kg per day, for fat 6–7 g/kg per day, for carbohydrates 12–14 g/kg per day.

EXAMPLE OF CALCULATION OF DAILY NUTRITION VOLUME
The child is 2 months old, body weight 5 kg.
1. According to the “volume” method, the amount of breast milk will be 1/6 of body weight:
5000: 6 = 833 ml/day.
2. “Calorie” method: the child’s energy requirement is 120 kcal/kg:
120 kcal × 5 = 600 kcal/day.
The required amount of milk is calculated based on the proportion:
1000 ml of breast milk – 700 kcal.
X ml – 600 kcal.

3. Finally, when calculating based on the child’s protein needs (2.2 g/kg), the sequence is as follows:
2.2 g/kg × 5 kg = 11 g of protein a child needs per day.
Considering the average amount of protein found in 1 liter of breast milk (12 g/l); the required daily volume will be:
1000 ml – 12 g
X ml – 11 g

The above example convincingly shows that all of the above calculation methods give very similar results. From our point of view, due to its simplicity, it is preferable to use the “volumetric” method.
These methods are necessary to determine the daily amount of food. To determine the volume of one feeding, it is necessary to divide the daily volume of food by the total number of feedings. For example, a child aged 2 months. should receive 840 ml of milk per day, with 7 feedings the volume of each feeding will be 120 ml, and with 6 feedings 140 ml.
I would like to draw attention to the fact that all calculations of food volumes should always be considered as indicative. So, for example, in the given
In the examples of calculating the daily volume of food, approximately the same figures were obtained. Fluctuations of 10–20 ml in one direction or another do not sin against the truth, since with good lactation the child actually sucks out the required volume of milk within the calculated limits.
To illustrate the possible problems that arise during natural feeding, some of them can be given.
Problem 1. The child was born at term with a body weight of 3500 g and a length of 50 cm. He was attached to the breast immediately after birth, then was in a free feeding mode with a feeding frequency of 10–11 times a day. Physiological loss was 150 g, body weight was restored by the 5th day. After being discharged from the maternity hospital, on the advice of relatives, the mother switched the baby to 7 feedings a day. She contacted the pediatrician on the 9th day with complaints of the child’s anxiety, which intensified 1.5–2 hours after feeding and at night. It is not possible to express milk from the breast after feeding the baby. On examination, the child is restless, body weight is 3.5 kg. The somatic status of the child is without pathology.
Doctor's tactics. It is necessary to explain to the mother that complaints of anxiety and lack of weight gain are most likely associated with a sharp decrease in the number of feedings, including at night, that is, a return to the free feeding regime is necessary. Subsequently (after a month), the reduction in the number of feedings should be carried out gradually, focusing on the development and behavior of the child.
Task 2. The child is 1.5 months old... He was born with a body weight of 3200 g, length 48 cm. Before this visit to the doctor, he was developing normally. Currently, the body weight is 4100 g, the child begins to hold his head up and smiles at his mother. The number of feedings was 6 times a day; after feeding, the mother was able to express 10–15 ml of milk. For the last two days, the child has become restless, cannot withstand the intervals between feedings, and after feeding the mother is unable to express milk.
Doctor's tactics. The mother must be explained that at the 6th week of lactation, a lactation crisis may have occurred, which is a physiological phenomenon. It usually lasts 3-4-5 days. In this regard, it is recommended to increase the number of feedings by 1-2 times a day and, if the child stops worrying, return to the previous diet.
It is also possible another solution. While maintaining the number of feedings, after the baby has completely emptied the mother's breast, offer him another breast and start the next feeding with it.
In cases where such measures do not help, the question of supplementary feeding of the child can be raised (see section “Mixed feeding”).
Task 3. The child is 3 months old, born with a body weight of 3400 g, length 49 cm. Before this visit to the doctor, the child was developing according to his age. Currently, body weight is 5800 g, length is 60 cm. Lying on his stomach, he raises his chest, holds a toy, laughs at the sight of his mother. The number of feedings is 6 times a day, it maintains the intervals between feedings well, receives a vitamin D correction (400 IU) per day, every other day a 5% solution of calcium gluconate, 1 teaspoon 2 times a day. The mother noticed that during the first feeding at 6 a.m. the baby suckled worse than during the daytime hours. When monitoring the milk sucked during one feeding, its volume at different times of the day ranged from 90 to 100 ml.
Doctor's tactics. It is necessary to reassure the mother and explain to her that any child can suck out different amounts of milk during the day. Since the baby is developing optimally, there is no cause for concern, and let the baby feed as before.

Correction of natural feeding

The most natural deficiency conditions during breastfeeding are deficiency of vitamins K, D, as well as iron and fluorine.
1. Vitamin K Due to the low content of vitamin K in human milk and the possibility of bleeding, the tactics of a single parenteral administration of vitamin K 3 - vikasol (1 mg) immediately after birth in the maternity hospital have been adopted.
2. Vitamin D From 4 weeks of age, specific prevention of rickets is carried out. Vitamin D is prescribed orally in a daily dose of 400 IU. Prevention is carried out in autumn, winter and spring. In the summer months, specific prevention of rickets is not carried out due to sufficient natural insolation at this time of year. During the year, it is advisable to conduct two courses of preventive general ultraviolet radiation (10–12 sessions every other day). At the time of the Ural Federal District and the next 3–4 weeks. Vitamin D is not given to the child.

End of free trial

Feeding a baby with breast milk is called natural.

Human milk is a unique and most balanced food product for a child of the first year of life;
The composition of each mother's breast milk exactly corresponds to the needs of her baby for various substances: proteins, fats, carbohydrates, vitamins and minerals;
Mother's milk contains special substances - enzymes that promote the digestion and absorption of proteins, fats and carbohydrates;
Mother's milk contains immunoglobulins and immune cells that protect the child from most infectious diseases: intestinal infections, infectious hepatitis, diphtheria, tetanus and others;
Breast milk contains substances that regulate the growth and development of the child and ensure the correct formation of his brain and intellect (hormones, growth factors, taurine, zinc, iodine, etc.);
In the process of breastfeeding, a special, very close relationship arises between mother and child, the warmth of which remains throughout the rest of life;
Breastfeeding is good for the mother's health because... it promotes contraction of the uterus after childbirth, helps restore the figure and is the best prevention of mastopathy and breast cancer.

early attachment of the baby to the breast (in the delivery room);
in the first weeks, it is advisable to provide the child with a free feeding regime (at the child’s request) and only later transfer the child to feeding according to the hour, which he himself has chosen;
when introducing complementary foods, to prevent the extinction of lactation, it is recommended to put the baby to the breast at the end of each feeding;
If there is not enough milk, it is necessary to put the baby to the breast often. We must remember that every drop of mother’s milk is priceless for an infant. At the same time, frequent breastfeeding can increase milk production in the mammary gland.

NUTRITION FOR A NURSING MOTHER. A nursing mother must receive a complete, balanced diet, since a woman spends additional energy and nutrients to produce milk, and, therefore, it is necessary to replenish these costs.

Vegetables are best consumed in their natural form or in the form of salads and vinaigrettes. The most appropriate cereals to use are oatmeal and buckwheat. Wholemeal bread with added bran is recommended. You should avoid spicy seasonings, excess spices, large amounts of onions and garlic, which give milk a specific taste and smell. During breastfeeding, it is necessary to limit the consumption of foods with increased allergenic properties: chocolate, cocoa, natural coffee, citrus fruits, honey, nuts. Alcoholic drinks, including beer, are strictly prohibited for a nursing mother.
A woman is recommended to eat 5 times a day within 30-40 minutes. Before breastfeeding.
The amount of liquid (including soups, vegetables, etc.) should average 2 liters.
During breastfeeding, mothers should take some kind of multivitamin preparation containing vitamin D (for example, Gendevit - 2 tablets per day).

LURE. KINDS. INTRODUCTION RULES. Complementary feeding is an independent type of nutrition, replacing one and then several feedings with breast milk or formula. Talk to your pediatrician about prescribing complementary foods. The introduction of complementary foods is due to:

increasing the growing baby’s need for energy and basic food ingredients (P.ZH.U.);
an increase in the child’s body’s need for minerals (iron, calcium, magnesium) and vitamins;
the need to train the masticatory apparatus;
the need to stimulate the digestive glands and their gradual adaptation to the digestion of adult food;
the need to introduce plant fibers, which play an important role in the proper functioning of the child’s gastrointestinal tract;
the need to educate the child in the skills of consuming new types of food, including thicker consistency, which prepares him for weaning.

BASIC RULES FOR INTRODUCTION OF COMPLETE FEEDINGS.

Start introducing complementary foods only to a healthy child or, as a last resort, during the recovery period, with normal stool;
It is recommended to give the first complementary food during the second feeding;
complementary foods are introduced warm before breastfeeding or formula feeding;
Complementary feeding is given from a spoon, vegetable puree can first be added to a bottle of milk so that the child can more easily get used to the new taste;
each complementary food is introduced gradually, from small quantities (1-2 teaspoons) and is brought up to the age-appropriate dose within two weeks;
they switch to a new type of complementary feeding 1.5-2 weeks after the introduction of the previous one;
the density of complementary foods should gradually increase;
It is recommended to introduce vegetable puree as the first complementary food;
the second complementary food - cereal porridges - you need to start introducing them with gluten-free porridges (rice, corn, buckwheat) and cook them with the milk or formula that the child receives;
Baby food in jars contains the optimal amount of salt and sugar and therefore should not be added.

DIFFERENT PERIODS OF CHILD NUTRITION. The processes of assimilation of food in the human body are quite complex, and in children of the first year of life, given their intensive growth and insufficient maturation of the formations of all organs and systems, they proceed with a particularly heavy load.

We can roughly distinguish several periods of feeding children:
1. from 0 to 3-6 months, when the child receives only milk;
2. from 3-6 months to 1 year - transitions, during which complementary foods are gradually introduced into the child’s diet;
3. from 1 year to 3 years - early childhood, when the child gradually and carefully gets accustomed to traditional family dishes;
4.5. preschool (from 3 to 6 years old) and school (from 7 to 14 years old), characterized by a wide range of foods and dishes used in nutrition, basically no different from those received by adults.

1st period.
If a child is naturally fed with mother's milk, then up to 3 months it is inappropriate and even harmful to include other products in the diet in addition to milk. It may be necessary to include vitamin D. In the absence of human milk, commercially produced substitutes should serve as the main food product.

2nd period.
Breast milk or breast milk substitutes continue to be the mainstay of a child's diet. The recommended daily dose, depending on the age of the child, is from 400 to 800 ml. milk. The number of products that are primarily included in the diet of children as a supplement to breast milk or its substitutes are fruit juices. This is primarily due to the fact that they have the same liquid consistency familiar to a baby as milk. At the same time, the introduction of juice allows you to provide the child with a number of new nutrients that he needs; sugars new to the baby (glucose, fructose), organic acids (citric, malic); promotes the absorption of milk nutrients, as well as additional amounts of vitamin C, potassium, and iron. Taking into account the unfavorable environmental situation, it is most advisable to introduce natural industrial juices into the diet of children. Juices should be introduced into the diet gradually, starting with two teaspoons, and increased over 2-3 weeks to 30-40 ml, and then by 8-10 months to 80-100 ml. in a day.
When breastfeeding, juices should be introduced into the child’s diet no earlier than 3 months of age.
It is advisable to introduce regular juice first into the child’s diet, which is characterized by low acidity and low potential allergenicity, then pear, plum, apricot, peach, raspberry, cherry, blackcurrant, orange, tangerine, strawberry juices, which are among the products with potentially high allergenicity, can be recommended. , which should not be given earlier than 6-7 months. This also applies to tropical juices and juices from other exotic fruits (papaya, mango). The introduction of juices should be made from one type of fruit (to exclude its possible allergenic effect) and only after getting used to it, mixed fruit juices can be introduced into the baby’s diet.

3rd period, 4th period, 5th period.
Starting from the age of one year, the child, as a rule, no longer receives breast milk and can consume the same foods as an adult. However, one should avoid giving dried fruits, which can only be introduced after 18 months. Pancake week fruits (peanuts, almonds and others) are practically prohibited for up to 5 years. Sausages can be given in very small quantities. It is better to give chocolate and chocolate candies to children after 5 years of age, but before this age, give the child marshmallows, marmalade, marshmallows, honey, jam, jam. To instill healthy habits in a future adult, you should not add too much sugar and salt to your food, and you should limit your consumption of fatty foods and sauces. It is better to use eggs no more than twice a week, boiled or fried.

Fruit puree should be recommended to breastfed children 2-3 weeks after the appointment of juices, that is, at 3.5-4 months, using approximately the same assortment of fruits as in the case of juices. And in this case, we recommend industrially produced baby puree, which guarantees the required composition and safety.

At 4.5-5 months, thicker foods - complementary foods - can be introduced into the child's diet. Vegetable purees are prescribed as the first complementary food. Introducing vegetable complementary foods from one type of vegetable (for example, potatoes, zucchini), then moving on to a mixture of vegetables with a gradual expansion of the assortment and introduction into the diet: cauliflower, pumpkin, white cabbage, carrots, and later tomatoes, green peas.

It is better to start introducing cereal complementary foods (milk porridge) 3-4 weeks after the introduction of vegetable puree. However, in cases where the child is not gaining weight well or has unstable stools, you can start introducing complementary foods with milk porridge, and only then introduce vegetable puree. The first to be given are porridges that do not contain gluten (a special type of protein, grain), which can cause intestinal disease in the child - clumping - rice, corn, buckwheat. Porridge should be included in the diet gradually. In the beginning, you should add one teaspoon to the evening feeding, 2-3 teaspoons to increase the calorie content of the food.

Then, within two weeks, cereal porridges are introduced into the morning feeding in the form of a thick milk mixture, which is given to the child from a spoon. After the introduction of the first type of cereal porridge, after a two-week adaptation period, the child is accustomed to another type of porridge.

Cottage cheese should be prescribed to healthy, normally developing children no earlier than 5-6 months, since mother's milk in combination with complementary foods already prescribed by this time can, as a rule, satisfy the child's need for protein, an additional source of which is cottage cheese.

Yolk during natural feeding should be prescribed from the 6th month of life. Its earlier administration quite often leads to allergic reactions in children.

Meat should be introduced into a child’s diet from 7 months, starting with meat or vegetable puree (meat with vegetables and cereals), which are later replaced by meatballs (8-9 months) and steamed cutlets (by the end of the first year of life). Fish can be recommended from 8-9 months.

From 7.5-8 months, a child can be prescribed kefir, cow's milk or other fermented milk mixture as complementary foods. Instead of cow's milk, it is better to use specialized milk formulas, the so-called "follow-up formulas", which are special products instead of milk, but with a reduced protein level compared to cow's milk and an optimized fatty acid and vitamin composition.

TEN GOLDEN RULES OF BABY FOOD.

Mother's milk or its substitutes for children of the first age group, and then milk formula for children of the second age group (subsequent formulas) are given a primary role in the nutrition of children under 12 months.
For children from one to 3 years of age, it is also better to give not ordinary cow's milk, but special powdered milk for children or continue to give special milk formulas intended for children over 6 months (subsequent formulas).
From the very first months of a child’s life, it is necessary to limit the consumption of salty, fatty and sweet foods. Proper education of taste is the key to preventing obesity and other diseases.
A child should drink relatively a lot, more than an adult.
There needs to be a balance in both the quality and quantity of products used. You should not increase food intake under the pretext of stimulating the growth of the child.
The food of a child under three years of age should differ in quality, quantity and consistency from the food of an adult.
Premature, ahead of the child’s needs, introduction into the diet of foods that are not appropriate for his age is not only impractical, but, moreover, entails many undesirable consequences.
When organizing meals, it is necessary to adapt to the individual natural rhythm of the child’s life.
You cannot force a child to eat. For a child, the satisfaction derived from food and the variety of food must be inextricably linked.
You should not prematurely give up food products whose recipes are designed specifically for children (instant porridge, canned puree in jars).

Not a single person will dispute the importance of breastfeeding a child, even if he is the most notorious skeptic. Can anyone in their right mind deny the importance of this unique opportunity given to man and all mammals by nature? True, the level of lactation in not all mothers is at the proper or at least average level, but this process can easily be stimulated through simple actions.

The importance of natural feeding of children in the first year of life

Natural feeding of children is feeding an infant with mother's milk with nutritional correction after 2 months of age and the introduction of complementary foods after 5 months. Breast milk for a baby is natural food, intended for him by nature itself. The factor that determines the amount of milk a mother has is genetic predisposition. This indicator, necessary for breastfeeding newborns, is influenced by the state of the nervous system of the nursing woman (negative emotions, insufficient sleep, fatigue), and the adequacy of nutrition, existing diseases.

Lactation- a secretory process occurring in the mammary gland. In the first days after childbirth, a secretion of a unique composition is released, which is called colostrum. On the first day there is very little of it, just a few drops. In subsequent days, lactation may increase at different rates: sometimes by the 3rd day lactation reaches its full volume, in another case (more often in primiparous women) in the first 3-4 days the amount of colostrum does not increase, but on the 4th day the mammary glands sharply enlarge, become engorged, their secretion becomes abundant, and “ milk flow."

Starting from the 2-3rd day, the composition of colostrum changes, it “ripens” and by the end of the 2nd week (and sometimes a little later) turns into mature milk.

Thus, the secretion of the mammary gland in the first 2-3 days is called colostrum, after the 4-5th day - transitional milk, after the 3rd week the milk, which acquires a constant composition, is mature.

The calorie content of colostrum decreases from 1500 calories per liter to 600 calories on the 7th day.

Microscopically, colostrum differs from mature milk, which is secreted in the form of milk globules. Colostrum contains colostrum corpuscles - large cells filled with fat droplets.

The photo of breastfeeding newborns shows how visually colostrum differs from mature milk:

The importance of natural feeding of a child is difficult to overestimate. Mother's milk best meets the baby's needs. In addition to the communication and feeling of closeness that accompany the feeding process, the mother’s milk supplies the baby’s body with antibodies necessary to protect the baby’s body from diseases and prevent allergies. A newborn breastfed baby receives essential amino acids, polyunsaturated fatty acids, milk sugar, vitamins in the most digestible form, iron, a sufficient amount of water, lactose, hormones, biologically active substances (growth factors, substances that ensure metabolic processes in the body).

The importance of breastfeeding for a newborn baby is also that mother’s milk protects the baby from infections. And not only due to the presence of immunoglobulins - lysozyme and interferons in breast milk are highly active against many microbes.

Breastfeeding a newborn: feeding technique

The technique of breastfeeding a newborn is not complicated, but first-time mothers would do well to familiarize themselves with the basic rules.

To properly breastfeed a newborn, before feeding, the mother should wash her hands and express 1-2 drops of milk. The classic feeding position is sitting or lying down. When feeding while sitting, there should be support for the back and legs.

According to the breastfeeding technique, the baby is turned to face the mother (his head should be in line with the body), pressed against him, supported behind his back, and applied to the breast (but not the breast to the baby!) so that the lower lip is under the nipple.

The breast is supported during feeding. To do this, you need to put your hand under your chest, lifting it from below with your thumb. Then they touch the baby’s lips with the nipple, wait until he opens his mouth, when the nipple touches the palate, the baby begins to make sucking movements, the oral cavity is filled with milk, and the child swallows it.

Observing the feeding technique, when breastfeeding, it is necessary to pay attention to the fact that when sucking the child takes into his mouth not only the nipple, but also the isola, so that the head is not thrown back too much and nasal breathing is not obstructed by pressing against the mother's breast.

At the end of natural feeding of children in the first year of life, it is recommended to leave the breast open for 5-10 minutes. The milk remains on the nipples, its fat protects the skin from damage.

Each feeding is carried out from one breast. The duration of feeding with proper breastfeeding of a newborn is 15-30 minutes.

Difficulties in natural feeding of young children by the mother

Difficulties with breastfeeding on the mother's side include:

difficulty releasing milk;
decreased secretory activity of the mammary glands - hypogalactia;
milk leakage;
flat, inverted nipples;
cracks, inflammation of the nipples;
blockage of the milk duct;
maternal illness or taking medications that are contraindicated for the baby and are excreted in breast milk.

If the outflow of milk is impaired, the temperature rises, the mammary glands are enlarged and painful, it is necessary to express milk.

When the milk duct is blocked, a painful lump forms, which often leads to the development of inflammation of the mammary gland - lactation mastitis.

To prevent this complication when breastfeeding young children, the duct is cleared by frequent feeding, changing the feeding position, and applying dry heat.

With hypogalactia, first of all, it is necessary to streamline the sleep pattern of a nursing woman. She should rest at least 8 hours a day, but since this is often unrealistic, daytime sleep for 1.5-2 hours, walks in the fresh air, timely high-calorie meals, drinking actogenic drinks, taking vitamin-mineral complexes containing vitamins A, E, P, glutamic acid, dried brewer's yeast hydrolysates, carrot juice. To prevent hypogalactia, the diet of nursing mothers is also enriched with milk, fermented milk drinks, honey, cottage cheese, sour cream, cheese, and walnuts. The amount of free fluid is increased to 2.5 liters per day. The intake of fresh juices, fruits, and berries without sugar is increasing. Rose hip decoction, coffee and cocoa with milk, and strong green tea promote milk production.

Excessive energy value of the diet does not affect the amount of human milk, but worsens its fatty acid composition. There is an increase in the content of saturated fatty acids, which can lead to obesity in the child.

To prevent hypogalactia, Femilak-2 can be recommended to nursing women. It is produced from skim milk, corn oil, and milk sugar (lactose). This milk formula is enriched with essential vitamins and minerals. "Femilac" is recommended to take from 40 to 80 g per day. One glass of this formula provides almost 30% of nursing mothers' additional energy needs, more than 20% of additional protein and 50% of calcium.

Breastfeeding difficulties: difficulties from the baby

Difficulties in breastfeeding for a child include:

underdeveloped sucking reflex;
“fear” of the breast;
congenital defects of the mouth and nose, short frenulum of the tongue.

The sucking reflex is weakly expressed in premature babies and infants born weakened. They have to be fed through a tube or using special devices.

If the child is “afraid” of the breast, you need to find out whether the mother is receiving bitter medicines or food products that give the milk some taste qualities that are unpleasant for the baby.

In the case of congenital clefts, the lips or palate adapt to feeding by covering the cleft with the breast. Before surgical correction of the defect, feeding is recommended to be done while holding the baby upright.

If sucking is difficult due to a short frenulum of the tongue, it is trimmed (the operation is performed on an outpatient basis by a surgeon in a clinic).

Stimulation of breastfeeding: how to increase lactation

Considering the importance of breastfeeding, mothers need to take care to increase their milk supply.

To stimulate breastfeeding, it is necessary to breastfeed the baby as often as possible, including at night. To increase milk lactation during breastfeeding, during one feeding you need to apply the baby to both breasts alternately.

How else to increase lactation during breastfeeding so that the baby receives the required amount of milk? To do this, you need to introduce nuts and fish into your diet. It is also recommended to take a warm drink 20-30 minutes before feeding.

Artificial feeding of children in the first months of life is 80% due to hypogalactia.

The flow of milk after or between feedings (galactorrhea) is a neurosis. Treatment is often ineffective. Typically, a woman is prescribed restorative treatment and massage. To prevent the skin in the breast area from being protected, moisture-absorbing wipes are placed on the nipple.

Irregular shape and size of nipples can also cause difficulties during breastfeeding. Already during pregnancy, it is recommended to retract nipples that have an irregular shape (flat, inverted, etc.). In some cases, stretching the nipples before each breastfeeding helps. There are a number of devices in the form of pads that change with each feeding.

Very firm breasts with abundant milk secretion may interfere with nipple latching. In these cases, it is recommended to express some of the milk before breastfeeding.

The most common causes of difficulties when breastfeeding are cracks, abrasions of the nipples and mastitis.

In case of cracks, it is necessary to reduce irritation as much as possible by feeding through a protective pad; sometimes the child is not attached to the breast for several days. He is fed expressed milk obtained through breast milk collection pads.

With mastitis, milk is sucked out with a breast pump immediately after breastfeeding.

How to stop breast milk correctly

No less pressing is the question of how to properly stop breast milk lactation if the mother has decided, for objective reasons, to stop breastfeeding her baby naturally.

chest compression bandage;
restriction of fluid intake for 2-3 days;
exclusion from the diet of foods that increase lactation: nuts, dill, tea with milk, etc.

Before you stop breastfeeding, remember that it is not recommended to deny breastfeeding to a child during his illness, during and after vaccinations, changes in climatic conditions and other situations that are unusual for him.

When treating inflammation and injuries of the nipples, you must adhere to the following rules:

wash your breasts no more than once a day;
after finishing feeding, leave the breast open;
Use only hygroscopic pads.

When the mother is ill, the approach to breastfeeding is different and depends on the woman’s pathology.

In case of a viral infection, the woman puts on a mask, and after feeding she is isolated in a room different from the child.

It is not recommended to take herbal laxatives while breastfeeding; neuroleptic and psychotropic drugs, alkaloids that depress the respiratory center, and other drugs, including alcohol and nicotine.

Rules and stages of breastfeeding a newborn baby

The rules for breastfeeding a newborn baby, developed by WHO (UNICEF), are as follows:

strictly adhere to the established rules of breastfeeding;
inform pregnant women about the benefits and techniques of breastfeeding;
help mothers initiate breastfeeding within the first half hour after birth;
show mothers how to breastfeed and how to maintain lactation, even if they are temporarily separated from their children;
Another rule for breastfeeding a child is not to give newborns any other food or drink other than breast milk, except for medical reasons;
practice keeping the mother and newborn side by side in the same room around the clock;
Encourage breastfeeding on demand rather than on a schedule.

As the child grows and develops, he gradually switches to eating regular food. Conventionally, this period is divided into:

only breastfeeding stage;
transitional nutrition stage;
weaning stage.

The first stage lasts up to 5-6 months, and then complementary foods are introduced. Complementary feeding in the diet is necessary to expand the range of food products; for the development of motility of the digestive system; to train the masticatory apparatus for eating hard foods; for the additional introduction of protein, microelements, and vitamins necessary for the child’s growth.

It has been established that the protein content in breast milk in the early lactation period is 16-18 g/l. Then it begins to decline, and by the 3-4th month the amount of protein drops to 8-10 g/l, and by 6 months it decreases even more. The child needs it more and more every month.

Contraindications to breastfeeding young children

Contraindications to natural feeding of children are divided into temporary and permanent.

Temporary contraindications include birth trauma of a child with cerebrovascular accident or other serious illnesses of the infant accompanied by respiratory and heart failure. A permanent contraindication is intolerance to breast milk. In this case, the child is put on a special diet.

Permanent contraindications on the part of the mother are: infectious diseases (tuberculosis, syphilis and others with bacilli excretion), severe kidney damage, uncompensated heart disease, taking cytostatics.

In case of flu, sore throat, pneumonia, the issue is resolved individually. During the acute period, milk is expressed; in other cases, the mother feeds the baby wearing a mask.

Proper breastfeeding of premature babies

Breastfeeding for premature babies born in the most satisfactory condition begins 6-8 hours after birth. Children in serious condition are fed for the first time 24 hours after birth. During the first day of life, such children are administered a 5% glucose solution in sufficient quantities.

Children born weighing less than 1.5 kg are fed through a feeding tube or through a catheter intravenously with special liquids. For breastfeeding premature babies weighing more than 1.5 kg, expressed mother's milk from special devices (horn, bottle) is used, and children weighing more than 2 kg are breastfed. However, if the baby does not suck actively enough and gets tired quickly while sucking, then you should immediately supplement with expressed breast milk from a bottle or bottle.

The feeding regimen for premature babies is 8-9 times a day (per day).

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