Breast milk

Human milk (HM) is recognized for its safety, efficacy, availability and cost/effectiveness. Consequently, it is the best food for newborns, even if they are small, premature or sick.

Breastfeeding improves child survival, health and development.

HM has the potential to reduce morbidities and improve health, especially in those born extremely prematurely, as it contains bioactive substances with bactericidal, immunomodulatory, and gut maturation-inducing properties.

Banked human milk (BHM) is the alternative of choice for feeding preterm infants (PTNB) as it provides the opportunity for them to receive a diet consisting of exclusive human milk when the milk of the baby’s own mother is unavailable, scarce or contraindicated.
In terms of its benefits, BHM is somewhat inferior to the mother's own, but superior to artificial formula.

The theme of Breastfeeding Week 2023 is “Let's make breastfeeding and work work”.

After birth, breastfeeding is initiated by the newborn if he/she is in direct and uninterrupted skin-to-skin contact with the mother for at least one hour after birth.

When there is a medical indication to administer a human milk substitute for a specific situation, it must be prepared under safe conditions.
• Wash hands.
• Boil filtered water (after it begins to boil, wait 15 minutes), and then allow to cool to room temperature.
• Use the quantity of water corresponding to the quantity of feed desired; for every 30 ml of water add one level measure of milk powder.
• Shake the feeding bottle until the powder is totally dissolved.
• Milk should be prepared at the time of each feeding.

Mothers with normal babies (including those born by caesarean section) should stay with them in the same room day and night, from the moment they come to their room after delivery (or from when they were able to respond to their babies in the case of caesareans) except for periods of up to an hour for hospital procedures.
This practice rooming-in should start no later than one hour after normal vaginal deliveries. Normal postpartum mothers should have their babies with them or in cots by their bedside unless separation is indicated for medical reasons.

Breastfeeding provides both short- and long-term benefits to the child and the mother.

For the child, breastfeeding provides optimal nutrition and reduces incidence of disease and death. Breastfeeding, particularly exclusive breastfeeding, protects children from diarrhea and pneumonia, the two leading causes of death among children under age five. Other infections, including otitis media, Haemophilus influenzae meningitis, and urinary tract infections, are less common and less severe in infants who are breastfed.

The Ten Steps involve changes in maternity services. Every facility providing maternity services
should have a breastfeeding policy and carry out structural changes and train all health care staff in skills necessary to implement this policy. They are aimed to protecting, promoting, and supporting breastfeeding in facilities that provide maternity services.

The Baby Friendly Hospital Initiative (BFHI) was launched in 1991 by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), with the goal of protecting, promoting, and supporting breastfeeding in facilities that provide maternity services, ensuring that the facilities follow the WHO/UNICEF “Ten Steps to Successful Breastfeeding” (the Ten Steps) and adhere to the 1981 International Code of Marketing of Breast-milk Substitutes.

To date, active COVID-19 (virus that can cause infection) has not been detected in the breastmilk of any mother with confirmed/suspected COVID-19. It appears unlikely, therefore, that COVID-19 would be transmitted through breastfeeding or by giving breastmilk that has been expressed by a mother who is confirmed/suspected to have COVID-19