Preface

Breastfeeding and human milk are the standard recommendation for infant feeding and nu‐ trition resulting in improved infant and maternal health outcomes. This is based on exten‐ sive strong evidence of the benefits of breastfeeding to infants and mothers. However, even though efforts have been made to increase adherence to exclusive breastfeeding until six months, and in different countries policies have been implemented to support and promote breastfeeding, the objectives and goals established have not yet been achieved.

This book includes important topics related to breastfeeding. In five chapters that address rele‐ vant issues about breastfeeding, it seeks to contribute to the training of students and the updat‐ ing of health professionals linked to the care of infants who face the process of breastfeeding.

Chapter 1 introduces global and fundamental aspects of neonatal care. This introductory chapter reviews the general aspects of breastfeeding and a conceptual framework that em‐ phasizes the need to consider breastfeeding as a multifactorial phenomenon with important participation in sociocultural and psychological factors.

Chapter 2 describes the great potential of breastfeeding for mothers and babies and discuss‐ es the functionality of some components of human milk and its similarities and differences with infant formulas. This chapter presents current knowledge regarding evidence on the importance of breastfeeding, the functionality of selected human milk ingredients, infant formulas as a human milk alternative, and the similarities and differences between human milk and infant formulas.

Chapter 3 is based on evidence that breastfeeding and an enriched environment provide sig‐ nificant contributions to the infant's brain development, focusing its effect in the first 1000 days as the most significant period of an infant's life.

Chapter 4 reviews important elements to consider in the initiation and maintenance of breast‐ feeding, reviewing historical, physiological, and epidemiological aspects based on the guide‐ lines of the World Health Organization and strategies to promote and support breastfeeding.

Finally, Chapter 5 shows an interesting review that provides scientific evidence regarding the relationship between breast cancer and certain aspects of pregnancy as breastfeeding period.

As described, this book includes various topics of interest for all those students and health professionals who are dedicated to child health care. It is necessary to thank each one of the authors, who through their contributions have allowed this interesting book to develop.

> **R. Mauricio Barría P., DrPH** Universidad Austral de Chile Faculty of Medicine Nursing Institute Valdivia, Chile

**Chapter 1**

**Provisional chapter**

**Introductory Chapter: A Comprehensive Approach to**

**Introductory Chapter: A Comprehensive Approach to** 

Breastfeeding is a fundamental pillar of child nutrition, with important implications for the health welfare due to its impact on morbidity and mortality, especially among children under 1 year of age. Therefore, there is consensus among different organizations dedicated to the health of children about the importance of breast milk as a food of choice during the first 6 months of life, and it is considered a fundamental public health policy. The World Health Organization (WHO) recommends early initiation of breastfeeding within the first hour after birth and exclusive breastfeeding during the first 6 months of life [1]. Recently, the WHO defined the 2025 Global Nutrition Targets aimed at improving maternal, infant, and young child nutrition. Among these, breastfeeding has been prioritized in the fifth target: *"increase* 

The United Nations Children's Fund (UNICEF) describes breastfeeding as an important indicator, noting that "*Breastmilk alone is the perfect food for all infants in the first six months of life.*" In addition to being an ideal nutritional source for infants, exclusive breastfeeding is associated with a lower chance of dying from diarrhea and acute respiratory infections and strengthens the infant immune system. It also protects against chronic diseases such as obesity and diabetes [3]. However, UNICEF recently communicated that many countries continue to underestimate the benefits of breastfeeding even when the evidence supports its short- and long-term effects such as protective role against childhood infections, an increased intelligence, and

What is more, the American Academy of Pediatrics reaffirms the recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as they introduce complementary foods, for 1 year or more, as mutually desired by the mother and baby, with

*the rate of exclusive breastfeeding in the first 6 months up to at least 50%"* [2].

lower prevalence of diabetes and being overweight [4].

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.82177

**the Process of Breastfeeding**

**the Process of Breastfeeding**

Additional information is available at the end of the chapter

René Mauricio Barría PAdditional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.82177

René Mauricio Barría P

**1. Introduction**

#### **Introductory Chapter: A Comprehensive Approach to the Process of Breastfeeding Introductory Chapter: A Comprehensive Approach to the Process of Breastfeeding**

DOI: 10.5772/intechopen.82177

René Mauricio Barría P

Additional information is available at the end of the chapter René Mauricio Barría PAdditional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.82177

### **1. Introduction**

Breastfeeding is a fundamental pillar of child nutrition, with important implications for the health welfare due to its impact on morbidity and mortality, especially among children under 1 year of age. Therefore, there is consensus among different organizations dedicated to the health of children about the importance of breast milk as a food of choice during the first 6 months of life, and it is considered a fundamental public health policy. The World Health Organization (WHO) recommends early initiation of breastfeeding within the first hour after birth and exclusive breastfeeding during the first 6 months of life [1]. Recently, the WHO defined the 2025 Global Nutrition Targets aimed at improving maternal, infant, and young child nutrition. Among these, breastfeeding has been prioritized in the fifth target: *"increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%"* [2].

The United Nations Children's Fund (UNICEF) describes breastfeeding as an important indicator, noting that "*Breastmilk alone is the perfect food for all infants in the first six months of life.*" In addition to being an ideal nutritional source for infants, exclusive breastfeeding is associated with a lower chance of dying from diarrhea and acute respiratory infections and strengthens the infant immune system. It also protects against chronic diseases such as obesity and diabetes [3]. However, UNICEF recently communicated that many countries continue to underestimate the benefits of breastfeeding even when the evidence supports its short- and long-term effects such as protective role against childhood infections, an increased intelligence, and lower prevalence of diabetes and being overweight [4].

What is more, the American Academy of Pediatrics reaffirms the recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as they introduce complementary foods, for 1 year or more, as mutually desired by the mother and baby, with

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

medical contraindications to breastfeeding being rare [5]. Additionally, in their last policy statement regarding breastfeeding, they recognized that the decision to breastfeed should not be conceived by the mother, doctor, or society as a lifestyle option but as a basic and critical health decision that affects the welfare of the baby and the mother and therefore should be considered regardless of the parenting style or as a simple nutritional problem. They also emphasized that professionals must go beyond the maternal–infant binomial and incorporate new principles and concepts in daily activities to be true advocates and supporters of breastfeeding [6, 7].

In lower income countries, breastfeeding is associated with a significant reduction in infant mortality and disease, and it is estimated that a high degree of protection, promotion, and support for breastfeeding can potentially prevent 1.3 million child deaths per year [8]. It has been estimated that if children under 1 year of age were breastfed for at least 4 months, 56.4% of hospital admissions for infection of nonperinatal origin could be prevented [9]. In addition, there is evidence that breastfeeding decreases the incidence and severity of digestive, respiratory, urinary, and middle ear infections, as well as atopic diseases; producing a lower incidence of sepsis and necrotizing enterocolitis in preterm infants [10]. In the long term, breastfeeding has beneficial effects on cardiovascular risk factors, reduces the risk of obesity during childhood, and improves cognitive development. Additionally, breastfeeding women have a lower risk of developing breast cancer, better spacing of births, and lower risk of diabetes and ovarian cancer compared to women who have never breastfed [11].
