Course:KIN366/ConceptLibrary/Breastfeeding

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Movement Experience for Children
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KIN 366
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Instructor: Dr. Shannon S.D. Bredin
Email: shannon.bredin@ubc.ca
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Breastfeeding is the act of feeding an infant with breast milk. The benefits of breast milk for health and preventing illness are widely recognized (Sacker, Quigley, & Kelly, 2006). Breast milk is nutritious food that is likely to cause the least allergic reactions, it is inexpensive and it is readily available (“Definition of Breastfeeding”, 2013). The WHO (World Health Organization) recognized breastfeeding as the nutritional standard for infants. It is believed that with the proper education and support from one’s family, community and health care providers, women will be successful with breastfeeding (Eglash, Montgomery & Wood, 2008).

Importance of Breastfeeding

Benefits for the Infant

  • Breastfed children do not share the same mortality rates and illnesses as children who were formula fed (Eglash et al, 2008).
  • The infant’s immune system is immature and susceptible to infection. The substances and nutrients found in breast milk protect the infant from infection, while this type of nutrition is not found in formula milk (Eglash et al, 2008).
  • Infants who are formula fed have an increased likelihood of obtaining acute otitis media, lower respiratory infections, asthma, sudden infant death syndrome (SIDS), both type 1 and type 2 diabetes and developing childhood leukemia (Eglash et al, 2008).

Benefits for the Mother

  • Women with a history of gestational diabetes who breastfeed improve their pancreatic B-cell function. Likewise, breastfeeding did not increase the risk of developing type 2 diabetes for those that had gestational diabetes (Eglash et al, 2008).
  • Ovarian and breast cancer rates are higher in women who did not breastfeed, and the risks are inversely associated to the duration of breastfeeding (Eglash et al, 2008).
  • Breastfeeding provides skin-to-skin contact and a special bond between mother and child (Eglash et al, 2008).

Statistics

Current Recommendations

  • The WHO and UNICEF passed the “Innocenti Declaration” policy in 1990. This policy was aimed to increase breastfeeding rates globally in an effort to decrease infant mortality rates (Eglash et al, 2008).
  • This declaration states that every government should have a national breastfeeding committee, that every facility providing maternity services practices the “10 steps to successful breastfeeding”, and demands that every government should have legislation to protect the breastfeeding rights of every working women (Eglash et al, 2008).
  • WHO recommends that infants be exclusively breastfed for the first 6 months, in order for the infant to achieve optimal health, growth and development (Eglash et al, 2008).

Breastfeeding Rates

  • The 2004 Center for Disease Control National Immunization Survey found that approximately 73.8% of mothers in the USA initiated breastfeeding, 41.5% were still breastfeeding at 6 months and only 20.9% were breastfeeding at 1 year (Eglash et al, 2008).
  • Breastfeeding rates are higher among women who are older, have higher education and have a supportive family (Eglash et al, 2008).
  • Adolescents are more likely to breastfeed if their mothers did (Eglash et al, 2008).
  • There is prevalent difference between ethnic groups and breastfeeding, with Hispanic women breastfeeding the most, and non-Hispanic African American women breastfeeding the least (Eglash et al, 2008).

Physical Ability: comparing breast milk to formula milk

Breastfeeding has a long-term influence on brain development. As soon as the infant is born, the brain experiences a growth spurt for 12-18 months postpartum. This suggests that nutrition is especially crucial during this time period. The majority of studies have discovered that infants who are breastfed are more advanced in neurodevelopment than those who are formula fed. Differences seen can be explained by differences in parental skills, and genetic predisposition. However, the main influential factors are the nutrients and essential substances in human milk. Docosahexaenoic acid (DHA) is of particular importance because it is not found in standard formulas. DHA is responsible for optimal neurodevelopment. Additionally, human milk contains hormones, oligosaccharides, and other trophic factors that may affect brain growth and maturation (Vestergaard et al., 1999).

Motor Development

There is a close association between breastfeeding duration and emergence of developmental milestones. An increased duration of breastfeeding is correlated with an increased proportion of infants mastering specific milestones. The mastery of three developmental milestones: fine motor skills, general motor skills and early language development at 8 months old (Vestergaard et al., 1999). The acquisition of these milestones is crucial as they are the precursors to many important movement patterns such as being able to hold their head up, sitting, walking, and general movements of the hands, feet, wrists and fingers (Early Intervention Support, 2014).

A different study found that infants who had never been breastfed were 50% more likely to have gross motor coordination delays, compared to infants who were exclusively fed for 4 months. Furthermore, any breast milk consumption by the infant was also positively related to development. Infants who breastfed for 2 months were 30% less likely to experience gross motor delays, than infants who were never breastfed. It was also discovered that infants who were not breastfed were 40% more likely to experience fine motor delays, than those who were given breast milk for extended periods (Sacker et al., 2006). The results of this study propose that breastfeeding acts as a protective mechanism against developmental delays, and is crucial for the attainment of gross motor milestones.

The benefits of breast milk are present regardless of social position, education or parenting style. In comparison, the correlation between breastfeeding and fine motor delay was related to biological, socioeconomic and psychosocial factors. The long chain polyunsaturated fatty acids and oligosaccharides in breast milk are elevated during the first weeks of lactation. This can be used to explain why any breastfeeding is better than no breastfeeding in the attainment of gross motor development (Sacker et al., 2006). However, a study split infants into two groups: (1) Infants that continued breastfeeding until 6 months and (2) infants that were breastfed until 4 months of age and then switched to supplementary food. The results of this study showed that the infants in group 1 had an earlier development of certain motor milestones compared to group 2. The differences were even greater in a situation where the complementary foods were of poor nutrition and microbiological quality. Overall, the infants that continued breastfeeding were able to crawl earlier, and were more likely to be walking by 12 months, than the infants in the other group (Dewey, Cohen, Brown, & Landa Riviera, 2001).

Eglash et al., (2008) identified a significant positive relationship between duration of breastfeeding and the initiation of walking (As cited in Douglas, 1950). Likewise a better quality and fluency of movements was apparent in infants at 42 months of age, who had been fully breastfed for 6 weeks or more, compared to children who were formula fed since birth. Exclusive breastfeeding for greater than 6 weeks was associated with optimal neurological function in general movements. Furthermore, the duration of exclusive breastfeeding was found to influence motor development (gross motor, fine motor and self help skills) at 6 years of age (As cited in Lanting et al., 1998). In all these different studies, we see how breastfeeding directly influences movement experiences in children, by determining the likelihood of mastering developmental milestones and reducing developmental delays.

Visual Development

Visual development is additionally related to breastfeeding. Eglash et al., (2008) performed a study in which the visual acuity of breastfed and formula fed infants was compared, and it discovered that infants that were breastfed had better acuity throughout the first 4 months of life, and in turn this advantage was correlated to the DHA in child’s red blood cells (As cited in Jorgensen, Hernell, Lund, Holmer & Michaelson, 1996). Moreover, the prevalence of myopia was also lower in children that were breastfed. Visual development is an important determining factor of the movement experiences in children, as visual feedback is essential for effective movement patterns.

Cognitive Development and Educational Achievements

Breastfeeding has long lasting advantages on brain and cognitive development. Breastfed children showed higher levels of cognition starting at 6 months and lasting all the way to 15 years of age. Increased duration of breastfeeding was significantly associated with better academic performance as measured both in middle school and at 18 years of age. Children who had been breastfed for 8 months or more were one-third less likely to leave high school (As cited by Horwood & Ferrgusson, 1998). Petryk (1998) found that children who breastfed for 7 months or longer had greater educational achievement at 26 years of age than those who were not breastfed (As cited by Richards, Hardy & Wadsworth, 2002). Therefore, a child who is not breastfed might be missing an opportunity for the brain’s circuitry to reach its full potential for a specific function, making it difficult to teach motor skills after age 9 because neural circuitry for gross and fine movements is already laid down (Petryk, 1998).

Maternal Factors and how it Affects Developmental Delays

The mastery of the three developmental milestones of fine motor skills, general motor skills and early language development are influenced by both maternal education and age (Vestergaard et al., 1999). Older mothers had a greater proportion of infants who experienced gross motor delays in comparison to younger mothers. In contrast, the opposite was seen for fine motor delays, with less educated mothers having infants who experienced fine motor delays (Sacker et al., 2006). A different study found a significant relationship between the initiation of breastfeeding and the reduction in mother’s concern about a child’s language and motor development. In this study, mothers who did not initiate breastfeeding were one third more concerned with their children’s fine and gross motor skills (Dee, Li, Lee & Grummer- Strawn, 2007).

Interesting Fact

Obesity

A dose-response relationship has been reported between duration of breastfeeding and risks of becoming obese or overweight. Breastfed babies have significant lower rates of fat compared to formula fed infants at one year of age. It has been suggested that breastfeeding acts as a protective mechanism against obesity, and that each additional month that infants were breastfed was correlated with a 4% of obesity later in life. It was also seen that children and adolescents who were breastfed for longer than 6 months had even lower percentage of being overweight and obese (Soukup & Marcos, 2007). Being overweight can hinder a child’s motor development by delaying walking and rolling, as they have more weight to carry.

References

Deborah, L.D., Li, R., Lee, L., Grummer-Strawn, L.M. (2007). Associations between breastfeeding practices and young children’s language and motor skill development. 119 (1): 594-597. Retrieved from http://pediatrics.aappublications.org.ezproxy.library.ubc.ca/content/119/Supplement_1/S92.full.pdf+html

Dewey, K.G., Cohen, R. J., Brown, K.H. Riviera, L.L. (2001). Effects of exclusive breastfeeding for four versus 6 months on maternal nutritional status and infant motor development: results of two randomized trials in Honduras. 131(2): 262-267. Retrieved from http://jn.nutrition.org/content/131/2/262.full.pdf+html

Early Intervention Support. (2014). How Children Develop. Retrieved from http://www.earlyinterventionsupport.com/how-children-develop/

Eglash, A., Montgomery, A., Wood, J. (2008). Breastfeeding. 54(6): 343-411. Retrieved from http://www.sciencedirect.com.ezproxy.library.ubc.ca/science/article/pii/S0011502908000230

MedicineNet.com. (2015). Definition of Breastfeeding. Retrieved from http://www.medicinenet.com/script/main/art.asp?articlekey=38708

Petryk, A. (1998). The relationships of breastfeeding to mental and motor development in children under two years of age. 2-6. Retrieved from http://circle.ubc.ca/bitstream/handle/2429/18122/ubc_2006-0616.pdf?sequence=1

Sacker, A., Quigley, M.A., Kelly, Y.J. (2006). Breastfeeding and developmental delay: findings from the millennium cohort study. 118(3): 682-689. Retrieved from http://pediatrics.aappublications.org.ezproxy.library.ubc.ca/content/118/3/e682.full.pdf+html

Soukup, G., San, M. (2007). Preventing Childhood Obesity: does breastfeeding help? LEAVEN, 43(2): 2-4. Retrieved from http://www.llli.org/llleaderweb/lv/lvjanfebmar07p2.html

Vestergaard, M., Obel, C., Henriksen, T., Sorensen, H., Skajaa, E., Ostergaard, J. (1999). Duration of breastfeeding and developmental milestones during the latter half of infancy. 88(12): 1327-1332. Retrieved from http://onlinelibrary.wiley.com.ezproxy.library.ubc.ca/doi/10.1111/j.1651-2227.1999.tb01045.x/abstract;jsessionid=F9A084AB89DBE5BEDE9DF65FECFF2842.f02t04