Breastfeeding and Complementary Feeding Notes

Every infant and child has the right to good nutrition according to the "Convention on the Rights of the Child".
Approximately 44% of infants aged 0–6 months are exclusively breastfed.
Few children receive nutritionally adequate and safe complementary foods; in many countries, less than a fourth of infants aged 6–23 months meet criteria for dietary diversity and feeding frequency appropriate for their age.
Optimal breastfeeding (0–23 months) could save over 820,000 children's lives each year for those under 5 years.
Benefits of breastfeeding include improved IQ, school attendance, and higher income in adulthood.
Economic gains from improved child development and reduced health costs benefit families and nations.

Early initiation of breastfeeding within 1 hour of birth.
Exclusive breastfeeding for the first 6 months of life.
Introduction of nutritionally adequate and safe complementary foods at 6 months, continuing breastfeeding up to 2 years or beyond.

Definition: Feeding the baby only breast milk without any other food or liquids, except for medications or vitamins/mineral supplements.
Nutritional Benefits:
- Breast milk is a primary source of energy and nutrients, supplying over half of a child’s energy needs between 6–12 months.
- Critical during illnesses, helping reduce mortality among malnourished children.
Recommendations:
- The U.S. Dietary Guidelines suggest exclusive breastfeeding for about the first 6 months, followed by continued breastfeeding alongside appropriate complementary foods until at least 12 months.
- The American Academy of Pediatrics advocates similar guidelines.

For the Baby:
- Lower risk of:
- Asthma
- Obesity
- Type 1 diabetes
- Severe respiratory diseases
- Ear infections
- Sudden infant death syndrome (SIDS)
- Gastrointestinal infections
- Necrotizing enterocolitis (NEC) in preterm infants
For the Mother:
- Lower risk of:
- Breast and ovarian cancers
- Type 2 diabetes
- High blood pressure
- Longer breastfeeding contributes to spacing pregnancies through hormonal effects (Lactation Amenorrhoea Method).

Policy Adoptions:
- Maternity Protection Convention 183
- International Code of Marketing of Breast-milk Substitutes
Implementing the Ten Steps to Successful Breastfeeding from the Baby-Friendly Hospital Initiative:
- Skin-to-skin contact and breastfeeding initiation within the first hour.
- Breastfeeding on-demand and rooming-in for mothers and infants.
- Supportive health services including counseling during antenatal and postnatal stages.
- Community support through mother support groups.

Newborn to 6 Months:
- Frequency: Every 2-3 hours (8-12 times per day), including night feeds.
- Amount per feeding:
  - Day 1: Few milliliters (baby’s stomach is very small, about the size of a cherry).
  - Week 1: 30-60 mL (1-2 oz) per feeding.
  - By 1 month: 90-120 mL (3-4 oz) per feeding.
6 to 12 Months:
- Frequency: Every 4-5 hours (5-6 times per day), but still on demand.
- Amount per feeding: 120-180 mL (4-6 oz).
12 to 24 Months:
- Frequency: 3-4 times per day, plus on demand.
- Amount per feeding: 180-240 mL (6-8 oz).

Begins around 6 months as the infant's need for energy exceeds breast milk.
Foods should be:
- Timely: Introduced when energy needs increase.
- Adequate: Provide sufficient energy, protein, and micronutrients.
- Safe: Hygienically stored and prepared.
Caregivers should respond to the child’s hunger signals and encourage eating.
Guiding principles:
- Continue breastfeeding for 2 years or beyond on demand.
- Start with small amounts and gradually increase texture and variety.