Lactose is a disaccharide and the predominant sugar found in breastmilk.1 It constitutes around 40% of the energy and considered as optimum food for infants.
World Health Organization recommends exclusive breast-feeding for all infants up to 6 months of age, and hereafter continued breast-feeding up to the age of 24 months or beyond.2
Mechanism of action of lactose:
Lactose is a disaccharide formed by glucose and galactose linked via a β-1-4 glucosidic bond. Most lactose is digested by enzyme lactase bound to brush border membrane of the small intestine (Fig 1).
Fig:1 Lactase splits lactose into glucose & galactose
Undigested lactose continues to the colon where it is fermented by the colonic microbiota and lactate to produce short-chain fatty acids and gas and result in a reduction of luminal pH (Fig 2.).2
Prebiotic effect: Lactose that escapes digestion serve a substrate for the intestinal flora & favor growth of bifidobacteria and lactobacilli.2,3
Increased mineral absorption: Lowering of pH increases mineral solubility and/or osmotic pressure which in turn enhances paracellular transport of calcium and other minerals across epithelial wall.2,3
The World Health Organization (WHO)* has recommended that pregnant women and new mothers be informed of the benefits and superiority of breastfeeding, in particular, the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for and maintenance of lactation, with special emphasis on the importance of the well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial bottle-feeding or other foods and drinks should be discouraged since it will have a negative effect on breast-feeding. Similarly mothers should be warned of the difficulty of reversing a decision not to breastfeed. Before advising a mother to use infant formula, she should be advised of the social and financial implications of her decision. For example, if a baby is exclusively bottle-fed, more than one can (500g) per week will be needed, so the family circumstances and cost should be kept in mind. Mother should be reminded that breast milk is not only the best but also the most economical food for babies. If a decision to use an infant formula is taken, it is important to give instruction on correct preparation methods, emphasizing that unboiled water, unsterilized bottles or incorrect dilution can lead to illness.
*See : International Code of Marketing of Breast Milk Substitutes, adopted by the World Health Assembly in Resolution WHA 34.22, May 1981.
Mothers should be explained the following advantages & nutritional superiority of breastfeeding:
- Immediately after delivery, breast milk is yellowish and sticky. This milk is called colostrum, which is secreted during the first week of delivery. Colostrum is more nutritious than mature milk because it contains more protein, more anti-infective properties which are of great importance for the infant's defence against dangerous neonatal infections. It also contains higher levels of, Vitamin 'A'
- Breast Milk:
- Is a complete and balanced food and provides all the nutrients needed by the infant (for the first six months of life)
- Has anti-infective properties that protect the infants from infection in the early months
- Is always available
- Needs no utensils or water (which might carry germs) or fuel for its preparation
- Breastfeeding is much cheaper than feeding infant milk substitutes as the cost of the extra food needed by the mother is negligible compared to the cost of feeding infant milk substitutes
- Mothers who breast-feed usually have long periods of infertility after childbirth than non-lactators
Details of management of breast feeding, as under:
- Breast Milk:
- Immediately after delivery enables the contraction of the womb and helps the mother to regain her figure quickly
- Is successful when the infant suckles frequently and the mother wanting to breast-feed is confident in her ability to do so
- In order to promote and support breastfeeding the mother's natural desire to breastfeed should always be encouraged by giving, where needed, practical advice and making sure that she has the support of her relatives.
- Adequate care for the breast and nipples should be taken during pregnancy.
- It is also necessary to put the infant to the breast as soon as possible after delivery.
- Let the mother and the infant stay together after the delivery, the mother and her infant should be allowed to stay together (in hospital, this is called "rooming-in").
- Give the infant colostrum as it is rich in many nutrients and anti-infective factors protecting the infants from infections during the few days of its birth.
- The practice of discarding colostrum and giving sugar water, honey water, butter or other concoctions instead of colostrum should be very strongly discouraged.
- Let the infants suckle on demand.
- Every effort should be made to breast-feed the infants whenever they cry.
- Mother should keep her body and clothes and that of the infant always neat and clean
Breastfeeding is the best form of nutrition for babies and provides many benefits to babies and mothers. It is important that, in preparation for and during breast-feeding, you eat a healthy, balanced diet. Combined breast and bottle feeding in the first weeks of life may reduce the supply of your own breast-milk, and reversing the decision not to breast-feed is difficult.
Always consult your Healthcare Professional for advice about feeding your baby. The social and financial implications of using infant formula should be considered. Improper use of an infant formula or inappropriate foods or feeding methods may present a health hazard. If you use infant formula, you should follow the manufacturer's instructions for use carefully - failure to follow the instructions may make your baby ill.
IMPORTANT NOTICE: MOTHER’S MILK IS BEST FOR YOUR BABY