The Italian children of 4-5 months breastfed exclusively at the breast are 23.6%. At 12-15 months, those who were still breastfed, that is, who took only one breast milk, are 31.3%. And children between zero and 2 years never breastfed 11.7% (data from the Child Health Surveillance System between 0-2 years 2018-2019). With beautiful regional differences: ranging from 16.6% of exclusive breastfeeding in Campania to 44.7% in the province of Trento, but in any case we are outside the WHO recommendations and the same national indications to breastfeed exclusively, that is with only breast milk, for 6 months. Naturally then adding other foods, and then possibly continuing up to 2 years of the child, depending on needs and situations, different for each woman.
“I’ll tell you why mother’s milk saved our species”
by VALERIA PINI
There are many reasons for breastfeeding, known and documented. Breast milk is a natural choice and a promise of health: for the nursing mother, whose risk of developing ovarian and breast cancer over the years is reduced, as do the complications of osteoporosis after menopause. And for the nursed child, who is more protected from diabetes, obesity, infectious diseases and allergies, the most common chronic diseases in Italian children. And speaking of allergies, a recent study published in Allergy by Ceinge researchers, the Center for Advanced Biotechnologies of the Federico II University of Naples, of the University of Salerno, of the CNR and of the Evangelico Betania Hospital has identified in breast milk the butyrate, a compound capable of exerting a very powerful protective action against allergic diseases in children. “It is a small short-chain fatty acid capable of effectively regulating all the main defense mechanisms against the onset of allergic diseases in children”, explained Roberto Berni Canani, director of the Ceinge Immunonutrition Laboratory and of the Pediatric Allergy Program of the University of Naples Federico II. “The effectiveness of breast milk – continues the expert – is based on the immunoregulatory compounds it contains, such as butyrate. Increasing the concentration of this compound by modulating the maternal diet (favoring, for example, the consumption of foods rich in vegetable fibers), could be an effective strategy to amplify the protective role of breast milk against the onset of allergic diseases “.
Coronavirus, return home with the newborn
by TINA SIMONIELLO
In Italy, during the first wave of the pandemic, 77.6% of newborns born to mothers who tested positive at the time of delivery or immediately after delivery were fed breast milk at the birth points (Sin data, Italian Society of Neonatology). So why despite the good reasons and organizational efforts in times of pandemic, are we still so far from the set goals?
“The reasons for abandoning exclusive breastfeeding are many and varied: personal, social, cultural factors”, he says Riccardo Davanzo, neonatologist at Burlo-Garofolo in Trieste and president of TAS, the Technical Breastfeeding Table of the Ministry of Health. “There is a personal experience, which counts – Davanzo resumes – there are women who live in a context in which they have not breastfed: their mothers have not breastfed, and they themselves are less motivated to do so. There are social factors: women with a higher level of education are more aware of health choices and even if their professional and working life is dynamic they tend to adhere more to breastfeeding. Of course, not all jobs are the same: anyone who is employed in the public sector or has an employee job has the right to benefits but for merchants, self-employed workers, freelancers it can be difficult to breastfeed for a long time exclusively “.
In times of coronavirus, even the newborn is a nice puzzle
by TINA SIMONIELLO
“As counterintuitive as it may seem – he confirms Angela Giusti, researcher at the Higher Institute of Health, National Center for Disease Prevention and Health Promotion – it is often women who are not working who stop before breastfeeding. There is an association between exclusive breastfeeding and higher education level, absence of economic and family difficulties, participation of mothers in at least one accompanying birth meeting, having other children and having a job. Working mothers and college graduates breastfeed more.
Mom and baby are inseparable even in the days of Covid
by Tina Simoniello
In Italy, breastfeeding has declined since the 1950s, since giving birth in the hospital “and mothers and children began to be managed separately, with newborns in the nursery and fed with artificial milk that is he considered it to be better, more substantial as well as a status symbol. And so it went until the end of the 1970s “. When we have reached the minimum. “Exactly, a minimum that has remained so until a few years ago in many areas of Southern Italy. Since the 1980s, international organizations such as Unicef, WHO, scientific societies and individual institutions have begun to commit themselves to spreading the culture of recovery. breastfeeding and its support “, explains the neonatologist.
A smartphone to manage breastfeeding
by TINA SIMONIELLO
Now let’s dispel a myth: breastfeeding is a natural gesture, it’s true. But natural does not always mean that it is easy, not always everything goes smoothly. New mothers, especially their first child, would need to be initiated into breastfeeding at the birth points, and then supported afterwards, once home. But not all regions succeed. “There is no trained staff with adequate aptitude everywhere, and structures such as counseling centers or districts – specifies Davanzo – health professionals are very clear on the benefits of breastfeeding but their performance in protecting and supporting it can be improved. positive is important, professionals are asked to organize health structures in such a way that they promote breastfeeding and concretely support mothers, respecting the needs and different personal choices of women “.
After giving birth, the newborn can stay with the positive mother without symptoms, the risk of contagion is very low
by Fabio Di Todaro
“It takes a shared strategy at every birth point. The new essential levels of assistance as well as the National Prevention Plan provide for breastfeeding to be protected, supported and promoted, and for the adoption of training strategies for health professionals, communication campaigns, individual counseling ”, continues Giusti.
Speaking of strategies, there is the international initiative Ospedale Amico dei Bambini by Unicef (or Bfhi which stands for Baby-Friendly Hospital Initiative) to which various Italian structures also adhere. And Bfhi proposes exactly this: a strategy to support all-round breastfeeding, divided into 10 steps. A few examples? Promote the rooming-in (mother and baby together 24 hours a day during hospitalization), help mothers to start breastfeeding within half an hour of giving birth, set up support groups to turn to after discharge from the hospital. And more. These are 10 clear indications that work together.
Covid, when breastfeeding mothers are forced to lie to get vaccinated
by Riccardo Davanzo
“We have excellent national policies and exclusive and continuous breastfeeding rates have increased in many regions – the ISS researcher said – but not in all and, within the same region, not in all birth centers. Giving birth at a birthplace that has an exclusive breastfeeding prevalence of 80% is not like giving birth to one that stops at 30%. And this generates more inequality, because it is above all women of the lowest socio-cultural level who start at a disadvantage “.
Those that cannot: pathologies and drugs
Then there are the physical conditions that prevent women from breastfeeding. We are talking about a few cases: mothers with agalease who cannot start lactation (about 1%) or those with important pathologies, such as cancer or congenital heart disease. “For these women, who in total do not exceed 4-5%, breastfeeding would lead to excess fatigue,” she says. Massimo Agosti, Professor of Paediatrics at the Insubria University and President of the Sin Breastfeeding Commission, Italian Society of Neonatology. And then there are the cases in which mothers take drugs that contraindicate breastfeeding. And in this regard, “the anti-Covid vaccine is not among those – Agosti points out – those who breastfeed can be vaccinated, the choice is individual, and women can choose by consulting with a health worker”.
Last December Sin, Sip (Italian Society of Pediatrics), and other scientific societies in fact signed a consensus document considering “Covid-19 vaccination compatible with breastfeeding”, and that “biological plausibility suggests that in a nursing baby breastfeeding the risk consequent to the mother’s Covid-19 vaccination is extremely low, while on the contrary the interruption of breastfeeding would lead to a sure loss of well-documented benefits “.
The milk banks
We are the country with the most milk banks in Europe: we have 38. “We are proud of our mothers – says Agosti – during the pandemic there was a slowdown in donations but we are recovering.” Milk banks or Blud ( which stands for Donor Human Milk Banks) are systems for collecting and storing the milk of women who donate it to premature or ill babies or whose mothers have difficulty breastfeeding. The milk is collected in hospital or at home by operators, frozen and sterilized. “It does not preserve all the characteristics of unprocessed breast milk, but – resumes the neonatologist – it is still a better solution than formulated milk: it is more digestible and in the literature we have data that indicate that premature babies fed with donated milk have better prognoses. The Bluds are not able to cover the national needs, but the most fragile children are ”.
Feeding time, research and premature babies
And speaking of frail children, a research by the University of Birmingham published in Allergy helps explain why breastfed babies achieve better health outcomes. Over a 3-year period, the researchers analyzed data from 38 mothers and their infants, all of whom were healthy: 16 were exclusively breastfed, nine were given mixed feeding and 13 were fed formula only. The result was that regulatory T lymphocytes, immune system cells that control the baby’s immune response and help reduce inflammation, were present in breastfed infants at nearly twice the levels measured in formula-fed infants. In addition, bacteria in the intestines of breastfed babies Veillonella e Twin, which support the activity of regulatory T, were more abundant. “We hope, for those babies who are formula-fed, that these results will help optimize the composition of the formulations so as to exploit these immunological mechanisms.”
.