Breast Feeding the Issue of Attachment - Essay Example

Breastfeeding - the Issue of Attachment I. Introduction Babies were born ready to be breastfed. Breastfeeding is an action of a woman feeding an infant with milk produced from her mammary glands, usually directly from the nipples. Babies have a sucking instinct allows them to extract milk from the mother. According to WHO/UNICEF breastfeeding is defined as the child receives breast milk direct from the breast. However definition is further subdivided into exclusive breastfeeding, predominant breastfeeding, full breastfeeding, complementary breastfeeding and bottle-feeding. Variance of definitions allows a more complete description of any potential obstacle to the maternal/child interactive physiology of breastfeeding (Labbok, 2003). Public health intervention is recommended to facilitate decrease of developing a disease and to help promote or maintain a healthy lifestyle. The Public Health Nurses are specially trained in lactation counseling offer education and support during the prenatal and postpartum period to help mothers get a good start with nursing. Public Health Nurses can give advice and support by sharing extensive experiences on babies and children and will be able to answer any questions or problems mothers might encounter while breastfeeding. They provide support and services especially for new mothers to enable the uptake and continuation of breastfeeding (http://www.publichealth.nice.org.uk/page.aspxo=503272, 2006) The health benefits of breastfeeding for both mothers and infants are increasingly recognized worldwide and in Scotland. It is a big public issue that concerns the health of the nation. Statistic shows that breastfeeding rates affect the public heath. In 1995, only 55% of Scottish mothers started breastfeeding compared to 68% in England and Wales. The multidisciplinary approach to breastfeeding promotes and support awareness about the value and practice of breastfeeding. In year 2000, the proportion of infants' breastfed in the UK increased by 3%, for Scotland (8%), while a 2% improvement in England and Wales due to changes in the age and educational attainment of mothers. Scotland was also the only part of the UK to record an increase in breastfeeding beyond birth, with higher prevalence at all ages up to 9 months. Scotland now has the UK's highest breastfeeding rate at all ages from 4 months (http://www.babyfriendly.org.uk/ukstats.asp, 2002) "Promoting breastfeeding is a key public health measure." (http://www.nhslothian.scot.nhs.uk/publications/health_plan_2005/pdf/breastfeeding.pdf, 2004). The Breastfeeding (Scotland) Bill was approved to make it an offence to prevent or stop anyone feeding milk to a child or infant who is otherwise permitted to be in a public place or licensed premises; to make provision in relation to the promotion of breastfeeding; and for connected purposes. This Bill stands a strong political message to support the importance to increase the rates of breastfeeding in Scotland for the health and welfare of our children. Breastfeeding is not a shameful act but a normal nurturing behavior (http://news.bbc.co.uk/1/hi/scotland/4021137.stm, 2004) Breastfeeding can also affect the relationship between the mother and the child. The maternal bond is strengthened through breastfeeding, by the mother's nurturing feelings towards the child. Breastfeeding provides physiological and psychological benefits for both mother and child. It creates a special emotional attachment and parental bonding (http://en.wikipedia.org/wiki/Breastfeeding#Bonding, 2006) Research on breastfeeding opened topics on interventions both in medical and political issues. The search were focused on the importance of breastfeeding in mothers and infants. The system of searching were based on relevant issues pertaining to breastfeeding. The search started on historical overview, prevalence in UK and Scotland, promotional support, physiologic and psychologic effects or benefits of breastfeeding. The research materials were based on the following key words used such as breastfeeding - Scotlant, breastfeeding - prevalence, history - breastfeeding, breastfeeding Scotland bill, affection - breastfeeding, promotion - support - breastfeeding, UNICEF - breastfeeding, breastfeeding - WHO, breastfeeding - public health etc. The recommendations were based on UNICEF and WHO to better support concerns on breastfeeding. Materials used were up to date mostly from year 2000 to 2005 to be able to gather recent findings and results. This study is conducted to provide a clearer picture regarding breastfeeding in Scotland, and its impact to the mother and the child as well. Specifically,t his looks on the matter of the frequency percentage of of mother who subject their new born babies to breastfeding. At the same time, this also tackles certain issues that mothers andh child undorgo when breastfeeding akesplace. These issues include the attachment or bond between the mother and the child, the health benefits for both the mother and child and the psychological and personlaity development that comes in when mother intiates breastfeeding to her children. Through research review is conducted to come up with the desired results. The most recent published journals and articles were subjected to reviews and analysis to acquire a deeper appreciation regarding the research problem. II. Review of Related Literature History of Breastfeeding In the past, breastfeeding was a norm, with only a less number of babies not breastfed. Rich women had access to wet nurses; nevertheless the rise of industrial revolution led high paying jobs for wet nurses resulting to decrease of breastfeeding. By the late 19th century, infant deaths from unsafe artificial feeding became a public health problem. Public health nurses addressed the problems by promoting breastfeeding and home pasteurization of cows' milk. After the turn of the century, commercial formula companies found a market for artificial baby milks as safer alternatives to cows' milk. During same period, infant-feeding recommendations and support of physicians' vision of "scientific" infant care, led to widespread use of formula as breast milk substitute that transpired in the first half of the 20th century. In the middle part of the 20th century, most physicians did not support breastfeeding, and most mothers did not prefer to breastfeed. As a result, an entire generation of mothers and physicians grew up not seeing breastfeeding as the normal way to feed babies. Despite the reappearance of breastfeeding in the late 20th century, breastfeeding and formula feeding continued to be seen as comparable, representing merely a lifestyle selection of parents without significant health issue. The manufacturers of human milk substitutes assertively created markets for their products shaping current views concerning infant nutrition. Endorsements to physicians and directly to the public in ways are contradictory with the International Code of Marketing for Human Milk Substitutes. Moreover literatures about breastfeeding were given by formula companies may mislead mothers, reinforce misconceptions about breastfeeding, and suggest that breastfeeding mothers also need to use substitutes. Physicians have been advertised and encouraged brand loyalty through "free" literature and samples. Use of literature and samples has demonstrated decline of breastfeeding rates and increase premature weaning. Currently, the World Health Organization (WHO) recommends that a child must be breastfeed for at least two years. The American Academy of Pediatrics, recommends that all babies, with rare exceptions, be exclusively breastfed for about six months. Health professionals can help increase breastfeeding rates, and breastfeeding continuation rates, by advocating breastfeeding, supporting breastfeeding patients and providing appropriate, evidence-based care for breastfeeding. (http://www.aafp.org/x6633.xml, 2001) Breastfeeding in Scotland Prevalence of breastfeeding at ages up to 9 months by country (1995 and 2000)(http://www.breastfeed.scot.nhs.uk/, 2006). Age of Baby England & Wales Scotland Northern Ireland United Kingdom 1995 2000 1995 2000 1995 2000 1995 2000 Percentage who breastfed initially Birth 68 71 55 63 45 54 66 69 1 week 58 57 46 50 35 37 56 55 2 weeks 54 54 44 47 32 34 53 52 6 weeks 44 43 36 40 25 26 42 42 4 months (17 weeks) 28 29 24 30 12 14 27 28 6 months (26 weeks) 22 22 19 24 8 10 21 21 8 months (35 weeks)* 16 17 14 18 6 7 15 16 9 months (39 weeks)* 14 14 13 15 5 7 14 13 Base (all babies at Stage 3) 4598 4112 1863 1718 1476 1437 5181 7267 *Based on a reduced number of cases excluding those babies who had not reached this age by stage 3 It best be remembered that Scot people were not into breastfeeding before, but this increase in breastfeeding rates in England and Wales since 1995 could mainly be accounted for by changes in the age and educational profile of mothers. The increased incidence in Scotland and Northern Ireland however, remained significant even after taking into account changes in the characteristics of mothers sampled (http://www.breastfeed.scot.nhs.uk/, 2006). The duration of breastfeeding refers to the length of time that mothers who breastfed initially continue to breastfeed even if they were also giving their babies other milk and solid foods (http://www.breastfeed.scot.nhs.uk/, 2006). Of Scottish mothers who initiated breastfeeding, 67% were still breastfeeding at 6 weeks post partum. The proportion of Scottish mothers who initiated breastfeeding and were still breastfeeding at four months, increased from 45% in 1995 to 50% in 2000 (http://www.breastfeed.scot.nhs.uk/, 2006). Scottish mothers breastfed for longer on average than women in other UK countries. By six months 40% of Scottish women who breastfed initially, were still breastfeeding compared to 34% of women in England and Wales and 21% in Northern Ireland (http://www.breastfeed.scot.nhs.uk/, 2006). Duration of breastfeeding for those who were breastfed initially by country (1995 and 2000) (http://www.breastfeed.scot.nhs.uk/, 2006) Age of Baby England & Wales Scotland Northern Ireland United Kingdom 1995 2000 1995 2000 1995 2000 1995 2000 Percentage who breastfed initially Birth 100 100 100 100 100 100 100 100 1 week 86 85 84 83 79 72 85 84 2 weeks 81 80 79 78 73 66 80 79 6 weeks 65 65 66 67 56 51 65 64 4 months (17 weeks) 42 45 45 50 27 30 42 44 6 months (26 weeks) 32 34 35 40 19 21 32 34 9 months (39 weeks)* 21 19 24 23 11 11 21 19 Base (all babies at Stage 3) 3106 2900 1029 1082 659 778 3410 4760 *Based on a reduced number of cases excluding those babies who had not reached this age by stage 3 Breastfeeding (Scotland) Act 2005 The Breastfeeding (Scotland) Act passed by the Parliament on November 18, 2004 and received Royal Assent on January 18 2005. The Act is stated as to make it an offence to prevent or stop anyone feeding milk to a child who is otherwise permitted to be in a public place or licensed premises or on those premises; to make provision in relation to the promotion of breastfeeding; and for connected purposes. 1. Offence of preventing or stopping a child from being breastfed It is an offence to prevent or stop a person in charge of a child from feeding milk to a child in a public place or on licensed premises. A person guilty of an offence under is liable on conviction to a fine. 2. Vicarious liability Anything done by a person in the course of that person's employment shall be treated for the purposes of this Act as done also by that person's employer, whether or not it was done with the employer's knowledge or approval.Anything done by a person as agent for another person with authority whether express or implied of that other person shall be treated for the purposes of this Act as done also by that other person. In proceedings brought under this Act against an employer in respect of an offence alleged to have been done by an employee of the employer, it shall be a defense for the employer to prove that the employer took such steps as were reasonably practicable to prevent the employee from committing such an offence in the course of the employee's employment. 3. Offence of bodies corporate and partnerships An offence committed by a body corporate is proved to have been committed with the consent or connivance of an officer; to be attributable to any neglect on that officer's part, the officer as well as the body corporate or partnership is guilty of the offence and liable to be proceeded against and punished accordingly. 4. Promotion and support of breastfeeding According to National Health Service (Scotland) Act 1978 38A Breastfeeding - The Scottish Ministers shall make arrangements and meet all requirements, for the purpose of supporting and encouraging the breastfeeding of children by their mothers. They shall have the power to disseminate, by whatever means, information promoting and encouraging breastfeeding." 5. Commencement and short title This Act shall come into force two months after the date of Royal Assent or on such earlier day as the Scottish Ministers may, by order made by statutory instrument, appoint. This Act may be cited as the Breastfeeding (Scotland) Act 2005 (http://www.opsi.gov.uk/legislation/scotland/acts2005/20050001.htm, 2005). Breastfeeding Promotion and Support in Scotland Healthy diet and lifestyle are vital in improving the health of the Scottish people and it is increasingly important to start healthy eating in infancy. Breastfeeding is the optimal method of infant feeding, has major health benefits for both mother and baby, and continues to confer health gain into childhood and beyond. Government Support In 1987, Minister Health Edwina Currie challenged health professionals and voluntary organizations to work together to promote and support breastfeeding. This result of the collaboration of Joint Breastfeeding Initiative was launched in England in 1987 and in Scotland in 1990. The Scottish Joint Breastfeeding Initiative (SJBI) was supported and funded and was successful in starting the process of raising awareness about the value and practice of breastfeeding. In November 1994, the Secretary of State for Scotland announced a national target for at least 50% of mothers to be still breastfeeding their babies at six weeks of life by the year 2005. Scotland was the first UK country to set a breastfeeding target. The work of the SJBI was carried forward by the Scottish Breastfeeding Group (SBG) from October 1995 to maintain a focus on breastfeeding and is ongoing. The group is chaired by Scotland's Chief Nursing Officer. A part time National Breastfeeding Adviser was appointed in October 1995 with a remit to contribute toward achieving Scotland's breastfeeding target, provide support and advice to fieldworkers and Local Joint Breastfeeding Initiatives and report and make recommendations to the Scottish Breastfeeding Group. The importance of breastfeeding to infant and maternal health is highlighted in government policy documents, encouraging support for breastfeeding at all levels. The Breastfeeding (Scotland) Bill, supported by the Scottish Executive, became law in March 2005 Breastfeeding Promotion NHS Health Scotland (formerly The Health Education Board for Scotland) is funded by The Scottish Executive and plays a vital role in encouraging women to breastfeed and promotes a positive public attitude towards breastfeeding. Following needs assessment research carried out in 1994, the organization initiated a program of support in 1995 and developed a wide range of resources for parents and training materials for health professionals. NHS Health Scotland has produced two television advertisements, the first in 2001 focusing on the health benefits of breastfeeding for mother and baby, the second in 2004 focusing on cultural attitudes to breastfeeding in public settings. A position paper addressing breastfeeding education for children and young people was circulated for consultation in October 2002. NHS Health Scotland, NHS Education Scotland, and the Scottish Executive have worked in partnership with the UNICEF UK Baby Friendly Initiative, Higher Education Institutions and Scottish Higher Education Institute lecturers to support effective breastfeeding education for student midwives and public health nurse students in Scotland. The resulting resource was launched in September 2004. UNICEF UK Baby Friendly Initiative The Baby Friendly Initiative is a WHO/UNICEF global initiative launched in 1991. The UK Initiative was launched in late 1994. The initiative was recommended by Scotland's Chief Nursing Officer. From 1996 onwards, the National Breastfeeding Adviser engaged Scottish maternity units regarding the negative impact of poor practice on breastfeeding and recommended the initiative as providing a framework to implement evidence based practice, and improved support for all mothers, whether they breast or formula fed their babies. Scotland has the highest level of participation in the initiative within the UK. 86% of Scottish maternity units are participating, with 46% of all units having achieved Baby Friendly status, and 58% of Scottish babies being born in a Baby Friendly accredited maternity unit (UNICEF 2005). (http://www.breastfeed.scot.nhs.uk/Breastfeeding_Promotion_and_Support_in_Scotland_1990-2005.doc, 2005) WHO Code The WHO Code is also known as "International Code of Marketing of Breast Milk Substitutes," which was adopted by the World Health Organization. This code recognized marketing formula as an attempt to reduce the number of breastfeeding which is vital public health and economic issue. The WHO Code PROHIBITS certain aggressive infant formula marketing strategies, such as: 1. Promoting infant formula through health care facilities 2. Lobbying health care personnel with free gifts 3. Providing free formula samples to new mothers 4. Using words or pictures in advertising which idealize bottle feeding The Code also mandates to place formula ads and labels facts about the benefits of breastfeeding and the hazards associated with formula feeding. The Code does not prohibit the existence of infant formula nor the choice to bottle feed. Instead, it seeks to give all women only pure facts about breastfeeding, free of marketing strategies, so that they have free and informed choices. The Code tries to level the playing field so that the superiority of breast milk, which has no million dollar marketing budget for promotions would not be in the lost of formula marketing hype. (http://www.breastfeedingtaskforla.org/WHOcode-print.htm, 2006) Effects of Breastfeeding Very few people are unaware of the benefits of breastfeeding for babies, but the many benefits to the mother are often overlooked. From the effect of oxytocin on the uterus to the warm emotional gains, breastfeeding gives a mother many reasons to be happy. One of the secrets about breastfeeding is that it's as healthy for mothers as for babies (Dermer, 2001).Breastfeeding provides physiological and psychological benefits for both mother and child. It creates emotional bonds, and has been known to reduce rates of infant abandonment. http://www.linkagesproject.org/technical/bf_benefits.php Not only does lactation continue the natural physiologic process but also it provides many short and long-term health benefits. Physiologic Effects of Breastfeeding Immediately after birth, the repeated suckling of the baby releases oxytocin from the mother's pituitary gland. This hormone not only signals breasts to release milk to the baby, but at the same time produces contractions in the uterus. The resulting contractions prevent postpartum hemorrhage and promote uterine involution (the return to a non-pregnant state). Bottle-feeding mothers frequently receive synthetic oxytocin; they are at highest risk of postpartum hemorrhage. As long as a mother breastfeeds without substituting formula, foods, or pacifiers for feedings at the breast, the return of her menstrual periods is delayed. Unlike bottle-feeding mothers, who typically get their periods back within six to eight weeks, breastfeeding mothers can often stay amenorrheic for several months. This condition has the important benefit of conserving iron in the mother's body and often provides natural spacing of pregnancies. The lactational amenorrhea method (LAM) is a well-documented contraceptive method, with 98 to 99 percent prevention of pregnancy in the first six months. The natural child-spacing ensures the optimal survival of each child, and the physical recovery of the mother between pregnancies. In contrast, the bottle-feeding mother needs to start contraception within six weeks of the birth. Long-Term Benefits of Breastfeeding A number of studies have shown potential health benefits through breastfeeding such as optimal metabolic profiles, reduced risk of various cancers, and psychological benefits. Production of milk is an active metabolic process, requiring the use of 200 to 500 calories per day, on average. To use up this many calories, a bottle feeding mother would have to swim at least 30 laps in a pool or bicycle uphill for an hour daily. Clearly, breastfeeding mothers have an edge on losing weight faster than a bottle feeding mother. This is important for mothers who have had diabetes during their pregnancies. After birth, mothers with gestational diabetes who breastfeed have lower blood sugars than non-breastfeeding mothers. Breastfeeding mothers tend to have high HDL cholesterol. The optimal weight loss, improved blood sugar control, and good cholesterol profile provided by breastfeeding may ultimately pay off with a lower risk of heart problems. Another important element used in producing milk is calcium. Because women lose calcium while lactating, some health professionals incorrectly assumed an increased risk of osteoporosis for women who breastfeed. However, existing studies show that after weaning their children, breastfeeding mothers' bone density returns to pre-pregnancy or even higher levels. In the long term, lactation may actually result in stronger bones and reduced risk of osteoporosis. Recent studies have confirmed that women who did not breastfeed have a higher risk of hip fractures after menopause. Non-breastfeeding mothers have been shown in numerous studies to have a higher risk of reproductive cancers. Ovarian and uterine cancers have been found to be more common in women who did not breastfeed. This may be due to the repeated ovulation cycles and exposure to higher levels of estrogen from not breastfeeding. It is expected that breastfeeding from 6 to 24 months throughout a mother's reproductive lifetime may reduce the risk of breast cancer by 11 to 25 percent. This phenomenon may also be due to suppressed ovulation and low estrogen, but a local effect relating to the normal physiologic function of the breast may also be involved. Studies show that appearance of flare-ups in rheumatoid arthritis in breastfeeding mothers. However, in another study, overall severity and mortality of rheumatoid arthritis was worse in women who had never breastfed. There have been no other studies showing any detrimental health effects to women from breastfeeding. Bottom line: Breastfeeding reduces risk factors for three of the most serious diseases for women-female cancers, heart disease, and osteoporosis-without any significant health risks. Psychological Effects for Breastfeeding Mothers Public health agencies advocate for breastfeeding because of its well-documented health advantages to babies, but they fail to convey to individual mothers and families the potential emotional impact of this very crucial infant-feeding decision. Breastfeeding provides a unique interaction between mother and child, an automatic, skin-to-skin closeness and nurturing that bottle-feeding mothers have to work to replicate. This can enhance the emotional connection between mother and infant. The child's suckling at the breast produces a special hormone, Prolactin, the milk-making hormone, appears to produce a special calmness in mothers. Breastfeeding mothers have been shown to have a less intense response. Many mothers are not being told how good breastfeeding is for their health. Whether out of ignorance or due to the influence of the artificial baby milk industry, many health care providers fail to inform mothers of the facts. It's time for this well-kept secret to come out. As word spreads about these little-known facts, more mothers will not merely choose to breastfeed briefly to provide early disease protection for their baby, but will continue to breastfeed, providing optimal outcomes both for their children and for themselves (Dermer, 2001). During the 1990s, Scotland started to show continuing commitment to the promotion and support of breastfeeding. Considerable progress has been achieved through multidisciplinary working, multifaceted programs of support, and working in partnership with UNICEF/WHO. The Scottish Executive has shown commitment through its policies, the Scottish Breastfeeding Group and the National Breastfeeding Adviser while NHS Health Scotland has provided valued guidance, support and resources. Breastfeeding strategies are of key importance and have enhanced multidisciplinary and partnership working, team building, and extensive sharing of their successes, and failures, throughout Scotland. This will create an opportunity to enable more satisfying and successful breastfeeding experience for Scottish mothers and babies, and contribute to the future health of the Scottish nation (http://www.breastfeed.scot.nhs.uk/Breastfeeding_Promotion_and_Support_in_Scotland_1990-2005.doc, 2005). Breastfeeding is vital in the public health. It provides health advantages to the mother, child and most of all the community. Breastfeeding offers the natural link of the mother and child. Some people thought of breastfeeding as an act of being dependent of the child to the mother. However this emotional and unexplainable bond of breastfeeding would let the mother feel the needs of her child and the closeness of the child to his of her mother. Not only the emotional connection but the numerous advantages offered by breastfeeding both in short and long term effects. The support of the different government organizations helps achieve promotion of breastfeeding, increase breastfeeding rates and help the economic costs of the family and the society as well. References: Labbok, Miriam. What is the Definition of Breastfeeding. 12 March 2003. Volume 19, Number 3, pp.19-21. 20 March 2006. < http://www.lalecheleague.org/ba/Feb00.html> Public health intervention guidance. 2006. "Breastfeeding in Scotland". March 20, 2006 Breastfeeding in the UK: current statistics. May 2002. UNICEF UK Baby Friendly Initiative . 20 March 2006. Breastfeeding in Lothian 2004. 2004. 20 March 2006. Breastfeeding bill gains approval. 18 November 2004. BBC News. 20 March 2006. Breastfeeding. 18 March 2006. Wikipedia Encyclopedia. 20 March 2006. < http://en.wikipedia.org/wiki/Breastfeeding#Bonding> Breastfeeding (Position Paper). 2001. American Academy of Family Physicians. 20 March 2006. < http://www.aafp.org/x6633.xml> Breastfeeding etc. (Scotland) Act. 4 February 2005. 20 March 2006. Breastfeeding Promotion and Support in Scotland 1990-2005. 2005. 20 March 2006. What is the WHO Code. 20 March 2006. Dermer, Alicia. A Well-Kept Secret Breastfeeding's Benefits to Mothers. July-August 2001. New Beginnings, Vol. 18 No. 4, p. 124-127. 20 March 2006. < http://www.lalecheleague.org/NB/NBJulAug01p124.html> Benefits of Breastfeeding. 20 March 2006. Read More