12.1: Chapter Introduction

This chapter is the first of two that exploring nutrition through the life cycle and it looks at pregnancy through the toddler years. Topics include pregnancy, breastfeeding, introducing solid foods, and nutrition during the toddler years. In this chapter and the next, we will explore how the dietary decisions we make affect our health and wellness throughout the life cycle. We begin by examining the developmental changes that occur during pregnancy, infancy, and the toddler years, and how nutritional choices affect those changes. From pregnancy through the toddler years, children are entirely dependent on parents or caregivers for nutrients. Parents also help to establish a child’s eating habits and attitudes toward food. So, adults must be mindful of the choices they make and how those choices influence a young child’s development, health, and overall well-being.

The World Health Organization (WHO) recommends that infants should be given only breast milk for the first six months of life. Exclusive breastfeeding is one of the best ways a mother can support the growth and protect the health of her infant child. Breast milk contains all of the nutrients that a newborn requires and gives a child the best start to a healthy life. Many women want to breastfeed their babies. Unfortunately, a mother’s intention alone may not be enough to make this practice possible. Around the world, less than 40 percent of infants under the age of six months are breastfed exclusively.World Health Organization. “10 Facts on Breastfeeding.” Accessed February 21, 2012. http://www.who.int/features/factfiles/breastfeeding/en/. In the United States, about 75 percent of babies start out being breastfed. Yet by the age of six months, when solid foods should begin to be introduced into a child’s diet along with breast milk, only 15 percent of infants in the United States were still breastfed exclusively, according to the Centers for Disease Control and Prevention (CDC).Centers for Disease Control and Prevention. “Breastfeeding: Promotion and Support.” Last updated August 2, 2011. http://www.cdc.gov/breastfeeding/promotion/index.htm. However, the approval and assistance of family members, friends, employers, health-care providers, and policymakers can make an enormous difference and provide the needed promotion and support for mothers who wish to breastfeed their children.

Figure 12.1.1: The choice to breastfeed is one that all new mothers face. Support from family members, friends, employers, and others can greatly help with both the decision-making process during pregnancy and the practice of breastfeeding after the baby’s birth. Image used with permission (public domain; Yves Picq http://veton.picq.fr)

Education about breastfeeding typically begins with health-care providers. During prenatal care and often soon after a woman has given birth, doctors, nurses, and other clinicians can explain the benefits of breastfeeding and describe the proper technique. Nearly all births in the United States and Canada occur in hospital settings, and hospital practices in labor, delivery, postpartum care, and discharge planning can inform and support women who want to breastfeed. Once a new mother has left the hospital for home, she needs access to a trained individual who can provide consistent information. International Board Certified Lactation Consultants (IBCLCs) are health-care professionals (often a registered nurse or registered dietitian) certified in breastfeeding management that work with new mothers to solve problems and educate families about the benefits of this practice. Research shows that breastfeeding rates are higher among women who had infants in hospitals that make IBCLCs available to new mothers, rather than those who gave birth in institutions without these professionals on staff.US Department of Health and Human Services, Office of the Surgeon General. “Executive Summary: The Surgeon General’s Call to Action to Support Breastfeeding.” January 20, 2011. http://www.surgeongeneral.gov/topics/breastfeeding/executivesummary.pdf. In addition, spouses, partners, and other family members can play critical roles in helping a pregnant woman make the decision to breastfeed and assisting with feeding after the baby is born.

Employment can also factor into a woman’s decision to breastfeed or her ability to maintain the practice. Employed mothers have been less likely to initiate breastfeeding and tend to breastfeed for a shorter period of time than new mothers who are not employed or who have lengthy maternity leaves. In 2010 in the United States, the passage of the Affordable Care Act (ACA) called for employers to provide accommodations within the workplace for new mothers to pump breast milk. This law requires a private and clean space within the workplace, other than a restroom, along with adequate break time for a woman to express milk.US Department of Health and Human Services, Office of the Surgeon General. “Executive Summary: The Surgeon General’s Call to Action to Support Breastfeeding.” January 20, 2011. http://www.surgeongeneral.gov/topics/breastfeeding/executivesummary.pdf.

Members of a community can also promote and support breastfeeding. New mothers can join peer counseling groups or turn to other women within their community who have previous experience with breastfeeding. In addition, community-based programs can provide education and support. The US Department of Agriculture’s Women, Infants, and Children program provides information on breastfeeding for low-income families. Launched in 2004, the Loving Support program combines peer counseling with breastfeeding promotion efforts to increase duration rates across the United States. La Leche League is an international program that provides mother-to-mother support, encouragement, and education about breastfeeding for women around the world.

Video 12.1.1: Breastfeeding and Working. This video from the Colorado Breastfeeding Coalition focuses on the importance of making workplace accommodations for employees who are breastfeeding their infants. https://youtu.be/S2XmUPpQsFc

YOU DECIDE

How can you help to promote and support breastfeeding practices in your community?

Although breastfeeding should be recommended and encouraged for almost all new mothers, it is important to remember that the decision to breastfeed is a personal choice and women should not be made to feel guilty if they cannot, or choose not, to breastfeed their infants. In some rare cases, a woman is unable to breastfeed or it is not in the baby’s best interest.

Nutritional choices that parents make, such as the decision to breastfeed or bottle-feed, not only affect early childhood development, but also a child’s health and wellness later in life. Therefore, it is imperative to promote and support the best practices for the well-being of infants and mothers alike. Throughout this chapter, we will examine how dietary choices—from daily caloric intake for pregnant women to serving sizes for toddlers—impact health and wellness during pregnancy and the early childhood years.