 Hello everyone, today I am going to talk about breastfeeding, the science and an art, this is session number 5 and very interesting session because now we are going to start with you know breast milk, breastfeeding, art, science you know, so you will learn about infant nutrition, extremely important in child's life because that gives foundation to child's health. So you know we always think that only poor mothers or uneducated mothers or illiterate mothers they may need help or sometimes people feel that oh somebody who is highly educated you know she may need help because she does not probably know the culture or you know there are all these myths you know but what we found that whether a woman is educated whether she is coming from very you know I mean the earliest quintile or if she is poor or she is tribal, open does not matter, each and every woman needs guidance with breastfeeding. So it is important that you know we do not create this you know kind of preconceived notion that you know she will need help or she will know it or you know every woman needs help so that is important you know. Human milk, beautiful, beautiful infograph, what it has it has different sections as you can see and it gives kind of information about the ingredient of human milk, content of human milk. So we will start with basically the right most corner, top right most corner. What it has it has all this threonine and methionine, cysteine those are all amino acids, amino acids make your protein okay. So basically it has all the amino acids which are required in the diet all of them it has essential amino acid it has non-essential amino acids very good very digestible protein breast milk has it is called whey protein so very high whey protein very easily digestible okay. Second section over here it is your triglyceride your you know all these different kind of fats loric acid and you know phosphatidyl choline and all this this are all basically different kind of fats okay. The kind of fat that breast milk has it has omega 3 DHA and EPA and those fats are important for your brain, baby's brain for eyes and for heart okay. So and there are many studies that as I mentioned earlier also many studies which are published showing that babies who take mother's milk have higher IQ and that's because of the kind of fat that mother's milk has. When you buy a formula you know what they do is they remove the cow milk's fat so they remove that saturated fat which is important for brain okay and they put in all vegetable oils okay so that's it's kind of unnatural really so that's why I've given in one of my tutorial on complications of you know formula and cow milk about this fats. Another thing what it has this are your macrophages or IgA IgA you know complements this are all basically your immune function immune cells okay breast milk is a live substance so if you add any micro bacteria or any any you know bacteria or viruses it immediately gets killed okay because this breast milk is a live product very very very important macrophage macrophages large cells macromins large the large cells and they engulf bacteria they engulf you know a lot of your microorganisms okay it has all immunoglobulin it has IgA you know IgM IgE there are all these immunoglobulins that that breast milk has and that's why you know even in Covid you know babies are protected if babies get mother's milk right any type any type of infection if mother has any kind of infection in fact breast milk will increase those immune cells you know will fight against the infection so many times mother may ask whether I can breastfeed yes she can breastfeed even if she has cold cough diarrhea or any of those infection okay even in HIV actually mother can breastfeed okay all right then you have this are all enzymes so enzymes are your you know your antitrypsin and histaminase this are the enzymes which digest your you know your food and it is helping in a lot of biochemical reactions okay this are all your hormones so you have your T3, T4, TSH you know all all those different prostaglandin, cholecystokin, cortisol, insulin so mother's milk has all this you know hormones leptin again very very important for the baby okay here what you have in this section you have kind of growth hormone kind of factors you know so it has you know GCSF it has you know calcitonin it has like all these other kind of hormones insulin like growth factors it's all again you know you know kind of ingredient which are required for growth okay then you have over here all the vitamins so basically all your fat soluble vitamin and what soluble vitamin remember if vitamins are low in mother then those mothers will have less vitamin in their breast milk okay vitamin is your type 1 nutrient so any type 1 nutrient which is lacking in mother will be lacking in breast milk also this one also has minerals so you have your zinc iodine all that potassium magnesium you know so type 2 micronutrient will not kind of you know change so much if mother is lacking because those micronutrient will come from cells will come from muscle tissue okay so that that remember that type 2 micronutrient does not change in breast milk then you have something called nucleotides okay so this are your nucleotides very important information of DNA you know in repair of DNA kind of making new cells so this all your nucleotides which are present in mother's milk okay so there is nothing that you can compare to mother's milk the best natures gift to baby so please make sure that each and every mother get this information we have a very good tutorial on importance of breastfeeding complications of formulas and cow milk you know if you have any family member who is planning to become pregnant or who is pregnant you know please kind of pass on this to talk to them it's crucial that mother and the family listen to you know what science has to say okay and once they understand this then I would recommend that they watch those you know technique tutorial you know the art of breastfeeding with this that's that's another thing which is which is kind of you know you have to pass through that hurdle okay because many mothers give up too soon you know because of the poor technicality okay for your understanding of the techniques okay so let's talk a little bit about the science of breast milk so you know breast milk has a lot of different factors of course most important is nutrition right it's optimum in nutrition for an infant okay they don't need anything except probably vitamin D it is optimal food for health growth and development of the infant it's not only beneficial to infant but also to mothers okay what are the advantage of breastfeeding so basically it has nutritional factors it has immunological factors it has psychological factors economical factors and physiological factors okay now this is the table which shows the composition human milk composition it is compared to cow milk and buffalo milk okay so if you look at comparison so this is your protein so protein is lowest in human milk but is highly digestible okay very easily digestible cow milk protein is predominantly casein casein protein is really hard you know very heavy it's the same protein basically when you make paneer out of milk you know so that casein that paneer is casein and whatever water is left behind that's way okay just make sure when you make paneer at home don't throw away that way you know just use it and either right making rice or dal or whatever you make you know and buffalo milk has 4.3 grams of protein so buffalo milk has highest protein okay carbohydrate basically highest in human milk okay fats highest in buffalo milk 6.5 grams for 100 ml calcium you can see look at the amount of calcium you know cow milk and buffalo milk some of the highest amount phosphorus again is increasing okay not necessarily good for baby in a so much high amount and basically vitamin C is high in human milk okay so this is just a main difference basically between human milk cow milk and buffalo milk this is what I spoke about that protein is low in human milk you know kind of high in cow and goat here they have given goat so protein is kind of you know pretty much a little bit lower than cow but higher than human milk lactose as I told you earlier also lactose is higher in human milk kind of a little bit less in cow and goat milk but goat milk has a high amount of fat as you can see goat milk is very fatty okay this is the difference between poor milk and high milk okay now if you look at mature milk mature milk comes in say on around day three you have a transition milk and after about a week or so then a mature milk comes in so when the mature milk comes in the front part of the milk okay which is in front part of the breast it's for milk and that's kind of little bit watery and it has kind of good amount of protein but the fat fat is not much informal as you can see over here the fat is not much okay high milk the back part of the milk okay that is much higher in fat so babies who drink much more baby completely empties one breast those babies kind of tend to do well not only in terms of weight but also night you because fat is again very high in omega 3 omega you know your DHAPA okay so make sure that you completely empty your breast and then go on the other side and when you completely empty you know you want to do objective examination by looking at breast the breast you know I'll show you in my one tutorial how to express manually you know but there is a technique to it so you learn it okay you make sure that there is no handmade left then you go on the other side okay close trim is basically your fat close trim is very fatty and it's high amount of protein okay so you can see compared to mature milk look at the amount of fat it has amount of protein because it's so much it's a very small quantity that the babies get in the beginning the mothers produce so it's very kind of calorie dense okay and a lot of time you know initially for a couple of days you know baby tend to sleep more do not worry about it you know it's it's okay because it has good amount of fat and protein okay so that is about colostrum in one of our tutorial we have given how much colostrum mothers get you know on day one day two day three day four it's important to understand that because many times for the feel that oh I'm not getting milk I'm not getting milk but you need to know that there's only some amount of milk that they'll get okay carbohydrate human milk is the sweetest milk due to high amount of lactose lactose which is present in higher level in human milk facilitate absorption of magnesium calcium and amino acids okay so that lactose is really important in mother's milk the high content of galactic lipids promote rapid brain growth also so it's important for brain growth and galactose which is milk sugar present in milk is essential for formation of myelin okay which is important for the normal function nerve function my lean is the sheet which covers the nerve nerve you know neuron cells so galactose is really important it gives you know immediate energy to the baby okay next is your macro protein protein is present in the form of lactose human okay that's your milk protein which forms a soft curd so many times you see when the baby finished feeding they will have a little bit of a cuddling you know like a cuddle milk cuddles and that's that's your lactose human and this lactose is very easily digestible and absorb by infant very fast so it's it's predominantly a way protein okay human milk is rich in sulfur now you know of course in my previous session I discussed about sulfur again crucial for liver crucial for you know brain development systems important for brain development so just make sure that babies get a human milk okay it is also rich in amino acid called taurine and taurine is a very important neurotransmitter okay we're just discussing very kind of short I don't want to go too much in detail because you know we have kind of people from different backgrounds so I don't want to go too much in that medical aspect of on nutrition and dietitian nutrition aspect of breast milk you know but we have explained a very simple way in our tutorials now this is the difference of quality of protein in different milk so here if you look at it human milk has predominantly whey protein 35% casein over here cow milk has 80% casein casein is the no paneer okay so definitely when children have cow milk it's very difficult to digest they tend to have a lot more vomiting bloating you know stomach upset babies who are breastfed they are generally very quiet you know unless they have colic okay but otherwise they are they are pretty happy babies now let's talk about fats so fats in present in human milk are essential fatty acids they also have cholesterol unsaturated fatty acid and phospholipids okay so cholesterol is one of the most important you know nutrient which are required for brain formation and for brain function and for myelene you know myelene synthesis so please you know make sure that you kind of give your milk okay and cholesterol is not bad infants have very limited ability to convert alpha linonic acid to EEPADH that means what what it means that some of the vegetable oils like flaxseeds oil walnut oil you know some of this vegetable oils have omega 3 but which omega 3 alpha linonic acid okay only 4 to 10 percent of this alpha linonic acid gets converted to you know your EPA DHA okay now young children young babies they don't have ability to convert this alane to EPA DHA okay so even if suppose they're not drinking mother's milk and if they're taking this cow milk or formula you know formulas doesn't have EPA DHA they claim that they have added EPA DHA but studies have not confused with that that helps with the child's IQ okay so best way to make your child intelligent is to just give your own milk there are other fats in mother's milk acetylcholine, choline, phospholipids, carnitine this are all basically very important for brain development okay so fat is one of the most important kind of macro in mother's milk then let's talk about minerals a mineral is basically you know your sodium potassium magnesium saying the sodium mineral okay breast milk has a low level of iron but it's very highly viable because of the presence of lactobium and lactoferrin okay which enhances iron absorption calcium to phosphorous ratio is 2 is to 1 which helps in his ideal position okay absorption sorry zinc absorption is also better from breast milk due to presence of zinc binding protein in breast milk okay so all these minerals are there and they are in a very good viable state so it's easy to absorb from breast milk okay similar kind of suppose iron was present in cow's milk but cow milk iron is not viable so even if it may anyway cow milk is not high anyway but whatever iron is there you know it's the viability is very very poor okay vitamins are the vitamin content of human milk choline reflects a vitamin intake and nutritious status of the mother and this is why I already explained that if mother is deficient on those vitamins then baby will have vitamin deficiency too so for example most common deficiency which mother has is your vitamin D okay so make sure that babies they get vitamin supplements or at least they expose to the sun okay protection against infection so mother is infected okay I already explained to you what happens when the mother is infected her immunity goes up okay and her immunity basically passes on to the baby through breast milk okay so that's important that you know um mother continue to breastfeed even if she has the viral infection for any other bacterial infections too okay giving substance with unique component that cannot be replicated infant formula I keep reiterating this you know and I cannot say enough uh it's impact on brain development immunities unparallel it is a personalized medicine for your baby okay very very crucial very important please let mothers know okay it's a personalized medicine it's a foundation of baby cell if if breastfeeding kind of not given in first at least minimum enforced one day or so you know as I mentioned about the golden hour then the lifelong repetition is bound to happen okay so to prevent from a lot of infections a lot of other conditions you know diseases make sure the children get your milk right away and continue to get milk as long as you can you can give it okay what are the immunological factors? Immunological factors are present in colostrum as well as in the milk okay macrophages are those big cells okay I mentioned to you the engulf and digest bacteria okay and thus the bacteria and the viruses responsible diseases can be destroyed in this way okay second one is lymphocytes those are your white cells lymphocytes are the white blood cells responsible for attacking wide range of infectious organism human milk contain T cells and B cells okay T lymphocytes offer protection against malaria what is lactoferrin lactoferrin is iron containing protein found both in colostrum and mature milk okay this is again another important ingredient I want you to remember lactoferrin what it does it inhibits the growth of certain iron-dependent bacteria in the GI tract okay and therefore it affords protection against GI infections okay so that's why lactoferrin is really important because it will prevent diaries especially you know it's all GI infections also basically it's iron binding iron containing protein okay uh lactobacillus bifurus factor okay so basically this particular factor is present in human milk okay and it has a lot of function what are the function it has it encourages the growth of certain microorganism like lactobacillus bifurus okay that's why it's called lactobacillus bifurus factor okay because it it kind of stimulates the growth of this organism and it produces lactic acid okay lactic acid is produced from what from lactose which is your milk sugar okay and what it does what does this lactic acid do it depresses the growth of diseases producing organism like E. coli so there are certain organisms which are pathogenic means which causes disease so this particular lactic acid will prevent the growth of those disease producing pathogens or the disease producing organisms okay growth of lactobacillus bifurus is enhanced on high lactose and low protein ratio present in human milk okay so why does how does this growth of lactobacillus bifurus occur because of the high lactose in milk and also low protein ratio in human milk okay so your your sugar to protein ratio is low immunological factor so enzymes breast milk supplies enzymes like amylase, lipo protein, lipase, lactobacillus, peroxylase it's a lot of other enzymes which I showed in the diagram okay this enzyme what it does increases digestibility and act as a defense against microbes okay so there is another factor of immunological interesting immunoglobulins, immunoglobulins are the defensive protein, secretory IgA IgG IgAM are present in human milk, fatty acids and monoglyphsides fatty acids and monoglyphsides present in human milk are able to penetrate the members of viruses and bacteria and destroy them okay so again very important fatty acids and monoglyphsides which are your fats okay so breast milk pulse immunity and modulate the gene expression which is a fine tune for life okay it's basically gene modulator okay I would say gene expression modulator not the gene modulator gene expression what does it mean is like for example when it's basically kind of I would say epigenetic factor epigenetic means it will not change the genes but it will change the environment around the gene so gene will express in a good way okay so the gene expresses like gene expresses like for example if you if somebody has diabetes okay and say if nobody in the family has and that person has diabetes so basically what it means that there are the problems in the epigenetic factors means something that went wrong in the environment that that he expressed diabetes okay the gene expressed diabetes or gene modulation there is gene expression modulated and that's how he developed diabetes so that is your epigenetic factors okay gene by itself does not change that gene changes are basically occurring in mutation you know when you have a mutation when you have a like something like cancer then your gene changes but otherwise most of this diseases which are lifestyle diseases are because not because of genetics yet because of the epigenetics is the environment around that person which makes that person get diseases okay so there are a lot of diseases that now insulin resistant is one of the biggest kind of root cause that they have found which causes diabetes blood pressure and all different kind of diseases okay so here I am going to talk about now how breastfeeding works because unless we understand the physiology about anatomy we won't understand how breastmake is produced and you know what exactly happens okay so here we will discuss about that the cells it causes basically kind of you know contraction of the cells and the milk kind of flows out okay so that's important there you go and when does it work it works before during to make milk flow so many times what happens is you know if mother is pumping with the pump okay and she will realize that she's just not getting milk she's not getting milk you know she will get maybe two teaspoon or three teaspoon and mostly that is because she has not gotten let down reflex and she will immediately know if she got the let down reflex by certain signs and symptoms which I'll explain to you later but remember that the let down reflex is very very important and for that mother has to be in a very good state of mind okay if she's happy if she's confident if she is relaxed you know she will definitely have let down reflex but if she's not kind of into it she's in pain she's worried she's stressed she's in doubt she's sad you know let down reflex will not happen and when you don't have let down reflex the cells do not contract when the cells do not contract the milk does not come into the areola okay so that's why just keep mother happy let her relax tell her to go out for a walk you know not to get too worked up she has to rest drink water they eat proper food you know and then of course relax and meditate I think I really recommend mothers to meditate because that relaxes them a lot okay now what are the signs and symptoms of oxytocin release so most of the time at least in first few weeks or so what happens she feels a suddenly there is a tingling sensation abreast and just before when she's trying to feed or when she's full or when she's thinking of the baby even at work she will suddenly feel the tingling sensation and the milk will start flowing okay so that is kind of very typical sign of oxytocin release but you know you won't see that kind of oxytocin release you know after a couple of months or so so many times she says she feels oh my god now I'm not getting that tingling sensation what happened you know so it's very kind of obvious in first couple of months or so then what happens that you know of course when she's feeding the baby on one side the other side drips that is also a sign of oxytocin release that you know she's she's pushing that milk out basically you know the breast is pushing that milk out okay and when milk when mother suppose baby comes off the breast suddenly what she sees is like the milk flowing it's like a you know spray coming out of the breast and that's that's amazing actually there's so much of milk coming out you know and that's the importance of let down reflex it but baby will not have to work too hard you know it just milk just flows okay because of oxytocin then you know in early days because of oxytocin there is like a pain from uterine contraction and this there is a rush of blood during this feed in the first week okay and slow deep sucks and swallowing by the baby which shows the breast milk is flowing into his mouth so when you look at baby's mouth you know they'll have slow suck and they'll have really good you know suck then swallow suck and swallow okay few suck and then swallow so that's another way but again you know it's it's very common in first couple of months or so you know and then mothers know babies know so then it kind of decreases you know and that sensation so this is my last slide this happens if mothers don't breastfeed or for some reason she's breastfeeding very infrequently okay or if baby is sick and baby mother is not baby is not sucking then some amount of milk stays into the breast okay those are called milk inhibitor factor MIR okay these are inhibitors it stays in the breast okay and basically it tells the breast that you know milk is not needed you know stop producing the milk okay and that's how basically slowly slowly milk dries up okay and it will stop producing milk so this is your you know milk inhibiting factor okay