Abstract

PIP: This pamphlet on breast feeding provides information on the Belagio Guidelines, an explanation of how breast feeding decreases fertility, and a description of how child spacing impacts on child survival. 10 steps to promote breast feeding are listed for hospitals: 1) have a policy that is communicated to all health care staff; 2) train all health care staff; 3) inform all pregnant women about the benefits and management of breast feeding; 4) help mothers initiate breast feeding within a half hour after birth; 5) demonstrate to mothers how to lactate and how to maintain lactation even when separated from their infants; 6) withhold any food or drink for infants unless medically indicated; 7) keep mothers and infants together during the first 24 hours; 8) encourage breast feeding on demand; 9) withhold use of pacifiers; and 10) establish breast feeding support groups for mothers released from the hospital. The Belagio Guidelines communicate the findings from prospective studies in 8 countries that maximum birth spacing is achieved when mothers fully breast feed infants. Full breast feeding means no supplemental food or liquid during the first 6 months after giving birth; the infant is fed solely on breast milk. Prolactin levels, luteinizing hormone, and the altered gonadotrophin-releasing hormone are currently considered responsible for suppression of ovulation. Even after return of menses breast feeding women have a reduced chance of pregnancy. Frequency of suckling is associated with gonadotrophin secretion and reduced fertility. Night time breast feeding is considered particularly important in delaying the return of fertility. Longer child spacing, as assisted by prolonged and full breast feeding, contributes to healthier infants. Breast feeding also contributes to improved maternal health and psychosocial benefits. Women should use breast feeding and lactational amenorrhea as a family planning method and as a means of empowering women. The return of menses requires the use of another family planning method, even with full breast feeding. Nonhormonal methods are preferred for breast feeding women. Breast feeding is declining around the world, but in the Philippines a strict National Code of Marketing of Breast Milk Substitutes was adopted in 1986 for promotion of breast feeding.