Breastfeeding - Breastfeeding

It refers to giving milk components to infants. In addition to breast milk, the main milk components used in breastfeeding are infant formula, which is a commonly used form of artificial nutrition, and as long as this infant formula is available, it is generally best not to use cow's milk. However, once the infant has started weaning and is eating three meals a day at around nine months of age, it is okay to switch to cow's milk, either as is or with a small amount of sugar added.

Of course, breast milk is the most desirable form of milk, but artificial nutrition, especially infant formula, has improved year by year and comes to have a composition close to that of breast milk. If there is a shortage of breast milk or breast-feeding is difficult for various reasons, there is no need to worry about the baby's development if infant formula is used.

The first breastfeeding after birth is attempted 12 to 24 hours after birth, depending on whether the mother has recovered from fatigue or the newborn's desire to breastfeed. The breast milk at this time is called colostrum, and is rich in milk components, which gives the newborn a temporary passive immunity. After 2 to 3 weeks of age, when breastfeeding is established, breastfeeding time is about 15 minutes per feeding, but in reality, the baby will suck about two-thirds of the milk in one go in the first 5 minutes. When breastfeeding, a clean gauze is soaked in hot water and the nipple is thoroughly wiped before the baby is placed in it. Breastfeeding is done in a comfortable environment, with the mother sitting and holding the baby at an angle, with both mother and child in a comfortable position, making eye contact. After breastfeeding, the baby's upper body is straightened and slightly leaned forward, and its back is gently rubbed from bottom to top to encourage the air it has swallowed. Even in the case of breastfeeding, it is advisable to discontinue breastfeeding and switch to artificial feeding in cases of cracked nipples, mastitis, infectious diseases in the mother, etc. Also, when breastfeeding, attention must be paid to the nutritional and health management of the mother to avoid malnutrition or extreme nutritional imbalance in the mother and to prevent a decline in the quality of milk.

Autonomous breastfeeding is the most common method of feeding, but until about two months of age, infants are not yet mature enough to regulate the amount of milk they feed on themselves, and care must be taken to ensure that the amount does not exceed 1,000 milliliters per day and 200 milliliters per feeding, especially when formula-fed. However, when breast-fed, the infant's muscles become fatigued when breastfeeding, and there is a limit to the amount of breast milk secreted, so it is okay to leave it to nature. If the amount of breast milk secreted during breastfeeding is insufficient, it must be supplemented by preparing infant formula as needed. This can be done in various ways, such as using formula for one feeding or adding formula each time, but it is best to use a method that suits the infant. As the baby begins to eat weaning food, the amount of milk fed will gradually decrease, but until about nine months of age, when the baby is fed three meals a day, breast milk or infant formula is sufficient, and it is desirable to switch to cow's milk after that. This switch can be made completely at once without any problems, and there is no need to dilute it by mixing it with infant formula.

The most important thing about breastfeeding is not whether it is breast milk or formula, but that the act of breastfeeding is enjoyable for both the infant and the mother and that it fosters and deepens the mother-child bond.

[Hoashi Eiichi]

Source: Shogakukan Encyclopedia Nipponica About Encyclopedia Nipponica Information | Legend

乳児に乳汁成分を与えることをいう。授乳の際の乳汁成分としては、母乳のほか、人工栄養として一般的に普及している調製粉乳が中心となっており、この育児用ミルクが入手できる限りは、原則として牛乳は用いないほうがよい。しかし離乳食が進行して3回食となる9か月ごろから牛乳に切り替えてよく、その際には牛乳をそのまま、ないしは少量の砂糖を添加して用いる。

　乳汁としては、母乳がもっとも望ましいことは当然であるが、人工栄養、とくに育児用ミルクも年々改善されて母乳に近い組成となっており、母乳不足や種々の事情で母乳栄養が困難な場合は、育児用ミルクを用いても、発育に不安をきたすことはない。

　出生(しゅっしょう)後初めての授乳は、母親の疲労回復や新生児の哺乳(ほにゅう)欲をみて、生後12～24時間後に試みる。このときの母乳は初乳とよばれ、乳汁成分が濃厚で、新生児は一過性の受動免疫も得る。生後2～3週を過ぎ、母乳栄養が確定すると、授乳時間は1回に15分ぐらいとなるが、実際には初めの5分間に、哺乳量の3分の2ぐらいを一気に吸う。授乳にあたっては、清潔なガーゼに湯を浸し、乳首をよくふいたうえで含ませる。授乳は、母親が座って乳児を斜めに抱き、母子ともに楽な姿勢で、まなざしをあわせ、心地よい環境のもとに行う。授乳後は子の上半身をまっすぐにさせ、わずかに前傾させた姿勢で背中を下から上へと軽くさすり、飲み込んだ空気を吐かせる。母乳の場合でも、乳頭の裂傷や乳腺(にゅうせん)炎、母親の感染性疾患などのときは母乳栄養を中止し、人工栄養に切り替えることが望ましい。また母乳栄養の際には、母体の栄養ならびに健康管理に留意し、母体の低栄養や極端な栄養素の偏りを生じないようにし、乳汁の質の低下を防止しなければならない。

　授乳方法としては、自律授乳が一般的となっているが、生後2か月ごろまでは、乳児自身で授乳量を調整するには未熟であり、とくに人工栄養の際には1日量1000ミリリットル、1回量200ミリリットルを超えないように配慮する必要がある。しかし母乳栄養の場合には、乳児自身が授乳に際して筋肉の疲労を生じ、また母乳の分泌量にも限界があるため、自然に任せて差し支えない。授乳に際して母乳分泌量の不足をきたした場合には、随時育児用ミルクを調乳して補給しなければならない。このときは1回分を人工乳としたり、毎回人工乳を追加するなどさまざまであるが、乳児にあった方法をとればよい。離乳食の進行に伴い、しだいに授乳量は減少していくが、離乳食が1日3回となる生後9か月前後までは、母乳あるいは育児用ミルクでよく、その後牛乳に切り替えることが望ましい。この切り替えは、一挙に完全に変更させても支障なく、育児用ミルクと混ぜて薄くしたりする必要はない。

　授乳にとってもっともたいせつなことは、母乳か人工乳かではなく、乳児にとっても母親にとっても授乳行動が楽しいものであり、母子関係をはぐくみ深めていくものであるということである。

［帆足英一］

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