EVIDENCIAS A FAVOR DE LA LECHE MATERNA

Edwin Villacorta Vigo

Proporción de menores de seis meses de edad con lactancia exclusiva por regiones

Fuente: INEI – ENDES 2007 . 2009 , 2010 Elaboración Propia: DIGEMID

Costa Sierra Selva0

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60.1

72.4

80.8

59.3

76.2 77.6

52.8

83.7

77.2

2007 2009 2010P

orce

nta

jes

Desciende

Asciende Desciende

Productos más vendidos en el mercado privado

Fuente: IMS - 2010 Elaboración Propia: DIGEMID

BACTRIM

SIMILAC 1 EYE Q PL

PLIDAN CPTO NF

BONVIVA

SIMIL.GAIN 2E Q PL

ENFAGROW

PEDIASURE

ELECTRORAL NF

DOLO-NEUROBION

ARCOXIA

PEDIASURE PLUS

ENFAMIL PREMIUM 1

ENFAGROW PREMIUM

0 5 10 15 20 25 30 35 40 45

55

66666

7777

88

999

1010

1215

1618

2134

43

Millones de Dólares

Estos son los 25 productos más vendidos en el mercado retail durante el año 2010, los mismos que ascienden a un total de 68 millones de dólares. Asimismo, en este grupo se encuentran 11 productos que corresponden a Fórmulas Infantiles, por un total de 16 millones de dólares.

COINCIDENCIA???

Impacto de las Fórmulas para Lactantes con el Ingreso Salarial Mínimo

FÓRMULA PARA LACTANTESCONSUMO

PROMEDIO POR MES

PRECIO ESTIMADO DE VENTA

GASTO MENSUAL DÍAS DE TRABAJO

ENFAGROW PREMIUM POLVO 900 G 4 Latas 62.23 soles 248.92 soles 14 días

PEDIASURE POLVO VAINI 900 G 4 Latas 75.44 soles 301.76 soles 16 días

NAN 1 PROTECT PLUS POLVO 400 G 7 Latas 35.55 soles 248.85 soles 14 días

Ingreso Salarial Mínimo Mensual: 550 nuevos soles Elaboración Propia - DIGEMID

Valor por día de trabajo: 18.33 nuevos soles

Cuadro 4: Gasto Promedio Mensual de 3 Fórmulas para Lactantes

¿LO PAGAMOS LOS MÉDICOS?

MITAD DEL SUELDO MENSUAL!!!

POR QUE ES MEJOR LA LECHE MATERNA…?

Álbum de fotos moderno

Bottle-feeding and the Risk of Pyloric Stenosis

QUE HAY DE NUEVO?Los niños alimentados a LECHE ARTIFICAL tienen un Incremento del riesgo de 4.6 veces

Estenosis o Hipertrofia CONGENITA DEL PÍLORO es la condición mas común que requiere cirugía en el infanteTípicamente aparece despues de las primeras dos semanas., NO SE CONOCE CAUSA

Bottle-feeding and the Risk of Pyloric Stenosis

El riesgo aumentado de HCP entre niños alimentados con leche adaptada se observó aún 30 dias después de la primera exposición y no varía con la edad a la primera exposición

El riesgo aumentado de HCP entre niños alimentados con leche adaptada se observó aún 30 dias después de la primera exposición y no varía con la edad a la primera exposición

CMAJ. 1989 February 15; 140(4): 401–404. PMCID: PMC1268663

Infantile hypertrophic pyloric stenosis: a study of feeding practices and other possible causes.B F Habbick, C Khanna

We found that bottle-feeding was 2.9 times more prevalent among the infants with IHPS than among the control subjects. We speculate that the recently observed decrease in the incidence of IHPS is due to the decline in bottle-feeding.

An international peer-reviewed journal for health professionals and researchers covering conception to adolescence

The epidemiology of infantile hypertrophic pyloric stenosis in Sweden 1987–96G Hedbäcka, K Abrahamssona, B Husbergb, T Granholmb, A Odénc

AbstractAIMS To find out whether the incidence of infantile hypertrophic pyloric stenosis (IHPS) has changed over the past decade, and if so, to investigate possible contributory factors.

RESULTS There was a substantial decline from 2.7/1000 to 0.85/1000 over the time period. The incidence in the south was almost three times greater than in the north.

CONCLUSION The declining incidence and geographical difference suggest that environmental factors are of importance in this disorder.

Arch Dis Child 2001;85:379-381 doi:10.1136/adc.85.5.379

Journal of

Tropical PediatricsJ Trop Pediatr (2009) 55 (2): 132-134. doi: 10.1093/tropej/fmn094

Does Exclusive Breastfeeding Confer Protection Against Infantile Hypertrophic Pyloric Stenosis? A 30-year Experience in Benin City, Nigeria David Osarumwese Osifo and Iyekoretin Evbuomwan

The incidence of infantile hypertrophic pyloric stenosis has steadily decreased in developing countries, and this study was designed to confirm this and establish any protection conferred by exclusive breastfeeding. Following the introduction of exclusive breastfeeding in late 1980s and early 1990s in Nigeria, a steady drop in incidence was noticed, with only five cases seen in the last decade and just one case seen in the past 5 years. All were babies who had artificial feeds, with none recorded among babies exclusively breastfed. This decrease in the incidence of infantile hypertrophic pyloric stenosis may have been due to exclusive breastfeeding.

Human milk feeding prevents retinopathy of prematurity (ROP) in preterm VLBW neonates.Early Hum Dev. 2013 Jun;89 Suppl 1:S64-8. doi: 10.1016/S0378-3782(13)70019-7.Manzoni P, Stolfi I, Pedicino R, Vagnarelli F, Mosca F, Pugni L, Bollani L,

Incidencia de ROP 11 of 314; 3.5% vs 29 of 184; 15.8% (RR 0.14; 95% CI 0.12-0.62; p = 0.004).

Coppa GV, Zampini L, Galeazzi T, Gabrielli O.Prebiotics in human milk: a review. Dig Liver Dis. 2006;38(suppl 2):S291–S294

LA COLONIZACION MICROBIANA SE INICIA AL NACERLM: bifidobacterias y lactobacilos L.ARTIFICIAL Flora mixta con escasas bifidobacterias.

LA LECHE MATERNA tiene un “efecto bifidogénico" debido a la baja concentración de proteónas y fosfatos, a la presencia de lactoferrina, lactosa, nucleótidos y oligosacaridos

Oral lactoferrin for the prevention of sepsis and necrotizing enterocolitis in preterm infants.Cochrane Database Syst Rev. 2010 May 12;(5):CD007137. doi: 10.1002/14651858.CD007137.pub2.Venkatesh MP, Abrams SA.

Oral lactoferrin prophylaxis reduces the incidence of late-onset sepsis in infants weighing less than 1500 g and most effective in infants weighing less than 1000 g. There is no evidence of efficacy of oral lactoferrin (given alone) in the prevention of NEC in preterm neonates

DHA – ARA - LCPUFA

Long-chain polyunsaturated fatty acids (LCPUFA) notably docosahexaenoeic acid (DHA) and arachidonic acid (ARA) are important for the optimum growth and development of the infant

DHA and ARA levels in breast-milk are thought to be influenced both by direct nutritional intake, and by the genetic variation of the FA desaturase enzymes.

Breast milk DHA levels in Sri Lankan mothers vary significantly in three locations that have different access to dietary fish.

Ceylon Med J. 2013 Jun;58(2):51-5. doi: 10.4038/cmj.v58i2.5679.Lee PS, Wickramasinghe VP y col

Brazil its rate has increased from around15% in the 1970’s to 50% in 2011 [3], reaching 77% insome private clinics [4].

This trend is reflected in manyparts of the world. In China, the most populous countryin the world, CS rates are approaching 50% [5].

Recent data have revealed that the gut microbiota can beconsidered to be an environmental factor that modulatesobesity and other metabolic diseases [17].Other mechanism could also be hypothesized. CS hasalso been associated with alteration of newborn hormonalmilieu, characterized by, for example, lower concentrationsof plasma leptin and ghrelin in human newborns and otherorexigenic peptides in animal models, which are related topost partum appetite control and have been reported to beassociated with an increased risk for later obesity [23,30,36].

In 2004/2005, at reassessment of the two birth cohortsstudied, the obesity rate was 13.0% in RP, whereas in SLit was 2.1%. The CS rate was 54.5% in RP and 30.8% inSL. The prevalence of obesity in RP was significantlyhigher in children delivered by CS compared with thoseborn by vaginal delivery (15.7% vs 9.8%, P = 0.022).

In SL, despite obesity not being significantly associated withtype of delivery (p = 0.091), the obesity rate in childrenborn by CS was more than twofold higher than amongthose born by vaginal delivery (3.5% and 1.4% respectively).

Protection is provided by components including regulatory cytokines and growth factors. In addition, breast milk contains several other factors such as lysozyme, lactoferrin, and oligosaccharides, which assist in preventing infections and supporting the growth of beneficial bacteria

breast milk is also a continuous source of microbes,their growth factors, and components that regulate host-microbeinteractions. These factors emphasize the key position of breastfeedingin conferring protection during a critical period in life,when breast milk is the sole source of nutrition for the infant andwhen the neonate’s own immune defenses, including the integrityof the gut barrier, are immature

EXPOSICION PRECOZ- Modo de parto (microbios maternos)- Dieta del Infante (sustrato selectivo(- Atbs (muerte selectiva)- Probioticos (enriquecimiento selectivo)- Medio ambienbte físico (microbios del medio ambiente)

MICROBIOTAINTESTINAL

DISBIOSIS

TOLERANCIA INMUNEHOMEOSTASIS INTESTINALMETABOLISMO SALUDABLE

ENFERMEDAD INMUNE(atopía, asma, esclerosisM´pultiple)ENFERMEDAD INTESTINAL(Enf. Inflamatoria intestinal, ECN, Ca colon)ENFERMEDAD METABOLICA(diabetes, obesidad)

SIMBIOSIS

Methods: Medical literature was searched in the Pubmed and Embase databases to identify all English-language relevant studies up to April 10, 2013.

There is limited evidence for an inverse association between breastfeeding and risk of childhood Hodgkin lymphoma.

The anticancer mechanism of breastfeeding remained unclear, which may be a direct effect of human milk on malignances or an indirect effect of reducing early childhood infections (Section on Breastfeeding, 2012). A complex biological liquid containing numerous immunoactive agents might play an important role in the anticancer activity of human breast milk. High levels of human soluble TNF-related apoptosis-inducing ligand were found in human colostrum and breast milk, which is an immunoactive substance that plays a key role in controlling apoptosis and cell proliferation in various organs and tissues (Davanzo et al., 2013). Human alpha-lactalbumin made lethal to tumor cells, which is a substance with anticancer activity in human milk, has been reported (Mossberg et al., 2010).

The benefits of breastfeeding for children are well-known. Indeed, breastfeeding affects cancer, obesity, diabetes mellitus, and cardiovascular disease, in addition to reducing episodes of diarrhea, decreasing the incidence of infections (enteric, otitis media, and respiratory infections) and eczema (Oddy et al., 2003; Paramasivam et al., 2006; Das, 2007; Ip et al., 2007; Hosea Blewett et al., 2008; Monterrosa et al., 2008; Rosenbauer et al., 2008; Ladomenou et al., 2010).

Increased bone mineral density is associated withbreastfeeding history in premenopausal Spanish women

Maria Luz Canal-Macias, Raul Roncero-Martin, Jose Maria Moran, Jesus Maria Lavado-Garcia, Maria del Carmen Costa-Fernandez, Juan Diego Pedrera-Zamorano

Arch Med Sci 2013; 9, 4: 703–708

Four hundred and thirty-three premenopausal healthywomen, 295 with a mean of 7.82 ±6.68 months of exclusive breastfeeding and 138 control women, were studied. This study adds to the growing evidence that breastfeeding has no deleterious effects and may confer an additional advantage for BMD in premenopausal women.

Breastfeeding may protect against persistent stuttering.J Commun Disord. 2013 Jun 24. pii: S0021-9924(13)00034-8. doi: 10.1016/j.jcomdis.2013.06.001. [Epub ahead of print]Mahurin-Smith J, Ambrose NG.

El perfil de ácidos grasos de la leche humana con su POTENCIAL PARA AFECTAR LA EXPRESIÓN GENÉTICA Y LA COMPOSICIÓN DEL TEJIDO NEURAL PODRÍA EXPLICAR ESTA ASOCIACIÓN

Lactancia materna y protección de la obesidad infantilLa Lactancia materna protege contra la obesidad infantil(Canadá)*Un estudio sistemático y metaanálisis deestudios epidemiológicos (cohortes,casos-controles,estudiostransversales)

* KramerMS. J Pediatr1981; 98: 883 –7 ** ArenzS et al. InternJ Obes2004; 28: 1247 –56

YO SOY

ENTONCES¿Que prefieres,Al IMITADOR?

JOE ARROYOO AL ORIGINAL?

YO SOY

IMITADOR

JULIO IGLESIASJULIO IGLESIAS ORIGINAL

YO SOY

IMITADOR

FHERORIGINAL

YO SOY

IMITADOR

LECHE MATERNA!!!!

YO PREFIERO EL ORIGINALYO PREFIERO EL ORIGINAL

TAMPOCO HAY QUE EXAGERAR!!

SOMOS LECHEROS!!!Porque mamá trabaja y nos

alimenta con leche materna!Porque mamá trabaja y nos

alimenta con leche materna!