"The Science of Infant Feeding" Authors: R.K. Anand, N.B.
Kumta, K.P. Kushwaha & A. Gupta. New Delhi: Jaypee Brothers Medical
Publishers. First Edition 2002, 309 pages Rs. 450/-.
The knowledge, attitude and practices of the health
care providers and health managers regarding feeding of the infant and
young child are awfully inadequate. Most health personnel are not
skilled enough to counsel the mother and her family to choose
appropriate feeding strategies. A book, which scientifically focuses
on, the myriad issues related to breastfeeding and complementary
feeding is the need of the day.
The present book is a welcome step in this
direction. This book has six sections, 18 chapters and 6 appendices.
The first chapter on "Feeding practices in infants and young children"
is extensively researched, very well written, appropriately supported
by statistical data and vividly identified difficult areas and ground
realities regarding feeding of infants and young infants. There is
minor irritation in the Fig. 1.1, which gives a confusing message
regarding duration of EBF.
Section Two deals with the basics of the breast,
breast milk, breastfeeding and the growth and development of an
infant. Topics have been wisely chosen and written with the intention
to impart practical skills. The language is simple with plenty of
appropriate figures. The description does not include congenital and
acquired defects of the breast and their later impact on the
breastfeeding. Similarly, discussion on the lactagouges is sketchy.
Areola has been wrongly depicted in the Fig. 2.2. Author should have
used the term "suckling cycle’ instead of suck cycle. A few pictures
of mother and baby in proper body position and attachment in sitting
and lying postures soon after normal and operative delivery and for
very small and twin babies would have helped the readers to increase
their under-standing of breastfeeding process. The chapter on
"Biochemistry and Immunology of Breast milk" is very informative but
many queries of the readers remain unanswered due to paucity of
discussion on the factor/s which may or may not affect composition and
quantity of the human milk like maternal age, parity, multiple births,
preterm labour, intrauterine growth retardation, nutritional status,
chronic illnesses, medication, contraception, menstrua-tion, outdoor
work, length of lactation, ensuing pregnancy and medical termination
of pregnancy.
The most important and readily measurable aspect of
exclusive breast feeding (EBF) is growth and development of an infant.
The description of growth is more of an overview than to impart
understanding to the health professionals about growth characteristics
of an exclusively breastfed infants. It is to be emphasized that
ability to sustain optimal growth and development of an infant by
currently advocated breastfeeding strategies is by far the most
powerful argument in favor of universal breastfeeding. It was expected
that scientific information on daily breast milk intake, energy and
other nutrients supply in relation to duration of lactation and
weekly/monthly gain in weight, length and head circumference for at
least first 6 months of life would be given so that student and health
care givers can monitor the growth with confidence. Figs. 5.1 and 5.2
are also not clear.
Third section of this book deals with some critical
issues including introduction of solid foods after the age of 6 months
along with breastfeeding. Very good scientific evidences have been
provided in favor of appropriate time, amount and energy density of
the complementary feeding. It will help readers to adopt appropriate
feeding strategies for the infant and young child. Unfortunately
printer’s devil has taken away some sheen from the tabulated data in
Fig 10.4 (should be length and weight). Figure 10.6 (X-axis should be
head circumference, Y-axis; age), Table 10.3 (caloric intake 12-13
month), Table 10.5 (energy requirement at 12-23 month) and Table 10.11
(protein intake at 9-11 month).
Section 4 and 5 focus on some practical issues like
breastfeeding and maternal illness, outdoor work and socio-cultural
pressures. The contents are up to-date and read fluently and will help
readers to manage breastfeeding in difficult situations.
By providing appropriate references at the end of
each chapter and by enclosing appendices on IMS Act (1992) and other
global legislations, authors have done a commendable job and improved
the readability and scientific value of the book. However, including
of topics like maintenance of breast milk supply in the nursery and
neonatal intensive care unit, assessment and observation of
breastfeeding and counseling and confidence building of the nursing
mothers would have added attraction to the book.
The paper, printing and size of the book are
appreciable. I recommend this book for all medical and health
professionals, and undergraduate and postgraduate students of
Pediatrics, Obstetrics, Gynecology and Nursing. The health policy
managers and nutrition scientists will be equally benefited by this
book.
M.M.M. Faridi,
Professor and Head,
Department of Pediatrics,
University College of Medical Sciences and
GTB Hospital, Delhi 110 095, India.
E-mail: [email protected]
