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Book Review

Indian Pediatrics 2003; 40:809-810

Book Review


 

"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]

 

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