In this issue, we are featuring an interview with two medical doctors from Ukraine, who are specialists in breastfeeding, and work with the implementation of the Baby-Friendly Hospital Initiative (BFHI) in Ukraine. The authors met during the Eleventh BFHI Network Meeting of Country Coordinators from Industrialized Countries, Eastern Europe, and the Commonwealth of Independent States, in Brussels in June 2022 (Hernández-Aguilar, M. T., 2022). Ukrainian citizens have lived in a war situation since February 24, 2022, when Russia first attacked; this has had a huge impact on infant feeding issues.
The article presents the advantages of natural feeding, current recommendations for breastfeeding of infantsobtained by analyzing the scientific literature. It details current evidence emphasizing the importance, uniquenessof the qualitative and quantitative composition of breast milk, the best form of infant feeding. Emphasis is placedon existing scientifically defined facts explaining the importance of natural feeding as a natural model, vividlyillustrating the main points of the concept of optimal infant feeding. Focuses on the fact that adequate feeding isconsidered one of the major components of the health and optimal growth of the newborn infant. The importance ofcolostrum at the beginning of enteral feeding for the newborn's body is emphasized. The properties of colostrum thatfully meet the morpho-functional needs of the infant are described.It focuses on new, scientifically supplemented, over the past few years, data on the benefits of breast milk: optimaland balanced levels of nutrients; high assimilation of breast milk by the body of the child; the presence of a widerange of biologically active substances, essential fatty acids and amino acids, enzymes, vitamins and protectivefactors; favorable effect on intestinal microflora. Namely, it is shown that breast milk contains in the right quantitiesto provide individual not only nutritional but also immunological, endocrine needs of the child, depending on the age:alpha-lactalbumin proteins, beta-lactoglobulin, caseins, enzymes, growth factor, hormones, lactoferrin, lysozyme,secretory IgA, IgG and IgM. Non-protein components: alpha-aminonitrogen; creatine; creatinine; glucosamine; nonnucleic acid polyamines; urea; uric acid. Composition of mature milk: lipids; fat-soluble vitamins (A and carotene,D, E, K); fatty acids; phospholipids; sterols and hydrocarbonates; triglycerides; carbohydrates; water-solublevitamins; biotin; folin; cholate; inositol; niacin; pantothenic acid; riboflavin; thiamin; vitamins B12, B6, C. Cells:cytoplasmic fragments, epithelial cells, lymphocytes, leukocytes, macrophages, neutrophils, minerals, bicarbonates,calcium, chloride, citrate, magnesium; potassium; soda; sulfate; trace elements: chromium; cobalt; copper; iodine;iron; manganese; molybdenum; nickel; selenium; zinc.Biologically active substances that are part of breast milk: hormones, enzymes, immune complexes, help newbornsto overcome birth stress faster and better adapt to new living conditions.It is noted that the nature of breastfeeding in the first year of life to a large extent determines the health of thechild not only in the early years, but also in subsequent periods of his life.
Breast milk is the standard of infant nutrition, recognized worldwide as the optimal fi rst source of food, and breastfeedingis the ideal way to feed children, meeting all their needs. Breast milk is especially valuable for premature infants, who require specialized medical care from the fi rst seconds of life and for a long time, and for sick newborns born at term. Preterm or sick preterm infants are most vulnerable to perinatal illness, have a high probability of dying and, most importantly, are at the greatest risk of not receiving the life-saving benefi ts of breast milk. In today’s world, the World Health Organization and the American Academy of Pediatrics recommend the use of donor human milk as the fi rst alternative for feeding preterm infants of any gestational age, including very preterm infants (<32 weeks gestation) or very low birth weight infants (<1500 g), when human milk is not available. Studies have shown that breastfeeding, even partial breastfeeding, reduces the risk of necrotizing enterocolitis and late neonatal sepsis, retinopathy of prematurity, and sudden infant death, improves cognitive outcomes in preterm infants, and helps establish optimal functioning of the digestive system and enteric digestive processes. In many countries around the world, targeted support for breastfeeding in neonatal intensive care units, including enteral feeding of sick and premature infants, is provided by donor human breast milk that is concentrated and stored in an established and functioning network of breast milk banks.A breast milk bank is an institution whose purpose is to collect breast milk from mothers who produce more than theirinfants need, and to process and store breast milk for the feeding of infants who, for medical or other reasons, cannot receive it temporarily or for a long period. International associations of breast milk banks have been established throughout the world to promote the activities of banks and to establish international cooperation among breast milk banks.The European Milk Banks Association (EMBA) was offi cially launched on October 15, 2010. There are currently 282 activebanks in 31 European countries and 18 banks in the process of becoming active. The Southern African Milk Banks Association (HMBASA) was established in 2009. HMBASA coordinates the activities of the network of milk banks throughout the country. The North American Milk Banks Association (HMBANA) was founded in 1985 and brings together 30 non-profi t breast milk banks in the United States and Canada. There is a positive trend in the establishment of new breast milk banks in all countries of the world. There are currently about 500 in 37 countries. Brazil is the world leader in breast milk banks, with 222 breast milk banks and 217 milk collection centers. The first donor breast milk bank in Ukraine was established in 2019 in Kyiv at the Perinatal Center, where about 80 % of all premature babies in the city are born. In December 2022, when the country was at war, a high-tech breast milk bank was opened at the Lviv Regional Clinical Perinatal Center. This is the second bank of donated breast milk successfully operating in Ukraine on the basis of perinatal centers.The operation of the breast milk bank at the Lviv Oblast Clinical Perinatal Center is one of the many modern high-tech areasof the healthcare facility. The breast milk bank is equipped with all the necessary equipment, which meets the highest modern world standards. Active daily teamwork of obstetricians, neonatologists, lactation consultants and mothers has allowed the bank to attract 32 donors of breast milk and collect more than 380 liters of donor milk since its opening. The fi rst batch of donor milk was received on January 12, 2023.Promoting the creation of a network of mother’s milk banks in Ukraine at the state level will help to make a signifi cantcontribution to the preservation of the full healthy development of newborns and infants in our country, which has becomeespecially important in the current military situation in Ukraine.
This article informs about the state of breastfeeding in Ukraine after more than 2 years of war. The article presents important information on breastfeeding data, the widespread implementation of the baby-friendly hospital initiative, human milk banks working in difficult situations, the first overestimation of breast milk substitute needs, the International Code, and the presence of donations reaching an overburdened health system. It covers the training of health care professionals as well as counseling in wartime.
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