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Your continued support is needed! If you are interested in becoming a member or renewing your membership, visit our website at www.breastfeeding.org or contact our office. For more information, please call (858) 966-5981 or email mmkennedy@chsd.org. The SDCBC has promoted and supported breastfeeding through education and outreach in San Diego County since May 1994. With an entirely volunteer work force, minimal annual dues, small grants and significant contributions from many San Diego institutions, we have managed to address many of the County's needs in a limited, but effective, manner. In October 2000, $100,000 in grant funding was received from the San Diego County Children and Families "Prop 10" Commission to expand the SDCBC's activities and to establish a formal office and organizational structure. The California Children and Families Commission was established by the California Children and Families Act (Proposition 10), passed by voters in November 1998. This statewide ballot initiative increased the tax on cigarettes and tobacco products. The revenue is used to provide health, child development, and parent support programs to promote the well-being of children from the prenatal period to age five. The San Diego County Children and Families Commission was established to implement Prop 10 on a local level. The Commission's vision is that all children in San Diego County will enter school physically, mentally, emotionally and developmentally ready to learn. We would like to thank the San Diego County Children and Families Commission for their continued support of our efforts. Visit the San Diego County Children and Families Commission website at www.ccfc.ca.gov/sandiego.
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Martha A. Lee RN, MPH, IBCLC
Colostrum is the first milk that the mother has long before the baby is born. It is perfect as the baby's first food. It is an opaque, yellow, sticky fluid secreted during the first few days postpartum. It provides nutrition, protection against infectious disease, and some cathartic effects. It contains more protein and minerals, less sugar and much less fat than mature breast milk (1). It also contains live cells like T and B lymphocytes, neutrophils, macrophages, and epithelial cells, plus hormones, carrier proteins, enzymes, and of course, immunologically specific and non-specific factors. It's very important to remember that constituents in human colostrum and milk are multifunctional and interactive (2).
The mysteries and taboos about colostrum go back to the dawn of civilization. Most ancient primitive peoples let several days go by before putting the baby to the breast, with exact times and rituals varying from tribe to tribe (3). Every society had a long list of foods, fluids and herbs which were deemed especially suitable for newborns and their mothers. Every society had its prescribed routines and rituals to purge or stimulate or protect: in India, it was butter and honey; in Bali, premasticated rice and banana; in Peru, syrup of wild endive and chicory. Given what we know now about the effects of such concoctions on the bacteria of the gut and the long term impact this can have, it is reasonable to assume that much of the mortality among breastfed infants was related to such food rituals interfering with the protective mechanisms of breastfeeding (4).
If babies were given something else as soon as they were born, what happened to the colostrum? Even in our day, in some countries it is still discarded (5). Hispanic, as well as Southeast Asian mothers, tend to be reluctant to breastfeed in the first days "until milk comes in", even with all the risks that that implies, like engorgement and nipple confusion. Knowledge about how breastfeeding works in the first few days is paramount to help mothers of all cultures to feel confident about breastfeeding from the start.
Secretory material that resembles colostrum appears in the mammary gland acini from the third month (12 weeks) of gestation. At about 18 weeks, the composition of prepartum secretions are fairly constant until delivery (6). It is not necessary to demonstrate colostrum is present. Some mothers will lose confidence if their breasts are expressed unsuccessfully. As a newborn's stomach is about the size of a walnut the first day (7), the baby will nurse often (about 12 times/day if mother was unmedicated for delivery), and the baby will drink just a few drops and then sleep. Those precious drops of live fluid will give the baby the best start for a healthy, secure life.
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