A composição do leite materno e as desvantagens do aleitamento artificial
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Amamentação
O leite materno está sempre em perfeitas condições para a criança, mesmo que a mãe esteja doente, menstruada, grávida ou desnutrida.
3.1 Porque o leite materno é um alimento perfeito
O leite materno contém todos os nutrientes de que a criança precisa para os 4-6 meses de vida.
Contém:
– proteína e gordura mais adequadas para a criança, na quantidade certa.
– mais lactose (açúcar do leite) do que a maioria dos outros leites, o que preenche as necessidades da criança.
– vitaminas em quantidade suficiente. Não há necessidade de suplementos vitamÍnicos.
– ferro em quantidade suficiente. Não há grande quantidade de ferro, mas ele é bem absorvido no intestino da criança. Crianças amamentadas não desenvolvem anemia ferropriva.
– água em quantidade suficiente, mesmo em clima quente e seco.
– as quantidades adequadas de sais, cálcio e fosfato.
– uma enzima especial (lipase) que digere gorduras.
– proteína e gordura mais adequadas para a criança, na quantidade certa.
– mais lactose (açúcar do leite) do que a maioria dos outros leites, o que preenche as necessidades da criança.
– vitaminas em quantidade suficiente. Não há necessidade de suplementos vitamÍnicos.
– ferro em quantidade suficiente. Não há grande quantidade de ferro, mas ele é bem absorvido no intestino da criança. Crianças amamentadas não desenvolvem anemia ferropriva.
– água em quantidade suficiente, mesmo em clima quente e seco.
– as quantidades adequadas de sais, cálcio e fosfato.
– uma enzima especial (lipase) que digere gorduras.
O leite materno é facilmente digerido e observado. A criança em aleitamento materno pode querer uma nova mamada em intervalo menor do que aquela em aleitamento artificial.
COMO O LEITE MATERNO PROTEGE CONTRA INFECÇÕES
3.2 Como o leite materno protege as crianças contra as infecções
Crianças em aleitamento materno tem menos quadros infecciosos porque o leite materno é estéril, isento de bactérias e contém fatores antiinfecciosos que incluem:
– células brancas vivas (leucócitos) que matam as bactérias.
– anticorpos (imunoglobinas) contra mu itas das infecções mais comuns. Isto ajuda a proteger a criança até que ela comece a produzir seus próprios anticorpos. Se a mãe tiver uma infecção, anticorpos logo aparecerão em seu leite.
– uma substância chamada fator bífido que facilita o crescimento de uma bactéria especial (Lactobacillus bifidus), no intestino da criança. Os lactobacillus bifidus impedem que outras bactérias cresçam e causem
diarréia.
– lactoferrina que se junta ao ferro. Isso impede o crescimento de algumas bactérias patogênicas que precisam desse elemento.
– anticorpos (imunoglobinas) contra mu itas das infecções mais comuns. Isto ajuda a proteger a criança até que ela comece a produzir seus próprios anticorpos. Se a mãe tiver uma infecção, anticorpos logo aparecerão em seu leite.
– uma substância chamada fator bífido que facilita o crescimento de uma bactéria especial (Lactobacillus bifidus), no intestino da criança. Os lactobacillus bifidus impedem que outras bactérias cresçam e causem
diarréia.
– lactoferrina que se junta ao ferro. Isso impede o crescimento de algumas bactérias patogênicas que precisam desse elemento.
Crianças em aleitamento materno têm menos diarréia que as alimentadas artificialmente. Têm também menos infecções respiratórias e de ouvido médio. A criança que continua em aleitamento materno durante uma infecção se recupera mais rapidamente. O leite materno continua ajudando a evitar doenças e facilitando a recuperação durante o segundo e terceiro anos de vida.
CRIANÇAS EM ALEITAMENTO MATERNO TEM MENOS INFECÇÕES
O aleitamento materno facilita o estabelecimento do vínculo afetivo mãe-filho, isto é, facilita uma maior união entre ambos (ver item 4.1). Essa ligação emocional muito forte e precoce pode facilitar o desenvolvimento
da criança e seu relacionamento com outras pessoas.
da criança e seu relacionamento com outras pessoas.
A COMPOSIÇÃO DO LEITE MATERNO
Se a mãe usar mamadeira é mais fácil deixar a criança para alguém alimentar ou deixar que ela se alimente sozinha. Desse modo, ela pode receber menos afeição e estímulo.
A saúde da mãe
O leite materno ajuda a reduzir o sangramento após o parto e auxilia a mãe a voltar mais rapidamente ao peso normal. Freqüentemente o leite materno, usado em livre demanda, ajuda a evitar nova gestação (Ver item
8.5).
8.5).
Conveniência
– O leite materno está sempre pronto para ser dado à criança e não precisa de preparo.
– Nunca azeda ou estraga na mama, mesmo que a mãe não amamente durante mu itos dias. Algumas mulheres acreditam que seu leite pode azedar e talvez seja necessário esclarecer que isso não acontece.
– O leite materno é barato e não é preciso comprar.
– O leite materno é somente da criança. Não é preciso repartir com os demais memb ros da família ou com visitas.
– Nunca azeda ou estraga na mama, mesmo que a mãe não amamente durante mu itos dias. Algumas mulheres acreditam que seu leite pode azedar e talvez seja necessário esclarecer que isso não acontece.
– O leite materno é barato e não é preciso comprar.
– O leite materno é somente da criança. Não é preciso repartir com os demais memb ros da família ou com visitas.
3.4 Alterações na composição do leite
O leite materno nem sempre tem exatamente a mesma composição.
Há algumas modificações importantes e normais. A composição do leite também apresenta pequenas variações com a alimentação da mãe, mas essas alterações raramente têm algum significado.
Às vezes, a mãe percebe que alguns alimentos que ela ingere mais raramente podem fazer mal para a criança (ver item 6.4). Mas a grande maioria das mulheres pode continuar com sua alimentação normal enquanto estão amamentando. Mesmo condimentos fortes como pimenta malagueta não afetam o leite ou fazem mal para a criança.
Colostro
Nos primeiros dias depois do parto as mamas secretam colostro. O colostro é amarelo e mais grosso que o leite maduro e é secretado apenas em pequenas quantidades. Mas isto é suficiente para a criança normal e é
exatamente aquilo de que precisa para os primeiros dias.
exatamente aquilo de que precisa para os primeiros dias.
ALTERAÇÕES NA COMPOSIÇÃO DO LEITE
Contém mais anticorpos e mais células brancas que o leite maduro.
Dá a primeira “imunização” para proteger a criança contra a maior parte das bactérias e vírus.
O colostro é também rico em fatores de crescimento que estimulam o intestino imaturo da criança a se desenvolver. O fator de crescimento prepara o intestino para digerir e absorver o leite maduro e impede a
absorção de proteínas não digeridas. Se a criança recebe leite de vaca ou outro alimeno antes de receber o colostro, estes alimentos podem lesar o intestino e causar alergias.
O colostro é laxativo e auxilia a eliminação do mecônico (primeiras fezes muito escuras). Isto ajuda a evitar a icterícia.
Há algumas comunidades que não permitem que as crinças recebam colostro. Os auxiliares de Saúde devem discutir o valor de proteção do colostro e estimular a mudança dessa prática.
O COLOSTRO É EXATAMENTE O QUE A CRIANÇA PRECISA NOS PRIMEIROS DIAS
Leite maduro
Em uma ou duas semanas, o leite aumenta em quantidade e muda seu aspecto e composição. Este é o leite maduro que contém todos os nutrientes de que precisa para crescer. O leite materno maduro parece mais
ralo que o leite de vaca, o que faz com que muitas mães pensem que seu leite é fraco. É importante esclarecer que esta aparência aguada é normal e que o leite materno fornece água suficiente, mesmo em climas muito quentes.
Leite do começo e leite do fim
A composição do leite muda durante a mamada.
Leite do começo
O leite do começo surge no início da mamada. Parece acinzentado e aguado. É rico em proteína, lactose, vitaminas, minerais e água.
Leite do fim
O leite do fim surge no final da mamada. Parece mais branco do que o leite do começo porque contém mais gordura. A gordura torna o leite do fim mais rico em energia. Fornece mais da metade da energia do leite materno.
A criança precisa tanto do leite do começo quanto do leite do fim para crescer e se desenvolver. É importante deixar que ela pare espontaneamente de mamar. A interrupção da mamada pode fazer com que receba pequena quantidade de leite do fim.
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