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52 views55 pages

Presentation 1

Uploaded by

roshen02
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Breast feeding “

the gift of life”

Dr.Roshen Mascarenhas
Consultant Pediatrician
MBBS, DCH, DNB (pediatrics)
The nature has designed the provision that infant be fed
upon their mothers milk.
They find their food and mother at the same time.
It is a complete nourishment for them both for their
body and soul.

- Rabindranath Tagore
Mother’s Milk – The best milk for Infant

Like mothers love there is no substitute for


mothers milk.
04/20/24
Preparing mother for breast feeding
Antenatal mother should take extra
calories 300kcal and 15 g protein.

In the last trimester breast and nipple


should be examined for inverted or
cracked nipple.

Oiling , massaging and inverted suction


technique can be useful.
04/20/24
Does size of breast determine
amount of milk produced ?
“Milk is produced in special glands in breast
which are present in good number in all
women irrespective of size of breast “

04/20/24
Anatomy of breast
How is the milk produced?
Oxytocin
Prolactin

Milk production reflex


Milk ejection reflex/ let down reflex
Prolactin Reflex
Secretion continues AFTER feed to
produce NEXT feed

To increase milk productions


Oxytocin Reflex

For milk ejection


Helping and Hindering the Oxytocin Reflex

For milk ejection


Let-down reflex
◦ Infant begins to actively suck and swallow.

◦ Milk may drip from the opposite breast.

◦ Mother may feel a tingling or a full sensation


(after the first week of nursing) in breasts.

◦ May feel thirsty.


Feeding Reflexes
Rooting reflex
When something
touches lips,
baby opens mouth
Sucking reflex
puts tongue down
and forward When something touches palate
baby sucks

Skill
Mother learns to position baby
Baby learns to take breast

Swallowing reflex
Gag reflex When mouth fills with milk,
When something touches baby swallows
anterior part of the tongue,
baby pushes it out.
Art and technique of breast feeding
Normal delivery: within half hour.
C section : within four hours
Mother is on IV sedation .....

WHY ????
Soon after birth baby is biologically ready ie
awake and active and thereafter goes to prolong
sleep , therefore initiation may be difficult.
Rooming in
Bedding in
Mothering in

Skin to skin
contact
Eye to eye contact

Mother infant bonding


Position:
Mother should sit up comfortably, back to be
supported by firm surface preferably.

 Baby head to be kept slightly higher, facing towards


the breast .

 Baby head and neck are comfortably placed on


hollow of elbow , while the back and buttock are
supported by the forearm and hand of the mother.

 Effective seal/ latching.

Alternate breast for each feed. 04/20/24


Attachment at Breast
•Baby mouth is wide open and
lower lip turned outward.

•baby chin is close to the breast.

•More areola is visible above the


mouth than below it.

•baby's tongue is under the


lactiferous sinuses and nipple
against the palate.

•baby cheeks are full , not hollow .

•Regular ,slow ,deep sucks

•No pain while breast feeding


What Differences Do You See?

Picture 1 Picture 2
Good attachment Poor attachment
 Baby mouth is wide open and lower  Baby sucks only at the nipple.
lip turned outward.  Mouth is not wide open
 baby chin is close to the breast.
 MUch of the areola is visible and
 more areola is visible above the lactiferous sinuses are outside the
mouth than below it
mouth.
 baby's tongue is under the lactiferous  baby tongue is also inside the
sinuses and nipple against the palate.

mouth and doesnot cup the breast
baby cheeks are full , not hollow
tissue.
 regular slow deep sucks  chin is away from the breast.
 No pain while breast feeding
 breastfeeding is painful
`Dislatching the baby after breast feeding

Slide the index finger into the corner of


babys mouth to break suction and dislatch
the baby.
Burping after feeding ?

Babies tend to swallow lot of air during


feeding, so in order to prevent regurgitation,
colic's , distension ...... put the baby on the
either shoulder and gently pat on the back.

04/20/24
Breast feeding
positions
Breastfeeding Positions
Cradle Hold

 This is the most common


position used by mothers.

 Infant’s head is supported


in the elbow, the back and
buttock is supported by the
arm and lifted to the
breast.
Breastfeeding Positions
Football Hold Position
 The infant’s is placed under the
arm, like holding a football

 Baby’s body is supported with


the forearm and the head is
supported with the hand.

 Many mothers are not


comfortable with this position

 Good position after operative


procedures
Breastfeeding Positions
Side Lying Position

 The mother lies on her side propping up


her head and shoulder with pillows.

 The infant is also lying down facing the


mother.

 Good position after Caesarean section.

 Allows the new mother some rest.

 Most mothers are scared of crushing the


baby.
Breastfeeding Positions
Cross Cradle Hold Position

 Ideal for early breastfeeding.

 Mother holds the baby crosswise in the


crook of the arm opposite the breast the
infant is to be fed.

 The baby's trunk and head are


supported with the forearm and palm.

 The other hand is placed beneath the


breast in a U-shaped to guide the baby's
mouth to your breast.
Breastfeeding Positions
Australian Hold Position
 This is also called the
saddle hold

 Usually used for older


infants

 Notcommonly used by
mothers.

 Best used in older infants


with runny nose, ear
infection.
Side lying position
Football hold position
Cradle hold position
Cross cradle hold position
Saddle Hold
Twin Football Hold
How to know baby is getting enough milk?

1. He is contented for 1-2 hours after a feed.

2. He passes clear dilute urine 5-6 times a day.

3. He passes bright yellow watery stools 6-8 times


a day.

4. He regains birth weight after 2 weeks


Types of breast milk
1) Colostrum
Thick, yellow fluid, 10 to 40 ml, secreted in the
first 2 to 4 days.

High in protein
electrolytes
Lactobacillus bifidus factor
antibodies.

Low in fat and carbohydrate.


Benefits of colostrum feeding:

1. Perfect food for infants in initial days.


2. Laxative effect
3. Prevents infection.
4. Provides immunity.
II) Foremilk ( QUENCHES THIRST )
◦ Released first
◦ Higher in carbohydrate
◦ Lower in fat

III) Hindmilk ( SATISFIES HUNGER)


◦ Resembles cream
◦ Higher in fat
◦ Lower in carbohydrate
◦ Released after 10-20 minutes into the feeding
Advantages of Breast Feeding
To the infant:
1. Full nutritional requirement.

2. Protects allergies : asthma, rhinitis eczema, and food allergies.

3. Anti infective , antibodies : Reduces the incidence of


coughs and colds ( by 4 times)
ear infections/otitis media ( by 3 time)
pneumonia,
diarrheas ( by 14 times).

4. Prevents childhood obesity.


4. Provides emotional security , increases the bonding
with mother.

5. These babies are more smarter , have higher IQ ,


also it helps in visual development .

6. Stimulates 5 senses of baby- touch , sight, smell,


hearing and taste.

04/20/24
Maternal benefits of breastfeeding
•Involutes uterus and reduces maternal
bleeding after delivery.

Facilitate positive metabolic changes.

Reduce stress, they feel more calmer and


relaxed to carry out mother craft skills with
joy.

40
Maternal benefits of breastfeeding
Prolong lactational amenorrhea and delays
ovulation.

Reduce breast and ovarian cancer risk.

Reduce type 2 diabetes risk, cardiovascular risk.

Reduces risk of osteoporosis .

41
Why no to top feed?????
Formula feeding delays lactogenesis.

Formula feeding increases the risk of


engorgement .

It alters infant intestinal flora, bioactive


factors.

Formula feeding is associated with increased


childhood acute and chronic illnesses
What is nipple confusion??
Sucking from bottle is much easier task as
compared to breast feeding as it takes
effort to suck.
Once baby gets used to easier option , he
refuses to accept breast feeds .
Duration of breast feeding
- Feeds are offered in semi demand schedule.

 colostrum – feed are often but short durations.

- can nurse for 10 to 15 minute per breast; every 2 to


3 hours. ( 10 – 12 feeds/day).
BREAST MILK SUPPLY CAN BE
INCREASED BY:
1. Frequent feeds day and night.

1. Mother to eat and drink sufficient quantities to


satisfy baby’s suckling her hunger and thirst.

1. Cultural foods like ginger, garlic, methi are


natural galactogues.

2. Self confidence, freedom from anxiety,


adequate rest and emotional support
Breast milk storage
- EBM to be stored in tight fitting lid
container .
- Milk can be stored for 8 hours at room
temperature and up to 24 hours in a
refrigerator.
Contraindication to Breastfeeding
 HIV , HLTV 1 & 11 infections. (Adult T-cell lymphoma
virus)

 Active Tuberculosis.

 Herpes lesions on mother’s breast.

 Infantwith Inborn error of metabolism; galactosemia,


phenylketonuria.

 Mothers on certain medications ; anticancer therapy,


radioactive isotope etc.
Common problems during
breastfeeding
Flat or inverted nipple :
- Do a nipple protractility test.
- Inverted syringe technique.

04/20/24
Fullness and engorgement:
- The breast becomes very full, tender and
lumpy.
- Cause: Giving prelacteal feeds.
Delayed initiation of breastfeeds.
Early removal from the breast.
bottle feeding.
Management : avoiding prelacteal
Teaching correct position
unrestricted and exclusive BF

04/20/24
Hot water fomentation
Paracetamol
Giving expressed breast milk

04/20/24
Sore and cracked nipple :
Cause: poor attachment- physical trauma.
oral thrush in the baby
Dislatching baby inappropriately

Prevention: correct latching

Management: Washing nipple once a day

04/20/24
Exposure nipple to air
Application of hindmilk drop after each
feed
Give EBM if she getting pain.

04/20/24
Mastitisand abscess: Blockage or
engorgement persist , infection can
supervene.

Management : supportive counseling


Effective milk removal
antibiotic therapy
symptomatic treatment.

04/20/24
? ? ?
o n s?
e st i
q u
An y

04/20/24
k you
Than

04/20/24

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