breast feeding final.pptx

Breast feeding an important aspect of child growth and development.

1. BREASTFEEDING MS..JAYA SHARMA KGMU COLLEGE OF nursing

2. Globally about 38% of babies are just breastfed during their first 6 months of life. Malnutrition is responsible for 1/3 of death and above 2/3 of death often associated with inappropriate feeding practice. Unicef provided a statistical data, In India(2012) about 40.5% mothers initiate early breastfeeding and 46.4% babies are breastfed during their 6 months of life. In infancy, no gift is more precious than breastfeeding. INTRODUCTION

3. All healthy infants should be breastfed exclusively for the first six months of life Exclusive breastfeeding is defined as "an infant's consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk, and no foods) except for vitamins, minerals, and medications." Exclusive breastfeeding

4. Breast milk contain all the nutrients in the right proportion. Breast milk and human colostrum are made for babies and is the best first food. Easily digested and well absorbed Contains essential amino acids Rich in essential fatty acids Benefits of breast milk to the baby

5. Prevents under five child deaths Protects against infections Prevents allergies Better intelligence Promotes emotional bonding Less heart disease, diabetes and lymphoma Benefits of breast milk (contd.)

6. Helps in involution of uterus. It promotes close physical and emotional bondage with baby. Delays pregnancy Decreases mother’s workload, saves time and energy Lowers risk of breast and ovarian cancer Helps reduce weight faster Benefits to mother

7. Contributes to child survival Saves money, time and energy. Promotes family planning Environment friendly Community expenditure on health care contraception are reduced. Benefits to family and society

8. Anatomy of breast Myoepithelial cells Epithelial cells ducts Lactiferous sinus Areola Montgomery gland Alveoli Supporting tissue and fat Nipple

9. Hormonal secretions in the mother Prolactin helps in production of milk Oxytocin causes ejection of milk Reflexes in the baby – rooting, sucking & swallowing Physiology of lactation

10. Prolactin “milk secretion” reflex Enhancing factors Hindering factors Emptying of breast Good attachment & effective suckling Early initiation of breastfeeds Frequent feeds including night feeds Delay in initiation of breastfeeds, Pre-lacteal feeds, Bottle feeding, Incorrect positioning, Painful breast Sensory impulse from nipple Prolactin in blood

11. Baby sucking Sensory impulse from nipple to brain Oxytocin contracts myoepithelial cells Oxytocin “milk ejection” reflex

12. Oxytocin reflex Thinks lovingly of baby Sound of the baby Sight of the baby Confidence Worry Stress Pain Doubt Stimulated by Inhibited by

13. Feeding reflexes in the baby Rooting reflex Swallowing reflex Sucking reflex

14. Preparation must begins in the antenatal period. In this period , breast examination and identification of problems like retracted nipple, should be done with necessary advice for intervention. Preparation for Breast feeding

15. Educate about prevention of micronutrients deficiency, proper rest, regular exercise and hygienic measures. Mother should psychologically prepare to fed her baby immediate after birth. Preparation for Breast feeding contd..

16. Breastfeeding should initiated first half an hours to one hours of birth or as soon as possible. “Colostrum” the baby’s first immunization. Mothers should demonstrated about the techniques of breast feeding. Rooming-in or bedding-in should be done with infant and mother In case of preterm babies, they should fed with expressed breast milk. Initiation of Breast feeding

17. COMPOSITION OF BREAST MILK COLOSTRUM - it is secreted during first 3 days after delivery.it contain more antibodies and high protein. TRANSITIONAL MILK -it follow colostrum and secretes during first two weeks in postnatal period. It has increased sugar and fat content. MATURE MILK- it is secreted usually from10-12 days after delivery.

18. PRETERM MILK- the breast milk secreted by mothers who has deliver a preterm baby. This milk contain protein, sodium, iron etc. FORE MILK- it is secreted at the starting of the regular breastfeeding. It is more watery to satisfy the baby’s thirst. HIND MILK- it is secreted towards the end of regular breastfeeding and contain more fat and energy. Cont.…

19. A willing and motivated mother An active and sucking newborn A motivator who can bring both mother and newborn together (health professional or relative) For successful breastfeeding

20. Mother: Make the mother sit in a comfortable and convenient position (she can feed in lying down position) Ensure that she is relaxed and comfortable Baby: Baby’s head and body are in a straight line Baby’s whole body is supported Baby’s face is opposite the nipple and the breast Baby’s abdomen touches mother’s abdomen Key points of positioning

21. Good positioning

22. Baby’s mouth is wide open Baby’s chin touches the breast Baby’s lower lip is curled outward Usually the lower portion of the areola is not visible Key points of good attachment

23. Good attachment baby’s mouth is wide open lower lip is curled outward lower portion of the areola is not visible chin touches the breast

24. Good and poor attachment

25. Latching Teaching Aids: ENC NF- 26

26. POSITIONING

27. For an infant who shows signs of good attachment, the next step would be to assess suckling: If the infant takes several slow deep sucks followed by swallowing and then pauses , then he/she is sucking effectively Effective suckling

28. Problems in breastfeeding: Inverted nipple Treatment should begin after birth Manually stretch and roll the nipple between the thumb and finger several times a day Teach the mother to grasp the breast tissue so that areola forms a teat, and allows the baby to feed Syringe suction method

29. Inverted nipple: treatment by syringe method STEP 1 STEP 3 STEP 2 Cut along this line with blade Mother gently pulls the plunger Insert the plunger from cut end Use 10 or 20cc syringe Before feeds 5-8 times a day STEP 4 Press at the edge and allow air to enter before removing the syringe

30. Problems in breastfeeding: Sore nipple Look for a cause: Check the baby’s attachment at the breast Check the baby’s position if attachment is poor Examine the breasts – engorgement, fissures, candida Ask if mother washes the breasts after each feed (frequent washing leads to sore nipple) If the problem persists, check the baby’s oral cavity for candida

31. Sore nipple: management Give appropriate treatment: Build mother’s confidence Improve the baby’s attachment and continue breastfeeding Reduce engorgement, feed frequently, express breast milk Treat candida Advise the mother to: Wash breasts only once a day; avoid using soap Avoid medicated lotions and ointments Gently apply hind milk onto nipple and areola after each feed

32. Problems in breastfeeding: Breast engorgement Causes Delayed and infrequent breastfeeds Incorrect latching of the baby Treatment Give analgesics to relieve pain Apply warm packs locally Gently express milk prior to feed Put the baby frequently to the breast

33. Full vs. engorged breasts Full breasts = NORMAL Engorged breasts = ABNORMAL

34. Full breasts: 36/72 hours after birth. Hot, heavy, may be hard Milk flowing Fever uncommon Engorged breasts: can occur at any time during breastfeeding Painful; oedematous Tight, especially nipple area Shiny May look red Milk NOT flowing Fever may occur May cause a decrease in milk supply if it happens often Full vs. engorged breasts

35. Not breastfeeding often enough Too short or hurried breastfeeding Night feeds stopped early Poor suckling position Poor oxytocin reflex (anxiety, lack of confidence) Engorgement or mastitis Causes of “Not enough milk”

36. Put baby to breast frequently Baby to be correctly attached to breast Build mother’s confidence Back massage and relaxation can help Adequate weight gain and urine frequency 5-6 times a day are reliable signs of enough milk intake Management-“ Not enough milk”

37. Breastfeeding is considered adequate by following - Audible swallowing sound during the feed . Let down sensation in mother’s breast. Breast is full before feed and softer afterward. Goes to sleep for 2-3 hours after each feed Passes urine 6-8 times in 24 hours Gains weight at 15-30 gram/kg/day Do not cry frequently. Adequacy of breastfeeding

38. Indications Sick mother, local breast problems Preterm / sick baby Working mother Storage Clean wide-mouthed container with tight lid At room temperature: 6 hrs Refrigerator: 24 hours; Freezer (20°C): for 3 months Expressed breast milk

39. Every facility providing maternity services and care for newborn infants should Have a written breastfeeding policy that is routinely communicated to all health care staff Train all health care staff in skills necessary to implement this policy Inform all pregnant women about the benefits and management of breastfeeding Ten steps to successful breastfeeding

40. Help mothers initiate breastfeeding within half hour of birth Show mothers how to breastfeed, and how to maintain lactation even if they are separated from their infants Give no food or drink, unless medically indicated Practice rooming-in : allow mothers and infants to remain together 24 hrs a day Ten steps to successful breastfeeding (cont.….)

41. Encourage breastfeeding on demand Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital. Ten steps to successful breastfeeding (cont.….)

42. Review Question 1. How many calories should a lactating woman increase above her non-pregnant baseline calorie consumption?

43. Answer 1 5 00 calories

44. Key Messages Breastfeeding is desirable and achievable. Professional help and community support are available. Breastfeeding should be comfortable. Breastfeeding promotes close physical and emotional bondage with baby Exclusive breastfeeding is important . In infancy, no gift is more precious than breastfeeding

45. 1 . Parul Dutta ,Pediatric Nursing , Jaypee Brothers, Medical Publishers Pvt.Limited ,Third Edition ,2014. 2. Rimple Sharma ,Essential Pediatric Nursing ,Second Edition , 2017. 3.Piyush Gupta ,Essential Pediatric Nursing Fourth Edition ,2019. 4.Ghai ,Essential Pediatrics ,Ninth Edition 2019. REFERENCES Teaching Aids: ENC NF- 49

46. THANK YOU