Breast Feeding.pptx

breast feeding

1. BREASTFEEDING

2. INTRODUCTION Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breast via lactation rather then using infant formula from a baby bottle or container Babies have sucking reflex that enables them to suck and swallow milk Experts recommend that children be breastfed within one hour of birth, exclusively breastfed for the first 6 months , and the breast until age two .

3. INTRODUCTION " The more we know about human breast milk the more we discover about its value in human nutrition and development”.

4. WHERE AND HOW

5. WHERE AND HOW

6. PHYSIOLOGY The physiological basis of lactation is divided into four phases : Preparation of breasts (mammogenesis). Synthesis and secretion from the breast alveoli (lacto genesis). Ejection of milk (galactokinesis). Maintenance of lactation (galactopoiesis).

7. MAMMOGENESIS

8. LAC T OGENESIS Begins when estrogen and progesterone are withdrawn following delivery, Prolactin begins its milk secretary activity The secretary activity is enhanced growth hormone, thyroxine, glucocorticoids and insulin. Milk secretion actually starts on 3 rd or 4 th postpartum day

9. GALACTOKINESIS Milk let down reflex Discharge of milk from the mammary glands depends not only on the suction exerted by the baby during sucking but also on the contractive mechanism which expresses the milk from the alveoli into the ducts.

10. HOW IT HAPPENS

11. GALACTOPOEISIS Prolactin appears to be the single most important galactopoietics hormone. For maintenance of effective and continuous lactation, suckling is essential.

12. MILK PRODUCTION A healthy mother may produce about 500-800 ml of milk a day to feed her infant with about 500 kcal /day

13. REFLEXES IN THE BABY The rooting reflex The suckling reflex The swallowing reflex

14. FACTORS WHICH LESSEN MILK PRODUCTION Dummies, pacifiers, bottles-even one or two feeds. Making the baby wait for feeds. Giving feeds like sugar water gripe water, honey, breast milk substitutes or formula, either as pre-lacteal feeds or at anytime. Certain medications for mothers like oral contraceptives or methergine. Painful breast conditions like sore or cracked nipples & congested breast.

15. DRUGS TO IMPROVE MILK PRODUCTION Metclopramide (10 mg thrice daily) Increases the blood volume by increasing prolactin level. Intranasal oxytocin contracts myoepithelial cells and causes milk let down

16. COMPOSITION OF BREASTFEEDING

17. COMPOSITION COLOSTRUM : Is the secretion of breast during the later part of pregnancy & for 2-4 days after delivery It has deep lemon yellow colour as it contain several times the protein of mature breast milk but less fat & more minerals. It has important immunological factors ( antibodies - IgA ) It’s alkaline in nature

18. COMPOSITION TRANSITIONAL MILK During the next two weeks, the milk increases in quantity and changes in appearance and composition and this is called transitional milk . The immunoglobin and protein content decreases while the fat and sugar content increases. MATURE MILK The milk which replaces the transitional milk after 2 weeks of lactation

19. DIFFERENCES DIFFERENCES BETWEEN COW'S MILK AND BREAST MILK Both contain equal amounts of water. The energy contents are equal approximately 20Kcal/kg/oz ,as 1oz=30 ml of milk Protein : Cow milk contains higher protein approximately 3 folds, its contents of casein is about 6 folds , while the human milk protein is mainly whey protein (lactalbumin & lactglobulin ) but 30% casein . Carbohydrates: Human milk 7% which is lactose while cow milk is 4.5% . Fat : Contents are almost equal but there is qualitative differences ,as both containing triglycerides (olein ,palmitin & stearin ) but human milk contain twice of the more absorbable olein .

20. DIFFERENCES DIFFERENCES BETWEEN COW'S MILK AND BREAST MILK Minerals : Cow milk contains much more of all the minerals except iron &copper &although breast milk iron is low but better absorbed (bioavailable) and the infant will depend on the iron stores in the first 4-6 months . Vitamins: Both has large amount of vitamin A, cow milk has low vitamin C & D ,also human milk has low vitamin D and depends largely on the maternal nutrition and sun exposure .both milk contains adequate amount of vitamin B complex so breast fed infants should receive the daily requirements of vitamin D which is 400 I.U / day .

21. DIFFERENCES DIFFERENCES BETWEEN COW MILK, FORUMULA MILKAND BREAST MILK BREAST MILK COW MILK FORMULA MILK WATER Enough Extra needed May need extra ENERGY Equal Equal Equal PROTEIN Correct amount easy to digest Too much difficult to digest Partially corrected CARBOHYDRATE Lactose – plenty oligosaccharides Lactose – less oligosaccharides Lactose + Sucrose Lacks lipase FAT EFAs present Lipase to digest No EFAs No lipase Some EFAs added No lipase VITAMINS Adequate depending on mom’s nutritional adequacy Low vitamin A, C and Iron Vitamin / mineral added – usually enough A NT I -I NF E CT IVE FACTORS IgA, Lactoferrin, Lysozeme, etc None None GROWTH FACTORS Present None none

22. DIFFERENCES DIFFERENCES BETWEEN COW'S MILK AND BREAST MILK

23. TECHNIQUE OF BREASTFEEDING

24. INITI A TION Breast feeding should be started within half an hour of birth as soon as possible after normal delivery where as in case of caesarian section delivery, within 1 hours . Rooming in and bedding should be done with mother and baby to prevent separation and promote breast feeding.

25. TECHNIQUE

26. TECHNIQUE

27. TECHNIQUE Here are the basic steps for breast feeding: Make sure you’re comfortable and well supported with pillows. Lean back rather than sit upright Place your baby on your bare chest between your breasts, facing you. Gravity will help keep her in position. It’s best if your baby is awake but not crying – if she’s crying, calm her first, perhaps by letting her suck your finger. 3 . When calm, your baby will begin to follow his instincts. He’ll start to move towards one breast. Support your baby behind his shoulders and under his bottom (hold his head only if he needs it). Let him move to where he’s trying to go – towards your nipple. He knows where to go. Your job is to keep him calm. You can help him by moving his whole body a little if necessary.

28. TECHNIQUE Here are the basic steps for breast feeding: 4. Your baby will most likely position herself on an angle, with her mouth near your nipple and her feet supported by your thigh or lap. 5 . When your baby is just below your nipple, he’ll dig his chin into your breast, reach up with an open mouth, attach to the breast and start sucking

29. POSITIONS Baby’s head & body straight. Baby’s body turned towards the mother, nose opposite the nipple. Baby’s body touching mother’s abdomen. Baby’s whole body well supported not just neck or shoulders. Mother should than support her breast with her finger flat against her chest wall under her breast.

30. POSITIONS Cradle Hold (Tummy to Tummy) Sit as straight as possible with a pillow behind you, or sit on the edge of the bed. Cradle your baby in your arm, her tummy against yours and her head resting in the bend of your elbow. Her ear, shoulders and hip should be in a straight line. Tuck your baby's lower arm out of the way, with her mouth close to your breast. Support your breast with your free hand; place all of your fingers underneath it, well away from the areola. Rest your thumb lightly on top of your breast above your areola. Lift your breast upward and lightly stroke your nipple on your baby's lower lip. As part of the rooting reflex, her mouth will open wide. Pull her quickly onto the breast to latch-on when her mouth is opened wide, like a big yawn, and her tongue is down. Do not lean over your baby; keep your back straight, and pull your baby up to your breast.

31. 2. Football hold Position your baby so her legs and body are under your arm, with your hand holding her head (as if you were holding a football). Place your fingers below your breast. Allow your baby to latch-on while pulling her in close, holding her head tightly against your breast. Keep your baby's body flexed at the hip with her legs tucked under your arm. The football hold is a good position when: You have had a caesarean birth and want to avoid placing your baby against your abdominal incision. You need more visibility in getting your baby to latch-on. Your breasts are large. You are nursing a small baby, especially if premature. Your baby tends to slide down your areola onto your nipple. Your baby is fussy, restless and hard to latch-on. Your baby is sleepy. Sitting upright may encourage her to remain alert for a longer period. You have inverted nipples. POSITIONS

32. 3 Side lying position First, position yourself and your baby on your sides tummy-to- tummy. Bend your top leg and position with pillows Place your fingers beneath your breast and lift upward, then pull your baby in close as she latches-on. The side-lying position is an especially good choice for breastfeeding when: You must be flat after a caesarean birth with spinal anesthesia. POSITIONS

33. POSITIONS

34. ADVANTAGES OF BREASTFEEDING

35. MATERNAL AND FETAL MATERNAL FETAL Reduces the risk of breast cancer, ovarian cancer, diabetes, hypertension and heart disease Meets the full nutritional requirement of infant Promotes post partum weight loss and emotional health Reduces the risk of infectious disease and illness Emotional support and bonding Lowers the risk of developing allergi es Prevents post partum hemorrhage and delays ovulation Lowers the rate o f sudden infant death syndrome (SIDS), cancer, gastrointestinal disrupt

36. IMMUNITY During breast feeding approximately 0.25-0.5grams per day of secretory IgA antibodies is passed to the baby via the milk.This is one of the most important feature of breast feeding. The main target of these antibodies is the microorganism in the fetal intestine. Breast milk also contains several substances such as bile salt stimulated lipase which protects against amoebic infection, lactoferrin which binds to iron and inhibits growth of intestinal bacteria.

37. SUDDEN INFANT DEATH SYNDROME Non breast fed babies have worst arousal from sleep at 2-3 months This coincides with the peak of incidence of sudden infant death syndrome. The risk of SIDS is doubled among infants whom has been not breastfeed.

38. MENTAL HEALTH Breastfeeding for more than 6 months is an independent predictor of better mental health through childhood and adolescent. The more months the child has been breastfeed they less likely suffer from depression, dequilent behavior, attention issues and physiological issues Breastfeeding can also improve cognitive function

39. HORMONE RELEASE Breastfeeding releases oxytocin and prolactin , hormones that relax the mother and make her feel more nurturing toward her baby. This hormone release can help to enable sleep even where a mother may otherwise be having difficulty sleeping. Breastfeeding soon after giving birth increases the mother’s oxytocin levels , making her uterus contract more quickly and reducing bleeding. Pitocin , a synthetic hormone used to make the uterus contract during and after labor, is structurally modeled on oxytocin.

40. WEIGHT LOSS As the fat accumulated during pregnancy is used to produce milk , extended breastfeeding as least 6 months can help mothers lose weight. However, weight loss is highly variable among lactating women monitoring the diet and increasing the amount of intensity of exercise are more reliable ways of losing weight. The 2007 review for the AHRQ found “The effect of weight breastfeeding in mothers on return-to-pre- pregnancy weight” was negligible, and the effect of breastfeeding on postpartum weight loss was unclear.

41. LONG-TERM HEALTH For breastfeeding women, long-term health benefits incudes: Less risk of breast cancer, ovarian cancer, and endometrial cancer. Breastfeeding diabetic mothers requires less insulin. Reduced risk of metabolic syndrome. Reduce risk of post-partum bleeding. Women who breast fed for a longer duration have a lower risk for contracting rheumatoid arthritis than women who breast fed for a short duration or who had never breast fed.

42. CONTRAINDICATION OF BREASTFEEDING

43. CONTRAINDI C A TIONS IN MOTHER Chronic disease such as active TB, leprosy, AIDS etc. Mothers addicted to alcohol or heavy doses of some drugs. Mothers taking any of the following medications: radioactive isotopes, cancer chemotherapy agents, such as antimetabolites, and thyrotoxic agents. Psychosis Local condition like breast abscess, cracked nipples The mother should give adequate attention to her diet, personal hygiene and health and should have sufficient rest.

44. CONTRAINDI C A TIONS IN INFANT 1. Gross prematurity of baby or other conditions in which the newborn cannot suckle. 1. Inborn errors such as phenylketonuria, lactose intolerance, galactosemia

45. CONTRAINDI C A TIONS Commonly mistaken as contraindication are the following: Women who have cesarean deliveries: Initiate breastfeeding immediately, using a semi-recumbent position on the side or sitting up. Women received vaccinations or live with vaccinated children: Neither inactivated nor live vaccines administered to a lactating woman or other family members affect the safety of breastfeeding for the mother or infant. Women who take medications: Most medications can be taken while breastfeeding.

46. CONTRAINDI C A TIONS Commonly mistaken as contraindication are the following: Women who had breast surgery: breastfeed frequently to maintain milk supply. If the surgical wound is painful, the other breast can be used but monitor infant growth because milk supply could be insufficient. Women who have hepatitis A: Initiate breastfeeding after infant receives immune serum globulin, and then vaccinate at 1 year of age. Women who have hepatitis B: Initiate breastfeeding after infant receives hepatitis B immune globulin and first dose of the 3-dose hepatitis B vaccine series. Women who have hepatitis C: Hepatitis C is not a contraindication for breastfeeding, but reconsider if nipples are cracked or bleeding. Women who have pierced nipples: Remove nipple accessories before feeding to avoid the risk of infant choking.

47. PROBLEMS IN BREASTFEEDING

48. Blood stained nipple discharge Painful nipple Breast engorgement Plugged duct Mastitis PROBLE M S

49. BLOOD STAINED NIPPLE DISCHARGE Typically bilateral Due to epithelial proliferation 2 nd and 3 rd of pregnancy and < 3 months of postpartum Self limiting, no treatment needed.

50. BLOOD STAINED NIPPLE DISCHARGE

51. PAINFUL NIPPLES Causes: Improper latching and positioning Thrush (candidiasis) Symptoms: swollen, hard, warm and painful Prevention : Early and frequent feeds Correct the positioning and attachment Express your milk when feedings are missed Treatment: Resting the affected nipple Hand express some milk to allow for easier latching.

52. BREAST ENGORGEMENT If you baby does not adequately remove the milk from your breasts, it may lead to breast engorgement. Begins at the 2 nd and 3 rd postpartum day

53. BREAST ENGORGEMENT Causes: Delayed or infrequent feeding Improper latching and positioning Symptoms: swollen, hard, warm and painful Prevention : Early and frequent feeds Correct the positioning and attachment Express your milk when feedings are missed Treatment: Applying and ice bag, breast massage, analgesics Hand express some milk to allow for easier latching.

54. PLUGGED DUCT Plugged ducts are an occlusion or plug has occurred in the milk passageways. This plug prevents milk from passing through or slower than usual.

55. PLUGGED DUCT Causes: Infrequent feeding and milk stasis Inadequate removal of milk from one area of the breast. Symptoms: swollen, hard, warm, painful and noticeable lump. Prevention : Early and frequent feeds Correct the positioning and attachment Express your milk when feedings are missed Wear a comfortable, properly fitting bra. Treatment: Warm water packs, breast massage Try to move the lump toward the affected nipple to assure drainage

56. MASTITIS Breast inflammation

57. MASTITIS Causes: Bacteria enter the breast through the nipple. Blocked duct obstructs the flow of the milk & distends the alveoli cracked or sore nipple. Symptoms: Painful, red and swollen Flu like symptoms Tachycardia Pyrexia, rigors Intense, localized pain Red, hot and swollen breast Treatment: Isolation of the mother and baby Ceasing the breastfeeding from the affected part Express the milk manually or electric pump Antibiotic such as flucloxacillin

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