Lactation Management for postpartum mothers

Lactation management is the science and art of assisting women and infants with breastfeeding, because the mother-infant pair is dynamically interrelated for breastfeeding, it is imperative to consider both individuals when attempting to assess and “manage” breastfeeding.

1. Lactation Management

2. LACTATION MANAGEMENT Lactation management is the science and art of assisting women and infants with breastfeeding, because the mother-infant pair is dynamically interrelated for breastfeeding, it is imperative to consider both individuals when attempting to assess and “manage” breastfeeding.

3. Objectives of Lactation Management Review public health impact of breastfeeding. Understand physiology of lactation. Identify the differential diagnosis and treatment for common breastfeeding problems Low milk supply, Mastitis, Breast abscess.

4. American Academy of Pediatrics (AAP) Recommendations Exclusive breastfeeding for the first six months of life Continued breastfeeding for at least one year, As long as is mutually desired by mother and child

5. Exclusive Breast Feeding Exclusive breast feeding means feeding the baby with breast milk soon after birth and continuing it until 6 month of age without giving baby any other food• The baby is given only breast milk and nothing else whenever the baby is hungry

6. Benefits of Breastfeeding to the Mother Reduces risk of developing osteoporosis Reduces breast cancer & ovarian cancer risk Produces oxytocin, which helps contract the uterus back to its pre-pregnancy size & prevents postpartum hemorrhage Burns calories by using fat stores for her breast milk Lowers chance of developing postpartum depression. Natural Contraception Improves the figure of the mother Saving money, since breastfeeding is free!

7. Benefits of Breastfeeding to the baby Provides ideal nutrition for the babies Contains important antibodies like (IGA), Reduce the risk of infections like respiratory tract infections, bowel diseases etc Promotes the baby’s to increase the weight Makes the children smarter Prevents Childhood obesity Prevents Necrotizing enterocolitis in premature infants

8. Physiology of Lactation

9. Mammogenesis

10. Lactogenesis

11. Galactokinesis

12. Galactopoiesis

13. Initiation of Breast Feeding Nurse the baby more often. Resting adequately. Eating a nutritious diet. Drinking at least 8-10 glasses of water per day Choosing a night time sleeping arrangement that allows for the best sleep.

14. Breastfeeding and Bonding Breastfeeding creates a bonding experience between mother and child because it promotes skin-to-skin contact, more holding and stroking. Many experts say that affectionate bonding during the first years of life helps lessen social and behavioral problems in both children and adults.

15. Factors which lessen the 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.

16. Drugs to improve milk production Metoclopramide (10 mg thrice daily) increases milk volume (60-100%) by increasing prolactin levels. Sulpuride (dopamine antagonist) has also been found effective. Intranasal oxytocin contracts myoepithelial cells and causes milk let down reflex

17. Positions of Breast Feeding 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 support her breast with her finger flat against her chest wall under her breast.

18. Positions of Breast Feeding

19. Contraindication of breast feeding for the mother In Mother 1. Chronic disease such as active TB, leprosy, AIDS etc. 2. Mothers addicted to alcohol or heavy doses of some drugs. 3. Psychosis 4. Local condition like breast abscess, cracked nipples 5. The mother should give adequate attention to her diet, personal hygiene and health and should have sufficient rest.

20. Contraindications of breast feeding for the infant In infant:- 1.Gross prematurity of baby or other conditions in which the newborn cannot suckle. 2. Inborn errors such as phenylketonuria, lactose intolerance

21. Problems in breastfeeding Flat/ Inverted Nipples Sore Nipples Breast Engorgement Breast Abscess, Mastitis

22. Inverted Nipples Treatment of inverted nipple is started after the birth of baby. Nipple is manually stretched and rolled out several times a day. A plastic syringe (10-20 ml) can be used to draw out the nipple before every feed

23. Sore Nipples Correct positioning & latching of the baby to the breast. Hind milk should be applied to the nipple after a feed The nipple should be aired & allowed to heal in between feeds If the baby has oral thrush, treat it and apply the same medicine on mother’s nipple. If sucking is impossible for a day or two express the milk and feed the baby from cup.

24. Breast Engorgement Treatment consists of local warm water packs, & analgesics to the mother to relieve the pain. Allow the baby to suckle as far as possible. If the baby cannot get hold of an engorged breast, help the mother to express milk. Milk should be gently expressed to soften the breast to make the mother comfortable & then the mother must be helped to correctly latch the baby to the breast. Hand expression is preferable

25. Breast Abscess, Blocked Duct, Mastitis Treatment - Mother must be treated with milk expression, analgesics and antibiotics. The abscess may have to be incised and drained. Breastfeeding must be continued from the other breast. If sucking is painful, help her to express her milk every 3 hours. Warm compression help to relieve pain. If mother develops fever, chills, body ache, she may need a full course .

26. Conclusion According to some authorities, increasing evidence suggests that early skin-to-skin contact between mother and baby stimulates breastfeeding behaviour in the baby. Newborns who are immediately placed on their mother’s skin have a natural instinct to latch on to the breast and start nursing.