Normal BreastFeeding presentation.docs.pdf

This are notes about breastfeeding,,it can help anyone regardless of the profession

1. BREASTFEEDING

2. Introduction
WHO and UNICEF’s global recommendations
for optimal infant feeding as set out in the Global
Strategy .
■Exclusive breastfeeding for 6 months (180
days) then given nutritionally adequate and safe
complementary feeding starting from the age of
6 months with continued breastfeeding up to 2
years of age or beyond.

3. Introduction Cont.
■After delivery ,lactation is established in the
breasts and the mother can start breastfeeding
the child.
■Some secretory activity is present during
pregnancy and accelerated following delivery
■Unlike other mammals, in humans milk is
secreted only by the end of the 2
nd
or 3
rd
day of
puerperium ,till then what is secreted is the
colostrum.

4. Colostrum
■Deep yellow/serous fluid
■Alkaline in reaction
■Higher specific gravity/higher vit A/higher
protein/ NaCl (minerals)
■Lower Carbo /fat /K+
■Contains immunoglobulin-IgA,G,M

5. COLOSTRUM-contd
■Microscopically
Fat globules
Colostrum corpuscles (large polynuclear leucocytes)
with lactalbumin /lactoglobulin
Acinar epithelial cells
■Advantages
Laxative action
Antibodies provide immunity

6. ■Variations in composition :
⮚Colostrum –antibodies and anti infective proteins,
white blood cells, baby's first immunization.
⮚Mature milk-larger quantity than colostrum, ‘coming
in’-breasts feel full heavy and hard.
⮚Foremilk –thin, proteins, lactose, water and other
nutrients.
⮚Hindmilk –more fat therefore whiter, provides much of
the energy of a feed.

7. ■Colostrum and breast milk –a comparison
proteinfatcarboWater
Colostrum8.6 2.3 3.2 86
Mature
milk
1.2 3.2 7.5 87

8. HUMAN MILK
■Milk is a suspension of fat and proteins in carbo-
mineral solution
■opaque/slightly yellow
■Slightly Alkaline
■Sweetish
■Characteristic odour
■Specific gravity-1025-1035
■Fluid portion-transudate containing sugar
,protein,milk ,salt and water

9. Contd-
■Protein in milk is 1/3 casein and 2/3
lactalbumin
■Sugar is lactose
■Rich in minerals-calcium Phosphate
/potassium carbonate/NaCl/Fe LOW
■All vitamins except vitamin K
■Compliment/macrophage/ lc / lactoferrin/
lysozymes/EGF / prolactin

10. Factors affecting milk secretion
■Diet
■Hormones
■Mental conditions
■Drugs
■Emotions
■Age/parity/state of health of mother

11. Contd-
■Most drugs the mother takes is secreted in
the milk.
■Quantity= 600ml/day
When to start breast feeding?
■As soon after a normal delivery
■1 hour after a cesarean section

12. Advantages of breast feeding
■Ideal food (good nutrients ,immunological factors
,antibacterial properties ,promote cellular growth
,cognitive function improved)
■Convenient
■Sterile
■Economical
■Emotional bonding
■Uterine involution fastened

13. PHYSIOLOGY OF LACTATION
4 stages
■Mammogenesis (preparation of the breast)
■Lactogenesis (synthesis and secretion from
the breast alveoli)
■Galactokinesis (ejection of milk)
■Galactopoiesis (maintenance of lactation)

14. MAMMOGENESIS
■Growth of ducts and lobuloalveolar systems
■Under influence of the hormones estrogen
and progesterone
■Other hormones-cortisol ,HPL ,insulin,
■Intact nerve supply is not essential for the
growth of mammary glands during
pregnancy

15. LACTOGENESIS
■Following delivery there is a fall in the level
of estrogen and progesterone .
■During pregnancy these hormones keep
the tissue unresponsive to the action of
prolactin.
■Following delivery prolactin causes milk
secretion in an already well developed
mammary gland

16. Contd-
■Secretion is increased by
GH/ thyroxine /insulin/ glucocorticoids
■Nursing effort is not essential for milk
secretion.

17. GALACTOKINESIS
■Depends not only on the suckling mechanism of
the baby but also by the contractile action which
will express milk from the alveoli into the ducts.
■This contraction is brought about by the action of
Oxytocin
■Milk let down reflex/milk ejection reflex
■Inhibited by psychic condtn /pain /breast
engorgement

18. GALACTOPOIESIS
■Prolactin is the hormone for maintenance of
lactation
■And suckling is essential for maintenance
of milk secretion
■Periodic breast feeding relieves pressure in
the ducts and promotes more secretion

19. Tips to improve lactation
■Care of the breast /nipples during
pregnancy
■Post natally frequent breast feeding
■Avoid breast engorgement
■Plenty of fluids
■Good diet

20. To Improve Milk Supply
■Breast feed as soon as possible
■Breast feed often
■Ensure proper latching
■Use medications with caution
■Avoid nicotine and alcohol

21. Cont.
■Good health;
■Early and sufficient
treatment of illnesses;
■Proper balance
between rest and
exercise;
■Freedom from worry
■Care of the breast
/nipples during
pregnancy
■Post nataly frequent
breast feeding
■Avoid breast
engorgement
■Plenty of fluids
■Adequate nutrition.

22. SUPPRESSION OF LACTATION
INDICATIONS
■Intrauterine death
■Neonatal death
■Mother do not want to breast feed
■Contraindications for breast feeding (Hep
B/ infant with galactosemia / untreated TB /
breast cancer treatment / CMV / alcoholics-
drugs)

23. Contd-
Methods
■Drugs
Bromocriptine(2.5mg BD for 2 weeks)
Cabergoline
Ethinyl estradiol(0.05mgTDS for 5 days)
■Mechanical
Tight breast binder
Do not express milk
Cold compresses/analgesics

24. The reflexes that aid lactation
■Rooting reflex.
■Sucking reflex.
■Swallowing reflex.

25. Positioning
Good positioning means:
■Baby's head and body are in line
■Baby held close to mothers body
■Baby's whole body supported
■Baby approaches breast nose to nipple.

26. Attachment
Good attachment means
■More areola is seen above baby's top lip
■Baby's mouth wide open
■Lower lip turned outwards
■Baby's chin touches the breast

28. Not enough milk?
■Weight gain-500grams /month or
125grams/week
(Baby should regain birth weight in 10 days).
■Wetness test-urinate 6 or more times in 24
hours,
■Colorless or pale yellow urine-breast milk alone.

29. Solutions
■Frequent feeds 3 hourly,
■Longer duration of feeds,
■Proper positioning and attachment,
■Free from worry/stress

30. Problems-Maternal
■Breast engorgment
■Sore Nipples/ Nipple trauma
■Infections-S. aureus, candidiasis
■Plugged ducts
■Galactocoele (from plugged ducts)
■Mastitis
■Breast abcess

31. Neonatal Problems
■Dehydration
■Jaundice-Breastfeeding vs Breastmilk
■Reduced caloric intake
■Lower immunity

32. ASSIGNEMENT
■Read on the Breast feeding Initiative
■It is a 10 step guideline put in place to
enforce breastfeeding and make it
conducive and easy for mothers to
breastfeed-including at the workplace.