Session-6.-How-milk-gets-to-babyNMMC.pptx

Medidas Medical Center INC
Lactation Training Management
Sesion 6
Session-6.-How-milk-gets-to-babyNMMC.pptx

1. HOW MILK GETS FROM BREAST TO BABY

2. OBJECTIVES 1 . Identify the parts of the breast and describe their function. 2. Discuss how breastmilk is produced and how production is regulated . 3. Describe the baby’s role in milk transfer. 4 . Discuss breast care .

3. Elements of a Normal Breastfeeding Process A BREAST that produces and releases milk A BABY who is able to remove the milk from the breast with effective suckling The manner in which the baby is attached at the breast will determine how successful these 2 elements come together

4. Parts of the Breast

5. Size and Shape There are many different shapes and sizes of breast and nipple . Babies can breastfeed from almost all of them

6. Types of Nipple

7. BREASTMILK PRODUCTION Factors involved : Hormones : 1 . PROLACTIN 2. OXYTOCIN Feedback inhibitor of lactation

8. Breastmilk Production Hormones or chemical messengers in the blood: During pregnancy – hormones help breasts >To develop and grow >To start to make colostrum After delivery , hormones of pregnancy decreases. Prolactin and Oxytocin- are important to help in the production and flow of milk

9. Prolactin Makes alveoli produce milk Works after a baby has taken a feed to make milk for the next feed. Can make mother feel sleepy and relax Level is HIGH 2 hours after birth and at night

10. Prolactin Reflex More prolactin secreted at night Suppresses ovulation Delays fertility and menstruation Sensory impulses from nipples Prolactin in blood Baby suckling Secreted during and a fter feed to produce next feed

11. OXYTOCIN REFLEX. Also called milk ejection reflex or let down Action: causes the muscle cells around alveoli to contract and makes milk flow down the ducts Signs : - painful uterine contraction - a sudden thirst - milk spraying from the breast or leaking - feeling a squeezing sensation in her breast

12. Oxytocin or Milk Ejection Reflex Milk Ejection Makes uterus contract Sensory impulses from nipples Oxytocin in blood Baby suckling Works before or during a feed to make milk flow

13. How can a mother assist the oxytocin reflex? Seeing, hearing, touching and thinking lovingly about the baby Feeling pleased about the baby and confident that her milk is best Expressing a little milk and gently stimulating the nipple Keeping her baby near so she can see, smell, touch and respond to her baby.

14. Helping and hindering of Oxytocin reflex help reflex hinder reflex * Worry * Stress * Pain * Doubt * Nicotine *Alcohol > Thinks lovingly of baby > Sounds / sight of baby >Touching baby >Confidence

15. Helping the Oxytocin Reflex

16. How to Rub a Mother’s Back Explain to mother what you will do /ask permission Breast and back naked Sit near a table with head resting on her arms Chair far enough from table for breast to hung freely Rub both sides of the spine with your thumbs, making small circular movements from neck to shoulder blades Ask if it makes her relaxed.

17. Feedback Inhibitor of Lactation (FIL) Reduces milk production Happens if milk is not removed and breast is full Once milk is removed, inhibitor and milk production THEREFORE: amount of milk depends on how much is removed

18. To prevent the Feedback Inhibitor of Lactation Make sure baby is well attached Encourage frequent breastfeeds Allow the baby to feed for as long as she or he wants at each breast If baby does not suckle- express the milk so the production continues

19. BABY’S ROLE IN MILK TRANSFER 10/6 BABY’S SUCKLING CONTROLS: 1. PROLACTIN PRODUCTION 2. OXYTOCIN REFLEX 3. REMOVAL OF THE INHIBITOR WITHIN THE BREAST Therefore: For a mother to produce more milk, the baby must suckle often and suckle in the right way .

20. What do we mean by “suckling in the right way?”

21. SIGNS OF GOOD ATTACHMENT WHAT’S HAPPENING INSIDE THE BABY’S MOUTH? NIPPLE AND AREOLA ARE STRETCHED OUT TO FORM A LONG TEAT. LARGE DUCTS ARE INSIDE THE BABY’S MOUTH. BABY’S TONGUE REACHES LOWER GUM, AND UNDER THE AREOLA. TIP OF NIPPLE REACHES HARD PALATE.

22. What can you see ? (INSIDE THE BABY’S MOUTH) nipple and areola are stretched out to form a long teat large ducts inside the babys mouth baby's tongue reaches lower gum Good Attachment Poor Attachment

23. Correct Attachment The tongue is under the AREOLA, with the tip of the nipple touching THE HARD PALATE.

24. SIGNS OF GOOD ATTACHMENT 1 . Chin touching the breast or nearly so 2. Mouth wide open 3. Lower lip turned outwards 4. Areola more visible above than below the mouth

25. What can you see ? ( BY LOOKING AT THE OUTSIDE ) Good Attachment Poor Attachment

26. RECOGNIZING GOOD ATTACHMENT Chin touching breast Mouth wide open Lower lip turned outward More areola showing above    

27. ©UNICEF C107-7 Wide Open Mouth 7/4

28.     Recognizing Good Attachment Not Well Attached Chin touching breast Mouth wide open Lower lip turned outward More areola seen above    

29. Recognizing Good Attachment Chin touching breast Mouth wide open Lower lip turned outward More areola showing above     Not Well Attached

30. Recognizing Good Attachment Chin touching breast Mouth wide open Lower lip turned outward More areola showing above     Poorly Attached

31. Recognizing Good Attachment Chin touching breast Mouth wide open Lower lip turned outward More areola showing above    ? Poorly Attached

32. Nipple Sucking in which the nipple is used as a teat

33. Why should we aim for good attachment ?

34. WELL ATTACHED BABY 1.Comfortable AND Painless breastfeeding for THE MOTHER AND THE BABY 2.BABY SUCKLES EFFECTIVELY

35. Results of Poor Attachment Pain and damage to nipples Breastmilk not removed effectively Apparent poor milk supply Breasts make less milk Sore Nipples Fissures Engorgement Baby unsatisfied wants to feed a lot Baby frustrated , refuses to suckle Baby fails to gain weight

36. THE ACTION OF SUCKLING

37. Reflexes in the baby Rooting Reflex When something touches lips, baby opens mouth, puts tongue down and forward Sucking Reflex When something touches palate, baby sucks Swallowing Reflex When mouth fills with milk, baby swallows Skill Mother learns to attach her baby to the breast Baby learns to take breast

38. THE ACTION OF SUCKLING All these reflexes happen in a healthy full term baby. Rooting Reflex Sucking Refle x Swallowing Reflex “Taking the breast far enough into the baby’s mouth is not completely automatic, so many babies need help.”

39. SIGNS OF EFFECTIVE SUCKLING Slow deep sucks and swallowing sounds Cheeks full and not drawn in Baby feeds calmly Baby finishes feed by him/herself and seems satisfied Mother feels no pain

40. INEFFECTIVE SUCKLING Feeds for a very long time-more than an hour at every feed, unless low birth weight. Is not contented at the end of a feed.

41. ARTIFICIAL TEATS CAUSES BREASTFEEDING DIFFICULTIES CAUSES NIPPLE CONFUSION BECAUSE OF A DIFFERENT MOUTH ACTION MAY REDUCE SUCKLING TIME AT THE BREAST, THUS REDUCING BREAST STIMULATION, MILK PRODUCTION AND MILK REMOVAL . Shall I use a feeding bottle?

42. Teaching Mothers How to keep Milk Production Plentiful Make sure there is good attachment and do not give artificial teats Breastfeed exclusively Help the baby to breastfeed soon after birth Feed the baby as frequently as he or she wants usually every 1-3 hours for as long as he/she wants at a feed Feed the baby at night , when prolactin release in response to suckling is high .

43. I NDICATORS OF ADEQUATE BREAST MILK INTAKE ( Early Postpartum Weeks) Breasts full before feeding and softer afterwards Let-Down sensation in mother’s breasts Wet nappies /diapers: 6 or more /24 hours 4. Bowel movements: Several times /day

44. 5. Contented baby between feeds. 6. Audible swallowing during a feeding 7. Average weight gain: 18 – 30 grams /day (3/4 – 1 oz. day) 125 – 210 grams /week (4 – 7 oz. per week) INDICATORS OF ADEQUATE BREAST MILK INTAKE (Early Postpartum Weeks)

45. BREAST CARE WHAT DO MOTHERS NEED TO KNOW ABOUT CARING FOR THEIR BREASTS WHEN BREASTFEEDING?

46. BREAST CARE 1. Clean breasts with water only. 2. Washing the breasts once a day as part of the general hygiene is sufficient. 3. Brassieres are not necessary, but can be used if desired. Choose a brassiere that fits well and is not too tight .

47. SUMMARY Size and shape of the breasts are not related to ability to breastfeed. Prolactin helps produce milk and can make the mother feel relaxed. Oxytocin ejects milk and the baby can remove it through s uckling .

48. SUMMARY … If breast gets overfull, feedback inhibitor of lactation will reduce milk production Early feeding and frequent feeds help to initiate milk production. Signs of good/poor attachment Signs of effective suckling/ not suckling effectively Breast Care is important .

49. Can YOU now help attach the baby to the mother’s breast so the baby suckles effectively ??

50. “ Ang bagay na gusto mong gawin ay marami kang paraan subali’t ang bagay na di mo gustong gawin ay marami kang dahilan ”

51. thank you!!