STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptx

STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI

1. Dr. Shashwat Jani M. S. ( Obs – Gyn ), F.I.A.O.G. Diploma in Advance Laparoscopy . Consultant Assistant Professor , Smt. N.H.L. Municipal Medical College. S.V.P. Hospital , Ahmedabad. Mobile : [phone]. E-mail : [email protected] Standard Techniques Of Breastfeeding

2. INTRODUCTION " The more we know about human breast milk the more we discover about its value in human nutrition and development”. 29-Jan-23 Dr Shashwat Jani. 9909944160 2

3. Successful lactation is determined by early initiation of breastfeeding and continuation of lactation and again that is determined by positioning. Positioning is key to get Latch on. 3 29-Jan-23 Dr Shashwat Jani. 9909944160

4. Factors Influencing Breast Feeding Emotional Status 4 Genetic Factors Nutrition Position Privacy Factors Attitude of the Mother 29-Jan-23 Dr Shashwat Jani. 9909944160

5. 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). 29-Jan-23 Dr Shashwat Jani. 9909944160 5

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8. 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. 29-Jan-23 Dr Shashwat Jani. 9909944160 8

9. TECHNIQUE OF BREASTFEEDING 29-Jan-23 Dr Shashwat Jani. 9909944160 9

10. 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 4 hours . Rooming in and bedding should be done with mother and baby to prevent separation and promote breast feeding. 29-Jan-23 Dr Shashwat Jani. 9909944160 10

11. Infant Feeding Cues Bringing hands to mouth Rooting Suckling Licking Nuzzling Lip smacking 11 29-Jan-23 Dr Shashwat Jani. 9909944160

12. TECHNIQUE 29-Jan-23 Dr Shashwat Jani. 9909944160 12

13. TECHNIQUE 29-Jan-23 Dr Shashwat Jani. 9909944160 13

14. TECHNIQUE Here are the basic steps for breast feeding : Make sure mother is comfortable and well supported with pillows. Lean back rather than sit upright Place baby on her bare chest between her breasts, facing her . Gravity will help keep her in position. It’s best if her baby is awake but not crying – if she’s crying, calm her first, perhaps by letting her suck mother’s finger. 1. When calm , baby will begin to follow his instincts. Baby wi ll start to move towards one breast. Support 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 nipple. He knows where to go. Mother’s job is to keep him calm. Mother can help him by moving his whole body a little if necessary. 29-Jan-23 Dr Shashwat Jani. 9909944160 14

15. TECHNIQUE 4. B aby will most likely position h im self on an angle, with his mouth near mother’s nipple and his feet supported by mother’s thigh or lap. 5. When baby is just below mother’s nipple, he’ll dig his chin into the breast, reach up with an open mouth, attach to the breast and start sucking . 29-Jan-23 Dr Shashwat Jani. 9909944160 15

16. 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. 29-Jan-23 Dr Shashwat Jani. 9909944160 16

17. Explaining the 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 . 29-Jan-23 Dr Shashwat Jani. 9909944160 17

18. 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. 29-Jan-23 Dr Shashwat Jani. 9909944160 18

19. Cross Cradle Hold Position Same of cradle position but just the opposite hand is used to support the infant and the same side hand is used to hold the breast . To learn Latching To maintain comfortness of the mother 29-Jan-23 Dr Shashwat Jani. 9909944160 19

20. 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. Explaining the POSITIONS 29-Jan-23 Dr Shashwat Jani. 9909944160 20

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22. The football hold is a good position when: Patient had a caesarean birth and want to avoid placing her baby against her abdominal incision. She needs more visibility in getting her baby to latch-on. Her breasts are large. Baby is premature B aby tends to slide down areola onto her nipple. B aby is fussy, restless and hard to latch-on. When baby is sleepy. Sitting upright may encourage her to remain alert for a longer period. I nverted nipples . 29-Jan-23 Dr Shashwat Jani. 9909944160 22

23. 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. Explaining the POSITIONS 29-Jan-23 Dr Shashwat Jani. 9909944160 23

24. 29-Jan-23 Dr Shashwat Jani. 9909944160 24 The side-lying position is an especially good choice for breastfeeding when : You must be flat after a caesarean birth with spinal anesthesia .

25. POSITIONS 29-Jan-23 Dr Shashwat Jani. 9909944160 25

26. Various Other Positions To Feed Twins 26 29-Jan-23 Dr Shashwat Jani. 9909944160

27. Latch on Mother holds the baby in upright position on her lap. Mouth is wide open and the chin touches the breast. Mother guide the nipple and areola into the baby’s mouth for effective milk transfer Peristaltic action from the tip of the tongue to the base. 27 29-Jan-23 Dr Shashwat Jani. 9909944160

28. Step 1 28 29-Jan-23 Dr Shashwat Jani. 9909944160

29. Step 2 29-Jan-23 Dr Shashwat Jani. 9909944160 29

30. Step 3 29-Jan-23 Dr Shashwat Jani. 9909944160 30

31. Step 3 29-Jan-23 Dr Shashwat Jani. 9909944160 31

32. Step 4 29-Jan-23 Dr Shashwat Jani. 9909944160 32

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35. How to find poor attachment Mother feels pain Clicking sound heard by mother Eager to suck 35 29-Jan-23 Dr Shashwat Jani. 9909944160

36. Results Of Poor Attachment Painful nipples Damaged nipples Engorgement Baby unsatisfied & cries a lot Baby feeds frequently & for a long time Decreased milk production Baby fails to gain weight 29-Jan-23 Dr Shashwat Jani. 9909944160 36

37. Basic Steps Sucks Swallow Pause 37 29-Jan-23 Dr Shashwat Jani. 9909944160

38. Baby suckles slowly and pauses in between to swallow (suck, suck, suck.. and swallow ). One may see throat cartilage and muscles moving and hear the gulping sounds of milk being swallowed . Baby's cheeks are full and not hollow or retracting during sucking. Effective Suckling 29-Jan-23 Dr Shashwat Jani. 9909944160 38

39. Cuddle and fiddle with the baby by stroking and tickling behind his or her ears or on the soles so that infant does not lapse into sleep without adequate feeds. 29-Jan-23 Dr Shashwat Jani. 9909944160 39

40. De latching Watch baby for cues that he /she has finished May spontaneously come off the breast May fall sleep If mother wants to stop the feeding early, break suction by inserting finger into corner of infant’s mouth. 40 29-Jan-23 Dr Shashwat Jani. 9909944160

41. Burping Propped up with baby’s tummy against shoulder of the mother. Sitting up, leaning forward on one hand of the mother with the other hand burps at back of infant. 41 29-Jan-23 Dr Shashwat Jani. 9909944160

42. Burping and de latching 29-Jan-23 Dr Shashwat Jani. 9909944160 42

43. Importance Of Good Position & Attachment 43 29-Jan-23 Dr Shashwat Jani. 9909944160

44. Signs of successful Breast feeding One or two wet diapers during the first few days. Six to eight wet cloth diapers (5 - 6 wet disposable diapers) per day (24 hours). At least two to five bowel movements every 24 hours. 6 - 10 feedings per24-hours. Baby’s swallowing sounds are audible. Gain at least 120 – 210 g per week after the fourth day of life. Appear healthy, have good colour , firm skin, and will be growing in length and head circumference. Sound sleep followed by feed. 44 29-Jan-23 Dr Shashwat Jani. 9909944160

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48. THANK YOU 29-Jan-23 Dr Shashwat Jani. 9909944160 48