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Breast feeding

This slides contain description about breast feeding, anatomy of breast, types of human milk, good position for latching, holding for the baby, advantages of breast feeding, contraindication of breast feeding, barriers and problems associated with breast feeding with their management

This slides contain description about breast feeding, anatomy of breast, types of human milk, good position for latching, holding for the baby, advantages of breast feeding, contraindication of breast feeding, barriers and problems associated with breast feeding with their management

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Breast feeding

  1. 1. . AMRITA A.S ASSISTANT PROFESSOR
  2. 2. Breastfeeding is the feeding of an infant or young child with breast milk directly from female breasts (i.e. via lactation). It is the normal way of providing young infants with the nutrients they need for healthy growth and development. INTRODUCTION
  3. 3. “Breast fed Infants… are Healthy Infants”
  4. 4. Breasts consists of gland tissues (consisting lactiferous sinuses) that make milk, which goes along milk ducts towards the nipple. • Suckling stimulates nerve endings, • Message is carried to anterior pituitary which synthesizes prolactin. • Prolactin stimulates gland cells to stimulate milk production. • Oxytocin is released from posterior pituitary, which helps in contracting the muscle cells around the alveoli, resulting in milk ejection from nipple. ANATOMY AND PHYSIOLOGY OF BREAST FEEDING
  5. 5. TYPES OF BREAST MILK Colostrum Transitional milk Mature milk Preterm milk Fore milk Hind milk
  6. 6. COLOSTRUM • Is milk secreted during first week after delivery • Yellow, thick, has more antibodies and WBC • Secreted in small quantity • High protein • NEVER BE DISCARDED TRANSITIONAL MILK • Milk secreted during two weeks • Contain immunoglobulin and low protein content • Increase fat and sugar content
  7. 7. MATURE MILK • Follows transitional milk • More thinner and watery • Contains all essential nutrients for growth of the baby PRETERM MILK • Is breast milk of a mother who delivers prematurely • High quantity proteins, sodium, iron and immunoglobulins
  8. 8. FORE MILK • Milk secreted at the start of a feed • Watery, rich in proteins, sugar, vitamins, minerals, water • Satisfied the baby’s thirst HIND MILK • Comes later towards the end of a feed • Richer in fat content • Provides more energy, satisfies baby’s hunger • For optimal growth baby needs both fore and hind milk • Baby be allowed to empty one breast fully first • Baby receives only foremilk cry excessively
  9. 9.  Human milk can be stored at room temperature for 6-8 hours.  Expressed milk can be stored in an insulated cooler bag with ice packs for 24hours.  Breast milk can be stored in the refrigerator for about 5 days at about 40°F.  It can also be kept in a freezer compartment of a fridge for up to 2 weeks at 0-5°F.  It can be stored in a deep freezer for about 3-12 months. STORAGE OF BREAST MILK
  10. 10. Caution mother in advance about engorgement Do not wash nipple before and after every feed Continue each feed as long as baby wants Recommended demand feeding Help baby suckle in a Good position Give colostrum and avoid prelacteal feeds Initiate Breastfeeding soon after delivery Avoid unnecessary use of drugs prior to delivery Select Right place for the delivery Motivate mother before Birth PREPARATION FOR SUCCESSFUL BREASTFEEDING
  11. 11. HELPING A MOTHER TO BREASTFEED PREPARING THE INFANT AND MOTHER  ensure infant is clinically stable & alert  ensure mother comfortable and relaxed Make her sit down in comfortable and convenient position
  12. 12. FOUR KEY POINTS IN POSITION • BABY’S HEAD IN LINE WITH THE BODY • WHOLE BODY WELL SUPPORTED • BABY’S TURNED TOWARDS THE MOTHER • BABY’S ABDOMEN TOUCHING MOTHER’S ABDOMEN
  13. 13. HOW TO SUPPORT HER BREAST WITH THE OTHER HAND • PUT HER FINGERS BELOW HER BREAST • USE HER FIRST FINGER TO SUPPORT THE BREAST • PUT HER THUMB ABOVE THE AREOLA HELPING TO SHAPE THE BREAST • NOT TO KEEP HER FINGERS NEAR THE NIPPLE
  14. 14. HOW TO HELP THE BABY TO ATTACH • EXPRESS A LITTLE MILK ON TO HER NIPPLE • TOUCH THE BABY’S LIPS WITH HER NIPPLE • WAIT UNTIL THE BABY’S MOUTH IS OPENING WIDE, AND THE TONGUE IS DOWN AND FORWARD • MOVE THE BABY QUICKLY ONTO HER BREAST, AIMING THE NIPPLE TOWARDS THE BABY’S PALATE AND HIS LOWER LIP WELL BELOW THE NIPPLE
  15. 15. SIGNS OF GOOD ATTACHMENT • MORE AREOLA IS VISIBLE ABOVE THE BABY’S MOUTH THAN BELOW IT • BABY’S MOUTH IS WIDE OPEN • BABY’S LOWER LIP IS TURNED OUTWARDS • BABY’S CHIN IS TOUCHING THE BREAST
  16. 16. EFFECTIVE SUCKING • Infant takes several slow deep sucks followed by swallowing and then pauses INEFFECTIVE SUCKING • Infant suckles for a short time but tires out and is unable to continue for long enough
  17. 17. • Frequent feedings 8-12 times daily. • Intermittent episodes of rhythmic suckling with audible swallows should be heard while the infant is nursing. • Infant should have about 6-8 wet diapers in a 24 hour period once breast feeding is established. • Infant should have minimum of 3-4 bowel movements every 24 hours. • Stools should be soft and yellow after day 3. • Average daily weight gain of 15-30g. • Infant has regained birth weight by 10th day of life. SIGNS OF EFFECTIVE BREAST FEEDING
  18. 18. 1. Complete nutrition- • contains most suitable protein and fat rich in essential fatty acids- linoleic acid and linolenic acid • More lactose than other milk • Offers enough vitamins, iron and water and has correct proportion of salt, calcium and phosphate. • Special enzyme ‘lipase’- helps in proper digestion of fat ADVANTAGES OF BREASTFEEDING TO CHILD
  19. 19. 2. Cover Against Infection- Has anti-infective factors- • Immunoglobulins (IgA) • Lactoferrin • Lysosymes • Cells (T & B lymphocytes) • Antiviral factor ADVANTAGES OF BREASTFEEDING TO CHILD
  20. 20. 1. Convenient 2. Cheaper than artificial milk 3. Helps in expulsion of placenta & minimizes risk of PPH 4. Calming effect 5. Contour of body come back to normal ADVANTAGES OF BREASTFEEDING TO MOTHER
  21. 21. 1. Develop a close loving bond 2. Child spacing 3. Cost benefits ADVANTAGES TO BOTH MOTHER AND CHILD
  22. 22.  Lack of confidence in mother  Belief that breast milk is not sufficient  Lack of adequate support system  History of previous breast surgery  Breast engorgement, crackled and sore nipples.  Embarrassment by mother  Chronic illness in mother; psychosis, cancer BARRIERS TO EFFECTIVE BREAST FEEDING
  23. 23. • HIV infection • Active Tuberculosis • Herpes lesions on mother’s breast • Infant with inborn error of metabolism, phenylketouria should not be breastfed. • Mothers on certain medications; anticancer therapy, radioactive isotope, etc.- Feeding is withheld for the period the mother is on the drug. She can express and discard the feed. After cessation of the medication. CONTRAINDICATIONS TO BREAST FEEDING
  24. 24. ISSUES IN BREASTFEEDING • INVERTED/FLAT NIPPLES • SORE NIPPLES • BREAST ENGORGEMENT • BREAST ABSCESS • NOT ENOUGH MILK
  25. 25. INVERTED/FLAT NIPPLES • Flat or short nipples which protract(become prominent or pull out easily) do not cause difficulty in breastfeeding • Inverted or retract nipples make attachment to breast difficult • Should be diagnosed in antenatal period
  26. 26. • Treatment is started after the birth • Nipple is manually stretched and rolled out several times a day • Stimulate nipple before feeding and shaping breast by supporting underneath with the fingers and pressing above with the thumb • A plastic syringe is used to draw out the nipple before putting the baby to breast
  27. 27. FLAT / INVERTED NIPPLES
  28. 28. SORE NIPPLES • caused by incorrect attachment of the baby to the breast • A baby who sucks only at nipples does not enough milk so he sucks more vigorously resulting in sore nipple • Pain during feeding and fissures or cracks on nipple
  29. 29. • Frequent washing with soap and water and pulling the baby off the breast while he is still sucking • Fungal infection after few weeks causes sore nipples TREATMENT  Correct positioning Correct attachment Hind milk applied to the nipple after feed Nipples should be allowed to heal between feeds
  30. 30. BREAST ENGORGEMENT • if feeding delayed, infrequent or the baby is not well positioned at the breast, the milk accumulates in the alveoli • As milk production increases, the amount of milk in the breast exceeds the capacity of the alveoli to store it • Breast becomes swollen, hard, warm and painful
  31. 31. TREATMENT  Early and frequent feeding Correct attachment Local warm water packs for not more than 15 minutes  PCM to relieve pain Gently express milk to soften the breast
  32. 32. BREAST ABSCESS • If conditions like engorged breast, cracked nipples, blocked duct or mastitis are not treated breast abscess develops • High grade fever and tenderness in breast TREATMENT  analgesic , antiboitics Abscess must be incised & drained Breastfeeding continued on other breast
  33. 33. BREAST ABSCESS
  34. 34. NOT ENOUGH MILK • Mothers often complains • Reassurance and psychological support only if baby is gaining weight and passing adequate amount of urine • CAUSES- not breastfeeding frequently, too short or hurried breastfeeds, poor position, breast engorgement or mastitis
  35. 35. TREATMENT  Proper attachment Treat painful condition Increase fluid intake Massage breast Back massage stimulate lactation (15-30 minutes, 3-4 times a day) Metoclopramide or Domperidone may be useful

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