Post on 21-Aug-2014
description
transcript
BREAST FEEDING
J.DASARATHAI/C DIVISION OF NEONATALOGY
RDT CHILDREN’S HOSPITAL, BATHALAPALLI
Why to breastfeed?Breastmilk:• Is the most appropiate and
natural food for the baby.• It adapts to the baby’s needs.
Even if baby is premature. Protects the baby against
infections : diarrhoea, bronchitis, pneumonia & immunological problems: allergies,diabetes..
• Favours utrine involution
and reduces the risk of PPH
• Reduces of uterine, ovarian & breast cancer
• Lactational amenorrhea helps in family planning
• Saves money and decreases the need for medical consultancies and drugs
Anatomy of breast
Physiology of Lactation
Murru Palu Bangaram
Colostrum• Contains a large
amount of proteins and vitamins, apart of many more inmmunoglobulins
• Even in small amounts it is enough to feed the newborn baby
Transitional milk: 3rd and 10th day post-partum
Mature milk: It’s composition changes during the course of the same feeding:
Fore milk: more proteins, lactose, water and
vitamins Hind milk: more creamy rich in fats and calories
Breastmilk contains:Anti infective factors Minerals
Anti-cancer Probiotics
Growth factors Prebiotics
Enzymes Fats
Hormones DHA/ARA
Anti-viruses Protein
Anti-allergies Water
Anti-parasites Vitamins
When ? AS SOON AS POSSIBLE.
• Strongly recomended during 1st hour after delivery
Skin to skin promotes a close bond between mother & baby
• Skin to skin in the 1st hour increases the production of Oxytocin
• Oxytocin is also called the love hormone
• This hormone promotes bonding & affection
How often do it?:
• Breastfeeding must be on demand
• Atleast 8 times a day
• Babies feed with different frequencies and take different amounts of milk at each feed
• No timetable for breastfeeding
Baby’s hunger signs
• Allow suckling until he/she spontaneously releases the nipple.
How to take the baby off
• Insert a finger into the edge of the baby’s mouth until the suction is broken
Warning signs:
• Staying on breast more than one half hour for every feed
• Wanting to feed more often than every 1–1½ hours each time
Poor attachment should be suspected
How to know if your baby is getting enough Breast milk
• You feel : your breast being pulled with NO PAIN• You hear : your baby swallowing• You see : a wide open mouth curled out lips chin pressed into your breast sucking and swallowing
Weight gain
• The new born may lose 7 % in the first 3 days• Should return to their birth weight by 10 days
of age• Should gain at least 20-35 grs a day in the first
3-4 months of age
Wet diapers
1 day At least 1 diaper 2 day At least 2 wet diapers
3 day Atleast 3 heavy diapers 4 day At least 4 heavy diapers
5-6 days At least 6 heavy wet diapers and older
For how long ?
WHO recommendations :
Breastfeed exclusively up to 6 months and with complementary foods up to 2 years of years or beyond
How to breastfeed?:
Skilled assistance
Wash hands,Be comfortableRelaxe your shoulders
• Head and body in straight line
• Whole body supported
• Nose to nipple• Tummy to tummy• Support your breast.
Thumb is on top and fingers are below the breast
How to achieve a good latch?:
• Nose to nipple so he has to open wide his mouth
• Draw the baby closer to the breast
• Covering the entire areola
Good latch-on
• Wide open mouth• Lower lip turned
outward• Chin to breast• More areola visible
above than below • No pain
Good latch-on
Usual positions:
• Changing positions help in prevention of mastitis.
Special situations:
• TWINS: Foot ball position
Premature Infant: Cross Cradle Hold
All infants > 34 weeks to be breastfed• Less than 34 weeks– Give colostrum– Initiate NNS– Lactation aid (Drip method)– Few minutes of breast feeding
Hypotonic Baby
A baby with low muscle tone usually sucks better when the head and bottomare level, or close to it. Support your baby using pillows on your lap
Hypertonic Baby
•Non Rhythmic sucking : Use Rocking chair & • Breast in quiet atmosphere•Cuddle and chat with the baby
extra chin support
Cleft Lip and Palate
• Cleft lip– Complete breastfeeding possible– Defect closed with a finger to create seal
• Cleft palate– Upright position, straddle position or modified
football position– Feed with a Palade expressed milk
Sitting
Maternal Illness
• HIV : Promote Exclusive breastfeeding unless AFASS criteria is met
• Hepatitis B : Breastfeed after Vaccine and or HepaB IV IG• Active Tuberculosis: Breastfeed along with
Chemo and BCG after stopping Chemo to baby
Expressing breast milk• Wash your hands• Use a clean glass or palada• Place your thumb and first
2 fingers outside the areola
• Push your fingers straight back towards your chest
• Gently compress your breast and roll fingers towards your nipple
Caring for your breast
• After breast feeding express some breast milk onto nipples & areola to protect the skin
Dificulties during breast-feeding
FLAT AND INVERTED NIPPLES
Solution
• Stimulate your nipple by rolling it between 2 fingers
• You can also use a syringe to pull it out
CRACKS
• In the first weeks
• Can be an sign of
poor latch on
• Pain
Solutions
• Reasses the latch – on & correct
• Spread a drop of hind milk on the nipple
• If still painful, EBM should be given
ENGORGEMENT
• Breast become hard, swollen , sensitive and tight, dry and red skin
• Breastfeed more frequently and change positions
• Warm and massage the breast before breastfeeding
After breastfeeding: Apply cold pads or clean cabbage leaves avoiding the nipples
Solutions
MASTITIS
• Bacterial infection of lactiferous glands
• RED, HOT and PAIN
• Sometimes fever and chills
Solutions• Breastfeed more
frequently and change positions
• Warm and massage the breast before breastfeeding
• Antibiotics treatment
• No reason for giving up breast feeding
Fungus
• Can affect your breast and baby’s mouth during breast feeding
• Your nipples are extremely itchy, burning, sore & wet
• The usual remedies for sore nipples aren’t working.
• Baby has oral thrush (white, cottage-cheese-like patches on the tongue and sides of the mouth)
Solutions
• Improve hygienic conditions
• Reasses latch-on• Apply an antifungical
cream • Analgesic if needed
THANK YOU
L atch on
A s soon as possible
T ummy to tummy
C olostrum is gold
H is/her Right
O n demand
N o to bottle