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breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
breast feeding problems
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breast feeding problems

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breast feeding problems can be easily tackled by obstetricians provided they make conscious efforts to look into the problem,they can create awareness among the paramedical people who are under their …

breast feeding problems can be easily tackled by obstetricians provided they make conscious efforts to look into the problem,they can create awareness among the paramedical people who are under their direct control

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  • 1. DR.VEERENDRAKUMAR C.M. MD.,DNB. Associate Professor VIMS,BELLARY
  • 2.  
  • 3.  
  • 4. PERFECT GIFT TO MANKIND <ul><li>PLACENTA- </li></ul><ul><li>INTRAUTERINE FETUS </li></ul><ul><li>COLOSTRUM- </li></ul><ul><li> EXTRAGESTATE FETUS </li></ul>
  • 5. Why emphasize on breast feeding? <ul><li>WHEN INDIAN WOMEN BREAST </li></ul><ul><li>FEED WITHOUT EXCEPTION! </li></ul>
  • 6. <ul><li>25% DO NOT INITIATE WITHIN 24 Hrs </li></ul><ul><li>50% DISCARD COLOSTRUM </li></ul><ul><li>75% GIVE PRELACTEAL FEEDS </li></ul><ul><li>MANY WOMEN BELIEVE THEY DO NOT </li></ul><ul><li>HAVE SUFFICIENT MILK &amp;INDULGE IN </li></ul><ul><li>TOP MILK FEEDING </li></ul>
  • 7. BREAST FEEDING promotion <ul><li>PRIMARY RESPONSIBILITY LIES WITH OBSTETRICIAN &amp; NOT THE PEDIATRICIAN ! </li></ul><ul><li>WOMAN BELIEVES MORE IN HER OBSTETRICIAN &amp; WE SHOULD NEVER FAIL HER IN EXCLUSIVE BREAST FEEDING </li></ul>
  • 8. <ul><li>It is a natural instinct , women take to breast feeding easily BUT </li></ul><ul><li>even with minor problem readily switch on to TOP feeding . </li></ul>
  • 9. Early Discontinuation <ul><li>Most women who stop breastfeeding prematurely do so in the first ten days. </li></ul><ul><li>To improve the duration of breastfeeding physicians must provide support during this critical early period. </li></ul>
  • 10. “ Not enough milk” <ul><li>Colostrum </li></ul><ul><ul><li>The newborn who cries loudly &amp; </li></ul></ul><ul><ul><li>sucks hard is getting enough to eat </li></ul></ul><ul><li>Elimination pattern after day 5 </li></ul><ul><ul><li>5 voids </li></ul></ul><ul><ul><li>2-3 stools </li></ul></ul>
  • 11. &nbsp;
  • 12. anatomy
  • 13. <ul><li>BREAST ENGORGEMENT </li></ul><ul><li>SORE/ CRACKED NIPPLE </li></ul><ul><li>INSUFFICIENT / NO MILK </li></ul><ul><li>RETRACTED NIPPLE/ inverted nipple </li></ul>
  • 14. BREAST ENGORGEMENT ENGORGED LYMPHATIC &amp; VENOUS CHANNELS AROUND THE ALVEOLI INCREASED ALVEOLAR PRESSURE FLATTENS EPITHELIUM &amp;BLOCKS THE DUCTS BREAST HARD &amp; PAINFUL
  • 15. BABY STRUGGLES &amp; TRAUMATIZES THE NIPPLES NO FURTHER BREAST FEEDING MASTITIS BREAST ABSCESS
  • 16. ANTENATAL BREAST EXAMINATION TEACH MOTHER HOW TO MANUALLY EXPRESS THE MILK BEFORE &amp; AFTER FEED EXPRESS THE MILK &amp; RENDER THE BREAST SOFT CORRECT POSITIONING
  • 17. &nbsp;
  • 18. &nbsp;
  • 19. &nbsp;
  • 20. Manual expression
  • 21. Manual expression
  • 22. <ul><li>BREAST SUPPORTING </li></ul><ul><li>ANALGESICS </li></ul><ul><li>ICE BAG </li></ul>
  • 23. SORE NIPPLE <ul><li>PORTAL OF ENTRY FOR PATHOGENIC ORGANISMS. </li></ul><ul><li>ANTENATAL EXAMINATON &amp; TREATMENT AVOIDS COMPLICATIONS </li></ul>
  • 24. <ul><li>EARLY SORE NIPPLE ALWAYS DUE </li></ul><ul><li>TO INCORRECT POSITIONING. </li></ul><ul><li>AVOID CRUST FORMATION </li></ul><ul><li>LOCAL HYGEINE </li></ul><ul><li>EXPOSE TO AIR ,application of breast milk or lanolin , USE NIPPLE SHIELD </li></ul>
  • 25. Retracted &amp; inverted nipple
  • 26. RETRACTED NIPPLE <ul><li>GENTLE MANUAL TEASING. </li></ul><ul><li>REVERSE SYRINGING EFFECTIVE </li></ul><ul><li>AGAIN ANTENATALLY CAN BE CORRECTED . </li></ul>
  • 27. MASTITIS &amp; ABSCESS
  • 28. MASTITIS &amp; ABSCESS <ul><li>BABY SOURCE OF INFECTION. </li></ul><ul><li>MORE LIKELY IN FISSURED NIPPLE. </li></ul><ul><li>STAPHYLOCOCCUS COMMONEST. </li></ul><ul><li>ANTIBIOTICS &amp; CONTINUED BREAST </li></ul><ul><li>FEEDING. </li></ul>
  • 29. <ul><li>DON’T WAIT TILL FLUCTUATION </li></ul><ul><li>APPEARS. </li></ul><ul><li>FAILURE TO RESPOND-SURGICAL </li></ul><ul><li>MANAGEMENT. </li></ul><ul><li>RECENTLY -USG GUIDED NEEDLE ASPIRATION </li></ul>
  • 30. INSUFFICIENT MILK &amp; LACTATION FAILURE <ul><li>A MYTH OR REALITY? </li></ul><ul><li>NO PARALLELS IN OTHER 4000 SPECIES. </li></ul><ul><li>THE PRICE WE PAY FOR CIVILIZATION ? </li></ul>
  • 31. Enhancing factors <ul><li>SUCKLING </li></ul><ul><li>SENSORY IMPULSES FROM NIPPLE </li></ul><ul><li>EMPTYING OF BREAST </li></ul><ul><li>NIGHT FEEDS </li></ul><ul><li>THINKING /SOUND/SIGHT OF BABY </li></ul><ul><li>CONFIDENCE </li></ul><ul><li>PROLACTIN &amp; OXYTOCIN </li></ul>
  • 32. Hindering factors <ul><li>PRELACTEALS, BOTTLE FEEDING. </li></ul><ul><li>INCORRECT POSITIONING. </li></ul><ul><li>PAINFUL BREAST CONDITIONS. </li></ul><ul><li>WORRY, STRESS , EMBARASSMENT. </li></ul><ul><li>DOUBT, NO SELF CONFIDENCE. </li></ul>
  • 33. LACTATION FAILURE PRIMARY HYPOPROLACTINEMIA SHEEHAN’S SYNDROME RETENTION OF PLACENTA HYPOPLASTIC BREASTS WRONG MANAGEMENT
  • 34. HOW TO OVERCOME? <ul><li>ANTENATAL PREPARATION </li></ul><ul><li>MATERNAL MOTIVATION </li></ul><ul><li>EARLY INITIATION </li></ul><ul><li>ROOMING IN </li></ul><ul><li>UNRESTRICTED DEMAND </li></ul><ul><li>FEEDING BOTH DAY,NIGHT </li></ul>
  • 35. <ul><li>BAN PRE LACTEAL FEEDS </li></ul><ul><li>LOOK FOR LOCAL OR SYSTEMIC </li></ul><ul><li>ILLNESS </li></ul><ul><li>EXCESSIVE CRY NOT ALWAYS DUE </li></ul><ul><li>TO INADEQUATE MILK </li></ul><ul><li>OBSERVE MOTHER-INFANT </li></ul><ul><li>COUPLE FOR PROPER TECHNIQUE </li></ul>
  • 36. Latching
  • 37. ROLE OF GALACTOGOGUE <ul><li>PLACEBOS TABLETS, TONICS </li></ul><ul><li>AYURVEDIC PREPARATIONS </li></ul><ul><li>DOPAMINE AGONISTS </li></ul><ul><li>BABY SUCKLING BREAST IN </li></ul><ul><li>CORRECT POSITION </li></ul>
  • 38. CONTRA INDICATIONS <ul><li>HIV .CMV, HBV INFECTION </li></ul><ul><li>ACTIVE TUBERCULOSIS </li></ul><ul><li>HERPETIC LESIONS ON BREAST </li></ul>
  • 39. &nbsp;
  • 40. &nbsp;

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