SHORT DESCRIPTION ABOUT BREASTFEEDING BY DR. ANAND SINGH BHADORIYA (MBBS)

1. Dr. Anand Singh Bhadoriya
MBBS (GRMC, GWALIOR)
“Breastfed Infants are
Healthy Infants”

2. INTRODUCTION
Breast milk is the best food for a newborn
baby
It provides all the essential nutrients
necessary for growth & development of the
newborn infant
WHO recommends exclusive breastfeeding for
THE FIRST SIX MONTHS OF LIFE
Yet, to be successful in breastfeeding, women
need practical help & support from all
quarters, like family, community & health care
professionals

3. LACTATION: Anatomy & Physiology
Structure of the Human Breast

4. Each breast contains about 20 lobes, each lobe
contains several lobules, each lobule contains
several alveoli, in which milk is produced
Milk production & secretion are responsive to the
Sucking Reflex and two major hormones –
prolactin & oxytocin
After production of milk in the alveolus, the milk
moves through the ducts & are stored in the
lactiferous sinus. When the infant attaches on
the breast, milk is expressed from the sinuses

5. SUCKING HORMONAL REFLEX ARC
Sucking Reflex Arc is a
hormonal positive
feedback mechanism
Sucking the breast by
an infant stimulates
the nipple; this sends
messages to the spinal
cord & then to the
brain

6. • More prolactin
secreted at night
• Secreted after feed
to produce next feed
• Suppresses
ovulation
The Prolactin reflex
Baby
sucking
Sensory Impulses
from nipple
Prolactin
in blood
Breast Milk Production

7. The Oxytocin reflex
Let-down Reflex
• Works before or during
feed to make milk flow
• Makes uterus contract
Baby
sucking
Sensory Impulses
from nipple
Oxytocin
in blood

8. How does the mother’s
confidence play part
Breast Milk Transfer
Thinks lovingly
of baby
CONFIDENCE
Sound of baby
Sight of baby
Smell/Cry of
baby
Pain
Worry
Stress
Doubt

9.  Colostrum:
 First Vaccine shot/ideal first Meal of the baby
 Thick golden yellow milk during first 3 days of
delivery
 More protein, more Secretory Ig’s
Human Milk
Species Specific and Baby Specific

10.  Pre-term Milk:
 More Energy/Protein/Fat/Sodium/Zinc/Anti infective Factors
and Macrophages
 Lower lactose/calcium and phosphorous
 Fore-Milk:
 Start of the feeding, rich in protein, sugar, vitamins, minerals
and water.
 Hind-Milk:
 End of the feeding, rich in fats and more energy. For satiety
Human Milk
Species Specific and Baby Specific(Contd.)

11. Global and National Recommendations
for Infant and Young Child Feeding
 Initiate breastfeeding
within one hour of birth
 Exclusive breastfeeding
for first 6 months of life
 Introduce nutritionally
adequate and safe
complementary foods
after the infant reaches 6
months of age
 Continue to breastfeed
for 2 years or beyond.

12. What is Exclusive Breastfeeding?
 Giving an infant only
breastmilk upto 6
months of age.
 No food or drink other
than breastmilk— not
even water
 No Ghutti/Honey/Gripe
water/Baboolin etc.
 Medications/Vitamines
if prescribe.

13.  Complete food for the first six months
 Perfect nutrition
 GI function
 Prevents infections
 Higher IQ
 Emotional bonding
 Prevents chronic diseases
 Easily digested(Whey protein & Lact albumin..)
Benefits to the Baby

14.  Breastfeeding:
i) Reduce the risk of death due to Diarrhea
by 14 times
ii) ARI by 4 times
iii) Other infections by 3 times
iv) Decreases risk of NEC & Ac. Otitis media
Benefits to the Baby(Contd.)

15.  Prevents Chronic diseases
Obesity
Cancers
Adult coronary heart disease
Allergy Condition
Diabetes Mellitus-I
IBD
Benefits to the Baby (Contd.)

16.  Reduces post delivery bleeding and anemia
 Helps delay next pregnancy
 Protective effect against breast and ovarian cancer
 Reduce risk of Osteoporosis.
 Helps to loose weight
 Emotional bonding
 Needs no preparation
Benefits to the Mother

17.  Saves Money
 Promotes Family Planning
 Decreased need for Hospitalization
 Contributes to Child Survival
Benefits to the Society

18. First year is critical!
Malnutrition strikes the most in infancy beginning in 3-4th month ,
29-30 % at 6 months, goes up and peaks about 46% by 18 months,
flat curve after that (NFHS 3).
Years of life
Brain development
Underweight (-2sd) NFHS-3
Over 60 million
10 lakh children
die during
first month,
14 lakhs by
1 year, and 20 lakhs
by 5 yrs. 2/3rd are related to poor feeding.

19. U-5 deaths reduction by preventive
Interventions
Source: Jones et al. LANCET 2003;362:65-71
0% 2% 4% 6% 8% 10% 12% 14% 16% 18%
Breastfeeding
Complementary feeding
Clean delivery
Hib vaccine
Clean water, sanitation, hygiene
Zinc
Vitamin A
Antenatal steroids
Newborn temperature management
Tetanus toxoid
Antibiotics for PRM
Measles vaccine
Nivirapine and replacement feeding
Insecticide-treated materials
Antimalarial IPT in pregnancy
Intervention
Percent
Breastfeeding is
defined as exclusive
breastfeeding for first
6 months and
continued
breastfeeding during
6-11 months

20. Major Hurdles
 Lack of family support
 Lack of support by health professionals
 Commercial influence
 Feeling of not enough milk among women
 The practice of introducing bottle feeds
specially to CS born babies during 1-2 days is
most important cause of Lactation failure.
Successful Breastfeeding…

21. Important Do’s
 Initiate breastfeeding as early as possible within one
hour of birth.
 Do not give the baby any prelacteal feeds
 No bottles, artificial teats or pacifiers
 Feeding on demand, Continue night feeds
 Breastfeed in a correct position
 Build mother’s confidence to sustain good milk supply
and alleviate feeling of not enough milk.
Successful Breastfeeding…

22. Successful Breastfeeding…
 Initiate Breastfeeding Within One Hour of Birth

23. Successful Breastfeeding…
 No Bottles, Artificial
Teats or Pacifiers for
Breastfeeding Infants
It leads to nipple
confusion

24. Build Mother’s Confidence
 During Antenatal Period
 During Natal Period
 During Postnatal Period
 Counslling- Positive
 Awareness, willingness, keenness & confidence on
mother are crucial for establishment of lactation.
 Active support to the mother, use of proper
technique should be given priority.
Successful Breastfeeding…

25.  Not true. Just a perception
 Reinstate mother’s confidence
 Consider adequate if:
1. Pass Urine 6-8 times in 24 Hr.
2. Goes to Sleep 2-3 Hr after the feed.
3. Gains weight @ 15 – 20 grams/kg/day.
The Feeling of “Not Enough Milk”

26.  Use of feeding bottles. Leads to nipple confusion
 Inexperienced mother
 Functional difficulty with the mother or the baby
 Lack of skilled support
Causes of Incorrect Attachment

27. 1. The baby’s head and body should be straight
2. The baby’s face should face mother’s breast.
3. The baby’s body should be closed to her body.
4. She should support baby’s whole body.
Good/Proper Position

28. Sucking Position: Good/Bad?

29. Sucking Position: Good/Bad?

30. Sucking Position
Bad Good

31. Sucking Position: Good/Bad?

32. Sucking Position
Good

33. Sucking Position: Good/Bad?

34. Sucking Position: Good/Bad?

35. Sucking Position
Bad Good

36. Signs of Correct Attachment
Mouth wide open
Lower lip is turned outward
Chin touching the breast
More areola visible above than below

37. Sucking Position and Attachment:
Good/Bad?
 Mouth is not wide open
 Chin is away from the
breast
 Baby is sucking only
nipple
 Most black portion of
the breast is outside the
baby’s mouth

38. Attachment:Good/Bad?

39. Attachment:Good/Bad?

40. Attachment: Good/Bad?

41. Attachment: Good/Bad?

42. Attachment
Good Good
Good
Bad

43. Attachment: Good/Bad?
 Mouth is not wide open
 Chin is away from the
breast
 Baby is sucking only
nipple
 Most black portion of
the breast is outside the
baby’s mouth
Bad Attachment

44.  Mother under Anti-Cancer Drugs
 Radiotherapy I131, Lithium Therapy
 Anti Thyroid Drug( except Propylthiouracil)
Contraindication

45.  The act prohibits advertising of IMS and feeding
bottles to public, free sampling, hospital
promotion and gifts or samples of IMS to health
workers.
 Violation of the act can lead to fine or
imprisonment
Infant Milk Substitutes(IMS), Feeding
Bottles and Infant Foods Act 1992

46. Complementary Feeding
When breast milk is no
longer enough to meet
the nutritional needs
of the infant,
complementary foods
should be added to the
diet of the child
Examples: soft cooked
mashed vegetables, soft
cooked rice, suji, dhal,
fruit juice, khichuri

47. Appropriate Complementary
Feeding
Timely: Additional food introduced when
need for energy and nutrients exceeds that
provided by BF
Adequate: Should provide sufficient
energy, protein, and micronutrients
Properly Fed: Active feeding method and
proper frequency according to age
Safe: Should be hygienically prepared,
stored and fed

48. Mash
Rice Curry
Mix
well
Airtight
pack
Boil in milk
/water for 5
min
Take out before spices/chilly
Add a little
Fried oil and sugar
Take 2
TSF
May add
6 to 9 mo: 2 to 3 times/day
9 to 12 mo: 3 to 4 times/day
Occasionally Fruits
COMPLEMENTARY FEEDING WITH HOME-MADE FOOD
Rice Dry fried Grounded : 6 parts
Dal Dry fried Grounded : 2 parts
Groundnut Dry fried Grounded : 1 parts
OR
Modified

49. Right Food for Infants
Begin breastfeeding within an hour
Exclusive breastfeeding for the first six months
Complementary feeding after six months
Continued breastfeeding for 2 years or beyond

50.  Strengthens the section regarding labeling
of infant foods, distribution of educational
materials and funding health workers and
their organizations for better
implementation and effective enforcement.
The IMS Amendment Act, 2003

51. Provide education about breastfeeding at first
prenatal visit
Physical exam should include breast exam
Ensure rooming-in after deliv
Ensure breastfeeding is started & established
before discharge after delivery
Observe at least a session of breastfeeding to ensure
it is done correctly
Staff should be well trained & willing to answer
questions mothers might have
Prenatal package should have literatures and
patient hand out that outlines benefit of
breastfeeding
Role of the Care Givers

52. India Manipur
Initiation of BF
within
1 hr
50.5% 65.4%
Exclusive
breastfeeding
57% 73.6%
Complementar
y Feeding at 6
months
49.6% 78.8%
Breastfeeding
for 6 to 23
months
10% 19.3%
NFHS-4

53.  Development of BREASTFEEDING support clinics/
Lactation management clinics in hospitals run by skilled/
trained counsellors
 Promoting BREASTFEEDING friendly PHCs/Private
clinics/hospitals supported by SKILLED staff.
 Building IYCF counselling as service in job profile of
workers
 Developing community led initiatives :Peer counselling
support groups
 Eliminate MISINFORMATION from media (International
Code)
 Establishing national and state level resource centers
Strategies

54. If I ever get a chance,
I would love to be
reborn,
just to have the ectasy
ofbeing
breastfed by the kindly
mother.

55. THANK YOU