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Breast feeding - Baby's Right

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pictorial description of anatomy, physiology of lactation, neonatal reflex of rooting,suckling,swallowing, good attachment, good position, special situations, problems while breastfeeding

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Breast feeding - Baby's Right

  1. 1. BREAST FEEDING J.DASARATHA I/C DIVISION OF NEONATALOGY RDT CHILDREN’S HOSPITAL, BATHALAPALLI
  2. 2. 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..
  3. 3. • 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
  4. 4. Anatomy of breast
  5. 5. Physiology of Lactation
  6. 6. Murru Palu Bangaram
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. When ? AS SOON AS POSSIBLE. • Strongly recomended during 1st hour after delivery
  11. 11. 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
  12. 12. 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
  13. 13. Baby’s hunger signs
  14. 14. • Allow suckling until he/she spontaneously releases the nipple.
  15. 15. How to take the baby off • Insert a finger into the edge of the baby’s mouth until the suction is broken
  16. 16. 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
  17. 17. 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
  18. 18. 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
  19. 19. 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
  20. 20. For how long ? WHO recommendations : Breastfeed exclusively up to 6 months and with complementary foods up to 2 years of years or beyond
  21. 21. How to breastfeed?: Skilled assistance
  22. 22. Wash hands,Be comfortable Relaxe 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
  23. 23. 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
  24. 24. Good latch-on • Wide open mouth • Lower lip turned outward • Chin to breast • More areola visible above than below • No pain
  25. 25. Good latch-on
  26. 26. Usual positions: • Changing positions help in prevention of mastitis.
  27. 27. Special situations: • TWINS: Foot ball position
  28. 28. Premature Infant: Cross Cradle Hold
  29. 29. All infants > 34 weeks to be breastfed • Less than 34 weeks – Give colostrum – Initiate NNS – Lactation aid (Drip method) – Few minutes of breast feeding
  30. 30. Hypotonic Baby A baby with low muscle tone usually sucks better when the head and bottom are level, or close to it. Support your baby using pillows on your lap
  31. 31. Hypertonic Baby •Non Rhythmic sucking : Use Rocking chair & • Breast in quiet atmosphere •Cuddle and chat with the baby extra chin support
  32. 32. 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
  33. 33. Sitting
  34. 34. 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
  35. 35. 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
  36. 36. Caring for your breast • After breast feeding express some breast milk onto nipples & areola to protect the skin
  37. 37. Dificulties during breast-feeding
  38. 38. FLAT AND INVERTED NIPPLES
  39. 39. Solution • Stimulate your nipple by rolling it between 2 fingers • You can also use a syringe to pull it out
  40. 40. CRACKS • In the first weeks • Can be an sign of poor latch on • Pain
  41. 41. Solutions • Reasses the latch – on & correct • Spread a drop of hind milk on the nipple • If still painful, EBM should be given
  42. 42. ENGORGEMENT • Breast become hard, swollen , sensitive and tight, dry and red skin
  43. 43. • 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
  44. 44. MASTITIS • Bacterial infection of lactiferous glands • RED, HOT and PAIN • Sometimes fever and chills
  45. 45. Solutions • Breastfeed more frequently and change positions • Warm and massage the breast before breastfeeding • Antibiotics treatment • No reason for giving up breast feeding
  46. 46. 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)
  47. 47. Solutions • Improve hygienic conditions • Reasses latch-on • Apply an antifungical cream • Analgesic if needed
  48. 48. 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

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