The document discusses breastfeeding and lactation management. It describes the anatomy and physiology of lactation, including the production of milk in the alveoli and its movement through ducts. The suckling hormonal reflex arc is explained, involving signals sent to the brain and release of prolactin and oxytocin in response to suckling. Advantages of breastfeeding are enumerated, such as immunological benefits from antibodies and growth factors. Proper techniques are outlined for breastfeeding, positioning, attachment and burping the infant. Guidelines are provided around breastfeeding frequency, exclusive breastfeeding for 6 months, and assessing milk supply. The composition of breast milk changes from colostrum to transitional to mature milk. Reasons for
Breast feeding is one of the most important gift, support, bond, attachment provided between the Mother and the baby even after the delivery of the baby to maintain the normal physiology of the mother, baby, family, society and the nation. some of the aspects of breast feeding especially the importance of proper feeding techniques to initiate, sustain and make the breast feeding successful is mentioned here.
Breast feeding is one of the most important gift, support, bond, attachment provided between the Mother and the baby even after the delivery of the baby to maintain the normal physiology of the mother, baby, family, society and the nation. some of the aspects of breast feeding especially the importance of proper feeding techniques to initiate, sustain and make the breast feeding successful is mentioned here.
Breast feeding is the most important physiological process we need to maintain as is maintained by all other mammal to sustain the life with good health. The responsibility lies not only on the mother, but on all the people like the family, society, place of work, the nation. the mother and the child needs to get the support from the entire world to sustain breast feeding. In this aspect the role of every individual at different levels is mentioned here.
This presentation is related with the contents regarding breast feeding. It includes complete information about breast feeding including different pictures and beautifully designed.
This Lesson Plan is regarding Breast Feeding-Introduction, Definition, Anatomy of Breast, Physiology of Lactation, Hormones, Reflexes in the baby, Advantages, Contraindications, composition of Human Milk, the types of milk,Breast Feeding Positions,Breast Feeding Pattern, Good and Poor attachment of the baby.
This PPT is regarding Breast Feeding-Introduction, Definition, Anatomy of Breast, Physiology of Lactation, Hormones, Reflexes in the baby, Advantages, Contraindications, composition of Human Milk, the types of milk,Breast Feeding Positions,Breast Feeding Pattern, Good and Poor attachment of the baby.
Notes on nutritional needs of children & infantsBabitha Devu
There are various methods of feeding a child. Like breastfeeding, weaning & artificial feeding.
All the types of feeding which help to fulfill the nutritional need of a child as per the increase in age are elaborated in this presentation.
Breast feeding is the most important physiological process we need to maintain as is maintained by all other mammal to sustain the life with good health. The responsibility lies not only on the mother, but on all the people like the family, society, place of work, the nation. the mother and the child needs to get the support from the entire world to sustain breast feeding. In this aspect the role of every individual at different levels is mentioned here.
This presentation is related with the contents regarding breast feeding. It includes complete information about breast feeding including different pictures and beautifully designed.
This Lesson Plan is regarding Breast Feeding-Introduction, Definition, Anatomy of Breast, Physiology of Lactation, Hormones, Reflexes in the baby, Advantages, Contraindications, composition of Human Milk, the types of milk,Breast Feeding Positions,Breast Feeding Pattern, Good and Poor attachment of the baby.
This PPT is regarding Breast Feeding-Introduction, Definition, Anatomy of Breast, Physiology of Lactation, Hormones, Reflexes in the baby, Advantages, Contraindications, composition of Human Milk, the types of milk,Breast Feeding Positions,Breast Feeding Pattern, Good and Poor attachment of the baby.
Notes on nutritional needs of children & infantsBabitha Devu
There are various methods of feeding a child. Like breastfeeding, weaning & artificial feeding.
All the types of feeding which help to fulfill the nutritional need of a child as per the increase in age are elaborated in this presentation.
When it comes to good positions to use while breastfeeding, your comfort as well as the ease with which your baby will be able to feed is the first and foremost concern. Finding a position that you are most comfortable and happy with will make it easier for your baby to latch on to your breasts and feed with ease. Here are some of the best breast-feeding positions that you might use when you are breastfeeding.
advantages, anatomy, physiology of lactation, composition of breast milk, techniques of Breastfeeding, contraindications, alternatives to breastfeeding, myths about breastfeeding, problems in breastfeeding and managements, public health concerns of Breastfeeding
skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender
3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender
3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender
3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender
3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender
3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, bec
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
5. • Each breast contains about 20
lobes, each lobes contains
several lobules which at the end
have alveolar in which milk is
produced.
• After production of milk in the
alveolus, the milk moves through
the ducts and are stored in the
lactiferous sinus.
• When the infant latches on the
breast, milk is expressed from the
sinuses.
7. Suckling Hormonal Reflex Arc
Source: Lactation Education Program Nutrition Policy and Education
• The sucking stimulates the nipple; this
sends messages to the spinal cord and
subsequently to the brain.
• Prolactin is released from the anterior
pituitary for milk production and oxytocin
from the posterior pituitary for the milk
let down.
• Prolactin receptors are established
within the first eight days of delivery.
• Suckling at breast increases prolactin
levels, so at each feeding, levels rise,
hence more milk production.
8. Reflexes that help in breast feeding
• Rooting reflex
• Sucking reflex
• Swallowing reflex
• Sucking and swallowing is coordinated by
34 weeks of gestation
• Prolactin refelx: milk production
• Let down reflex( Oxytocin reflex)
9. Advantages of breast feed
1. Optimum fluidity and warmth
2. Economical
3. Convenient: no need to carry utensils
4. Physiological: sweetest milk with high
lactose and digestible protein, lipids rich
in EFA, long chain PUFA
10. 5. Biochemically: superior
• Protein is mostly whey (80%) rich in lactalbumin and
lactoferrin and the rest is casein(20%).
• Lactoferrin is bacteriosataic and ensures iron and
zinc absorption.
• Alpha casein and lactglobulin which are allergens are
absent in human milk.
• Rich in binding proteins of thyroxin, B12, vitamin D etc.
• Calcium to phosphorous ratio is more than 2 and
ensures calcium absorption.
11. 6. Microbiologically:
Sterile and less chance of contamination
Lactoferrin bacteriostatic and inhibits E coli; binds iron and
makes it unavailable to Ecoli
Peroxidases and lipases kill bacteria
Bile salt stimulated lipase (BSSL) kills amoeba and giardia
PABA is important in protection against malaria
Transfer maternal antibodies
Bifidus bacteria and acidic ph associated with human milk
lead to colonization by Lacto bacilli
12. 7. Immunological:
• Supplies passive immunity
• Macrophages, lysozymes and complement offer
immunity to baby
• Supplies acute phase reactants
• Contains immunoglobulin, secretory IgA(SIgA)
• SIgA are produced mamary gland by plasma cell that
originate from immunocompetent lymphoid tissue ( gut
associated lymphoid tissue, bronchus associated
lymphoid tissue by virtue of enteromamary and
bronchomamary axes)
• Bioactive factors: milk are proteins like lactoferrin,
enzymes, hormones, growth factors, mucins, probiotic
substances and polyamines
13. 8. Psychologically: Emotional stabilty, mother infant
feeding
9. Mental growth: Breast fed have higher IQ than those
with other milks
10. Maternal benefits:
• decreases post partum bleed,
• involution of uterus,
• burn off extra fat that has accumulated during pregnancy
decreases breast and ovarian carcinoma
• Natural birth spacing
11. Epidemiologically: breast feed baby is 14 times less
likely to die from diarrhea, 4 times less likely to die from
respiratory disease, 2.5 times less likely from other
infections.
14. Preparing mother for breast feed
• Antenatal:
• Motivation and care
• Last trimester: examine breast and nipples for
retracted and cracked nipples-oiling, massaging and
suction: “inverted syringe technique
• Nutrition to pregnant: 300kcal and 15 gm protein extra
• Nutrition to lactating mother: 400-500kcal/ 25gm protein
15. Identify high risk mother
1. Primipara mother
2. Breast feeding problem in previous pregnancy
3. Breast problems: retracted nipple
4. Mother who has not been motivated
16. Initiation of breast feed
• Put to breast within half an hour after normal delivery
• Prelacteal feeds( eg water honey etc) should not be
given
• Soon after birth, baby is awake, alert and biologically
ready to breast feed -initiation of breast feed is very
easy. Later on baby goes to sleep
• Breast feed can be initiated when mother is sedated or
on IV fluids
• In 2-4 days small quantity of colostrum(10-40ml) is
secreted that is what baby needs
17. Ensure mother infant bonding
• Rooming in: keeping mother and baby in same room
• Bedding in: keeping mother and baby in same bed
• Mothering in: keeping baby on abdomen of the mother
• Skin to skin contact helps to maintain the body
temperatures, reduce risk of hypoglycemia, enhance
oxytocin release and beneficial nutrition with intake of
colostrum
• Skin to skin contact should occur for about 1-2 hours
after delivery.
• Procedures after delivery like weighing, administration
of vitamin K, eye prophylaxis and other procedures
should be delayed
18. Technique of Breast-Feeding:
1. Breast should be cleansed every day when the mother
takes a shower, otherwise breast is washed with plain
water and dries thoroughly.
2. Mother’s clothes should not be tight over the breast
and clean.
3. The mother should wash hand thoroughly before
nursing her infant.
4. The infant should be hungry, dry and warm.
5. The mother should be in comfortable position either in
sitting or lying position (support feet in sitting position).
19. 6. Positioning of infant:
• Baby’s head and body straight
• Baby’s body turned towards mother, nose opposite the
nipple
• Baby’s body touching mother’s abdomen
• Baby’s whole body well supported, not just neck or
shoulder’s
20. • The mother should support her breast; she can cup her
breast with her hand from underneath using four fingers
underneath and well behind the areola. Her thumb should
be resting on the top of her breast ”C-hold”.
correct breast support Incorrect breast support
21. 8. Rub the nipple or a finger gently against the infant’s cheek or
lips to stimulate “rooting reflex”.
• Touch the infant’s lip with the nipple to evoke oral searching
reflex where the infant opens his mouth widely and thrusts the
tongue forward and hold the nipple and apart of the areola
(depending on the size of the areola, if it is small it will
disappear, if it is large, a large part will be visible). This is what
is called “latch on”. Remember that the infant who should come
to the breast, not the breast to the infant.
Fig “Latch on”
22. 10. Proper attachment:
• Baby’s chin touching breast
• Mouth is wide open and tongue is under lactiferous
sinus and nipple against palate
• Lower lip turned outwards
• More areola is visible above baby’s mouth than below it
• No pain while breastfeeding
Effective suckling
• Cheeks are full, not hollow
• Regular slow, deeps suck
23. 11. No need to press the breast away from the infant’s
nostrils with finger. If the infant is well positioned and
well attached, he will be able to breathe through the
sides of the nostrils.
12. The common used “scissor” position (V-hold) of the
fingers may pull the breast out of his mouth. Mother
can cup her breast with her hand from underneath (C-
hold)
No position can be labeled “ideal”, the important thing is
that the mother is relaxed and can hold her infant close
to her breast comfortably for the time it takes.
24. 13. How often and for how long:
• Self-demand method is the key
• It also means letting the infant finish a feed and come
off the breast spontaneously.
• All newborn infants need some night feeds, the breast
feeding hormones help mothers go back to sleep
quickly after a feed, therefore, rooming in is very
important.
• Infants have different feeding patterns where:
A. Some infants feed fast, others slowly. Some
infants feed in spurt with rests in between, others
feed more steadily.
B. Some may need to feed as many as 10-15 times
or as few as 6-8 times within 24 hours.
C. Some infants feed on both breasts, others on
one breast only.
25. – Hold infant close to his mother’s body, tummy against
tummy and the infant facing the breast, so that he doesn’t
have to turn the head to feed.
– The infant’s nose should be level with nipple and he will tilt
his head back a little.
– In some positions, the infant’s bottom is supported with
mother’s hand (sitting, vertical and horizontal position). In
other position, she can support the head gently with her
hand.
– The classical feeding positions
1. Cradle position.
2. Cross cradle position.
3. Foot-ball hold.
4. Horizontal position.
5. Back wards position.
6. Position for two babies.
27. 14. Burping after feed
• Babies tend to take a lot of air during feeding which may lead to
abdominal distention, colic, regurgitation.
• Baby is put on shoulder head supported & gently pat on back
• Eructate the infant 1-2 times during and once at the end of the
feed.
• Regurgitation of 5-15 cc of milk when eructated or after feeding
is normal.
28. 15. When nursing is completed, the infant should be placed
in a crib on his right side or in prone position to facilitate
emptying if the stomach.
29. How often to breast feed
• Exclusive demand feeding
• Practice frequent breast feed initially and allow self regulation
by baby
• Exclusive breast-feeding: It means that no food or drink other
than breast-feeding is offered to breast-feeding baby up to 6
months and he/she is fed on demand, day and night, with no
restriction on the length or frequency of breast feeding.
• There is no need to give water or fruit juice in between while
baby is on exclusive demand feed
30. How to know whether breast milk is
sufficient or not?
• Is the baby resting or sleeping for 1-2 hours after
feeding?
• Passing urine frequently?
• Stool 1-6 episode stool per day?
• Baby gaining weight?
31. Signs of Effective Breastfeeding
• Frequent feedings 8-12 times daily.
• Intermittent episodes of rhythmic sucking 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 about one tablespoon or larger and should
be soft and yellow after day 3.
• Average daily weight gain of 15 -30g.
• Infant has regained birth weight by day 10 of life.
32. How long to breast feed
Should be continued well into second year of life; the period
of maximum brain growth and myelination
After 4-6 months weaning food should be offered in
addition to breast feed
34. Contraindications to breast feed
• Rare
• Congenital lactose intolerance
• Galactosemia
• Drugs: antimalignant drugs, antithyroid,
antipsychotic (lithium)
• Temporary contraindication: secondary
lactose intolerance, breast milk jaundice
35. Composition of breast milk
• Varies at different stages after birth to suit
needs of the baby
36. Types and Composition of Human Breast
Milk
• Types of Breast Milk:
• Colostrum or Early Milk
• Transitional Milk
• Mature Milk
37. Colostrum
• Colostrum or Early Milk is produced in the late stage of
pregnancy till 4 days after delivery; and is rich in antibodies.
• Yellow and thick
• Contains more antibodies and high amount of vitamins( A D E
K)
• Volume: 10 to 40ml
The perfect match: quantity of colostrum per feed and the newborn
stomach capacity
38. • Transitional milk:
Produced from day 4 – 10 is lower in protein in comparison to
Colostrum.
Following two weeks of delivery
Immunoglobulin and protein content decreases
Fat and sugar content increases
• Mature milk:
Mature milk is produced from approximately ten days after
delivery up until the termination of the breastfeeding.
It is thinner watery
But contains all nutrient essential for optimal growth
39. • Preterm milk:
Contains more proteins, sodium, iron, immunoglobulin
More calories
• Fore milk:
Secreted at start of milk
Watery and rich in proteins, sugar, vitamins, mineral
Water satisfy thirst
• Hind milk:
Richer in fat content
Provides more energy and satisfies hunger
40. Protein composition of human colostrum
and mature breast milk (per litre)
Constituent Measure Colostrum
(1-5 days)
Mature Milk
(>30 days)
Total protein G 23 9-10.5
Casein mg 1400 1870
α-Lactalbumin mg 2180 1610
Lactoferrin mg 3300 1670
IgA mg 3640 1420
From: Worthington-Roberts B, Williams SR. Nutrition in Pregnancy and Lactation, 5th ed. St. Louis,
MO, Times Mirror/Mosby College Publishing, p. 350, 1993.
41. Decreased frequency or effectiveness of suckling
Decreased amount of milk removed from breasts
Delayed milk production or reduced milk supply
Some infants have difficulty attaching to breast if formula
given by bottle
Impact of routine formula supplementation
Slide 4.6.4
42. Reason for Supplementation
• Birth weight < 1500 g or GA < 32 weeks
• Severe hypoglycemia
• Acute water loss
• Hyperbilirubinemia related to poor intake
• Delayed bowel movement or dark stools at day 5
• Delayed milk production
• Weight loss >8% of birth weight.
43. Problems encountered in breast-
feeding:
1. Breast engorgement
2. Nipple trauma
3. Inverted nipple
4. soreness of the nipple
5. Mastitis
6. Breast abscess
7. Prematurity of infants.
8. Cleft lip & Cleft palate
9. Cardiac diseases.
10. Jaundice.