Breastfeeding and complications


Published on

1 Comment
No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Breastfeeding and complications

  1. 1. Breast Feeding and itsassociated complications Dr. Varsha Atul Shah Senior Consultant Dept Of Neonatal and Developmental Medicine
  2. 2. Why Breastfeed?Literature is replete with scientific evidence on the benefit of the most natural process of a mother- breast feeding her babyExclusive breast feeding in the first six months of life can cut down under-five child mortality by 13-15%There could not be more compelling reasons for breastfeeding the baby.
  3. 3. AdvantagesBaby Mother Family
  4. 4. Advantages to the babyDecreased incidence of infections- diarrhea,RTI, otitis media, NE, late onset sepsis in pretermReduction of both Type I and II diabetes,leukemias, lymphomas, asthma and obesity.Enhances performance on cognitivedevelopment
  5. 5. Advantages to the motherInvolution of uterus and haemorrhagePostnatal amenorrhoeaDecrease risk of breast and ovarianmalignancyDecreased risk of hip fracture aftermenopause
  6. 6. Advantages to the familyReadily availableHygienicEconomicalKeeps children healthy
  7. 7. How is milk produced?Preparation of breast for milk productionProduction of milkLet down Reflex
  8. 8. The first few steps…..Proper antenatal counselingA well informed, supportive husbandRelative or nurse in the labour room
  9. 9. How Soon?
  10. 10. At The EarliestIn the healthy neonate suckling reflex is at its peak- 30 to 40 mins after birthEarly feeds stimulate production of prolactin and increases the mean duration of breast feeding
  11. 11. The first few steps…..Placed prone on the mother’s abdomenFeed in the 1st hr of delivery on the labour table itself
  12. 12. Breast Feeding In Operative DeliveryMaintain skin to skin contactBreast feeding within 1 hr when LSCS underspinal anesthesia; otherwise when the effectof GA weans off.Women should not have pain, as it decreasesproduction of milkPosition of baby is important
  14. 14. Latching – The Right TechniqueLatching on is the creation of a tight seal around nippleand most of the areola through baby‘s mouth.Ideally, baby’s lower lip should be covering more of theareola than the upper lip and nipple should not hurt afterfew min
  15. 15. Frequency And Length Of Breast FeedingExclusive breast feeding for 6 monthsOn an average 650 to 850 ml milk is producedper day.2 to 3 hourly or 8 feeds per day or feed ondemandDuration time is 25 to 30 min- both breastsshould be fed each time
  16. 16. The Right TechniqueBaby’s head should be always at a higherlevelCorrect latching onProper sucking and swallowingPost feed care of baby is important
  17. 17. Indicators Of Adequate FeedNo. of feeds each day (8 or on demand)If baby sleeps well for 2 to 3 hours after feedUrine output- 6 to 8 diapers per dayNo. of stools- 4 to 5 times per dayWeight gain- 30 gm per day
  18. 18. Care Of MotherCalorie intake- 300 to 500 extra calories ( 2200 to 3000 kcal per day)Balance diet and no weight reductionFluid intake : 22% from well balanced diet;increase fluid intake is essential but excessiveconsumption can result in reduction ofproduction of milk( Dusdiekor in 1994)Iron and Calcium Supplementation
  19. 19. Contra Indications For Breast FeedingMaternal: Acute febrile conditions and critically ill patients Breast abscess HIV +ve mother Open cases of pulmonary TB Anti thyroid drugs Anti cancer drugs Hepatitis A Following radio pharmaceuticals
  20. 20. Contra Indications For Breast Feeding (Contd….)For baby: Breast milk jaundice Cleft lip or palate Oromotor dysfunction Pre-maturity Under weight
  21. 21. GALACTOGOGUESThere is no ideal galactogogueChlorpromazine and metoclopromide- 10 mg 3 timesdaily for 7 daysGarlic, ginger, coconut, jaggery, ghee, panjeeri,saunth, khas-khas, bajra, pepper etc Self confidence, freedom from anxiety, soothing environment with vigorously sucking by an active baby are the most effective pre-requisites for successful establishment of lactation.
  22. 22. SUPPRESSIONEstrogenBromocriptinCabgolinThiazidePyridoxineOCPTestosterone
  23. 23. Lactation ComplaintsInsufficient Milk SyndromeRetracted nipplesSore nipplesBreast engorgementMastitisBreast abscessChoice of contraceptionProblem of working women
  24. 24. RETRACTED NIPPLEAntenatal examination and counseling for cleaningof nipples and their aversion is important20 cc syringe may also be used for correctingretractionNipple shieldUse of breast pump
  25. 25. SORE NIPPLECommonestCause improper latchingSymptoms: painSigns: nipple is red, cracked, bruised, blisteredand tenderTreatment: linolin/ emolient cream; air drying andapplying own milk, nipple shield for time being,EBM
  26. 26. ENGORGEMENTSwollen breast due to increasedmilk productionMaybe early or lateEarly engorgement resolves with baby suckingPainful, swollen, warm, hard or rigid breastsneeds treatmentTreatment: gentle massages, warm compresses,milk expression, breast support, oxytocics, NSAID
  27. 27. Mastitis And Breast AbscessPain, fullness, fever with or without chills,swollen, red, tender breastsTreatment: broad spectrum antibiotics, anti-inflammatory drugs, breast support,feeding to continue,Untreated or under-treated neglected casesmay lead to antibioma / abscess formation
  28. 28. Mastitis And Breast Abscess (cont.) Breast Abscess High fever with chills Localized, swollen, red, warm, tender, indurated mass with fluctuation Treatment is I&D and supportive therapy same as mastitis Breast feeding to be resumed as early as possible
  29. 29. Milk ExpressionManual or hand expressionVia pump: hand held pumps, mechanical, cylindrical,battery operated and semi operated pumpsMechanical, cylindrical pump is safe and easy to useand can be sterilized, cost effectiveSuction generated by battery operated pump can beregulated to suit the userEBM stays in good condition in room temp for 8 hrs;refrigerator 24 hrs or in the freezer at -20 degreecent for 3 months.
  32. 32. Electrical Breast PumpElectrical pumping is more effective in raisingmaternal prolactin levels and volumes of milk8 times expression in 24 hrs ( twice at nightand 1 in early morning) is required to keep upthe milk productionPumping both breasts simultaneouslyproduces more milk
  33. 33. Pacifier/ Dummies/ Soothers These should not be used within 4 weeks of age or until breastfeeding technique is fully established. It should not used to delay feeding
  34. 34. WEANING Aim is to introduce- iron, calcium, vitamins and calories to baby in adequate quantity throughliquid and semisolid diet from 4 to 6 months of age It should be done gradually
  35. 35. “The nature has designed the provision thatinfants be fed upon their mother’s milk. They find their food and mother at the same time.It’s a complete nourishment for them both for their body and soul” - Rabindranath Tagore
  36. 36. Breast Feeding and itsassociated complications
  37. 37. “The nature has designed the provision that infants be fed upon their mother’s milk. They find their food and mother at the same time.It’s a complete nourishment for them both for their body and soul”- Rabindranath Tagore