breast feeding - baby's right

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BREAST FEEDING J.DASARATHA I/C DIVISION OF NEONATALOGY RDT CHILDREN’S HOSPITAL, BATHALAPALLI

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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

TRANSCRIPT

Page 1: Breast feeding - Baby's Right

BREAST FEEDING

J.DASARATHAI/C DIVISION OF NEONATALOGY

RDT CHILDREN’S HOSPITAL, BATHALAPALLI

Page 2: Breast feeding - Baby's Right

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..

Page 3: Breast feeding - Baby's Right

• 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

Page 4: Breast feeding - Baby's Right

Anatomy of breast

Page 5: Breast feeding - Baby's Right

Physiology of Lactation

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Page 7: Breast feeding - Baby's Right
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Murru Palu Bangaram

Page 10: Breast feeding - Baby's Right

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

Page 11: Breast feeding - Baby's Right

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

Page 12: Breast feeding - Baby's Right

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

Page 13: Breast feeding - Baby's Right

When ? AS SOON AS POSSIBLE.

• Strongly recomended during 1st hour after delivery

Page 14: Breast feeding - Baby's Right

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

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Page 16: Breast feeding - Baby's Right

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

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Baby’s hunger signs

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• Allow suckling until he/she spontaneously releases the nipple.

Page 19: Breast feeding - Baby's Right

How to take the baby off

• Insert a finger into the edge of the baby’s mouth until the suction is broken

Page 20: Breast feeding - Baby's Right

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

Page 21: Breast feeding - Baby's Right

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

Page 22: Breast feeding - Baby's Right

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

Page 23: Breast feeding - Baby's Right

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

Page 24: Breast feeding - Baby's Right

For how long ?

WHO recommendations :

Breastfeed exclusively up to 6 months and with complementary foods up to 2 years of years or beyond

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How to breastfeed?:

Skilled assistance

Page 26: Breast feeding - Baby's Right

Wash hands,Be comfortableRelaxe 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

Page 27: Breast feeding - Baby's Right

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

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Good latch-on

• Wide open mouth• Lower lip turned

outward• Chin to breast• More areola visible

above than below • No pain

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Good latch-on

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Usual positions:

• Changing positions help in prevention of mastitis.

Page 31: Breast feeding - Baby's Right

Special situations:

• TWINS: Foot ball position

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Premature Infant: Cross Cradle Hold

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All infants > 34 weeks to be breastfed• Less than 34 weeks– Give colostrum– Initiate NNS– Lactation aid (Drip method)– Few minutes of breast feeding

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Page 36: Breast feeding - Baby's Right

Hypotonic Baby

A baby with low muscle tone usually sucks better when the head and bottomare level, or close to it. Support your baby using pillows on your lap

Page 37: Breast feeding - Baby's Right

Hypertonic Baby

•Non Rhythmic sucking : Use Rocking chair & • Breast in quiet atmosphere•Cuddle and chat with the baby

extra chin support

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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

Page 39: Breast feeding - Baby's Right

Sitting

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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

Page 41: Breast feeding - Baby's Right

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

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Page 43: Breast feeding - Baby's Right

Caring for your breast

• After breast feeding express some breast milk onto nipples & areola to protect the skin

Page 44: Breast feeding - Baby's Right

Dificulties during breast-feeding

Page 45: Breast feeding - Baby's Right

FLAT AND INVERTED NIPPLES

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Solution

• Stimulate your nipple by rolling it between 2 fingers

• You can also use a syringe to pull it out

Page 47: Breast feeding - Baby's Right

CRACKS

• In the first weeks

• Can be an sign of

poor latch on

• Pain

Page 48: Breast feeding - Baby's Right

Solutions

• Reasses the latch – on & correct

• Spread a drop of hind milk on the nipple

• If still painful, EBM should be given

Page 49: Breast feeding - Baby's Right

ENGORGEMENT

• Breast become hard, swollen , sensitive and tight, dry and red skin

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• 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

Page 51: Breast feeding - Baby's Right

MASTITIS

• Bacterial infection of lactiferous glands

• RED, HOT and PAIN

• Sometimes fever and chills

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Solutions• Breastfeed more

frequently and change positions

• Warm and massage the breast before breastfeeding

• Antibiotics treatment

• No reason for giving up breast feeding

Page 53: Breast feeding - Baby's Right

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)

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Solutions

• Improve hygienic conditions

• Reasses latch-on• Apply an antifungical

cream • Analgesic if needed

Page 55: Breast feeding - Baby's Right

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

Page 56: Breast feeding - Baby's Right