BFeeding

BREASTFEEDING
Introduction
WHO and UNICEF’s global recommendations
for optimal infant feeding as set out in the Global
Strategy .
■ Exclusive breastfeeding for 6 months (180

days) then given nutritionally adequate and safe
complementary feeding starting from the age of
6 months with continued breastfeeding up to 2
years of age or beyond.
Introduction Cont.
■ After delivery ,lactation is established in the
breasts and the mother can start breastfeeding
the child.
■ Some secretory activity is present during
pregnancy and accelerated following delivery
■ Unlike other mammals, in humans milk is
secreted only by the end of the 2nd or 3rd day of
puerperium ,till then what is secreted is the
colostrum.
Colostrum
■ Deep yellow/serous fluid
■ Alkaline in reaction
■ Higher specific gravity/higher vit A/higher
protein/ NaCl (minerals)
■ Lower Carbo /fat /K+
■ Contains immunoglobulin- IgA,G,M
COLOSTRUM- contd
■ Microscopically
Fat globules
Colostrum corpuscles (large polynuclear leucocytes)
with lactalbumin /lactoglobulin
Acinar epithelial cells
■ Advantages
Laxative action
Antibodies provide immunity
■ Variations in composition :
⮚ Colostrum –antibodies and anti infective proteins,
white blood cells, baby's first immunization.
⮚ Mature milk-larger quantity than colostrum, ‘coming
in’-breasts feel full heavy and hard.
⮚ Foremilk –thin, proteins, lactose, water and other
nutrients.
⮚ Hindmilk –more fat therefore whiter, provides much of
the energy of a feed.
■ Colostrum and breast milk – a comparison
protein fat carbo Water
Colostrum 8.6 2.3 3.2 86
Mature 1.2 3.2 7.5 87

milk
HUMAN MILK
■ Milk is a suspension of fat and proteins in carbo-
mineral solution
■ opaque/slightly yellow
■ Slightly Alkaline
■ Sweetish
■ Characteristic odour
■ Specific gravity-1025-1035
■ Fluid portion- transudate containing sugar
,protein,milk ,salt and water
Contd-
■ Protein in milk is 1/3 casein and 2/3
lactalbumin
■ Sugar is lactose
■ Rich in minerals-calcium Phosphate
/potassium carbonate/NaCl/Fe LOW
■ All vitamins except vitamin K
■ Compliment/macrophage/ lc / lactoferrin/
lysozymes/EGF / prolactin
Factors affecting milk secretion
■ Diet
■ Hormones
■ Mental conditions
■ Drugs
■ Emotions
■ Age/parity/state of health of mother
Contd-
■ Most drugs the mother takes is secreted in
the milk.
■ Quantity= 600ml/day
When to start breast feeding?
■ As soon after a normal delivery
■ 1 hour after a cesarean section
Advantages of breast feeding
■ Ideal food (good nutrients ,immunological factors
,antibacterial properties ,promote cellular growth
,cognitive function improved)
■ Convenient
■ Sterile
■ Economical
■ Emotional bonding
■ Uterine involution fastened
PHYSIOLOGY OF LACTATION
4 stages
■ Mammogenesis (preparation of the breast)
■ Lactogenesis (synthesis and secretion from
the breast alveoli)
■ Galactokinesis (ejection of milk)
■ Galactopoiesis (maintenance of lactation)
MAMMOGENESIS
■ Growth of ducts and lobuloalveolar systems
■ Under influence of the hormones estrogen
and progesterone
■ Other hormones- cortisol ,HPL ,insulin,
■ Intact nerve supply is not essential for the
growth of mammary glands during
pregnancy
LACTOGENESIS
■ Following delivery there is a fall in the level
of estrogen and progesterone .
■ During pregnancy these hormones keep
the tissue unresponsive to the action of
prolactin.
■ Following delivery prolactin causes milk
secretion in an already well developed
mammary gland
Contd-
■ Secretion is increased by
GH/ thyroxine /insulin/ glucocorticoids
■ Nursing effort is not essential for milk
secretion.
GALACTOKINESIS
■ Depends not only on the suckling mechanism of
the baby but also by the contractile action which
will express milk from the alveoli into the ducts.
■ This contraction is brought about by the action of
Oxytocin
■ Milk let down reflex/milk ejection reflex
■ Inhibited by psychic condtn /pain /breast
engorgement
GALACTOPOIESIS
■ Prolactin is the hormone for maintenance of
lactation
■ And suckling is essential for maintenance
of milk secretion
■ Periodic breast feeding relieves pressure in
the ducts and promotes more secretion
Tips to improve lactation
■ Care of the breast /nipples during
pregnancy
■ Post natally frequent breast feeding
■ Avoid breast engorgement
■ Plenty of fluids
■ Good diet
To Improve Milk Supply
■ Breast feed as soon as possible
■ Breast feed often
■ Ensure proper latching
■ Use medications with caution
■ Avoid nicotine and alcohol
Cont.
■ Good health; ■ Care of the breast
■ Early and sufficient /nipples during
treatment of illnesses; pregnancy
■ Proper balance ■ Post nataly frequent
between rest and breast feeding
exercise; ■ Avoid breast
■ Freedom from worry engorgement
■ Plenty of fluids
■ Adequate nutrition.
SUPPRESSION OF LACTATION
INDICATIONS
■ Intrauterine death
■ Neonatal death
■ Mother do not want to breast feed
■ Contraindications for breast feeding (Hep
B/ infant with galactosemia / untreated TB /
breast cancer treatment / CMV / alcoholics-
drugs)
Contd-
Methods
■ Drugs
Bromocriptine(2.5mg BD for 2 weeks)
Cabergoline
Ethinyl estradiol(0.05mgTDS for 5 days)
■ Mechanical
Tight breast binder
Do not express milk
Cold compresses/analgesics
The reflexes that aid lactation
■ Rooting reflex.
■ Sucking reflex.
■ Swallowing reflex.
Positioning
Good positioning means:
■ Baby's head and body are in line
■ Baby held close to mothers body
■ Baby's whole body supported
■ Baby approaches breast nose to nipple.
Attachment
Good attachment means
■ More areola is seen above baby's top lip
■ Baby's mouth wide open
■ Lower lip turned outwards
■ Baby's chin touches the breast
Not enough milk?
■ Weight gain-500grams /month or
125grams/week
(Baby should regain birth weight in 10 days).
■ Wetness test- urinate 6 or more times in 24
hours,
■ Colorless or pale yellow urine-breast milk alone.
Solutions
■ Frequent feeds 3 hourly,
■ Longer duration of feeds,
■ Proper positioning and attachment,
■ Free from worry/stress
Problems- Maternal
■ Breast engorgment
■ Sore Nipples/ Nipple trauma
■ Infections- S. aureus, candidiasis
■ Plugged ducts
■ Galactocoele (from plugged ducts)
■ Mastitis
■ Breast abcess
Neonatal Problems
■ Dehydration
■ Jaundice-Breastfeeding vs Breastmilk
■ Reduced caloric intake
■ Lower immunity
ASSIGNEMENT
■ Read on the Breast feeding Initiative
■ It is a 10 step guideline put in place to
enforce breastfeeding and make it
conducive and easy for mothers to
breastfeed-including at the workplace.

BFeeding

Uploaded by

Copyright:

Available Formats

BFeeding

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

BFeeding

Uploaded by

Copyright:

Available Formats

BREASTFEEDING

■ Exclusive breastfeeding for 6 months (180

Colostrum 8.6 2.3 3.2 86

Mature 1.2 3.2 7.5 87

You might also like