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Breastfeeding (CHILD HEALTH NURSING)

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BREASTFEEDING

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Breastfeeding (CHILD HEALTH NURSING)

  1. 1. BREASTFEEDING BY: Dinabandhu Barad Msc Tutor Dept. of child health nursing SNC, SOA, DTU
  2. 2. INTRODUCTION  Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breast via lactation rather then using infant formula from a baby bottle or container  Babies have sucking reflex that enables them to suck and swallow milk  Experts recommend that children be breastfed within one hour of birth, exclusively breastfed for the first 6 months, and the breast until age two.
  3. 3. WHERE AND HOW
  4. 4. WHERE AND HOW
  5. 5. PHYSIOLOGY The physiological basis of lactation is divided into four phases : 1. Preparation of breasts (mammogenesis). 2. Synthesis and secretion from the breast alveoli (lacto genesis). 3. Ejection of milk (galactokinesis). 4. Maintenance of lactation (galactopoiesis).
  6. 6. MAMMOGENESIS Mammogenesis is the process of growth and development of the mammary gland in preparation for milk production. This process begins when the mammary gland is exposed to estrogen at puberty and is completed during the third trimester of pregnancy.
  7. 7. LACTOGENESIS 1. Begins when estrogen and progesterone are withdrawn following delivery, 2. Prolactin begins its milk secretary activity 3. The secretary activity is enhanced growth hormone, thyroxine, glucocorticoids and insulin. 4. Milk secretion actually starts on 3rd or 4th postpartum day
  8. 8. GALACTOKINESIS MILK LET DOWN REFLEX Discharge of milk from the mammary glands depends not only on the suction exerted by the baby during sucking but also on the contractive mechanism which expresses the milk from the alveoli into the ducts.
  9. 9. HOW IT HAPPENS
  10. 10. GALACTOPOEISIS Prolactin appears to be the single most important galactopoietics hormone. For maintenance of effective and continuous lactation, suckling is essential.
  11. 11. MILK PRODUCTION A healthy mother may produce about 500-800 ml of milk a day to feed her infant with about 500 kcal /day
  12. 12. REFLEXES IN THE BABY 1. The rooting reflex 2. The suckling reflex 3. The swallowing reflex
  13. 13. FACTORS WHICH LESSEN MILK PRODUCTION  Dummies, pacifiers, bottles-even one or two feeds.  Making the baby wait for feeds.  Giving feeds like sugar water gripe water, honey, breast milk substitutes or formula, either as pre-lacteal feeds or at anytime.  Certain medications for mothers like oral contraceptives or methergine.  Painful breast conditions like sore or cracked nipples & congested breast.
  14. 14. DRUGS TO IMPROVE MILK PRODUCTION Metclopramide (10 mg thrice daily) Increases the blood volume by increasing prolactin level. Intranasal oxytocin contracts myoepithelial cells and causes milk let down
  15. 15. COMPOSITION OF BREASTFEEDING
  16. 16. COMPOSITION COLOSTRUM :  Is the secretion of breast during the later part of pregnancy & for 2-4 days after delivery  It has deep lemon yellow colour as it contain several times the protein of mature breast milk but less fat & more minerals.  It has important immunological factors (antibodies - IgA)  It’s alkaline in nature
  17. 17. COMPOSITION TRANSITIONAL MILK During the next two weeks, the milk increases in quantity and changes in appearance and composition and this is called transitional milk. The immunoglobin and protein content decreases while the fat and sugar content increases. MATURE MILK The milk which replaces the transitional milk after 2 weeks of lactation
  18. 18. DIFFERENCES DIFFERENCES BETWEEN COW'S MILK AND BREAST MILK 1. Both contain equal amounts of water. 2. The energy contents are equal approximately 20Kcal/kg/oz ,as 1oz=30 ml of milk 3. Protein : Cow milk contains higher protein approximately 3 folds, its contents of casein is about 6 folds , while the human milk protein is mainly whey protein (lactalbumin & lactglobulin ) but 30% casein . 4. Carbohydrates: Human milk 7% which is lactose while cow milk is 4.5% . 5. Fat: Contents are almost equal but there is qualitative differences ,as both containing triglycerides (olein ,palmitin & stearin ) but human milk contain twice of the more absorbable olein .
  19. 19. DIFFERENCES DIFFERENCES BETWEEN COW'S MILK AND BREAST MILK 6. Minerals: Cow milk contains much more of all the minerals except iron &copper &although breast milk iron is low but better absorbed (bioavailable) and the infant will depend on the iron stores in the first 4-6 months . 7. Vitamins: Both has large amount of vitamin A, cow milk has low vitamin C & D ,also human milk has low vitamin D and depends largely on the maternal nutrition and sun exposure .both milk contains adequate amount of vitamin B complex so breast fed infants should receive the daily requirements of vitamin D which is 400 I.U / day .
  20. 20. DIFFERENCES DIFFERENCES BETWEEN COW MILK, FORUMULA MILKAND BREAST MILK BREAST MILK COW MILK FORMULA MILK WATER Enough Extra needed May need extra ENERGY Equal Equal Equal PROTEIN Correct amount easy to digest Too much difficult to digest Partially corrected CARBOHYDRATE Lactose – plenty oligosaccharides Lactose – less oligosaccharides Lactose + Sucrose Lacks lipase FAT EFAs present Lipase to digest No EFAs No lipase Some EFAs added No lipase VITAMINS Adequate depending on mom’s nutritional adequacy Low vitamin A, C and Iron Vitamin / mineral added – usually enough ANTI-INFECTIVE FACTORS IgA, Lactoferrin, Lysozeme, etc None None GROWTH FACTORS Present None none
  21. 21. DIFFERENCES DIFFERENCES BETWEEN COW'S MILK AND BREAST MILK
  22. 22. TECHNIQUE OF BREASTFEEDING
  23. 23. INITIATION Breast feeding should be started within half an hour of birth as soon as possible after normal delivery where as in case of caesarian section delivery, within 4 hours.
  24. 24. TECHNIQUE
  25. 25. TECHNIQUE Here are the basic steps for breast feeding: 1.Make sure you’re comfortable and well supported with pillows. Lean back rather than sit upright 2.Place your baby on your bare chest between your breasts, facing you. 3.Support your baby behind his shoulders and under his bottom (hold his head only if he needs it).
  26. 26. SIGNS OF GOOD ATTACHMENT
  27. 27. POSITIONS  Baby’s head & body straight.  Baby’s body turned towards the mother, nose opposite the nipple.  Baby’s body touching mother’s abdomen.  Baby’s whole body well supported not just neck or shoulders.  Mother should than support her breast with her finger flat against her chest wall under her breast.
  28. 28. POSITIONS 1.Cradle Hold (Tummy to Tummy)  Sit as straight as possible with a pillow behind you, or sit on the edge of the bed.  Cradle your baby in your arm, her tummy against yours and her head resting in the bend of your elbow. Her ear, shoulders and hip should be in a straight line.  Tuck your baby's lower arm out of the way, with her
  29. 29. POSITIONS 1.Cradle Hold (Tummy to Tummy)  Support your breast with your free hand; place all of your fingers underneath it, well away from the areola.  Rest your thumb lightly on top of your breast above your areola.  Lift your breast upward and lightly stroke your nipple on your baby's lower lip. As part of the rooting reflex, her mouth will open wide.  Pull her quickly onto the breast to latch-on when her mouth is opened wide, like a big yawn, and her tongue is down.
  30. 30. 2.Football hold  Position your baby so her legs and body are under your arm, with your hand holding her head (as if you were holding a football).  Place your fingers below your breast. Allow your baby to latch-on while pulling her in close, holding her head tightly against your breast.  Keep your baby's body flexed at the hip with her legs tucked under your arm. POSITIONS
  31. 31. The football hold is a good position when: -You have had a caesarean birth and want to avoid placing your baby against your abdominal incision. -You need more visibility in getting your baby to latch-on. -Your breasts are large. -You are nursing a small baby, especially if premature. POSITIONS
  32. 32. The football hold is a good position when: -Your baby tends to slide down your areola onto your nipple. -Your baby is fussy, restless and hard to latch-on. -Your baby is sleepy. Sitting upright may encourage her to remain alert for a longer period. -You have inverted nipples. POSITIONS
  33. 33. 3 Side lying position  First, position yourself and your baby on your sides tummy- to- tummy.  Bend your top leg and position with pillows  Place your fingers beneath your breast and lift upward, then pull your baby in close as she latches-on.  The side-lying position is an especially good choice for breastfeeding when: You must be flat after a caesarean birth with spinal anesthesia. POSITIONS
  34. 34. POSITIONS
  35. 35. ADVANTAGES OF BREASTFEEDING
  36. 36. MATERNAL AND FETAL MATERNAL FETAL Reduces the risk of breast cancer, ovarian cancer, diabetes, hypertension and heart disease Meets the full nutritional requirement of infant Promotes post partum weight loss and emotional health Reduces the risk of infectious disease and illness Emotional support and bonding Lowers the risk of developing allergic Prevents post partum hemorrhage and delays ovulation Lowers the rate od sudden infant death syndrome (SIDS), cancer, gastrointestinal disrupt
  37. 37. IMMUNITY  During breast feeding approximately 0.25-0.5grams per day of secretory IgA antibodies is passed to the baby via the milk.This is one of the most important feature of breast feeding.  The main target of these antibodies is the microorganism in the fetal intestine.  Breast milk also contains several substances such as bile salt stimulated lipase which protects against amoebic infection, lactoferrin which binds to iron and inhibits growth of intestinal bacteria.
  38. 38. SUDDEN INFANT DEATH SYNDROME  Non breast fed babies have worst arousal from sleep at 2-3 months  This coincides with the peak of incidence of sudden infant death syndrome.  The risk of SIDS is doubled among infants whom has been not breastfeed.
  39. 39. MENTAL HEALTH  Breastfeeding for more than 6 months is an independent predictor of better mental health through childhood and adolescent.  The more months the child has been breastfeed they less likely suffer from depression, dequilent behavior, attention issues and physiological issues  Breastfeeding can also improve cognitive function
  40. 40. HORMONE RELEASE  Breastfeeding releases oxytocin and prolactin, hormones that relax the mother and make her feel more nurturing toward her baby.  This hormone release can help to enable sleep even where a mother may otherwise be having difficulty sleeping.  Breastfeeding soon after giving birth increases the mother’s oxytocin levels, making her uterus contract more quickly and reducing bleeding.  Pitocin, a synthetic hormone used to make the uterus contract during and after labor, is structurally modeled on oxytocin.
  41. 41. WEIGHT LOSS  As the fat accumulated during pregnancy is used to produce milk, extended breastfeeding as least 6 months can help mothers lose weight.  However, weight loss is highly variable among lactating women monitoring the diet and increasing the amount of intensity of exercise are more reliable ways of losing weight.  The 2007 review for the AHRQ found “The effect of weight breastfeeding in mothers on return-to-pre- pregnancy weight” was negligible, and the effect of breastfeeding on postpartum weight loss was unclear.
  42. 42. LONG-TERM HEALTH For breastfeeding women, long-term health benefits incudes:  Less risk of breast cancer, ovarian cancer, and endometrial cancer.  Breastfeeding diabetic mothers requires less insulin.  Reduced risk of metabolic syndrome.  Reduce risk of post-partum bleeding.  Women who breast fed for a longer duration have a lower risk for contracting rheumatoid arthritis than women who breast fed for a short duration or who had never breast fed.
  43. 43. CONTRAINDICATION OF BREASTFEEDING
  44. 44. CONTRAINDICATIONS The true contraindication of the breastfeeding are galactosemia and phenylketonuria. The maternal condition which are contraindicated for breastfeeding can be remembered as ‘REAL’ R: Radiotherapy E: Ergot therapy A: Antimetabolites therapy L: Lithium therapy
  45. 45. CONTRAINDICATIONS IN INFANT 1. Gross prematurity of baby or other conditions in which the newborn cannot suckle. 1. Inborn errors such as phenylketonuria, lactose intolerance, galactosemia
  46. 46. PROBLEMS IN BREASTFEEDING
  47. 47. 1. Blood stained nipple discharge 2. Painful nipple 3. Breast engorgement 4. Plugged duct 5. Mastitis PROBLEMS
  48. 48. BLOOD STAINED NIPPLE DISCHARGE  Typically bilateral  Due to epithelial proliferation  2nd and 3rd of pregnancy and < 3 months of postpartum  Self limiting, no treatment needed.
  49. 49. BLOOD STAINED NIPPLE DISCHARGE
  50. 50. PAINFUL NIPPLES Causes: – Improper latching and positioning – Thrush (candidiasis) – Symptoms: swollen, hard, warm and painful Prevention : – Early and frequent feeds – Correct the positioning and attachment – Express your milk when feedings are missed Treatment: – Resting the affected nipple – Hand express some milk to allow for easier latching.
  51. 51. BREAST ENGORGEMENT If the baby does not adequately remove the milk from your breasts, it may lead to breast engorgement. Begins at the 2nd and 3rd postpartumday
  52. 52. BREAST ENGORGEMENT Causes: – Delayed or infrequent feeding – Improper latching and positioning – Symptoms: swollen, hard, warm and painful Prevention : – Early and frequent feeds – Correct the positioning and attachment – Express your milk when feedings are missed Treatment: – Applying and ice bag, breast massage, analgesics – Hand express some milk to allow for easier latching.
  53. 53. PLUGGED DUCT Plugged ducts are an occlusion or plug has occurred in the milk passageways. This plug prevents milk from passing through or slower than usual.
  54. 54. PLUGGED DUCT Causes: – Infrequent feeding and milk stasis – Inadequate removal of milk from one area of the breast. – Symptoms: swollen, hard, warm, painful and noticeable lump. Prevention : – Early and frequent feeds – Correct the positioning and attachment – Express your milk when feedings are missed – Wear a comfortable, properly fitting bra. Treatment: – Warm water packs, breast massage – Try to move the lump toward the affected nipple to assure drainage
  55. 55. MASTITIS Breast inflammation
  56. 56. MASTITIS Causes: – Bacteria enter the breast through the nipple. – Blocked duct obstructs the flow of the milk & distends the alveoli – cracked or sore nipple. – Symptoms: • Painful, red and swollen • Flu like symptoms • Tachycardia • Pyrexia, rigors • Intense, localized pain • Red, hot and swollen breast Treatment: – Isolation of the mother and baby – Ceasing the breastfeeding from the affected part – Express the milk manually or electric pump – Antibiotic such as flucloxacillin
  57. 57. THANK YOU
  • AbdulAzisGCamid

    Nov. 21, 2021
  • pria87

    Oct. 15, 2020
  • DipikaKamat1

    Aug. 30, 2020

BREASTFEEDING

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