session 39 nutrition of lactating mothers and their health and fertility
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Session 39Session 39Nutrition of lactating
mothers and their health and fertility
Nutrition of lactating mothers and their health and fertility
Source of Energy and Nutrients in Source of Energy and Nutrients in BreastmilkBreastmilk
From mother reserves
From food which mothers eat
39/1
500 Calories
200 Calories
Effect of Mother’s Nutrition on Breastmilk Effect of Mother’s Nutrition on Breastmilk ProductionProduction
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WELL NOURISHED
MODERATE UNDERNUTRITION
SEVERE UNDERNUTRITION
Example of extra food needed each Example of extra food needed each day by a breastfeeding womanday by a breastfeeding woman
60g rice (1 fistful) 240 Calories
30g dahl (½ fistful) 120 Calories
Green vegetables
(1 fistful)
1 banana 90 Calories
7.5 ml oil (1½ teaspoonful) 50 Calories
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Helping a Sick Mother to BreastfeedHelping a Sick Mother to Breastfeed
Any sick woman
If admitted to hospital
If she has fever
If feels too unwell or unwilling to
breastfeed
If extremely ill
If mentally ill
When mother recovers
Ask “Do you have a breastfeeding
baby?”
Encourage her to continue
Admit baby with her
Give plenty to drink
Help her to express her breastmilk
Feed baby by cup
Consider expressing her breastmilk
Feed baby by cup
Find helper to care for mother and
baby together
Help her to increase her breastmilk or
relactate
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Mother’s Medication and BreastfeedingMother’s Medication and Breastfeeding
Breastfeeding contraindicated : Some anticancer drugs
Radioactive substances (temporarily)
Continue breastfeeding:
Side effects possible
Monitor baby for drowsiness
Psychiatric drugs and anticonvulsants
Use alternative drug if possible
Monitor baby for jaundice
Chloramphenicol, tetracycline, metronidazole
Sulphonamides, cotrimoxazole, dapsone
Use alternative drug
(May decrease milk supply)
Oestrogen containing contraceptives
Thiazide diuretics
Safe in usual dosage Most commonly used drugs
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Breastfeeding Delays PregnancyBreastfeeding Delays Pregnancy
While no menstruation:Up to age 6 monthsGood protection
From 6-12 monthsPartial protection
After menstruation returns:No protection
• Breastfeed fully• Breastfeed frequently day
and night
• Breastfeed frequently day and night (with complementary feeds)
• Use another family planning method
• Use another family planning method
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Lactational Amennorrhea Method (LAM)Lactational Amennorrhea Method (LAM)
No other family planning method needed
if : No menstruation
AND
Baby LESS than 6 months old
AND
Baby fully breastfed
Use other family planning FP method
if : Menstruation has returned
OR
Baby MORE than 6 months old
OR
Baby not fully breastfed
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Complementary Family Planning Options Complementary Family Planning Options for Breastfeeding Womenfor Breastfeeding Women
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1st choice 2nd choice 3rd choiceNon-Hormonal Methods LAMCondomsDiaphragmSpermicidesIntrauterine DevicesNatural Family
PlanningVasectomyTubal Ligation
Progestin-Only MethodsMini-pillsInjectablesImplants
Methods Containing EstrogenCombined Oral
ContraceptivesCombined Injectables
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