DR.VEERENDRAKUMAR C.M. MD.,DNB.

Associate ProfessorVIMS,BELLARY

PERFECT GIFT TO MANKIND

PLACENTA-

INTRAUTERINE FETUS

COLOSTRUM-

EXTRAGESTATE FETUS

Why emphasize on breast feeding?

WHEN INDIAN WOMEN BREAST

FEED WITHOUT EXCEPTION!

25% DO NOT INITIATE WITHIN 24 Hrs

50% DISCARD COLOSTRUM

75% GIVE PRELACTEAL FEEDS

MANY WOMEN BELIEVE THEY DO NOT

HAVE SUFFICIENT MILK &INDULGE IN

TOP MILK FEEDING

BREAST FEEDING promotion PRIMARY RESPONSIBILITY

LIES WITH OBSTETRICIAN & NOT THE PEDIATRICIAN !

WOMAN BELIEVES MORE IN HER OBSTETRICIAN & WE SHOULD NEVER FAIL HER IN EXCLUSIVE BREAST FEEDING

It is a natural instinct , women take to breast feeding easily

BUT

even with minor problem readily switch on to TOP feeding .

Early Discontinuation

Most women who stop breastfeeding prematurely do so in the first ten days.

To improve the duration of breastfeeding physicians must provide support during this critical early period.

“Not enough milk”

Colostrum The newborn who cries loudly & sucks hard is getting enough to eat

Elimination pattern after day 5 5 voids 2-3 stools

anatomy

BREAST ENGORGEMENT

SORE/ CRACKED NIPPLE

INSUFFICIENT / NO MILK

RETRACTED NIPPLE/ inverted nipple

BREAST ENGORGEMENTENGORGED LYMPHATIC & VENOUS CHANNELS AROUND THE ALVEOLI

INCREASED ALVEOLAR PRESSURE

FLATTENS EPITHELIUM &BLOCKS THE DUCTS

BREAST HARD & PAINFUL

BABY STRUGGLES & TRAUMATIZES THE NIPPLES

NO FURTHER BREAST FEEDING

MASTITIS

BREAST ABSCESS

ANTENATAL BREAST EXAMINATION

TEACH MOTHER HOW TO MANUALLY EXPRESS THE MILK

BEFORE & AFTER FEED EXPRESS THE MILK &RENDER THE BREAST SOFT

CORRECT POSITIONING

Manual expression

Manual expression

BREAST SUPPORTING

ANALGESICS

ICE BAG

SORE NIPPLE

PORTAL OF ENTRY FOR PATHOGENIC ORGANISMS.

ANTENATAL EXAMINATON & TREATMENT AVOIDS COMPLICATIONS

EARLY SORE NIPPLE ALWAYS DUE TO INCORRECT POSITIONING.

AVOID CRUST FORMATION

LOCAL HYGEINE

EXPOSE TO AIR ,application of breast milk or lanolin , USE NIPPLE SHIELD

Retracted & inverted nipple

RETRACTED NIPPLE

GENTLE MANUAL TEASING.

REVERSE SYRINGING EFFECTIVE

AGAIN ANTENATALLY CAN BE CORRECTED .

MASTITIS & ABSCESS

MASTITIS & ABSCESS

BABY SOURCE OF INFECTION.

MORE LIKELY IN FISSURED NIPPLE.

STAPHYLOCOCCUS COMMONEST.

ANTIBIOTICS & CONTINUED BREAST FEEDING.

DON’T WAIT TILL FLUCTUATION APPEARS.

FAILURE TO RESPOND-SURGICAL MANAGEMENT.

RECENTLY -USG GUIDED NEEDLE ASPIRATION

INSUFFICIENT MILK & LACTATION FAILURE

A MYTH OR REALITY?

NO PARALLELS IN OTHER 4000 SPECIES.

THE PRICE WE PAY FOR CIVILIZATION ?

Enhancing factors

SUCKLING SENSORY IMPULSES FROM NIPPLE EMPTYING OF BREAST NIGHT FEEDS THINKING /SOUND/SIGHT OF BABY CONFIDENCE PROLACTIN & OXYTOCIN

Hindering factors

PRELACTEALS, BOTTLE FEEDING.

INCORRECT POSITIONING.

PAINFUL BREAST CONDITIONS.

WORRY, STRESS , EMBARASSMENT.

DOUBT, NO SELF CONFIDENCE.

LACTATION FAILURE

PRIMARY HYPOPROLACTINEMIA

SHEEHAN’S SYNDROME

RETENTION OF PLACENTA

HYPOPLASTIC BREASTS

WRONG MANAGEMENT

HOW TO OVERCOME?

ANTENATAL PREPARATION

MATERNAL MOTIVATION

EARLY INITIATION

ROOMING IN

UNRESTRICTED DEMAND FEEDING BOTH DAY,NIGHT

BAN PRE LACTEAL FEEDS

LOOK FOR LOCAL OR SYSTEMIC ILLNESS

EXCESSIVE CRY NOT ALWAYS DUE TO INADEQUATE MILK

OBSERVE MOTHER-INFANT COUPLE FOR PROPER TECHNIQUE

Latching

ROLE OF GALACTOGOGUE

PLACEBOS TABLETS, TONICS

AYURVEDIC PREPARATIONS

DOPAMINE AGONISTS

BABY SUCKLING BREAST IN CORRECT POSITION

CONTRA INDICATIONS

HIV .CMV, HBV INFECTION

ACTIVE TUBERCULOSIS

HERPETIC LESIONS ON BREAST