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

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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