BREAST FEEDING

Breast milk is an ideal food for neonates. It is the best gift that a mother can give to her baby.

Mothers milk as the sole source of nutrition for the first 6 months of life, with continued intake for the first year, and as long as desired thereafter. Breast feeding has short- and long-term advantages for infant neurodevelopment.

Breast feeding benefits for mother

• Decreased risk of postpartum hemorrhages,
• More rapid uterine involution,
• Longer period of amenorrhea
• Decreased postpartum depression,
• Reduction of hypertension, hyperlipidemia,
• Reduced risk of cardiovascular disease
• Reduced risk of diabetes,
• Reduced risk of ovarian and breast cancer.
• Help you lose weight after the baby is born.

Adequacy of milk intake can be assessed by voiding and stooling patterns of the infant. A well-hydrated infant voids 6-8 times a day. By 5-7 days, loose yellow stools should be passed approximately 4 times a day. Rate of weight gain provides the most objective indicator of adequate milk intake. Total weight loss after birth should not exceed 7%, and birth weight should be regained by 10 days. The mean feeding frequency during the early weeks postpartum is 8-12 times per day.

Food during breast feeding for mothers

• You might need to eat a little more about an additional 330 to 400 calories a day to give you the energy and nutrition to produce milk.
• Protein-rich foods, such as lean meat, eggs, dairy, beans, and fish,seafood low in mercury.
• Enriched cereals, leafy green vegetables, peas, and dried fruit,garlic,
• Drink plenty of water which satisfy your thirst.
• Eating a variety of foods while breast-feeding will change the flavor of your breast milk. This will expose your baby to different tastes, which might help him or her more easily accept solid foods down the road.
• Avoid alcohol
• Quit smoking
• Avoid caffien
• Avoid stress,greif

BREAST FEEDING JAUNDICE

Infants who have insufficient milk intake and poor weight gain in the first week of life may have an increase in unconjugated bilirubin secondary to an exaggerated enterohepatic circulation of bilirubin. This is known as breast feeding jaundice.

BREAST MILK JAUNDICE

After the first week of life in a breast fed infant, prolonged elevated serum bilirubin may be due to the presence of an unknown factor in milk that enhances intestinal absorption of bilirubin. This is termed breast milk jaundice, which is a diagnosis of exclusion and should be made only if an infant is otherwise thriving, with normal growth and no evidence of hemolysis, infection, biliary atresia, or metabolic disease.

Factors which reduce milk production are:

• Dummies, pacifiers and bottles not only interfere with breastfeeding but also predispose the baby to diarrhea,respiratory infection.
• Giving supplements such as sugar water, gripe water, honey, breast milk substitutes or formula, either as prelacteal (before initiation of breastfeeding) or supplemental (concurrent to breastfeeding) feeds. Studies have reported that even 1 or 2 supplemental feeds reduce the chances of successful breastfeeding.
• Painful breast conditions like sore or cracked nipples and engorged breast.
• Lack of night feeding, as the prolactin reflex is not adequately stimulated.
• Inadequate emptying of breast such as when baby is sick or small and the mother does not manually express breast milk or when baby is fed less frequently.
• Smoking
• Alcohol
• Drug addict

Composition of Breast Milk

1. Colostrum is the milk secreted during the initial 3–4 days after delivery. It is small in quantity, yellow and thick and contains large amount of antibodies and immune-competant cells and vitamins A, D, E and K.
2. Transitional milk is the milk secreted after 3-4 days until two weeks. The immunoglobulin and protein content decreases while the fat and sugar content increases.
3. Mature milk follows transitional milk. It is thinner and watery but contains all the nutrients essential for optimal growth of the baby.
4. Preterm milk is the milk of a mother who delivers before 37 week. It contains more proteins, sodium, iron, immunoglobulins and calories as per the requirement of preterm baby.
5. Foremilk is the milk secreted at the start of a feed. It is watery and is rich in proteins, sugar, vitamins, minerals and water that quenches the baby’s thirst.
6. Hindmilk comes later towards the end of feed and is richer in fat that provides more energy and gives a sense of satiety. Thus, the composition of milk also varies during the phase of feeding. For optimum growth, the baby needs both fore as well as hindmilk. Therefore, the baby should be allowed to empty out one breast completely before switching over to the other.

Common Breast Feeding Problems

Engorgement

Engorgement, one of the most common causes of lactation failure, should receive prompt attention because milk supply can decrease quickly if the breasts are not adequately emptied. Applying warm or cold compresses to the breasts before nursing and hand expression or pumping of some milk can provide relief to the mother and make the areola easier to grasp by the infant.

Nipple tenderness

Nipple tenderness requires attention to proper latch-on and positioning of the infant. Supportive measures include nursing for shorter periods, beginning feedings on the less sore side, air-drying the nipples well after nursing. Severe nipple pain and cracking usually indicate improper latch-on.

Mastitis

If a lactating woman reports fever, chills, and malaise, mastitis should be considered. Treatment includes  frequent and complete emptying of the breast and homeopathy medicine.

Untreated mastitis may rarely progress to a breast abscess. Treatment includes  frequent and complete emptying of the breast and homeopathy medicine.

Inverted nipples.

Flat or short nipples which become prominent easily on pulling out do not pose difficulty in breastfeeding. However, truly inverted or retracted nipples make latching difficult. As the baby is not able to take nipple and areola in the mouth properly, sucking on the nipples makes them sore and excoriated. Treatment is started after birth of the baby. The nipple is manually everted, stretched and rolled out several times a day.

Not enough milk.

First make sure that the perception of “not enough milk” is correct. If baby is satisfied and sleeping for 2-3 hr after breastfeeding, passing urine at least 6-8 times in 24 hr and gaining weight, the mother is producing enough milk. There could be a number of reasons for insufficient milk such as incorrect method of breastfeeding, supplementary or bottle feeding, no night breastfeeding, engorgement of breast, any illness, painful condition, maternal stress or insufficient sleep.

Contraindication for breast feeding

HIV

Syphilis

Varicella

Herpetic lesions on her breast