Transcript LACTATION AND LACTATIONAL COMPLAINTS

Breast Feeding and its
associated complications
Why Breastfeed?
Literature is replete with scientific evidence on the benefit of
the most natural process of a motherbreast feeding her baby
Exclusive breast feeding in the first six months of life can cut
down under-five child mortality by
13-15%
There could not be more compelling reasons for
breastfeeding the baby.
Contra Indications For Breast
Feeding
Maternal:
Acute febrile conditions and critically ill patients
Breast abscess
HIV +ve mother
Open cases of pulmonary TB
Anti thyroid drugs
Anti cancer drugs
Hepatitis A
Following radio pharmaceuticals
Contra Indications For Breast
Feeding (Contd….)
For baby:
Breast milk jaundice
Cleft lip or palate
Oromotor dysfunction
Pre-maturity
Under weight
GALACTOGOGUES
There is no ideal galactogogue
Chlorpromazine and metoclopromide- 10 mg 3 times
daily for 7 days
Garlic, ginger, coconut, jaggery, ghee, khas-khas,
bajra, pepper etc
Self confidence, freedom from anxiety, soothing
environment with vigorously sucking by an active
baby are the most effective pre-requisites for
successful establishment of lactation.
Lactation Complaints
Insufficient Milk Syndrome
Retracted nipples
Sore nipples
Breast engorgement
Mastitis
Breast abscess
Plugged ducts
Overactive milk ejection reflex
Choice of contraception
Problem of working women
RETRACTED NIPPLE
Antenatal examination and counseling for cleaning
of nipples and their aversion is important
20 cc syringe may also be used for correcting
retraction
Nipple shield
Use of breast pump
SORE NIPPLE
Commonest
Cause improper latching
Symptoms: pain
Signs: nipple is red, cracked, bruised, blistered
and tender
Treatment: linolin/ emolient cream; air drying and
applying own milk, nipple shield for time being,
EBM
ENGORGEMENT
Swollen breast due to increased
milk production
Maybe early or late
Early engorgement resolves with baby sucking
Painful, swollen, warm, hard or rigid breasts needs
treatment
Treatment: gentle massages, warm compresses,
milk expression, breast support, oxytocics, NSAID
Mastitis And Breast Abscess
Pain, fullness, fever with or without chills,
swollen, red, tender breasts
Treatment: broad spectrum antibiotics,
anti-inflammatory drugs, breast support,
feeding to continue,
Untreated or under-treated neglected cases
may lead to antibioma / abscess formation
Mastitis And Breast Abscess (cont.)
Breast Abscess
High fever with chills
Localized, swollen, red, warm, tender,
indurated mass with fluctuation
Treatment is I&D and supportive therapy
same as mastitis
Breast feeding to be resumed as early as
possible
Milk Expression
Manual or hand expression
Via pump: hand held pumps, mechanical, cylindrical,
battery operated and semi operated pumps
Mechanical, cylindrical pump is safe and easy to use
and can be sterilized, cost effective
Suction generated by battery operated pump can be
regulated to suit the user
EBM stays in good condition in room temp for 8 hrs;
refrigerator 24 hrs or in the freezer at -20 degree
cent for 3 months.
CYLINDER BREAST PUMP
ELECTRICAL BREAST
PUMP
Electrical Breast Pump
Electrical pumping is more effective in raising
maternal prolactin levels and volumes of milk
3 times expression in 24 hrs ( twice at night
and 1 in early morning) is required to keep up
the milk production
Pumping both breasts simultaneously
produces more milk
Human Milk Banking Association of
NorthAmerica
 Non-profit association of donor
human milk banks
 Established in 1985
 To set standards for and to
facilitate establishment and
operation of milk banks.
Who can donate the milk?
Donors


Their babies must be in general good health.
Cannot be taking any medications or herbal supplements .

Undergo a thorough medical history .

Must also keep at least 100 oz of milk on hand for their own
babies.


Must not have had a positive blood test result for HIV,
hepatitis B or C, or syphilis.
Contd…..

Their sexual partners cannot be
at risk for HIV.

Must not use illegal drugs.

Must not smoke or use tobacco products.

Cannot have had an organ or tissue transplant or a blood
transfusion in the last 12 months.

Must not consume more than two ounces or more of
alcohol per day .
HOW TO STORE THE
MILK
 Milk is cooled and poured into autoclave stainless steel
containers measuring 150cc, 250cc or 300cc.
 Pasteurized at 65 degrees Celsius for 30 minutes and
then frozen at minus 20 degrees Celsius.
 It can be stored for up to six months.
Milk banking in India
•
Asia's first human milk bank was set up at the
Lokmanya Tilak Municipal General Hospital (LTMGH)
in Mumbai in 1989.
• 25 human milk banks across India - most of them sited
in the western states of Maharashtra and Gujarat.
• Performing vital services for premature babies requiring
temporary intervention in cases of delayed lactation,
abandonment or illness.
“The nature has designed the provision that
infants be fed upon their mother’s milk. They
find their food and mother at the same time.
It’s a complete nourishment for them both for
their body and soul”
- Rabindranath Tagore
THANK YOU