Breast Feeding and its associated

complications

Why Breastfeed?Literature is replete with scientific evidence on the benefit of

the most natural process of a mother- breast 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 patientsBreast abscessHIV +ve motherOpen cases of pulmonary TBAnti thyroid drugsAnti cancer drugsHepatitis AFollowing radio pharmaceuticals

Contra Indications For Breast Feeding (Contd….)For baby:

Breast milk jaundice Cleft lip or palate Oromotor dysfunctionPre-maturityUnder weight

GALACTOGOGUES

There is no ideal galactogogueChlorpromazine and metoclopromide- 10 mg 3 times daily for 7 daysGarlic, 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 SyndromeRetracted nipplesSore nipplesBreast engorgementMastitis Breast abscessPlugged ductsOveractive milk ejection reflex Choice of contraceptionProblem of working women

RETRACTED NIPPLE

Antenatal examination and counseling for cleaning of nipples and their aversion is important20 cc syringe may also be used for correcting retractionNipple shieldUse of breast pump

SORE NIPPLE

Commonest Cause improper latchingSymptoms: pain Signs: nipple is red, cracked, bruised, blistered and tenderTreatment: 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 lateEarly engorgement resolves with baby suckingPainful, swollen, warm, hard or rigid breasts needs treatmentTreatment: 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 AbscessHigh fever with chillsLocalized, swollen, red, warm, tender, indurated mass with fluctuationTreatment is I&D and supportive therapy same as mastitisBreast feeding to be resumed as early as possible

Milk Expression

Manual or hand expressionVia pump: hand held pumps, mechanical, cylindrical, battery operated and semi operated pumpsMechanical, cylindrical pump is safe and easy to use and can be sterilized, cost effectiveSuction generated by battery operated pump can be regulated to suit the userEBM 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 milk3 times expression in 24 hrs ( twice at night and 1 in early morning) is required to keep up the milk productionPumping 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