PROBLEMS AND COMPLICATIONS OF BREAST FEEDING

MRS KALYANI RATHASSO.PROFESSOR, KINS

“A newborn has only three demands. They are warmth in the arms of its mother, food from her breasts and security in the knowledge of her presence. Breastfeeding satisfies all three” .

(Grantly Dick Read)

WHY EMPHASIZE ON BREAST FEEDING??? When Indian women breast feed

without exception

CONT... 25% do not initiate

within 24 hrs 50% discard

colostrums 75% give prelacteal

feeding Many women believe they do not have sufficient milk & indulge in top milk feeding

BREASTFEEDING PROBLEMSDUE TO MOTHER Reluctance or dislike to breast

feeding Infant’s attachment to breast Anxiety and stress Following operative delivery Milk secretion is inadequate Breast ailments

DUE TO INFANT

Low birth weight baby

Temporary illness Over-distension of the stomach with swallowed air

Congenital malformation

BREAST FEEDING COMPLICATIONS Breast Engorgement Cracked and sore nipple Plugged Duct Mastitis Breast abscess

BREAST ENGORGEMENT Breast engorgement is

due to exaggerated normal venous and lymphatic engorgement of the breast which precedes lactation.

PREVENTION

Avoid prelacteal feeds

Initiate breast feeding early and unrestricted

Exclusive breastfeeding on demand

Feeding in correct position

MANAGEMENT Manual expression

of any remaining milk after each feed.

Administer analgesics for pain

The baby should be put to the breast regularly at frequent interval.

In sever case gentle use of breast pump , may be helpful.

PLUGGED DUCT

A Plugged duct is where an occlusion or plug has occurred in the milk passageways. This plug prevents milk from passing through or the milk passage may be slower than usual.

MANAGEMENT Learn how to

position your baby so that the baby can latch on properly

Try using warm compresses

Take a mild pain reliever, such as ibuprofen.

CRACKED NIPPLE

Loss of surface epithelium with the formation of raw area on the nipple

Fissure either at the tip or the base of the nipple.

MANAGEMENT Correct attachment Application of fresh human milk Application of lotion (miconazole) Rest to the affected nipple. Use of nipple shields.

SORE NIPPLES Sore nipples are any persistent pain

in the nipples that lasts throughout the entire breastfeeding or hurts between feedings.

PREVENTION use a proper breastfeeding

technique keep the nipples dry by exposing

them to air or sunlight  avoid products that remove the

natural protection of nipples, such as soaps, alcohol.

breastfeed on demand   avoid the use of nipple shields.

MANAGENENT Offer the least affected breast

first; Express enough milk before

breastfeeding to stimulate the let-down reflex, thus preventing the infant from sucking too vigorously on the breast;

Alternate between different positions, reducing the pressure on sore areas or on damaged tissues;

Use "breast shells" Use oral systemic analgesics, if

necessary.

MASTITIS One of the more serious complications of breast feeding includes a breast infection, otherwise known as mastitis.

Mastitis can be caused by an improperly or untreated plugged duct or cracked nipple

MANAGEMENT Breast support Plenty of oral fluid Breast feeding is

continued with good attachment.

The infected side is emptied manually with each feed

Antibiotic therapy to be continued for 7 days.

Analgesics- Ibuprofen are given.

BREAST ABSCESS

Breast abscess is caused by untreated mastitis or results from late or inefficient treatment. It affects 5 to 10% of women with mastitis.

MANAGEMENT Treatment is done with analgesic &

antibiotic. Abscess may need incision & drainage. Breast feeding must be continued in the

uninvolved side. The infected breast is mechanically

pumped every two hours. Once cellulitis has resolved breast

feeding from the involved side may be resumed.

INADEQUATE MILK PRODUCTION

 infrequent suckling. Anxiety state in puerperium. Ill development of nipple Painful breast lesion. Prolactine inhibition.

MANAGEMENT Counseling mother regarding

advantage of breast feeding. Treatment of abnormalities. Encourage adequate fluid intake. Treatment of painful local lesion.

THE BABY WHO DOES NOT SUCKLES Avoid artificial food or water. Expressed milk to be given. Nipple should be placed

slightly upward towards the roof of the baby mouth.

Keep the baby nose free during breast feeding.