Scribd Logo
Upload

Welcome to Scribd!

  • 32 views

    Breast Milk: Benefits & Barriers

    Uploaded by

    Nazia Arif
    The document discusses the composition and nutritional benefits of breast milk over time. It describes the progression from colostrum in the first few days, which is high in protein and immunoglobulins, to transitional milk around days 6-10 when fat and lactose levels rise, to mature milk by 2 weeks which provides optimal nutrition and growth factors for infants. The document also outlines the increased nutritional needs of lactating mothers and risks of not breastfeeding for both infants and mothers.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Breast Milk: Benefits & Barriers

    Uploaded by

    Nazia Arif
    32 views22 pages
    The document discusses the composition and nutritional benefits of breast milk over time. It describes the progression from colostrum in the first few days, which is high in protein and immunoglobulins, to transitional milk around days 6-10 when fat and lactose levels rise, to mature milk by 2 weeks which provides optimal nutrition and growth factors for infants. The document also outlines the increased nutritional needs of lactating mothers and risks of not breastfeeding for both infants and mothers.

    Original Description:

    Original Title

    BREAST 2

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document discusses the composition and nutritional benefits of breast milk over time. It describes the progression from colostrum in the first few days, which is high in protein and immunoglobulins, to transitional milk around days 6-10 when fat and lactose levels rise, to mature milk by 2 weeks which provides optimal nutrition and growth factors for infants. The document also outlines the increased nutritional needs of lactating mothers and risks of not breastfeeding for both infants and mothers.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    32 views22 pages

    Breast Milk: Benefits & Barriers

    Uploaded by

    Nazia Arif
    The document discusses the composition and nutritional benefits of breast milk over time. It describes the progression from colostrum in the first few days, which is high in protein and immunoglobulins, to transitional milk around days 6-10 when fat and lactose levels rise, to mature milk by 2 weeks which provides optimal nutrition and growth factors for infants. The document also outlines the increased nutritional needs of lactating mothers and risks of not breastfeeding for both infants and mothers.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 22

    Breast Milk

    Benefits & Barriers


    Dr Sheela Bano
    Obstetrician
    Aga Khan Medical Center, Gilgit
    Composition of Breast Milk
    • Colostrum: small amount during days 3 to 5
    – High in protein, immunoglobulins and minerals,
    – Low in lactose and fat
    • Transitional milk: produced during days 6 to10
    – High in fat, lactose
    – Lower in protein and minerals
    • Mature milk: available by 2 weeks post-partum
    – Average secretion: 750 ml/d
    – Provides 20-22 kcal/ounce
    – 60-80% whey protein, 40% lactose, 50% fat
    – Growth factor
    – Low in vitamin D
    Colostrum

    • The first milk, colostrum, is rich in protein and


    antibodies
    – Nuetrophils in colostrum promote bacterial killing,
    phagocytosis, and chemotaxis
    • Small volume is normal:
    – 7-123 ml/day first day
    – 2-10 ml/feeding day 1
    – 5-15 ml/feeding day 2
    Nutritional Requirements
    During Lactation
    • Breastfeeding is an anabolic state, resulting in increased energy and nutrient
    needs:
    – 500 kcal/day (birth to 6 mo)
    – 400 kcal/day (7 - 9 mo)

    • Protein, zinc, niacin, vitamins A, E, C requirements increase above those in


    pregnancy.
    – Protein = 71 g/day

    • Chronically low maternal iron, vitamin B, C, D, thiamin, and folate intake leads
    to low content in breast milk.
    Benefits of breastfeeding for the infant

    • Provides superior nutrition for


    optimum growth.
    • Provides adequate water for
    hydration.
    • Protects against infection and
    allergies.
    • Promotes bonding and
    development.
    Transparency 2.5
    Summary of differences between milks

    Human milk Animal milks Infant formula


    correct amount, easy too much, difficult to
    Protein partly corrected
    to digest digest
    enough essential fatty lacks essential fatty
    Fat no lipase
    acids, lipase to digest acids, no lipase

    Water enough extra needed may need extra

    Anti-infective
    present absent absent
    properties

    Adapted from: Breastfeeding counselling: A training course. Geneva, World Health


    Organization, 1993 (WHO/CDR/93.6).
    Transparency 2.6
    When Women Don’t Breastfeed...

    • They recover more slowly after birth


    • Have Increased risk of:
    Breast Cancer Ovarian Cancer
    Endometrial Cancer Cardiovascular Disease
    Osteoporosis Type 2 Diabetes
    High Blood Pressure Metabolic Syndrome
    Anemia Postpartum Depression
    • The longer a woman breastfeeds, the more
    her risk of breast cancer goes down
    7
    Benefits of breastfeeding for the mother

    • Protects mother’s health


    – helps reduces risk of uterine bleeding and
    helps the uterus to return to its previous size
    – reduces risk of breast and
    ovarian cancer
    • Helps delay a new pregnancy
    • Helps a mother return to pre-pregnancy weight

    Transparency 2.8
    Risks of artificial feeding
     Interferes with bonding
     More allergy and
     More diarrhoea and milk intolerance
    respiratory infections
     Increased risk of
     Persistent diarrhoea some
     Malnutrition chronic diseases
    Vitamin A deficiency  Overweight
     More likely to die  Lower scores on
    Mother intelligence tests
     May become  Increased risk of anaemia,
    pregnant sooner ovarian and breast cancer
    Adapted from: Breastfeeding counselling: A training course. Geneva,
    World Health Organization, 1993 (WHO/CDR/93.6). Slide 2.9
    Benefits of breastfeeding for the family
    • Better health, nutrition, and well-being
    • Economic benefits
    – breastfeeding costs less than artificial
    feeding
    – breastfeeding results in lower medical care
    costs

    Transparency 2.10
    • The most common reason given by mothers for early
    discontinuation of breastfeeding is the “perception that
    their milk is insufficient to satisfy their infant’s needs” a
    phenomenon now termed the “INSUFFICENT MILK
    SYNDROME” or IMS.

    • The insufficient milk syndrome can only be understood


    in the context of fundamental changes in the
    breastfeeding process undergone by women who live in
    industrialized societies.
    Management

    • Optimize positioning and latch


    • Treat sore nipples
    • Increase frequency of feeds
    • Express/pump milk after feedings to ensure
    complete emptying of breasts
    • Treat maternal or infant illness if present
    Management

    • If clinically indicated, supplementation may be


    necessary
    • Supplement with expressed breast milk if
    possible
    • Begin with only 1-2 oz after each feeding until
    milk production increases
    Treatment of Sore Nipples

    • Ensure infant is well-positioned and latching


    on correctly — this may be all that is needed
    • Apply breast milk to nipple and areola after
    feeding, allow to air dry, then apply medical-
    grade lanolin
    • Use only water to clean breasts
    • May use acetaminophen or ibuprofen for pain
    management
    Insufficient Lactation
    Infant Failure-to-Thrive

    • Maternal causes
    – Poor milk production: diet, illness, fatigue
    – Poor let down: psychological, drugs, smoking
    – Inverted nipples

    • Infant problems
    – Poor intake: poor suck, infrequent feedings, Cleft palate
    – Low intake: vomiting, diarrhea, malabsorption
    – High energy needs: CNS impairment, premie, SGA, CHD
    How do I know if the infant is
    breastfeeding effectively?

    • Baby is content after feedings


    • Audible swallowing during feedings
    • Mother’s nipples are not sore
    • 3+ stools/day after day 1
    • No weight loss after day 3
    • Breast feels less full after feeding
    How do I know when the milk has
    “come in”?

    • 6+ wet diapers/day
    • Yellow, seedy stools by day 4–5
    • Breasts are noticeably larger and feel firmer
    and heavier
    • Mother may begin to feel “let-down” reflex
    • Breasts may leak between or during feedings
    Management

    • REASSURANCE

    • AWARENESS

    • COMPLETE PHYSICAL EXAMINATION

    • OBSERVATION OF THE FEEDING

    • TREAT THE CAUSE IF ANY


    Reassurance

    • If the infant is gaining weight well and stooling


    and voiding appropriately
    – Reassure mother her milk supply is adequate
    – Discourage supplementation
    – Review normal patterns of breastfeeding,
    elimination, and weight gain
    • Complete physical exam including:
    – Mother’s breasts and nipples
    – Infant oral-motor exam
    – Evidence of congenital anomalies
    – Evaluation of frenulum
    • Observation of a feeding to look at:
    – Infant positioning
    – Latch
    – Infant suck
    Management

    • Optimize positioning and latch


    • Treat sore nipples
    • Increase frequency of feeds
    • Express/pump milk after feedings to ensure
    complete emptying of breasts
    • Treat maternal or infant illness if present
    GALACTOGOUS FOOD
    • Water
    • Oat meal
    • Garlic addition in food
    • Carrots
    • Fennel
    • Nuts
    • Papaya green
    • Sesame
    • Ginger in meals
    •

    You might also like