Breastfeeding in Normal Newborn: Basic Concepts

Breastfeeding is a complete nutrition for the baby and beneficial to the baby and the mother. Mothers should be prepared for breastfeeding and motivated antenatally. Breastfeeding should be initiated within 1 h of normal delivery and 4 h of Caesarean section. In the first 2 days, colostrum is secreted which is highly immunogenic to the baby. Mature milk comes by day 10 of life. Foremilk is rich in protein and vitamins, while hindmilk is rich in fat. Proper technique should be followed for successful breastfeeding. Reflexes in the mother while breastfeeding are prolactin and oxytocin reflexes, while reflexes in the baby are rooting, sucking and swallowing. In case of early discharge from the hospital, adequacy of breastfeeding should be checked at 3–5 days of life. Breastfeeding develops bonding between the baby and the mother and promotes brain growth of the baby. Human milk is suitable for the baby and contains less protein and minerals than cow’s milk and has less solute load for immature kidneys of the baby. Breastfeeding should be on demand, minimum eight times per day. The common feeding problems in the mother are flat or inverted nipple, sore nipple, engorgement of breasts, and mastitis which should be prevented.

Common problems Encountered during Lactation and their Management in a Lactation Management Center

Background: Breastfeeding is widely known to be beneficial for infants and the mothersand also economically advantageous for the community. Objective: The principal purpose of this study was to explore the common problemsencountered during lactation and their management in a lactation management center. Method: A cross sectional study was conducted at lactation management center of Instituteof Child and Maternal Health (ICMH), Dhaka. A total of 100 lactating mothers were recruitedconsecutively during the period of August 2008 to October 2008. Data was collected byhistory taking and required examination. Result: In this study, 46.0% mothers complained of poor milk secretion, 13.0% had breastengorgement, 9.0% had cracked nipple, 3.0% had inverted nipple, 2.0% had nipple infection,2.0% had flat nipple, 1.0% had sore nipple, 1.0% had breast abscess and in 23% casesthere was no reasonable cause. During interview twenty seven percent of the mothers wereadvised to start nursing as soon as possible; 45.0% mothers breast fed on demand, 75.0%mothers demonstrated proper breast feeding technique, 36.0% mothers avoided use ofartificial milk, 10.0% mothers applied last part of milk on nipple, then dry by exposing to air,12.0% mothers manually express milk from the areola before breast feed if it is engorgedand 1.0% advised to slip the index or little finger into the infant’s mouth between his/hergums before the infant is taken off of the breast, to break suction. Conclusion: Almost half of the mothers complained of less milk production. Apart from this13.0% mothers had breast engorgement, 9.0% mothers had cracked nipple and no reasonablecause for lactation problem was found in 23.0% cases. More than half of the mothers hadincorrect knowledge and skill of breast feeding. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 36-39

Barriers to exclusive breast feeding, the missing links: a cross sectional study from Puducherry, India

Background: Breast milk, the first natural food for a new-born, provides all the energy and essential nutrients an infant requires for the first 6 months of life. The NHFS -4 survey shows only 45.5% of children are exclusively breastfed (EBF) in Puducherry. This study aims at assessing the socio-demographic characteristics associated with exclusive breastfeeding in a tertiary hospital in Puducherry and identify the barriers in the promotion of exclusive breastfeeding.Methods: Community-based cross-sectional study at a tertiary hospital in Puducherry. Sample size: 115 mothers of 6 months to 2-year-old children, born term gestation with a birth weight of >2.5 kg, attending the Paediatric OPD. Questionnaire-based study comprising of socio-demographic and parameters pertaining to exclusive breast-feeding.Results: Only 44.3% of the mothers have exclusively breastfed in the first 6 months. Shorter duration of spacing between births and caesarean section had significant negative association with exclusive breast-feeding. Most of the mothers received postnatal counselling on breast-feeding (94%) of which 58% were by health care personnel. Despite that, only a sixth (19%) of them were well versed with proper breastfeeding techniques. Poor secretion (45.3%), sore/inverted nipple (23.5%) amounted to the most common of the barriers. Among working mothers, 42.9% attributed their jobs as the cause for early weaning.Conclusions: The prevalence of exclusive breastfeeding is still low even among a literate study group. There were no significant association with socio-demographic factors found, but lacunae were identified. A more objective post-natal counselling to mothers involving their caregivers may improve the current scenario.