Breast feeding and Complimentary feeding

Ten steps in BFHI

• Have a written breastfeeding policy that is routinely communicated to all health care staff.

• Train all health care staff in skills necessary to implement this policy.

• Inform all pregnant women about the benefits and management of breastfeeding.

• Help mothers initiate breastfeeding within one half-hour of birth.

• Show mothers how to breastfeed and maintain lactation,even if they should be separated from their infants.

Ten steps in BFHI

• Give newborn infants no food or drink other than breastmilk, unless medically indicated.

• Practice rooming in - that is, allow mothers and infants to remain together 24 hours a day.

• Encourage breastfeeding on demand.• Give no artificial teats or pacifiers (also called

dummies or soothers) to breastfeeding infants.• Foster the establishment of breastfeeding support

groups and refer mothers to them on discharge from the hospital or clinic.

Initiation of Breast Feeding

• Within half an hour after normal delivery and within 4 hours after caesarean section

• No prelacteal feeds

• First 2-4 days: colostrum (10-40 mL)

• Practice ‘Rooming in’

Proper positioning

Reflexes that help in Breastfeeding

Role of oxytocin and prolaction

Reflexes in mother

Breastfeeding

• Exclusive and on-demand feeding

• Proper ‘burping’ after feeds

• Right lateral position after feeding

Breast milk – Is it sufficient?

• Adequate urine output (6-8 times/day)

• Passing 2-6 liquid stools per day

• Gaining adequate weight

• Sleeps 2-3 hours after feeds

• Proper positioning and breastfeeding technique

Contraindications

• Infant – Galactosemia, Congenital lactose intolerance

• Mother – Antithyroid drugs, Chemotherapeutic drugs (malignancy) antipsychotic drugs

Common breast feeding problems

• Inverted nipples

Common breast feeding problems

• Sore nipples

• Breast engorgement

• Breast abscess

Complimentary feeding

Optimal Infant Feeding

Complimentary feeds

• Preferably home made feeds

• Cereals like rice is the best choice

• Locally available, economical and acceptable

• Cereal-pulse combination is better (fortification of aminoacids)

Amount of complimentary feeds

Complementary bridge and safety net