Breastfeeding
Introduction In the first year of life is when the older child will grow, so it is very important to the power supplied to this first year of life.
breastfeeding rates
breastfeeding rates we can find are:
Natural or maternal :
is the ideal and should be encouraged. It is the ideal food for the first six months of life. Should be alternated with complementary feeding (semi-solid food up to one year. hastq You can extend the child and mother are willing and able.
Artificial
which is administered by the bottle. They are derived from milk cow and try to match the breast milk. There are two types, namely:
- Home Milk is given, from the moment of birth to 4-6 months.
- Milk below is given from 4-6 months until the first year of life.
There are also some special cases of milk allergy. They are very expensive.
Mixed:
Try to alternate the two types of previous lactation (natural / artificial.
breast anatomy
Breasts are tubulo-alveolar glands of external secretion, considered embryologically as modified sweat glands in their structure and function.
Internal:
Each gland is composed of 15 to 20 lobes breast (like grapes) separated by connective tissue and fat. The lobes are divided into lobules (like grapes) and turn in small clusters formed by rounded internal surface of which is covered in secretory cells in which milk is produced.
Within the lobules there are two types of cells:
- alveolar cells, are the producers of milk. Are epithelial cells.
- myoepithelial cells, contain muscle fibers and cause milk ejection.
The milk is driven by galactófagos tubules and ducts (such as cluster stick) to the sinuses which are expansions of these, located at the height of the areola where it deposits a small amount of milk to be removed by the suction of the child. Leave them 15 to 25 ducts to the nipple, which will place the milk.
External:
In the center of each breast is a circular area called the mammary areola contains small corpuscles called Montgomery tubercles, which in infancy produce a secretion that lubricates the skin. In the center of each nipple areola is made up of erectile tissue and smooth muscle that provides the suction. Are also the sebaceous glands of Morgagni.
Physiology of lactation:
Milk is produced by breast epithelial glandular cells and stored in small spaces, sac grouped in bunches: the alveoli. Surrounding each alveolus are myoepithelial cells, forming a muscle sheath.
adequate milk production depends on two hormones:
- The prolactin that stimulates milk production. This hormone is secreted by the anterior lobe of the pituitary, the action is going to be on the alveolar cells. Especially at the end of pregnancy, the level of this hormone increases. During pregnancy is inhibited by estrogen and progesterone why there is no mature milk from the beginning.
- The oxytocin produced by the contraction of myoepithelial cells, allowing the milk produced and stored to escape. The milk flows into the sinuses (blisters) located behind the nipple, which can be emptied by rhythmic pressure of the baby's tongue. This hormone is secreted in the posterior pituitary lobe. The highest levels of the same, occur 2 hours after delivery.
ejection reflex milk "letdown" in response to the action of oxytocin is very variable in some women is very strong and the milk may come "Jet" while other women can just drip milk from the breast. After birth and the expulsion of the placenta begins the process of lactogenesis.
Home and maintenance of breastfeeding:
- Start breastfeeding as soon as the World Health Organization (WHO) recommends the first hour after delivery.
- complete emptying of the breast following breast. This is based on the law of supply and demand.
- baby's sucking reflex, which will be responsible for that secrete these hormones.
secretion Physiology milk
- mammogenesis: growth and mammary development.
- lactogenesis: breast milk.
- Lactopoyesis: maintenance and active transport of milk secretion.
Phases in milk production:
Milk is not just a liquid, is considered a living tissue. Containing cells from maternal blood: T and B lymphocytes, macrophages, mast cells and epithelial cells. They are responsible for anti-infective immune responses and cell-mediated synthesis of lactoferrin, lysozyme, complement and porstaglandinas. Store and release IgA and interferon.
- Colostrum: is secreted by the breast milk from the moment of birth to about 3-5 days after treatment. Promotes rapid growth of the baby and protects the baby's digestive system. It helps to evacuate as soon as meconium. Its properties are:
- Lots of protein.
- Abundant minerals and vitamins.
- Low fat and carbohydrates.
- Contains immunoglobulins.
- its value is Calorta: 67 kcal/100ml
- serum not find him because the child gets used to the bottle and then not take the breast.
- Milk transition: is milk that is secreted from the 5 th or 6 th day to 15 th day. Decreases the protein content and increased fat. Its caloric value is higher than the colostrum. There is a change in the stool of the newborn. The woman begins to notice the "rise of the milk."
- Mature milk or permanent : is milk that is secreted from Day 15 until weaning. It is more watery and liquid colostrum. Your calorie intake is higher. Is the time when the mother begins to enjoy breastfeeding, it's been for the inconvenience, and adapted to the new situation.
From 6-7 months the child needs other inputs besides breastfeeding.
A mother who is breastfeeding and the baby is well fed, it is not necessary that water, although it can be done (this in normal environmental conditions). Water can never be sweet and if they give must be given infusions of fennel water because it's digestive tract.
It is also true that during pregnancy a woman can raise the colostrum.
Composition of breast milk
87% vol Water ____________ __________
Protein 7% lime
fats (triglycerides) ___ 50% lime
Carbohydrates (lactose) __ 40% lime and mineral electrolytes
low __ %
Vitamins D and K
_______ all digestive enzymes and hormones promote digestion.
proximate composition of mature human milk proteins
total
0.90% 0.27% Casein Protein
serum 3.0 / 4.0%
Ash 0.20%
Benefits of breastfeeding:
Benefits for the child:
- condion hygienic and ideal temperature.
- Maintains the basal temperature of the infant.
- Lee with ideal characteristics.
- Avoid constipation, abdominal cramps, flushing perional.
- Prevent childhood obesity.
- Reduced risk of high cholesterol in adulthood.
- Suitable lips and mouth development.
- Strengthens the jaw.
- contributes to healthy teeth.
- Avoid overloading renal sodium and protein.
- Protection against infections and food allergies.
- Promotes effective link with the mother.
- Mayor precocious motor and intellectual development.
Benefits for the mother:
- Reduced risk of obesity in the mother breastfed.
- Major bond with your child.
- Reduces the risk of becoming pregnant during the period of lactation.
- Reduced risk of depression and neurosis.
- Reduces the risk of postpartum hemorrhage.
- Prevents anemia, to avoid cyclic shedding of the endometrium.
- Reduces the risk of breast and uterine cancer.
- His administration is more convenient (no need preparation)
- is cheaper than artificial. I-nhibición
breastfeeding
inhibits
If breastfeeding:
- Make dressing.
- Fluid restriction.
- Medical treatment.
Tandem Breastfeeding
A mother is breastfeeding her child when the knowledge that pregnant again, decided not to stop breastfeeding your child and continue to breastfeed throughout the pregnancy. Once born the youngest, is nursing the two together or separately. This is tandem breastfeeding. The disadvantages
of this type of breastfeeding are:
- - Feeling of being overwhelmed.
- - False taboos.
- - Rejection of health professionals. The
presents advantages are:
- - Improving the adaptation of the brothers.
- - Lets bring more episodes of jealousy.
breast engorgement
hot water should be given to increasing and decreasing the pressure, and then we massage (dilation and then massage), to decrease the volume of the chest ("milked the mother"). Try
chest congestion with the breast pump (manual or mechanical). Placing the child to suck, once clearing the chest.
Mastitis
Cracks in the nipple
- Avoid soaps.
- Keeping the nipples dry.
- Do not use protectors.
- Use a good technique.
- Friction with "hypericum oil" and "alcohol tatin 50% + glycerin."
- You can also use a cream preparation of vitamin A + D.
- Using liners.
- After breast milk implement the aura and allow to dry, is good because the milk has more protein.
clogged ducts.
A clogged duct is normally a bad position of the child, bras too tight. The woman starts with sore nipples. Considerations to keep in mind are:
§ No sleep upside down.
§ Change the position of each shot.
§ Apply moist heat.
§ Do not use liners, because it decreases the milking. § Provide
first breast pain.
§ Do not stop breastfeeding for no reason
§ Make sure the bra does not compress. §
Massage the area that bothers you.
and health care of the breasts
§ Use a good bra.
§ Have good hygiene.
§ Keep your nipples dry. §
protectors are not everyday but at certain times.
§ Do not use creams.
sore nipples
can advise the following:
- Use a proper position for breastfeeding.
- Avoid breast engorgement (the chest is about to burst).
- Breastfeed frequently.
- Applying ice to the nipples or moist, as do anesthetics. The mother should put it and then offer the child.
- Keeping the nipples dry.
- Chest to air and sun to harden.
- Manage your own milk for the amount of protein it has.
- Application of lanolin ointment, not harmful to children but we recommend spending a little greasers before every shot (not abuse it)
- Avoid irritants.
- Do not use protection because they hold moisture.
- Do not use soap because it dries very often.
abscesses and mastitis
It's the worst that can happen to a woman who is breastfeeding. It is an infection of the parenchyma by a strep or staph.
may occur for a crack, a blocked duct or mishandling.
Always treat mastitis symptoms: high fever (39 ° - 40 °), the vision of the breast (areola red, redness and heat), pain usually in the upper outer quadrant.
have to continue breastfeeding.
It involves a complication, an abscess when treatment fails, we must open and drain. Would have to stop breastfeeding, but according getting milk, when solving the problem, puts the baby at her breast again.
Conservation
milk
- Sterilization: should be separated from the bottle nipple ring, washed with boiling water (100 ° C).
sterilization is recommended once a day, the bottle should be kept dry and stored.
If she squeezes the breast milk to give the first 24 hours should not be frozen, should be stored in the refrigerator. If you are going to take more than 24 hours for the milk, it should be frozen. There are glass containers or bags (no need to fill the bag) to keep it. Should be labeled with the date. If there is a small amount, wait until complete 90 - 120 ml. In a refrigerator for 48 hours. Milk can be stored frozen at most 3 / 6 months. Thawed in the refrigerator, never outside.
never put in the microwave because it heats unevenly and can burn the baby. Whether to administer it is not completely thawed can be put under the faucet with warm water, then heating bath.
can hold up to 8 hours at room temperature in the refrigerator 48 hours. Should be shaken before use.
Once used milk can not be saved again. Milk must be transported in a cold environment.
In mixed feeding is recommended to give breast milk first. To remove the breast, is recommended to alternate days: breast, bottle diminishes to breast milk.
Collect your breast milk:
§ Wash the team maternal breast pump that comes in contact with breast milk or collection containers in a dishwasher or by hand in hot soapy water. Rinse with cold water and let it air dry on clean towel. §
schedule depends on you and your baby when you're going to draw milk from the breast. Try to pump when baby would nurse normally. The supply of breast milk is usually more abundant morning, so this is an opportune time to do so. Be flexible. If you are planning to return to work and continue breastfeeding, begin pumping one to two weeks before returning. And will try to mimic the pumping schedule at work.
§ Before pumping, sit comfortable and relaxed. Pump your breast milk according to the manufacturer's instructions for breast pump.
child nursing care of a nursing
There are four key signs for good posture:
§ Infant head and body straight.
§ The child should be facing the breast with his mouth in a position opposite the nipple. §
She should have it close to your body. §
whole body must hold not only for the head.
nursing care are:
§ Teach the mother's position.
§ Place the baby at her breast. § Identify and remove
(put your little finger in corner of the mouth and push to low). § Put
to expel the gases. During and after.
§ Explain how to set it.
Breastfeeding positions
Data
good posture: Chin §
baby in contact with the chest or close to it. Boca §
open fully.
§ upturned upper lip. §
most of the halo over the baby's mouth than below it. § The child breast
slowly, deeply and pauses. §
comfort should prevail.
Baby Common Positions:
§ Child in her lap: sat straight in his chair, hold your baby in your lap at breast height. If you need to put a pillow under the baby or a small stool under your feet. §
watermelon American football: the side of the mother and down to her back, holding his arm on the same side. Place a pillow under your arm. §
Lying: baby's feet to the head or side.
Duration of each breast taken into
is important to remember that the next shot, you offer the other breast (generally feel "heavier"). Also you can let the baby take what you want from a single chest (to take one parameter: Approximately 25 or 30 minutes) per serving. This will provide more milk "fat" (with fat), and is likely to increase over peso.Lo important is to check that everything goes well, without becoming obsessed by the clock, and following your instincts as both your baby's responses. Remember that each baby is unique, as is her mom, and we all have different rhythms that should be respected.
artificial Breastfeeding
Introduction:
§ First year of rapid growth and development. §
nutritional demands increase.
§ The first year three times the weight and increases in size by 50%. §
there is a contribution not only gives but eating habits. §
da Nutrition metabolic consequences in childhood and adolescence.
artificial Breastfeeding:
is an alternative to breastfeeding when there is no possibility or will not do it.
are used infant formulas (cow's milk as amended). There differences in breast milk, not only quantitatively but also qualitatively. Start with milk
"start" to the 4 / 6 months and then a "continuation" to 36 months (Committee on Nutrition of the European Society of Gastroenterology and Nutrition pedriática, ESPGAN).
allergies are more common in children with artificial feeding (2-7%) than infants to breast (0.5%)
adaptation milks are less adapted to the home. Are rich in iron, calcium and vitamins A, D and E.
Cow's milk is inadequate because:
High û renal solute load. Û
promotes anemia deficiency.
Recommendations for artificial feeding
§ Apply hygiene in the preparation of the bottle. §
Handwashing prior. §
Boiling water 5 minutes (controversy). §
Wash bottles and teats with warm water and detergent using a brush. See §
sodium levels in water (no greater than 100 mg / l). § Prepare
before. §
Heat in "bath", not the microwave. §
Discard leftover shots. Preparation
bottle
§ Measure the volume of water required. § Use
measuring scoop that comes with the package. §
Flush, but not pressing it.
§ Place the water first and then the milk. §
Shake hands turning between the nipple.
§ Avoid lumps. § Respect the proportion
water - milk (30:1)
Considerations:
§ Check the temperature of the bottle in the back of the hand.
§ Do not store in the refrigerator the water.
§ The water should be boiled. §
Tilt the bottle well to prevent entry of air from the teat.
§ Place the baby on her shoulder and banging on the back to burp. Use
soft on baby teats and harder in larger.
The "bottle" step by step
Wash the bottle, the pacifier and the screw until there is no residue above the food.
Boil them for five minutes, dry and store covered until ready to use.
Boil water for five minutes, let cool.
Pour half the volume of warm boiled water to prepare, in the bottle.
Use only as it is within this lata.Añada the recommended number of shallow steps. Cover and shake until smooth.
Then add the boiled water missing to complete the final volume, indicated for the-bottle. Shake the bottle until powder is completely dissolved.
Risks of artificial feeding:
Child:
§ atopic eczema, asthma, autoimmune diseases.
§ Sudden death. §
respiratory infections. § Minor
development of intelligence. §
gastrointestinal infections.
Mother: Cancer
§ § § Low self-esteem Anemia
mixed breastfeeding
The shots are taken, alternating
Way §: in making the other breast and bottle feeding. §
Coincidentally, in the same chest and then takes the bottle.
The disadvantages of mixed feeding are: § Promotes
agalactia (no milk)
§ Difficult to establish the continuity necessary supplement.
Weaning
term used when introducing solid foods in the diet, but still suck. It aims to introduce food and sustain breastfeeding up to one year.
Recommendations for desdetete:
§ Increase iron intake. §
Dar-cup water or juice. § Food
crushed with a spoon.
§ Prepare the porridge with milk.
§ The order to put food is: frutaàverduraà meat. § Give
cereal with breast milk when replacing a socket.
§ If the mother works, that the first shot of the morning and night.
Supplementary Feeding
is defined as any food other than breast milk or formula adapted. It starts at 6 months if:
§ sits with support. §
Communicates.
§ Open your mouth and points out the spoon. § Set aside
face (for example when you do not like something)
§ protrusion reflex disappears (to place a spoon on the tongue pushes it outside)
Recommendations:
§ Dar
one to one Paulato and new foods.
§ Do not give cow's milk until one year. § No gluten
enter up to one year. §
fish and eggs after the 9 / 10 months. § Go
replacing feedings for food.
§ Do not give more than 50% of calories from supplementary feeding.
§ Take into account the sociocultural.
one to one Paulato and new foods.
§ Do not give cow's milk until one year. § No gluten
enter up to one year. §
fish and eggs after the 9 / 10 months. § Go
replacing feedings for food.
§ Do not give more than 50% of calories from supplementary feeding.
§ Take into account the sociocultural.
Steps to successful breastfeeding:
All maternity services and child care must:
u know the written rules of staff.
or offering the expertise to implement the standards. Û
Report and technical benefits of breastfeeding. Û
Help mothers initiate breastfeeding. Û
Teaching as feeding and maintaining the discharge. Û
other foods not give the child different balance exceptions. Let û
mother and son are together. Û Encourage
breastfeeding on demand (when the child wants). Û
not give pacifiers to children. Û
promote support groups outside the hospital.
Poetry to breast
Extending the nest of the new moons,
beloved daughter.
Your lips like, are immediately
, looking nipple
the water of life runs like a river
joyful in your mouth,
warm as the sun, the dew fresh
. Tierno on my lap
your eyes look at me.
offer me your embrace, my soul
lights. Bebe
my all,
heart and life, have my white blood
,
my best song.
My milk feeds you and calm your crying,
also protects you with its white mantle.
you sleep serene, safe
in my heat,
while dreaming in full,
a beautiful future.
you lie on your birth, you bathroom
touching, funny
moon spy
smiles.
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