PRESENTED BY : DR.OWAIS ,DR.RAMEES,DR.JAVAID,DR.IMTIAZ, DR.SHOWKAT.

AFTER THIS WE WILL BE ABLE TO: 1.DEFINE EXCLUSIVE BREAST FEEDING? 2.STATE THE ADVANTAGES OF EXCLUSIVE BREAST FEEDING? 3.LIST THE DISADVANTAGES OF ARTIFICIAL FEEDING? 4.DESCRIBE THE MAIN DIFFERENCE BETWEEN BREAST FEEDING AND ARTIFICAL FEEDING?

THERE ARE THREE MAIN TYPES OF BREAST FEEDING: 1.EXCLUSIVE BREAST FEEDING 2.PREDOMINANT BREAST FEEDING 3.PARTIAL BREAST FEEDING

EXCLUSIVE BREAST FEEDING IS THE TYPE OF BREAST FEEDING IN WHICH BABY IS EXCLUSIVELY FED ON BREAST MILK AND NOTHING ELSE AND IS TO BE DONE FOR PERIOD OF FIRST SIX MONTHS OF BABYS LIFE.

RIGHT TEMPERATURE AND CONCENTRATION. PROVIDES ADEQUATE PHYSICAL AND MENTAL GROWTH AND DEVELOPMENT IT CONTAIINS IgA ,IgG and bifidus factor PROTECTIVE EFFECT AGAINST ENTERIC AND OTHER PATHOGENS LESS DIARRHEA,INTESTINAL BLEEDING LESS RTI,UTIS,MENINGITIS. LESSER ALLERGIES AS BREAST MILK IS SPECIES SPECIFIC. PASSIVE TRANSFER OF T CELL IMMUNITY.

HELPS IN MATERNAL-INFANT BONDING FASTER RETURN TO PRECONCEPTIONAL UTERINE SIZE BY THE RELEASE OF OXYTOCIN. INCIDENCE OF BREAST CANCER IS LESS INCIDENCE OF OVARIAN CANCER IS LESS HELPS IN SPACING THE CHILDREN BY CAUSING LACTATIONAL AMENORRHEA. IT IS ECONOMICAL.

IN ORDER TO UNDERSTAND THE COMPONENTS OF FORMULA MILK WE NEED TO UNDERSTAND DIFFERENCE BETWEEN HUMAN AND ANIMAL MILK AND HOW ANIMAL MILK IS MODIFIED TO BE LIKE HUMAN MILK WHICH HOWEVER IS STILL FAR FROM PERFECT.

FORMULA MILK IS MADE FROM VARIETY OF PRODUCTS,INCLUDING ANIMAL MILKS,SOYA BEANS AND VEGETABLE OIL ALTHOUGH THEY MAY HAVE BEEN ADJUSTED SO THAT THEY ARE MORE LIKE HUMAN MILK.HOWEVER THEY ARE STILL FAR FROM PERFECT FOR THE BABY.

AND MILK SUGAR CALLED LACTOSE WHICH ALSO PROVIDES ENERGY.

THEN

WHERE LIES THE DIFFERENCE???

THE ANIMAL MILK CONTAINS MORE PROTEINS THAN HUMAN MILK.ITS DIFFICULT FOR BABYS IMMATURE KIDNEYS TO EXCRETE THE EXTRA WASTE FROM THE PROTEIN IN ANIMAL MILKS. HUMAN MILK ALSO CONTAINS ESSENTIAL FATTY ACIDS THAT ARE NEEDED FOR BABYS GROWING BRAIN AND EYES AND FOR HEALTHY BLOOD VESSELS. THESE FATTY ACIDS ARENT THERE IN ANIMAL MILK BUT MAY BE ADDED IN FORMULA MILK

THE PROTEINS IN DIFFERENT MILKS VARY IN QUALITY AND QUANTITY. WHILST QUANITY OF PROTEIN IN COWS MILK CAN BE MODIFIED TO MAKE FORMULA,QUALITY CANT BE CHANGED..

MAIN PROTEIN IN COWS MILK IS CASEIN.CASEIN FORMS THICK INDIGESTIBLE CURD IN BABYS STOMACH. HUMAN MILK CONTAINS MORE WHEY PROTEINS WHICH HAVE ANTI INFECTIVE POWER TO PROTECT BABY AGAINST INFECTIONS.

BREAST MILK CONTAINS WBCS AND NUMBER OF ANTI INFECTIVE PROTEINS WHICH HELP TO PROTECT A BABY AGAINST MANY INFECTIONS. BREAST MILK PROTECTS BABY AGAINST DIARRHOEAL AND RESPIRATORY INFECTIONS,EAR INFECTIONS,MENINGITIS AND URINARY TRACT INFECTIONS

WHEN MOTHER DEVELOPS AN INFECTIONS,WBCS IN HER BODY ARE ACTIVE AND MAKE ANTIBODIES AGAINST INFECTIONS TO PROTECT HER.SOME OF THESE WBCS GO TO HER BREAST AND MAKE ANTIBODIES IN HER WHICH ARE SECRETED IN BREAST TO PROTECT HER BABY.SO BABY SHOULD NT BE SEPERATED FROM MOTHER WHEN SHE DEVELOPS TRIVIAL INFECTION COZ ITS PROTECTIVE FOR HER BABY.

Colostrum is the breast milk that women produce in the first few days after delivery. It is thick and yellowish or clear. It contains more proteins than mature milk. Mature milk is the breast milk that is produced after few days. The quantity becomes larger, and the breast feel full, hard and heavy. Some people call this "breast milk coming in variations in the composition of breast milk

Fore milk is the milk produced early in a feed Hind milk is the milk that is produced later in a feed. Hind milk looks whiter than foremilk, because it contains more fat. This fat provides much of the energy of a breastfeed. This is an important reason not to take off a breast too quickly. The baby should be allowed to continue until he has had all that he wants.

Foremilk looks thinner than hind milk. It is produced in larger amounts, and it provide plenty of protein, lactose, and other nutrients. Because gets larger amounts of foremilk, he gets all the water that he needs from it. Baby do not need other drinks of water before they are six months old, even in hot climate . If they satisfy thirst on water, they may take less breast milk.

Property importance: Antibody rich - Protects against allergy &infection. Many white cells - protects against infection Purgative - clears meconium - helps to prevent jaundice. Growth factors - helps intestine to mature prevents allergy, intolerance. Rich in vitamin A - reduces severity of infection.

Colostrum contains more antibodies and other ant-infective proteins than mature milk. It contains more white blood cells than mature milk. Colostrum helps to prevent the bacterial infection that are danger to newborn babies and provide the first immunization against many of the disease that the baby meets after delivery.

So it is very important for babies to have colostrum. It is ready in the breasts when a baby is born. Babies should not be given any drink or foods before they start breast feeding. Artificial feeds given before a baby has colostrum are likely to cause allergy and infection.

Interferes with bonding . .More diarrhoea and persistent diarrhoea. More frequent respiratory infections. Malnutrition, Vitamin A deficiency. More allergy and milk intolerance. Increase risk of some chronic diseases. Obesity. Lower scores on intelligence tests. Mothers may become pregnant sooner. Increased risk of anaemia, ovarian cancer, and breast cancer to the mother.

PATIENTS ON: ANTI NEOPLASTICS,IODIDE,ATROPINE LITHIUM,CHLORAMPHENICOL,CYCLOSPORINE NICOTINE,ALCOHOL

HIV CMV,HSV[IF LESIONS ON BREAST] ACUTE MATERNAL DISEASE IF BABY DOENT HAVE THE DISEASE[TB,SEPSIS] BREAST CANCER SUBSTANCE ABUSE BREAST FEEDING ISNT CONTRAINDICATED IN MASTITIS.

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STUDY KNOWLEDGE,ATTITUDE AND PRACTICE ABOUT BREAST FEEDING IN SUMBAL AND HAJIN AREA.

STUDY AREA:SUMBAL AND HAJIN STUDY PERIOD:11/7/11 TO 1/8/11[22 DAYS] TYPE OF STUDY:CROSS SECTIONAL STUDY SUBJECTS:PRIMI AND MULTIPAROUS WOMEN COMING EITHER FOR ANTENATAL CHECKUP OR FOR IMMUNIZATION IN PHC HAJIN AND CHC SUMBAL. TOTAL NUMBER OF STUDY SUBJECTS : 200 STUDY INSTRUMENT:PREDESIGNED PROFORMA

AGE GROUP:
20-24YRS 25-28YRS 18 68 9% 34%

29-32YRS
33-36YRS 37-45YRS

54
36 24

27%
18% 12%

SOCIOECONOMIC STATUS
CLASS 1 36 18%

CLASS 2
CLASS 3 CLASS 4 CLASS 5

51
33 40 40

25.5%
16.5% 20% 20%

OCCUPATION:
WORKING HOUSE WIFE

22 178

11% 89%

EDUCATION:
ILLITERATE LITERATE 113 87 56.5% 43.5%

OBSTETRICS:
P1 P2 P3 46 98 56 23% 49% 28%

FEEDING THE BABY:

BREAST FEED 167 83.5%

BOTTLE FEED

11

5%

BOTH

22

11%

STARTING THE BREAST FEED

WITHIN HALF HOUR 1-2 HRS >2 HRS 72 68 60 36% 34% 30%

KNOWLEDGE ABOUT TYPES OF BREAST FEEDING:

EXCLUSIVE 142 71%

PREDOMINANT

28

14%

PARTIAL

30

15%

KNOWLEDGE ABOUT PRELACTAL FEEDS:

YES NO 180 20 90% 10%

ARE THEY GOOD FOR THE BABY:

YES NO 74 126 37% 63%

KNOWLEDGE ABOUT COLOSTRUM:

YES NO 188 12 94% 6%

SHOULD IT BE GIVEN:
YES
NO

164
36

82%
18%

IS BREAST FEEDING GOOD FOR THE BABY:

YES NO 200 0 100% 0%

DURATION OF EXCLUSIVE BREAST FEEDING:

3 MONTHS 6 MONTHS 1 YEAR 61 137 2 30.5% 68.5% 1%

ADVANTAGES OF B.F.TO BABY:

PROPER 78 GROWTH AND DEVELOPMENT ,LESS INFECTIONS PROPER GROWTH AND DEVELOPMENT ONLY 122 39%

61%

ADVANTAGE OF B.F TO MOTHER:

LACTATIONAL 82 AMENORRHEA, INCREASED BONDING DECREASED BREAST PROBLEMS 118 41%

59%

KNOWLEDGE ABOUT WEANING:

YES 200 100%

NO

0%

WHEN SHOULD WEANING BE STARTED:

6 MONTHS 173 86.5%

8 MONTHS

27

13.5%

NATURE OF WEANING FOODS:

READYMADE 37 18.5%

HOMEMADE

163

81.5%

DURATION OF TOTAL BREAST FEEDING

UPTO 1 YEAR 2YRS 49 151 24.5% 75.5%

KNOWLEDGE ABOUT EXPRESSED BREAST MILK:

YES 121 60.5%

NO

79

39.5%

COMFORTABLE WITH BREAST FEEDING:

YES 142 71%

NO

58

29%

SUPPORT OF FAMILY/SPOUSE IN THIS REGARD:

YES 191 95.5%

NO

4.5%

PREVIOUS EXPERIENCE: EXCLUSIVE BREAST FEEDING: PREDOMINANT B.F PARTIAL B.F BOTTLE FEEDING:

START OF B.F. AFTER DELIVERY: 1 HR: AFTER 2 HRS: FREQUENCY OF FEEDS: 4 TIMES: 6 TIMES: ON DEMAND:

PRACTICE OF PRELACTAL FEEDS: YES: NO: NATURE OF PRELACTAL FEEDS: HONEY: SUGAR: PLAIN WATER:

PRACTICE OF COLOSTRUM: YES: NO: START OF WEANING: 6 MONTHS: 8 MONTHS:

NATURE OF WEANING FOODS: HOMEMADE: READYMADE: STILL B.F THE BABY: YES: NO:

ENCOURAGEMENT OF MIDWIFE/DOC: YES: NO: POSITION OF B.F SITTING: BOTH SITTING AND LYING: BOTH SITTING AND STANDING:

DOES BABY HIMSELF RELEASES BREAST :

DO U TAKE BABY OFF THE BREAST:

PROBLEMS ENCOUNTERED DURING BREAST FEEDING: FISSURES: ENGORGEMENT: DECREASED MILK SUPPLY:

THANK YOU