How to Control Proper Breast Feeding In Women

Breast Feeding In Women
 Breast Feeding In Women
It is advised that mothers practice exclusive breastfeeding of their babies. Exclusive breastfeeding means no other drinks or food is given to the baby, and the baby is fed exclusively on breast milk from birth to about four to six months of age. 

This is one of the components of the Baby-Friendly Hospital Initiative which is aimed primarily at protecting, promoting, and supporting breasts feeding for optimal maternal and child health. 

Feeding the baby on demand

Lactation starts soon after delivery but may not come down till after two days or more. The first milk produced is called colostrum. It runs for about one to two days before the real breast milk. It is creamy fatty and contains immunoglobulins

Comparison Between Human Milk And Cow Milk

Human Milk Cow Milk

  1. Total protein casein Lactalbumin
  2. Carbohydrate (lactose)
  3. Fat
  4. Calorie
  5. Water
  6. Calcium cax
  7. Phosphorus p
  8. Cap ratio
  9. Iron (Fe)
  10.  Protective factor

CASEIN:- There is a lot of this tough protein in cow milk. It requires a lot of enzymes and hydrochloric acid for digestion. Most parts of it remain undigested, especially in premature babies. Babies often regurgitate the undigested casein and this is seen as flakes in their month. The low casein in human milk is properly utilized.

LACTOSE:- Lactose is more in human milk than cow milk. It is essential for the growth of lactobacillus Bifidus which colonies the neonatal intestine to prevent pathogens. Due to its hygroscopic nature, it makes the stool soft.

FAT:- There are more unsaturated fat in human milk and more saturated fat in cow milk. It is known that the rate of absorption of fat is directly proportional to the degree of unsaturation.

MINERALS:- Cow milk contains three times more calcium than human milk. It also has a higher level of phosphorus. However, the calcium-phosphorus ratio is higher in human milk and the significance of this is that more calcium is absorbed by the baby's gut from human milk than from cow milk. 

It has been shown that babies fed on cow milk often develop hypocalcaemic tetany. In general, cow milk contains a high level of minerals in excess of the requirement of the baby and has to be passed out through the kidney. In a premature baby whose kidneys are not well developed and excretion is inadequate, electrolyte imbalance usually occurs.

IRON Fe? - Both kinds of milk contain the same amount of iron. This amount is insufficient where Fe deficiency anemia occurs. However, babies on. Affected children look fat with a distended abdomen.

At face value, they appear normal for their age but accurate assessment reveals gross deficiencies. The features are usually those of growth failure, oedema, psychomotor changes, and skin changes. Oedema of Kwashiorkor is mostly of the legs and feet. Ascites are less common.

The psychomotor changes include lethargy; drowsiness and loss of interest in the environment. The skin in kwashiorkor is dry, flaky, and peels with areas of both hypo and hyper-pigmentation.

lethargy and drowsy with no interest in the environment. The hair is brittle and pulls out easily. In summary, the clinical features of kwashiorkor are as follows:

  • Dry and flaky skin that peels.
  • Edema of leg and feet with occasional ascitis.
  • Brittle hair that is easily pulled out."
  •  Ulcer and cracks at the angle of the month.
  • Groin rashes due to candida infection.Anemia
  • Signs of vitamin deficiency.
  • Occasional diarrhea.

MARASMUS

A form of protein-energy malnutrition due to calorie deficiency. The clinical features of a marasmic child are:

  1. The child is alert, anxious, and extremely hungry unless the child is secondarily infected.
  2. Marked wasting of muscles and subcutaneous fat which gives the child flabby buttocks with skin fold. The child looks like a small "old" man.
  3. Loose stool is common with signs of dehydration.
  4. Growth failure.
  5. Signs of vitamin deficiency.

Investigation Done In Pem 

1. Full blood count.

2. Blood film

3. Total serum protein and serum albumin

4. Stool for ova of the parasite.

5. Heaf test and chest X-ray.

6. Serum electrolyte and urea.

Management Of Protein Energy Malnutrition

The mainstay of management is an adequate diet rich in protein and calories. The sources of protein in PEM include milk, egg, fish, and crayfish. If there is diarrhea, lactose-free milk such as soil is preferred. Sources of calories are pap, quaker oat, cornmeal, and soya beans, In mild PEM gives a patient a normal diet provided the patient has a good appetite. Ensure the diet is balanced. It is necessary to avoid pepper. 

In moderate PEM with fair appetite and no diarrhea give the patient:

  • Pap + soya beans + milk.
  • Add one teaspoonful of palm oil.
  • Add on a teaspoonful of ground crayfish:

If appetite improves, a normal balanced diet is introduced.

In severe PEM usually with diarrhea give the patient:-

  • IVF 5% D/Water 500ml + 12 str. Darrows 500ml
  • Papa + soya beans + soyamilk
  • Pap + soya beans + milk.
  • Add one teaspoonful of palm oil.
  • Add on a teaspoonful of ground crayfish.

For those that can afford it more balanced foods have complained and Casilan. However, the doctor should be consulted before using them.

1. Treat infection with broad-spectrum antibiotics such as intramuscular Rocephine or Claforan or Oritaxim or with other cheaper but effective drugs. If the patient keeps on losing weight or is not responding despite medication, 

Koch's should be suspected especially when the patient is coughing. The Heaf test may be negative and the chest x-ray may show no sign. Start patient or intramuscular streptomycin and add oral Rifampicin, cough syrup, and Vitamin C.

2. Routine antimalarial is given.

3. Haematinic is given but if the hemoglobin level is less than 79% then blood transfusion is indicated.

4 vitamin A is the most important vitamin to be given. It is important to avoid blindness in the patient. avoid blindness in the patient.

Complications Of Pem

  1. Malabsorption;
  2. Stunted growth; 
  3. Mental retardation.

Prevention Of Pem

  • good maternal and child health.
  • adequate immunization.
  • adequate breastfeeding for at least six months with the need to supplement when necessary
  • family planning
  • there is a need to grow more food.

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