The Secret to Pain Free Breastfeeding
Taking good care of the breasts is important for the health of both the mother and her baby. The baby should begin to breast feed soon after it is born. A baby may want to breast feed right away or just lick the breast and be held. Encourage the baby to suck because it will help the milk to start flowing. This will also help the mother's womb to contract and the afterbirth to come out sooner. The mother's first milk is a thick yellow liquid (called colostrum). The first milk has everything a new baby needs to prevent infection and is rich in protein. The first milk is very good for the baby, so
Human breast milk is the preferred food for full-term babies. It offers several advantages to both mother and infant. Breast milk is premixed at the right temperature and concentration. Breast milk has immunologic factors such as IgA, lactoglobulin, and maternal macrophages, which protect the infant from infections. Breast-fecfbabies have a lower incidence of upper respiratory tract infections and otitis media than their formula-fed counterparts. Breast milk also decreases the incidence of allergic diseases. Maternal advantages to breast feeding include a more rapid return to prepregnancy weight and faster uterine regression. Breast feeding also promotes maternal-infant bonding. Contraindications to breast feeding are few but include active or untreated tuberculosis, syphilis, HIV, galactosemia, and varicella. Herpes is a contraindication if there are active lesions present on the breast. Relatively few drugs are contraindicated in breast feeding, but they include antineoplastics,...
Dietary intake is known to affect the concentration of many nutrients in human milk, whereas others appear less affected.22,92,93 A very high percentage of vegetarian mothers breast-feed their infants and they do so for extended periods of time.94 Protein concentration was observed to decrease in the milk of macrobiotic women with increasing stage of lactation and, after adjustment for stage of lactation, it contained less calcium, magnesium, vitamin B12, and saturated fatty acids and more polyunsaturated fatty acids.94 In keeping with other studies, milk from the macrobiotic mothers contained lower concentrations of contaminants. Because of the great likelihood that vegetarians will breast-feed their infants for extended periods of time, it is important that they are provided with the appropriate dietary guidance to assure an adequate nutrient intake over the entire period of lactation. Particular nutrients of concern have been identified and suggestions have been made for obtaining...
The risk of HIV transmission from a mother to her child is between about 15 and 40 per cent, the higher levels of risk being associated with breast-feeding. This risk can be greatly reduced by anti-retroviral drug treatment of the woman before and after birth. In many countries, including the UK, treatment of HIV-infected women has resulted in a decline in the number of HIVpositive children. Although drug treatment reduces the risk of virus transmission to children, it does not cure infected individuals.
An 18monthold has failure to thrive and developmental delay The patient also has a history of recurrent ear infections
Most HIV-infected children are born in developing countries. The majority of HIV cases are acquired via vertical transmission from mother to child. Cesarean section combined with prenatal, intrapartum, and neonatal zidovudine (ZDV) therapy significantly reduces transmission of HIV. In developing countries breast-feeding is an important route of transmission. Other cases of HIV are obtained from parental exposure to blood products. Sexual contact is a major route of transmission of HIV in adolescents.
I have had only 19 out of 1100 patients who subsequent to the surgery had a pregnancy. Thirteen were able to breastfeed and seven supplemented. Five patients were not able to breastfeed, and one did not try. Dr. Norma Cruz-Korchin has studied breastfeeding in large-breasted women who came for a breast reduction consultation but who decided not to have surgery. She compared these patients with those who underwent a medial pedicle vertical breast reduction. Interestingly, she found that between 60 and 65 of patients in both groups were able to breastfeed, and one quarter of these patients supplemented. Maternity nurses have often commented that it is the large-breasted women who seem to have trouble breastfeeding. Does the size of the breast contribute as much to the problem as the surgery itself
A 24-year-old primigravid woman, who is intent on breast-feeding, decides on a home delivery. Immediately after the birth of a 4.1-kg (9-lb) infant, the patient bleeds massively from extensive vaginal and cervical lacerations. She is brought to the nearest hospital in shock. Over 2 h, 9 units of blood are transfused, and the patient's blood pressure returns to a reasonable level. A hemoglobin value the next day is 7.5 g dL, and 3 units of packed red blood cells are given. 227. Breast-feeding can be encouraged despite which of the following conditions Three days ago you delivered a 40-year-old G1P1 by cesarean section. The indication for operative delivery was failure to descend after 2 h of pushing. Labor was also significant for prolonged rupture of membranes. The patient had an epidural, which was removed the day following delivery. The nurse pages you to come see the patient on the postpartum floor because she has a fever of 102 F and is experiencing shaking chills. Her BP is 120...
It is key to preserve blood supply to the nipple areola complex however, it is also important to preserve sensation and breastfeeding potential. A dermal pedicle alone may have adequate circulation,but it is less likely to provide sensation (Fig. 2.2) and is unlikely to have any breastfeeding potential. It may appear that a full-thickness dermoglandular pedicle would be the ideal option however, there can occasionally be difficulties with inset, resulting in compression and torsion of the pedicle such that the blood supply is compromised. The classification that follows is necessarily arbitrary, and variations thereof can and will be used it does, however, provide a basis for pedicle planning and design (Fig. 2.3). branch of the fourth intercostal nerve travels just above the pectoralis fascia until the breast meridian, where it turns and passes upward toward the nipple-areola complex (Chap. 1). Sensation can therefore be preserved using both the inferior and central pedicles. Some...
The pedicle is deepithelialized, leaving a cuff of tissue around the new areolar edge (Schwartzmann maneuver 36 ). With either a knife or cutting cautery, the pedicle is created directly down to the chest wall. Not only is the pedicle easily undermined inadvertently,but,like the inferior pedicle, it is floppy and appears to have been undermined. But the pedicle should be left full thickness, with the tissue in the pedicle extending directly down to the pectoralis fascia at the level of the breast meridian. Leaving a full-thickness pedicle should help to preserve both sensation and breastfeeding potential.
Reducing volume is the object of the procedure,but maintaining blood supply to the nipple and breast skin, maintaining sensory innervation to the nipple and breast skin, and preserving the ability to breastfeed are the functional goals. A pleasing and long-lasting shape is the cosmetic goal. Historically breast reduction surgery has attempted to combine various skin resection patterns with different pedicles to maintain blood supply (as well as sensation and breastfeeding potential) to the nipple-areo-la complex 7 . Observing principles of limited skin undermining of the remaining breast skin along with a dermoglandular pedicle for the nipple are ideal goals that were satisfied by the inverted T inferior pedicle (or central mound) techniques, and they have achieved wide acceptance. But other skin resection patterns and other pedicle designs have been described over the years - each with its advantages and disadvantages 8-13 . Shorter scar skin resection patterns have been slower to...
A 24-year-old primigravid woman, who is intent on breast feeding, decides upon a home delivery. Immediately after the birth of a 4.1-kg (9-lb) infant, the patient bleeds massively from extensive vaginal and cervical lacerations. She is brought to the nearest hospital in shock. Over 2 h, 9 units of blood are transfused, and the patient's blood pressure returns to a reasonable level. A hemoglobin value the next day is 7.5 g dL, and 3 units of packed red blood cells are given.
Many viruses can be spread vertically. Congenital infection of the fetus in utero or during passage of the infant through the birth canal occurs with viruses such as HIV, cytomegalovirus (family Herpesviridae), and rubella virus (genus Rubivirus, family Togaviridae). Vertical transmission can also occur shortly after birth, by breast feeding for example. HTLV I (family Retroviridae), which causes leukemia in humans, is such a virus.
Sore or cracked nipples develop when the baby sucks only the nipple instead of taking the nipple and part of the breast when she is breast feeding. Treatment It is important to keep breast feeding the baby even if it hurts. To avoid sore nipples, breast feed often, for as long as the baby wants to suck, and be sure the baby is taking as much of the breast into her mouth as she can. It also helps to ij change the baby's position each time she nurses.- ___
As with the vast majority of pathogens causing diarrheal illness, proper sanitation and hygiene aimed at diminishing the risk of fecal-oral transmission is important for the prevention of enteric E. coli infections. Culturally sensitive education on the use of soap and handwashing after defecation and before eating or preparing foods and improvements in the disposal of human waste are the simplest and, perhaps overall, the most effective means of preventing disease caused by most enteric E. coli.234-238 Numerous studies have demonstrated the protective benefits of breastfeeding in preventing diarrheal diseases, including those associated with ETEC and EPEC.21,239,240 Not only does breastfeeding diminish the risk of fecal-oral exposure from exposure to weaning foods, but breast milk likely affords immunologic protection241 and may contribute oligosaccharides and other substances which interfere with attachment of E. coli to intestinal epithelium.112,113 Programs which address...
The greatest danger to children with diarrhea is dehydration, or losing too much liquid from the body. The danger is even greater if the child is also vomiting. Give Rehydration Drink (p. 152). If the child is breast feeding, continue giving breast milk, but give Rehydration Drink also
Before age twelve, does not have children or has her first child after age thirty, does not breastfeed her children, or undergoes menopause after age fifty-five. The correlation appears to be with the number of ovulatory cycles the woman undergoes in her lifetime. The period between menarche and first pregnancy, during which time the breast tissue is developing, appears to be most sensitive to environmental insults, possibly because rapidly dividing cells have the highest probability of incorporating mutations. It is thought that events initiating breast cancer may occur during this time, but that the promotional events necessary for the disease to be expressed occur over years.
Isolates in outbreaks of community-acquired and nosocomial infantile diarrhea in Great Britain.16 In these initial reports, mortality rates exceeded 50 in some cases.16 Although EPEC is no longer considered a common cause of diarrhea in most developed nations, sporadic cases and outbreaks have been reported in Great Britain, Finland, and the United States.17-21 Numerous studies in tropical or developing areas have demonstrated a convincing association of EPEC in infants with diarrhea,21-26 and in some studies EPEC was identified as the most common bacterial cause of diarrhea in the youngest children.26-28 Recent hospitalization has been identified as an important risk factor for EPEC diarrhea in children in Sao Paulo, Brazil.21 Older studies have suggested bottle feeding as a risk factor for EPEC diarrhea,16,29 and more recent series have demonstrated that breastfeeding is protective.21,28
This occurs most often in babies who stopped breast feeding early or suddenly, and who are not given sufficient high energy foods often enough. Severe malnutrition often starts when a child has diarrhea or another infection. We can usually recognize children who are severely malnourished without taking any measurements. The 2 main examples are The mother did not breast feed her baby. She fed him only maize porridge. Although this filled his belly, it did not provide enough nutrition for him to grow strong. As a result, this 2-year-old child is severely malnourished. He is very small and thin with a swollen belly, his hair is thin, and his physical and mental development will be slower than normal. To prevent this, mothers and their children need to eat better.
Although the vertical technique using the medially based pedicle has its limitations, it has not only reduced scarring in breast reduction surgery, it has given patients a more pleasing shape and a longer-lasting shape than what I had achieved with the inverted T, inferior pedicle approach. Nipple sensation and breastfeeding appear not to be compromised any more than in other techniques. The procedure is faster, blood loss is less, and recovery for the patient is shorter. On the other hand, there are size limitations to the vertical breast reduction and the revision rate is slightly higher. There is a learning curve with all forms of breast reduction surgery, but the benefits outweigh the disadvantages.
Treatment of Postpartum Breast Engorgement and Bleeding. Within 24 to 48 hours after delivery, the mother's breasts will become swollen and tender. If the mother intends to breast feed the infant, the nursing staff will provide care to help alleviate the pain. After a while, the pain will subside. If the mother does not wish to breast feed the infant, estrogen can be administered. A large dose of estrogen will feed back to the pituitary gland through the hypothalamus. Prolactin release will be inhibited and the breast engorgement will not occur. You should know that the use of estrogen to treat postpartum breast engorgement is not recommended because of the risk of clot formation. Such administration of estrogen is soon after delivery. Estrogen can also be given to decrease uterine bleeding, since estrogen stimulates the repair of the uterus and vagina (increases the lining of these structures).
Transplacental passage of the virus, during delivery, or postnatally through breast feeding however, it is believed that most infections are acquired at birth through contact with contaminated blood or secretions. Women who carry the virus should thus be discouraged from becoming pregnant or from breast feeding. The rate of transmission of HIV-1 from mother to infant has varied from 13 to 45 , with an average of 25 however, when AZT is administered to HIV-1-infected pregnant women and to infants during the first 6 weeks of life, the risk of maternal-infant transmission is significantly reduced.
Relieve Postpartum Breast Engorgement. Oxytocin is used to relieve postpartum breast engorgement in women who are going to breastfeed their infants in that it causes milk let-down. Milk let-down is a situation in which the milk in the breasts travels from alveoli to the nipples where it can be suckled by the infant. If the milk does not travel from the alveoli to the nipples, the breasts can become swollen and sore. In addition to relieving postpartum breast engorgement, oxytocin can also aid in milk ejection from the breasts by having the milk move toward the nipples.
It worked for me during my pregnancy and it was a great alternative to having to use medications you really didn't want to take when you're pregnant. And so that continued when I was breast-feeding for the same reasons. It just worked and I had no side effects. It was probably that I had read too much before I got pregnant and in my early pregnancy about how unnecessary some of the procedures were and the potential harm they could cause to be comfortable with them.
The answer is e. (Holmes, 3 e, pp 1117-1120. Eur. Mod. Deliv. Collab. Lancet 353, 1999.) The landmark randomized placebo controlled trial ACTG 076 demonstrated that zidovudine (ZDV) given at the beginning of the second trimester, during labor and delivery, and to the newborn for 6 weeks, significantly reduced the transmission of HIV to the newborn from 25.5 in the control group to 8.3 in the treatment group. Thus, ZDV can be highly effective for primary prevention in the newborn. Other promising treatment schedules with ZDV and other antiretrovirals are under study. Recent data demonstrates that a cesarean section can reduce vertical transmission, but it should not supersede antiretroviral therapy. Currently, it appears that it is not a routinely recommended procedure for HIV-infected pregnant women, but this may change in the future. HIV can be transmitted by breast feeding, and in some studies, the risk is increased by 14 . However, breast feeding has no impact on the highest...
Fortunately, vitamin B12 is required only in very small amounts, probably no more than 1 pg day.115 The present RDA is set at 2 pg day for adults and teenagers, about 2.5 pg for pregnant and breast-feeding women, and one microgram or less for children. Minimum needs are actually less than those amounts. In fact, 1 pg day can effectively treat anemic vegans128,129 and return people without B12 stores to normal. Human vitamin B12 deficiency may be slow to develop because of large liver stores. It is estimated that about 3000 pg are stored in an adult, and 30-50 pg are stored in an infant or child.130 Persons who completely give up animal products may go for years before any nervous system disorders or other signs and symptoms of a B12 deficiency are manifested. It is essential that pregnant and breast-feeding women have adequate B12 intakes, especially when following a vegan diet. During the latter half of pregnancy, the fetus removes about one fifth of a microgram of B12 per day from...
A 2-day-old neonate becomes lethargic and uninterested in breastfeeding. Physical examination reveals tachypnea (rapid breathing) with a normal heartbeat and breath sounds. Initial blood chemistry values include normal glucose, sodium, potassium, chloride, and bicarbonate (HCO3-) levels initial blood gas values reveal a pH of 7.53, partial pressure of oxygen (Po2) normal at 103 mmHg, and partial pressure of carbon dioxide (PCO2) decreased at 27 mmHg. Which of the following treatment strategies is indicated
Maintaining the continuity of the lactiferous ducts within the intact caudal glandular layer likely favors postoperative lactation. In all cases of pregnancy (five patients), uncomplicated breastfeeding was possible. The breasts showed stable, conical shape (Figs. 8.98.12), and no significant settling was necessary to find the final breast shape. There is no marked difference between early and late appearance. The technique allows one to adjust the final breast size to the individ
IMPLANTS are 1, 2, or 6 small, soft tubes that are placed under the skin on the inside of a woman's arm. These tubes contain the hormone progestin and prevent pregnancy from 6 months to 5 years, depending on the type of implant. The tubes must be inserted and removed by a trained health worker, usually at a clinic or family planning center. They can be inserted any time a woman and her health worker are reasonably sure the woman is not pregnant. If a woman is breast feeding, implants can be inserted 6 weeks after the baby was born. For more information see page 397.
There are no available data concerning the efficacy of either of the licensed vaccines for use in children under 2 years of age. Evidence exists to suggest that breastfeeding and careful preparation of formula may reduce the risk of infection in endemic regions.109 No safety data are available for the use of typhoid vaccines in pregnant women.
As it approaches the nipple the areolar layer may get less distinct, and a little more forceful blunt finger dissection may be necessary to reach the horizontal plane behind the nipple. Also, the cranial and caudal layers of lactiferous ducts and sinuses are separated bluntly along the horizontal septum as far as the nipple. In this way the caudal layer of duct openings into the nipple can be maintained intact, which very probably preserves the possibility of breastfeeding postoperatively.
Based on a well-vascularized and constant anatomical structure such as the horizontal septum, the pedicle is safer, especially in the case of significant breast hypertrophy. The septum-based mammaplasty technique shows clear advantages over the conventional techniques of breast reduction in terms of ease of pedicle shaping and modeling in addition to NAC sensation and breastfeeding.
The breast is a subcutaneous structure that consists of 15 to 25 separate lobules. We all know that the breast is a functional organ for breastfeeding, but we also need to remind ourselves that it is a very important cosmetic aspect of a woman's sense of self - both physically and psychologically.
The pedicle is designed to be a full-thickness pedicle (Fig. 7.4). It is believed that this is more likely to include good blood vessels and nerves. Although thinner pedicles have been described 35 , a full-thickness pedicle is also more likely to preserve ductal tissue for future breastfeeding potential. Once created, the pedicle is full thickness down to the breast meridian.
New Mothers Guide to Breast Feeding
For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.