Vomiting and Sucking & Swallowing difficulties

Vomiting may be due to overfeeding, prolonged burping, too much of swallowed air, gastroenteritis or some other infection. Persistent vomiting is an indication to meet the doctor. Also if the baby shoots the milk half way across the room you must consult the doctor. The so called projectile vomiting may well be a manifestation of hypertrophic pyloric stenosis, a disease needing specialized care and in all probability an operation. Some difficulty during the first few days after birth is normal. This is the time when you and the baby are still trying to master the technique. Certain mechanical problems like cleft pallet, cleft lip, very large tongue and obstruction in the nose may interfere in feeding. Local conditions of the breast like sore and cracked nipples, retracted nipples and engorgement also cause sucking difficulties. Mind you, a preterm baby has a greater chance of having poor sucking and swallowing difficulty. If your new born has developed jaundice (yellow discolouration of the skin and white of the eye) there will be poor activity and the baby will stop sucking as well. When this condition is noticed do not hesitate to consult a doctor. Contamination of food can also be a cause for vomiting.

Regurgitation

Several babies bring up a little of the feed along with swallowed air which condition is called posseting. This condition becomes a habit in some babies. They relish bringing back some milk and chew it just as a cow chews the cud. This is called rumination. Though harmless, it makes the baby smelly. In order that while doing so he does not inhale any bit of the regurgitated milk into the lungs, you should put him on his side. Never put the baby on his back, always put him on his side so that it will be difficult for him to regurgitate and to continue rumination. You do not have to bother about regurgitation unless it interferes with the nutrition of the baby. Also if the baby brings back the entire food particularly more than once, you should seek the opinion of a doctor. Regurgitation is because of the wind production in the stomach because of the excessive air that he swallows with the feed or because of excessive crying. If you are well trained in the technique of burping and if you are putting it into practice, the solution of the problem is round the corner. In fact the problem should not occur if you are doing good burping. You may well check up with your doctor how to do it properly.

Feeding the low birth weight baby

The low birth weight baby has an immature alimentary system which causes special feeding problems which need to be tackled in a special way. You must appreciate that in order to make up for his weight deficit, he needs more milk. He also needs additional vitamins, A, C, D, E and K as also iron and folic acid about the first month. As a rule he should receive his first feed early rather than late. Most good centres have a policy to give the feed just 3 hours after birth. If the baby is less than 1200 gms in weight especially when breathing difficulty or abdominal distension are also present, doctors prefer to start intravenous drip in order to give 5 to 10 percent glucose round the clock. Most babies with weight over 1800 gms and some even with less of it are able to suck well from the breast or bottle. Doctors would like you to breast feed such a baby. One precaution feed the baby small amounts but make it at more frequent intervals. Most babies weighing between 1200 and 1800 gms would need to be fed in the hospital through a tube passed through the mouth or the nose into the stomach. This kind of feeding is indicated if the baby becomes quickly tired or takes more than 20 minutes to finish the recommended amount of feed.

Baby’s addiction to the bottle

One of the most common problems faced by mothers is the baby’s addiction to the feeding bottle. This can be at time very embarrassing to the mother especially when they out to a party. I have seen some educated mothers with grown up babies clinging to the feeding bottle. This is a very common sight in a doctor’s clinic. If you ask the mother whether it does not look odd, the instant reply from the mother would invariably be “what can I do? He cannot do without it”. This only shows that the mother has not whole heartedly decided to wean her baby from the bottle or when she does so it is already too late. You should begin weaning the child from the bottle as soon as he is 6 to 9 months of age. By the time he is one year old, there is no reason why he should still be using the bottle. The cup is the right thing for him. Do not let any bottle lie around the house. He would certainly create fuss for some days. Eventually he will learn to do without the bottle. But remember it requires determination and not half heartedness on your part.

Which Milk to Choose

It is very important that you choose the right milk for feeding your baby. No doubt cow’s milk is the best and preferred by one all for artificial feeding especially if you do not want to make things too expensive. Milk powders are costly but have the advantage of being less contaminated and free from adulteration. The next option would be the buffalo’s milk. Cow’s milk or modified buffalo’s milk currently available for sale may contain about 5 to 6 percent of fat. The recommended dilution for cow’s milk for the first fortnight is 1:1. Subsequently it should slowly be decreased to 2:1, then to 3:1 and later as such without dilution. The suggested dilution of buffalo’s milk is more or less the same as that of cow’s milk. Skimmed milk powder should not be used for infant feeding. Not that there are no advocates of proprietary formulae. For instance it has been suggested that large amount of sodium consumed during infancy may cause high blood pressure in later life. So care should be taken to feed proprietary formulae with low sodium content only. If you choose to give powder milk, see that you start with a standard brand and also make sure that its supply is not going to be short in the subsequent months.

Artificial feeding and its hazards

The lack of knowledge of proper feeding technique, poor socio economic status, superstitions and customs are some of the factors that make bottle feeding hazardous to the baby. Over dilution of the formula can result in under feeding and eventually lead to multiple nutritional deficiencies. Super added infections, especially acute gastroenteritis, as a result of dirt from poor hygiene and untidy hands as also feeding bottle and other utensils constitute another danger of bottle feeding. Acute gastroenteritis may per se prove a “Killer”. In others, its recurrent attacks adversely affect the nutritional status of the baby, often leading to gross malnutrition in one shape or the other. Iron and vitamin deficiencies, especially those of C and D, are common in artificially fed infants unless they receive supplements of these constituents at the appropriate time. Prolonged use of skimmed milk may cause vitamin A and D deficiency. Likewise if a sweetened condensed milk is give for a long time, protein-energy malnutrition may result. Yet, if you have to give your baby artificial feeding, either on doctor’s advice or on your own the choice is yours. You must exercise greater vigilance and extra care in carrying it out. Do not forget to bear in mind that you are going to expose the baby to a lot of hazards.

Failure in lactation…..a myth or reality?

Many researchers worldwide believe that there is no such thing as failure of lactation. It is never real and on the contrary it is only the indifferent attitude of the mother towards breast feeding. They regard it as messy, an encroachment on their activities and so on. There is a great deal of evidence that attitude of the mother has a great bearing on the success or failure of lactation. All mothers should remember not to rush for artificial feeding as soon as you encounter some difficulty in starting the baby on breast feeding. This will only hamper on the very production of milk by the mother. There are certain conditions of the breasts that may contribute to the failure of breast feeding. For example sore or cracked nipples. This condition can be cure by taking the baby off feeding for a temporary period and apply some cream to the nipple. Resume feeding when the nipple is healed. Retracted nipples cause difficulty in the withdrawal of the areola into the baby’s mouth that is in sucking. In such conditions press the areola between the thumb and the index finger just before the nipple is put inside the mouth of the baby. If it does not work use a nipple shield temporarily. So just because you have some difficulty in initiating the baby on breast feeding is not a good reason to “call it a day”.

Nursing Mother’s Diet

In order to produce enough milk for adequate growth of the baby, you must eat a little extra of whatever you eat routinely. This is important to maintain your health as well. A little additional helping of food including green leafy vegetables, fruits, fish, and meat should suffice. Over eating must however be avoided. Many mothers hesitate to breast feed their babies because they think they are very weak. Remember that even malnourished mothers are able to breast feed their babies for the first 4 to 6 months. This no doubt puts extra strain on their vulnerable bodies, depriving them of calcium and proteins. The answer lies not avoiding breast feeding buy in improving their own nutrition. Nursing mothers must avoid alcohol and smoking. You can see numerous mothers who regretted terribly that they had smoked and perhaps drunk during pregnancy and after birth of the baby. I am sure that there will not be even a single woman who would have regretted in not having indulged in such activity. Nursing mothers should remember very spicy foods such as chillies and flavoured foods may cause a sort of smell in the milk that the baby finds annoying. These may also upset his tummy. So avoid such food.

Breast feeding during illness and when on medication

The mother can continue breast feeding while she is unwell. In such cases, the doctors prescribe medicines that are less likely to harm the baby. In aliments such as septicemia or jaundice, the doctors may discontinue breast feeding for a short period. During this gap, the mother should express the milk to safeguard against breast engorgement and to ensure free flow of milk when she resumes breast feeding after a few days. As far as the baby, feed him with a clean spoon and cup during this passing phase. Almost all drugs taken by lactating mothers are excreted through breast milk, usually in very small amounts. But, if a drug is required to be given in a large dose or over an extended period, breast feeding may prove damaging to the infant. Antithyroid drugs given to the mother with thyrotoxicosis for instance, may cause hypothyroidism in the infant. There are certain contraceptive pills which have an adverse effect on lactation. But, again a point that should not be overlooked is, that this is the case only when lactation is not yet established. The contraceptive pill does not however interfere with the full established lactation. All said and done it is advisable to wait about six weeks before starting on oral contraceptive.

How can the fairy collective surprise the sin?

How can the fairy collective surprise the sin?

Prenatal expression of Milk & Techniques of breast feeding

It is debatable whether prenatal expression of colostrum should be practiced. Expressing the breast milk during the last weeks of pregnancy allows the mother to get used to the handling of her breasts by the future baby. Thus, she learns a technique that might prove handy once breast-feeding has begun. It is claimed that the more the mother expresses her colostrums, the more ready will the breasts be to produce larger amounts of milk after childbirth. She should also learn to do manual expression by gently squeeze the skin above and below the nipple, avoiding the dark area with the forefinger and the thumb. This brings out a small amount of thick yellow material. In the beginning this may be difficult. But, with practice, this becomes easy. A few days after the birth of the baby her breasts get engorged. Unless she has initially expressed some milk, it becomes difficult for the baby to get his jaws around the nipple. Every pregnant mother should learn during the antenatal period how to bear down, how to relax and how to promote lactation, how to actually breast feed the baby and how to do burping else this will interfere in her from further feeding the infant on her breasts.

Antenatal preparation for Breast feeding

If nutrition is poor, the mother’s borderline malnutrition may become over. On the contrary, overeating may cause excessive gain in weight. Average gain during pregnancy in the first 20 weeks is 3kg. A gain of 0.4 kg per week is considered safe. Both malnutrition and over nutrition are risky for the mother as well as the baby. In both cases, successful breast-feeding is hindered. The expectant mother should learn mother craft and attend to motivation for breast-feeding during discussion with the nurses, lady health visitors or doctors during pregnancy. Care should be taken to wash the nipples with plain tap water. Application of soap, antiseptic lotion or vitamin ointment is best avoided. During the last month or so, gentle application of plain lanolin cream is allowed. Scrubbing the nipples to make them tough is not in order and should not be resorted to. Since it is usual for the breasts to increase considerably in size, particularly towards the last trimester, it is desirable to wear an uplift brassiere about one or two sizes larger. It helps to prevent sagging. If you notice any abnormality in your breasts immediately consult your doctor who will help you out. Do not be shy or hesitant in consulting him.

Promotion of breast feeding

Adequate prenatal advice to the young mothers about the several merits of breast-feeding. Proper reassurance and preparation for breast-feeding go a long way to make it a success as and when the baby comes. In the present modern times when women work on par with men, they have no time to breast feed their babies. Some organizations extend maternity leave for a period of three months which is mainly for the mother to breast feed the baby. There is also a wide spread misconception that breast feeding will spoil the figure of the women. In fact it helps her to regain her figure. Every mother should keep their breast clean. It should be periodically ascertained by your doctor that the nipples are neither retracted nor cracked or sore. Engorgement as also abscess interferes with successful lactation. The infant should be put to the breast as soon as possible after birth may be within the first 3 hours. The lactating mother should keep herself happy, confident and free from anxiety. Worry is the enemy of successful breast feeding. Good nourishing diet with plenty of water and fruit juices and frequent sucking by the baby is the best way for promoting milk production. Your doctor will advise you if you need to take a drug to help you in producing more milk.

When does milk begin to come after delivery?

I would say that it is a wonder of Nature. Milk begins to come on the second or third day after delivery in case of multipara. Primipara starts supplying milk a little later, i.e., on the third or fourth day. With the passage of days and weeks, the breasts tend to adjust well in their milk production to meet the infant’s needs. This is one unique example of how efficiently nature works. The milk secreted in the first few days is called colostrums (which is milk, as the cynics would have us believe but which is all nonsense). This is exceedingly rich in protein s and gets coagulated spontaneously on standing. Gradually, the protein content falls whereas the fat content shows a rise in colostrum as time passes. In the first month secretion of milk is called intermediate or transitional milk. Thereafter, it is the mature milk which supplies most of the required nutrients with the exception of iron, vitamins C and D and copper. Depending on the demand and health condition of the mother milk production continues even for many years after the birth of the last child. A unique case where a mother continued to have lavish amount of milk even after 30 years after the last childbirth.