The Breastfeeding Atlas: Thai Edition” prepared by the Thai Breastfeeding Center Foundation can transfer the knowledge of breastfeeding to the complete practicality in a very easy format. The Breastfeeding Atlas: Thai Edition" is the prized manual of breastfeeding for officials and the pride of people in the breastfeeding arena.
Frequent Problems of Nipple, Areola and Breast
Breastfeeding under Special Circumstances
Tongue-tie 126 Sopapun Ngernchum
Breastfeeding problems in an infant with cleft lip and palate 130 - Benefits of breastfeeding an infant with cleft lip and palate 131 - Breastfeeding practices for an infant with cleft lip and palate 133 - Techniques to help breastfeeding infants with cleft lip and palate 133.
Storing breast milk for the case of mother-baby separation 147 Kannika Bangsainoi, Siraporn Sawasdivorn, and Walai Chetawan
Case Study
Difficulty in breastfeeding with high palate 174 Kusuma Chusilp and Walai Chetawan
Breastfeeding under the Working Mothers
Manual and mechanical breast milk expression 202 Siriluck Thavornvattana and Wilairux Busabun
Baby Bag (Grift Set to Promote Breastfeeding) 214 Siriluck Thavornvattana and Wilairux Busabun
Relevant Truth about Breastfeeding
Regulating marketing strategies of foods for babies and young children 236 Nipunporn Woramongkol
Breastfeeding : Nuture’s way
Learning about the mother’s breasts
Knowledge on breast milk
Correct positioning and proper suckling
Newborn stools after breastfeeding 1.6 Newborn urines after breastfeeding
Natural way of breastfeeding
Breastfeeding : Natureûs way
In practice, when the newborn is placed close to the mother's chest, he will automatically suck the nipple (Image 1.1.13). Skin-to-skin contact of mother and baby with a blanket covering them should sufficiently warm the newborn's body (Image 1.1.33).
Learning about the motherûs breast
Figure 1.2.5 The innermost muscle layer and muscle rings around the milk duct in the nipple. Figure 1.2.4 Large pores on the channel.
Learning about the motherûs breasts
Meanwhile, the large milk ducts in the area below the areola are emptied before lactation (Figure 1.2.26). Very large breasts (Figure 1.2.31) can cause the mother physical discomfort and concern about appearance.
Lactation (of colostrum) starts in the final trimester for up to three days after delivery. Within 24 hours after birth, an infant may receive 100 milliliters or less of breast
The mother must use her upper arm to support the baby's head and neck (Picture 1.4.19). The mother's arm on the higher side of her body supports the breast and brings the nipple and areola to the baby's mouth (Image 1.4.32).
Latching on
Newborn stools after breastfeeding
On day 3-4 after birth and once the baby starts to breastfeed more often, the color of the stool will become lighter from dark green to yellowish green. The stool will also increase in quantity with the baby having 3-4 stools a day. After examining the baby's diaper, the stool should appear in the middle of the diaper surrounded by soaked water.
Once the baby is over six weeks, there will be a change in his bowel movements. Certain vegetables, fruits or vitamins in the mother's diet can change the color of the baby's stool. For example, a 5-month-old baby with regular golden stools (Image 1.5.14) but passing green stools the next day after the mother's diet with a large amount of morning glory (Image 1.5.15).
Newborn urines after breastfeeding
The amount of urine excreted each day helps the child's caregiver determine whether the child has enough water or not. The baby who is getting enough breast milk should urinate 3-5 times a day during the first five days and at least six times a day thereafter. Diapered babies can be difficult to assess as the baby will pass around three tablespoons of urine per day.
This condition will disappear once the baby is three days old or older, and so no further evaluation is needed. However, if the condition persists with the baby still having dark or rusty colored urine (Image 1.6.2), it should be determined whether the baby is getting enough milk or not. One solution is to give hand-pumped breast milk in addition to breast milk until the baby is better able to nurse on his own.
Nipples and Areolas
Therefore, the mother should let the baby deeply grasp the nipple so that the baby's gums press on the areola and not on the nipple. When a baby nurses, the nipple and areola are stretched and pulled into the mouth. It makes it difficult for the baby to plant deep enough to reach the areola.
The child sucks only on the nipple due to the mother's slippage, or the child pulls the lips too much. The mother's crowded and tight breasts can result in hardening of the areola, which the baby can only suck on the nipple. After the baby has finished nursing, 2-3 drops of breast milk are extracted and distributed on the nipple.
Breasts
As the engorgement subsides and the areolas soften, bring the baby to the mother to breastfeed, all the while helping the baby to do this properly (Figure 2.2.12). Under normal circumstances it occurs in part of the breast and only in one breast (Figure 2.2.26). Breast milk can possibly be extracted by means of manual expression (Figure 2.2.28) or the breast pump (Figure 2.2.29).
For the mother with pus collected within the ducts (Image 2.2.35), let the baby nurse from the intact side (Image 2.2.36) and squeeze the pus and breast milk from the abscess. Cooper's ligaments suspend the breasts, attach them to the chest, and maintain the shape of the chest (Image 2.2.37). Then, bring the baby to the mother to breastfeed, with the pillow protecting the baby and the breast (Image 2.2.51).
Premature babies
Kangaroo mother care
Twins
Tongue-tie
Cleft lip and cleft palate
Down Syndrome
Storing breast milk for the care of mother-baby separation
Mothers should be encouraged to pump the increased amount of breast milk in a cup every 2-3 weeks. hour and store it correctly (picture 3.1.13). Put the last part of the mother's milk in the syringe with pressure control (picture 3.1.15). The father should be involved in feeding activities, such as helping to feed the mother's breast milk to the baby while she pumps breast milk (Figure 3.1.21).
The mother should be involved in feeding in the NICU, such as expressing breast milk next to the baby (Figure 3.1.22). The mother should hold the baby next to the breast for skin contact (Kangaroo Mother Care) (Figure 3.1.23). Once the baby has improved his ability to suck and swallow, you can train him to suck breast milk slowly by drinking from the cup (Figure 3.1.27).
Kangaroo Mother Care
Kangaroo Mother Care is used to care for newborns, especially premature or low birth weight babies, where the mother holds the baby skin-to-skin on her chest. With this method, the mother's body heat will be transferred to the baby and it will receive nutrients from the breast milk. The child should leave the mother's breast only during clinical examination, care of the umbilical cord, cleaning and changing of diapers.
Advise the mother to express and save breast milk for the baby every 2-3 hours after delivery. It is common practice for mothers with triplets to feed breast milk along with formula. The mother was worried that breast milk would not be enough for this baby, so he was given formula.
Ankyloglossia (Tongue-tie)
1 in 700 newborns is at risk of developing cleft lip and cleft palate due to genetic and environmental factors. Ethnic differences also explain the disparity in the occurrence of cleft lip and cleft palate. Treatment for cleft lip and cleft palate depends on the physical severity of the condition.
Therefore, classification of the severity of cleft lip and cleft palate is essential from the beginning of treatment, its follow-up and the reporting of results. The child with only cleft palate is often unilateral and incomplete (incomplete cleft palate). The child with both cleft lip and palate often has types 3 and 4 cleft palate and cleft lip with clefts in the nostrils.
Increased feeding time
The baby with only a cleft palate, or both a cleft lip and a cleft palate, experiences the following problems during breastfeeding:
Swallowing air during suckling and food intake
Milk and food entering the nasal cavity
Coughing and choking while swallowing
Slow weight gain
Middle ear infection
Slow speech development
- Down syndrome
- Storing breast milk for the case of mother-baby sepa- ration
The child with cleft lip all the way to the nose (Types 1 and 2) has the least problem with breastfeeding. The problem of breast milk entering the nasal cavity can be found in the child with soft cleft lip and soft palate. Mothers should express some breast milk to start breastfeeding before letting the baby nurse (Figure 3.5.19).
The breast milk provided must be freshly expressed so that the baby can receive the necessary antibodies against infections. Let the breast milk flow to the edge of the cup and touch the baby's lower lip until he opens his mouth wide. Synchronize the tilt of the cup so that the milk falls to the rim as the baby sucks.
Case Study
Newborn with jaundice 4.2 Slow weight gain
Nipple confusion
Difficulty in breastfeeding with high palate 4.5 Milk protein allergy
Mother with chicken pox or shingles 4.7 Mother with excessive breast milk
Relactation
Newborn with Jaundice
Jaundice becomes apparent when the bilirubin level is higher than 5 mg/dl in one-day-old newborns and 7 mg/dl 24-36 hours after birth. Normal bilirubin level is 12 mg/dl and medical advice should be sought if it becomes higher than 20 mg/dl. Jaundice, as observed on the face and body (Image shows the bilirubin level of 18 mg/dl on the microbilirubin meter (picture 4.1.7) but without abnormalities of the additional blood test.
When the mother remains with the newborn and nurses continuously, jaundice will subside after three days of phototherapy (Image and bilirubin level down to 8.2 mg/dl (Image 4.1.11) No treatment is required if the newborn is full-term, healthy, and with the bilirubin level below 20mg/dl and breastfeeding can be continued If the bilirubin level is 20-25mg/dl it is an indication for phototherapy, breastfeeding can still continue or stop for a maximum of 24 hours and switch to formula in the meantime (in case of an absent mother).
Slow weight gain
To feed from the breast, the baby must use the tongue and jaw movement in a wave-like motion. To feed from the bottle, the child must contract the tongue muscle and lift it (picture 4.3.1) to press the teat to let the milk flow into the mouth. Allow the baby to open its mouth wide before latching onto the mother's breast and covering the areola.
If the baby prefers fast milk flow, the good secretion of breast milk will help the baby to latch onto the mother's breast and breastfeed more easily. If the child prefers a fast flow of milk, but rejects the milk from the mother's breast, you must use the breastfeeding aid (picture 4.3.3). Train the child to rub the mother's breast with the tongue so that the tongue muscle can lock easily (picture 4.3.6) and let the mother rest while breastfeeding.
Difficulty in breastfeeding with high palate
Difficult breastfeeding with high palate
The mouth cannot close completely during breastfeeding, and the milk drips to the side as the mother squeezes the milk to stimulate the breast (Image 4.4.13). Let the mother practice pumping milk (Image 4.4.14) and feeding the baby with alternative devices such as cups. Arrange a comfortable and painless position for the mother during breastfeeding, such as holding the baby on her side to nurse from one breast.
Initially, the mother can place the baby in a sitting position with the chin close to the areola (Figure 4.4.15). If the baby cannot fully attach to the breast, the mother should stretch the areola in a teacup position (Figure 4.4.16). Hold the breast in a U shape (Figure 4.4.17) to squeeze the areola so that it narrows.
Milk protein allergy
For example, mucus mixed with blood (Figure 4.5.2) is replaced by more mucus, the presence of undigested milk lumps (Figure 4.5.3) and returns to mucus mixed with blood (Figure 4.5.4). When you stop consuming milk and replace it with special milk for patients with milk protein allergies, the condition improves. The diagnosis of milk protein allergy can be made with a skin test or by stopping the consumption of milk.
If the condition recurs two times out of three, the child is diagnosed with a milk protein allergy. If the condition does not improve, the mother should stop consuming milk and all other dairy products until the baby is one year old. If the baby is fed with milk, switch to a special milk in which foreign milk proteins are destroyed.
