Post on 15-Dec-2015
DR RAVARI 2014
Impact of Birthing Practices on Newborn Baby Care and
Breastfeeding
دكتر محمود راوريمتخصص کودکان
عضوكميته كشوري شيرمادردانشکده علوم پزشكي ساوه
DR RAVARI 2014
WOMEN NEVER FORGET THEIR BIRTH DAYS
Giving birth is one of the most significant events in a woman’s life.
Pregnancy, birth and breastfeeding are all part of the same continuum
DR RAVARI 2014
The medicalization of birth and postpartum processes has created additional barrier to successful breastfeeding
Birth interventions that disrupt the natural interaction between the mother and the infant in the immediate postpartum period can impact long-term breastfeeding success.
DR RAVARI 2014
The first minutes after birth are a very vulnerable period for both mother and newborn.
Babies born by cesarean may also suffer from the consequences of this type of birth process.
A mother's breastfeeding experience can be:
“Profoundly affected by what happens during the first hours after birth”
DR RAVARI 2014
Benefits of normal vaginal delivery For BabiesBIRTH CANAL
Lowered risk of respiratory problemsAs the babies pass through the vagina, pressure in the vaginal helps baby to expulse the amniotic fluid inside the lung. This can help babies to breathe better once they are outside the mothers' body.
DR RAVARI 2014
What physical effects may occur in babies more frequently with CESAREAN DELIVERY?Respiratory distress syndrome (TTN.HMD) elective CS
Pulmonary hypertensionNot breastfeedingNeonatal mortality
DR RAVARI 2014
CESAREAN SECTION
Risk of maternal death is 3.6 times higher for cesarean than vaginal birth.
Infants are 1.5 times more likely to die during elective first cesarean than vaginal birth.
DR RAVARI 2014
Benefits of normal vaginal delivery For Babies☻BIRTH CANAL
Babies will pick up a protective bacterial as they pass through the vagina. This bacterial can boost his or her immune system and make him or her less vulnerable to some infectious diseases and protection against childhood chronic disease
DR RAVARI 2014
CESAREAN DELIVERY VERSUS VAGINAL DELIVERY
Play in the development of childhood chronic disease(Autoimmune) Allergic diseases (Asthma, food allergy, allergic
rhinitis, Wheezing, Hay fever) and Cow's milk allergy/intolerance
Type 1 diabetesObesityInfluences neonatal mucosal immunity Increases the risk digestive , respiratory and
infectious diseaseIncreases the risk in adults for allergic
diseases(asthma)Influences the acquisition time of cariogenic
Bactria in children.
DR RAVARI 2014
Benefits of normal vaginal delivery For Babies
Endorphin levels are highest during vaginal deliveries in unmediated mothers.
During labor, endorphin levels rise during each contraction, most noticeably in the second stage of labor. Endorphin levels are highest just after birth. It takes two weeks after birth for endorphin levels in the body to return to normal.
Endorphin levels protect and serve babies during childbirth as well. Endorphins are elevated in newborns that experience distress during the birth process.
Endorphins stimulate the production of prolactin, the relaxing “mothering” hormone that aids in breastfeeding and mama-baby bonding after birth
Epidural Analgesia decrease maternal endorphin production and lower endorphin levels to the neonate during breast-feeding. Lower endorphin levels, in turn, may render the neonate less likely to suckle optimally
Endorphins in Childbirth:Body’s Natural Painkillers
DR RAVARI 2014
These high levels of circulating catecholamines cause the olfactory bulbs in the infant’s nares to be extremely sensitive to the odor cues that guide the infant towards the mother’s nipple
Benefits of normal vaginal delivery For BabiesHuman infants experience a catecholamine
surge immediately post birth secondary to compression of the fetal head and intermittent hypoxia during contractions.
DR RAVARI 2014
Benefits of normal vaginal delivery For BabiesNewborns from VAGINAL
DELIVERY, with high levels of catecholamines from the maternal circulation, are better equipped to adapt to extra uterine life than those delivered by cesarean section.
DR RAVARI 2014
NINE INSTINCTIVE STAGES
Skin
-to-S
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con
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their
moth
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follow
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Bre
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STEP 4 BFHI
DR RAVARI 2014
Benefits of normal vaginal delivery For Babies Babies born by normal
delivery demonstrate more interest in pre-breastfeeding behaviors such as sucking mother's breasts. Babies born by normal delivery are also reported to nurse for longer periods within the first 90 minutes after birth, which has many benefits for both the mother and the baby
Higher breastfeeding success rate.
DR RAVARI 2014
INITIATION OF BREASTFEEDING
Self-attachment refers to the phenomenon that full term undrugged infants, left on their mother's chest undisturbed, will breastfeed spontaneously within one hour, without any assistance.
However, skin-to-skin contact is required in order for this behaviour to succeed. Mothers and babies should not be separated at birth.
The newborn actually stimulates hormonal responses (oxytocin) in the mother, which trigger caregiving and protective behaviours from the mother.
By kicking on the mothers abdomen � the baby helps the mothers uterus to contract strongly, preventing post-partum �bleeding.
Babies that are placed on their mother's bare chest are more likely to latch on to their mother's breast and are likely to latch on well, compared to babies that are not immediately placed on their mothers.
DR RAVARI 2014
SKIN-TO-SKIN CONTACT
Research has shown that early skin-to-skin contact between a mother and baby at birth reduces crying , decreased stress metabolic adaptation improves mother-baby interaction keeps the baby warmer facilitate the early initiation of exclusive breastfeeding helps women breastfeed successfully (effective suckling) and
for longer
DR RAVARI 2014
SKIN-TO-SKIN CONTACT
The first hour or so after birth are crucial for mother and baby in terms oftheir wellbeing, the opportunity to bond with each
other and, the first breastfeed.
SKIN-TO-SKIN CONTACT promotes all three of these
things.
DR RAVARI 2014
DYAD MOTHER AND INFANT PAIR
A baby knows instinctively that she is dependent on her mother to survive, and so if they are separated, the baby experiences distress and the mother does not experience the release of hormones that triggers her strong, protective 'mothering' instincts.
DR RAVARI 2014
MATERNAL INFANT SEPARATION
Separation “distress cry” when separated.
Levels of stress hormones rise and temperature, blood sugar, breathing, and heart rate become unstable when separated
Separation my lead to complications such as:hypothermia and
hypoglycemia, increased the likelihood of supplementation.
DR RAVARI 2014
BREASTFEEDING AFTER A CESAREAN
Babies born via c-section may be somewhat drowsy and lethargic, especially if the mother was exposed to analgesia and anesthetics for a prolonged period of time during labor.
Initiation of breastfeeding is often delayed
Urgent cesarean births have been associated with delayed milk production, possibly related to the stress involved(Risk factor in delayed Lactogenesis II)
DR RAVARI 2014
CAESAREAN BIRTH
Reduce initiation of breastfeeding, Increase the length of time before the
first breastfeed, Reduce the incidence of exclusive
breastfeeding, Significantly delay the onset of lactation Increase the likelihood of
supplementation.
DR RAVARI 2014
INDUCTION (OXYTOCIN)
Pitocin , when used to induce or stimulate labor, has an antidiuretic effect.
Edema may result from pitocin use, particulary in extremities such as the breast and nipple tissue ( meaty and flat) that make it difficult for infant to latch. it can take as long as 2 weeks for the edema is relieved.
Inducing laber >strong,close contarction> pressure on the baby head>more painful for the mother>more drugs>iv hydration>more need forceps or vacuum or surgery(episiotomy or CS)>duration epidural anesthesia> maternal fever >infant fever >more separation> sepsis workups.
DR RAVARI 2014
RE-EVALUATING CESAREAN
BIRTH
Cesareans with regional anesthesia is an option And mothers are able to breastfeed sooner