1. Session 28 BREASTFEEDING LOW-BIRTH-WEIGHT AND SICK BABIES

2. Breastfeeding and Low Birth Weight Babies Breastfeeding: Prevents hypothermia, hypoglycemia and other metabolic derangements Protects from sepsis and necrotizing enterocolitis. Optimizes growth and development. Reduces mortality 1/14

3. Full-term and Preterm Breast Milk 28/1

4. Methods of Feeding LBW Babies Gestational age weeks Approximate weights Oral feeding methods Before 30Nasogastric tube 30 - 32Cup feed 32 - 34+ 1,300gBreastfeeding possible 34 ++ 1,800gBreastfeeding well coordinated 28/2

5. Breastfeeding and Jaundice 2-10 days Glucose feeds Extra water Infrequent or restricted breastfeeds Breastfeed early Frequent unrestricted breastfeeds 20%extra (if on expressed breast milk) 28/3

6. Why do babies stop breastfeeding when they are ill? DIFFICULTY WITH BREASTFEEDING Difficulty suckling (eg respiratory infection) Loss of appetite (eg severe infections) Oral feeds not possible (eg some surgery) MISINFORMATIONSomeone says breastfeeding caused illness Health worker advises mother to stop breastfeeding 28/4

7. Why Breastfeed a Sick Baby If breastfeeding stopsIf breastfeeding continues Baby -gets less nourishment -loses more weight -takes longer to recover -lacks the comfort of suckling Baby -gets best nourishment -loses less weight -recovers more quickly -is comforted by suckling Breastmilk decreasesBreastmilk production continues Baby may refuse to start feeding againBaby more likely to continue breastfeeding 28/5

8. How to help breastfeeding if a baby is sick If baby: Is in hospital Can suckle well Suckles less than before Is not able to suckle or refuses Cannot take oral feeds Is recovering Help Mother to: Stay in hospital with baby Breastfeed more often Give more frequent, shorter feeds Express her breastmilk Give breastmilk by cup or tube Express 3 hourly to keep up supply Start breastfeeding again Breastfeed more often to build up supply 28/6