The main reason for the failure of natural feeding - hygogalactium, i.e. Secretor deficiency of dairy glasses. Select primary and secondary hypoglactic.

• Primary hypogalactium develops due to neuroendocrine disorders in the body of a woman.
• In the overwhelming majority of cases of hypogalactium, there is a secondary, developed due to the negative impact on the mother of the mother of a complex of biological, medical, social, psychological and economic factors. The leading role belongs to social factors and the reasons of a non-heroic nature.

According to WHO, only 1% of women are not able to feed their children with breasts. In our country, more than 10% of mothers do not feed the child with breasts from birth. By 6 months on natural feeding, less than a third of children remain, and about 66% of mothers begin to independently enter the discounts from 2 weeks of the child's life. The main reasons for hypoglactics are as follows:

• Insufficient breastfeeding motivation in a woman.
• Later first applying to the chest. Contraindications to the early (immediately after birth) applying to the chest is very small. In foreign countries, the overwhelming majority of newborns are applied to the chest immediately after delivery. In Russia, this occurs only in 20% of cases, and in 40% of a healthy child apply to the chest in a day after delivery.
  • In some countries, women are forbidden to give information about artificial feeding during the first 3 months after delivery; Advertising milk mixtures in maternity homes and hospitals is also prohibited.
• Rare attachment of the child to the chest, the regulation of breastfeeding, a technical approach to controlling the lactation process.
  • Insufficient lactation is not considered as a contraindication to frequent applying to the chest. On the contrary, it is recommended more frequent feeding (after 2-2.5 hours, without a night interval). Frequent and unlimited breastfeeding in the first 2 weeks of life (9-10 times a day or more) significantly enhances lactation. Often, the child itself sets the mode for 2 months of age - 7 times a day, i.e. Every 3 h with a 6-hour night interruption. It should not be given too much the amount of suused milk, especially in a single control feed, since children can suck different milk volume during the day in different hours. In addition, the composition of breast milk is characterized by emergency variability (for example, protein content in milk of different women ranges from 0.9 to 2.0 g per 100 ml).
  • As a rule, the mother is formed as much milk as a child is needed. Up to 1-2 months of life, for one feeding, it is better to give the child both mammary glands, as it stimulates lactation and reduces the risk of galactation. If, after feeding in the dairy glands, milk remains, it must be shot until it starts standing up drops (and not with trickles). If the mother has a lot of milk, it is better to give one breast for one feeding, and in the next feeding - the other for the child to receive a sufficient amount of fats (in the last portions of breast milk, the amount of fat is 1.5-5 times more than in milk allocated At the beginning of feed).
  • Often, women have "lactation crises", their usual frequency is about 1.5 months, duration - 3-4 days (less often 6-8 days). At this time, it is necessary to increase the number of feedings. It is unacceptable to return to the mixtures immediately.
  • Sometimes, even with sufficient filling of dairy glasses, there may be "hungry" anxiety of a child due to a stepped increase in its energy demand due to the growth of motor activity. It is most typically in 3, 6 weeks, 3, 7, 11 and 12 months. As a rule, in most cases, the increased sucking activity of the child leads to an increase in the volume of lactation.
• Violation of the course of a nursing woman (excessive physical and mental load, insufficient sleep) reduces lactation.
• Other reasons (violation of the power mode, various diseases, the age of a nursing woman) play a minor role in the development of hypoglactics.
  • The nutrition of the nursing mother more affects the qualitative composition of milk than its quantity.
  • Mother's disease oppress lactation. However, if a woman was still tuned for breastfeeding during pregnancy, her lactation is often preserved at a satisfactory level.
  • In all countries, too young and old mother and older mother are becoming less likely. In the elderly, this is explained by biological reasons, in young - social and psychological (lack of family planning, often random conception, lack of attitude to breastfeeding during pregnancy, etc.).

Treatment of hypoglactia

It is necessary to translate the child to more frequent feeding. Mode and nutrition of a nursing woman have important in the treatment of hypoglactics. To enhance lactation, nicotinic acid is used, vitamin E, prescribe phytotherapy [decoction of nettle leaves, hawthing extract, fresh greens of parsley, infusion of walnuts in milk, lactovit (herbs), etc.]. A good effect is registered after UFO, ultrasound therapy, massage, acupuncture, compresses on the mammary glands. It should be borne in mind that drugs have a smaller effect than the methods of physiological stimulation of lactation.

Almost all women are capable of breastfeeding. In rare cases of severe Mother's disease, it is necessary to abandon breastfeeding. In order for the lactation to be not problems, and milk answered all the necessary requirements, a rational organization of the day and nutrition regime is required during pregnancy.

Usually, in the first half of pregnancy It is not necessary to take any special measures, it is only important to take care of your health and health of your future baby, relaxing and walking more, there is only useful and vitamined food.

In the second half of pregnancy - The period of intensive growth of the fetus - the woman has the need for the main nutrients, which it should provide its baby. Therefore, in the second half, it is necessary to make special emphasis on products rich in proteins and microelements. Doctors belt to use at least 500 ml of fermented milk products, 200 g of cottage cheese, 500 g of vegetables and 300 g of fruit per day. If it is necessary to greatly increase the introduction of protein into the body, you can use special dry dairy mixes for pregnant women. The fact is that the development of the kid has a direct impact on lactation. In order for all the necessary restructuring in female ogrganism, nutrients, vitamins, hormones are required. If all this does not have enough baby, then the preparing a woman to lactation will not remain all the more. Therefore, it is so important to optimize the nutrition of the woman in the second half of pregnancy.

The diet of a nursing woman should include products such as cheese, cottage cheese and condensed milk. Many protein, so necessary and mother, and the child, is contained in meat and nuts. These products need to be eaten daily, like fruits with vegetables, because they contain natural vitamins and minerals.

A nursing mother should eat more often than an ordinary woman, because she, as they say, eats for two. Immediately before feeding, it is recommended to drink water or tea. In the diet, you need to include a wide variety of products, it should not be monotonous. It is believed that no products other than alcohol affect the taste of milk. It often happens that within 10-14 days after childbirth, a mother cannot eat a lot, as much as it should be. It is not worth incolmenting in such a situation, you need to eat as much as you want.

As a rule, by the middle of the first month after the birth of a child, a woman begins to appetite. Almost all doctors advise to eat and drink in need, do not limit themselves. But everything should be a reasonable measure. As for the method of preparation, then the preference is given to boiled, stewed and cooked steam dishes. Easy, pickled, smoked food. It is recommended to use fruits and vegetables in large quantities, but it concerns fresh, and not canned food.

Approximate weighting rate of products for a nursing woman per day:

• products containing protein (meat and fish not less than 100 g, 1 egg);
• milk and fermented milk products (up to 1 l); vegetables and fruits;
• creamy and vegetable oil, sour cream in small quantities;
• honey and jam, but only aloud, if your baby has allergies on them.

Check out the rules of feeding a nursing woman. Following them, do not hurt your child and provide yourself a full and balanced ration.

What you can eat a nursing woman:

• porridge any. It is recommended to eliminate porridge from rice cereals if your kid suffers from constipation;
• meat and fish of non-fat varieties in boiled, stew, baked form;
• cheese solid, raw materials and yogurts without fruit additives, cottage cheese;
• the coat and carrots are boiled, squeezed on a grade, tired with a small amount of vegetable oil;
• boiled or fried potatoes;
• pasta anyone without sharp and fat ketchups, seasonings and mayonnaise;
• bird, with the exception of broiler chickens;
• stuffing products (cutlets, dumplings, meatballs);
• products from cottage cheese (dumplings, cheesecakes);
• pancakes, pancakes;
• eggs 3-4 times a week, it is recommended to eat in the form of a steam omelet;
• milk sausage can only be bought when you are confident in its high quality;
• nuts, except hazelnuts, he very often performs an allergen;
• apples and pears (recommended in a liver form);
• bananas;
• milk milk and dairy products;
• compote from dried fruits, tea with milk, mineral water (without gas), green tea without sugar, apple and plum juices (with caution);
• saline (rarely and in small quantity);
• vegetable pancakes from zucchini or cabbage;
• cookies without fatty and fruit additives.

Unwanted dyes, preservatives, allergens, fatty food, concentrates, sharp seasonings and sauces, marinades, carbonated drinks, cucumbers and other vegetables and fruits (cabbage, peas, radishes, grapes), since these products actively contribute to gas formation in the intestine, meat and Fish Ripples, creams, cakes, cakes, chocolate candies, caviar, smoked.

Remember also that in the pursuit of the restoration of the former weight in no case cannot be sitting on the diet. After all, by excluding one or another product from its diet, you deprive your baby of many beneficial substances. Do not feed the baby with "empty milk", feed it with good, full and tasty natural nutrition so that it grows beautiful and healthy.

Remember also that, by going oily food, you can increase the fatty milk not for the better. 11% fat in milk is constant, and it is possible to increase fattyness so that it only leads to the emergence of constipation in the baby, because its body is configured to a certain composition of Mother's milk, he does not need more fat. Therefore, in order to feed and lose weight, a complete protein and carbohydrate dish must be present to your diet, and the fat are recommended to eat smaller, giving preference with vegetable oils. Thus, on the background of breastfeeding, you can really lose excess weight!

Evgeny Yakovlevich Gatkin
Doctor of Medical Sciences, Higher Category Doctor

It is necessary to pay attention to the correct mode and nutrition of a nursing mother. Conduct a conversation with her and if possible to talk about it with the nearest relatives, explaining the importance of this issue.

Nursing mother should eat right, and also fully rest. Approximately the daily set of products must contain:

The total caloric content of the diet should be 3200-3500 kcal;

In the diet, it is necessary to include 1 l of milk (in any form);

150 g of meat, poultry or fish 20-30 g of cheese, 100-150 g of cottage cheese, 1 egg (the need for proteins should be satisfied with 60-70% due to the proteins of animal origin);

50 g of oil (1/5 due to vegetable oils);

200-300 g of fruit;

500-600 g of vegetables (from them potatoes not more than 1/3);

The volume of fluid should be about 2 liters.

It is recommended to include buckwheat and oatmeal, berries, juices, compotes in the menu. Avoid sharp seasonings and spices, garlic, horseradish and other products of this kind, because They can create an unpleasant taste of milk and the child can refuse the chest.

It is advisable to take food 5-6 times a day, usually 30 minutes before feeding the child. This contributes to the formation of milk.

Nursing mother needed a good rest, walking out the fresh air for 2-3 hours in a day. Relatives should take care that the woman will sleep at least 8 o'clock at night, and also had the opportunity to sleep in the afternoon for 1-2 hours.

Treatment.

I. Women's tactics with hypoglactia in the maternity hospital:

1. Joint stay of the mother and the child (contributes to the establishment of closer psycho-emotional contact between mother and child);

2. Early applying to the chest (in the maternity block);

3. Psychotherapy, aimed at the formation of a resinant in the lactation, explaining the benefits of breastfeeding;

4. The exchange method is nicotinic acid 15 minutes to feeding;

5. Candles "Apilak", or in a tablet form sublingual;

6. "Kvercitin" - 1 tablet 3 times a day for half an hour before feeding;

7. "Eglonil", "Cerukal" - change the taste of milk, the child may refuse his chest;

8. Auriculoelectrostimulation - a method that allows the arrival of milk by irritation of the active points of the ears by irritation;

9. Proper breast care.

10. The spot self-massage - massage of biologically active points, has high efficiency in the treatment of hypoglactics, as an independent or complementary method;

11. Homeopathic preparations are highly efficient and safe;

12. Homotoxylogical therapy with complex drugs;

13. Fitotherapy.

II.. Breast careincludes:

Compliance with hygienic rules;

Cotton underwear (synthetic underwear can irritate the nipples, lead to crack formation);

For more complete dieting milk, it is possible to recommend the circulatory shower on the milk gland 20 minutes to each feed;

Fitting (in the first day after childbirth, dimming even a small amount of milk is mandatory, as it stimulates the process of the arrival of milk).

III. Phytotherapy.

mix of hops (cones) 20 g, dill (seeds) 25 g, cumin (seeds) 25 g, nettle of dry (leaves) 25 g, beans 50 g. HA 1 L boiling water brew 30-40 g of the mixture, insist 5-7 minutes and take up to or on time of eating 50 ml.;

blend of Fennel (Fruits), Anisa and Dopop (Seeds): 1 Chain. Spooning the mixture to brew on 1 cup boiling water, insist for 10-15 minutes. Take 3-4 cups of infusion during the day;

cumin 1 Chain. The spoon is brewed with 1 cup of boiling milk, it is notged for 10-15 minutes, drunk by sips during the day;

3 chain. The spoons of dry nettle are brewed with 2 glasses of boiling water, insist for 10-15 minutes (fresh grass insists 2 minutes), take the resulting volume during the day.

0.5 cups of purified walnuts brew 0.5 liters of boiling milk in the thermos and insist for 3-4 hours, the infusion is taken by 1/3 cups 20 minutes before each feeding. Take a day.

2. Formation of lactation

3. Definition of hypoglactia

4. Causes of primary (true) hypoglactics

5. Causes of secondary hypoglactics

6. Signs of shortness of milk

7. Forecasting lactation disorders

8. High risk groups for hypoglactic development

9. Stages of hypoglactia

10. Prevention of hypoglactia

11. Treatment of hypoglactia

12. Laccination crisis

Bibliography

1. Significance of breastfeeding

Breast milk is the optimal food product for the first year of life. There are many substitutes of female breast milk developed taking into account the characteristics of the body of a small child, but even the best mixture cannot be compared with maternal milk.

Breastfeeding is the best and at the same time the easiest way to ensure the normal physical and psychomotor development of the child, to protect it from many diseases, including infectious.

Almost every woman who had a safely endowed and giving birth to a child, able to feed his breasts.

Breast milk, the nature itself intended to satisfy children in nutrition, is the only reliable source of food. Mother's milk has a unique individual composition - all the ingredients are maximally (most) are close to the composition of the baby's tissues. With Mother's Mother, a child receives a balanced composition of proteins, fats and carbohydrates; enzymes that contribute to the most complete and easy assimilation; Vitamins and minerals in which it needs, as well as immunoglobulins, lysozyme, lactoferrin, living leukocytes and lymphocytes, bifespal and other substances of high biological difficulty performing protective and immunomodulating functions. It not only provides unique protection against infections, but also stimulates the development of its own immune system in a child.

An important role is played by an emotional aspect of breastfeeding. Special intimacy that is established between mother and child during feeding, remains for life, i.e. The foundation is laid for further normal mental development and has a huge positive effect on the woman's body. The attachment of the child to the mother's chest in the first hours after birth stimulates the allocation of the oxytocin hormone, which in turn stimulates the cutting of the uterus, and thereby warns postpartum bleeding. It was noted that women, nursing breasts, the malignant neoplasms of the mammary glands and cancer of the ovaries are developing significantly less often.

2. Formation of lactation

For a successful and long-term breastfeeding breastfeeding, physiological mechanisms need to contribute to the milk department of a woman.

Immediately after delivery, the inhibitory effect of the hormones of the placenta for the release of milk is reduced. This is facilitated by the earliest attachment of the newborn to the chest (in the first 30 minutes after birth), which stimulates the release of prolactin that causes the production of milk into the blood. In addition, tactile contact "Leather to the skin" immediately after birth, contributes to the establishment of a closer emotional relationship between mother and child. The successful formation of lactation also contributes to more frequent attachment of the child to the chest (approximately every two hours), when, along with the reflex mechanism, constant emptying of the breast occurs stimulates the release of prolactin and as a result of the production of milk. In addition, at the same time the development of oxytocin, which stimulates the Reflex "Rotim", contributing to the admission of milk to the child and providing postpartum reduction of the uterus and its involution. Free feeding regime has a positive impact not only to the mother, but also on the child, helping him get enough poles. It is precisely this milk formed by the woman in the first 30-40 hours after childbirth, the most energy is rich, contributes to the ripening of the intestinal mucosa, contains factors of immunological protection and growth factors.

3. Definition of hypoglactia

The process of formation of milk and the release of it from the mammary glands is called lactation, and the insufficient production of milk - hypoglactia. It is divided into early (up to 10 days from the date of birth) and late (from 11 days after delivery).

Also isolated primary and secondary hypoglactic.

4. Causes of primary (true) hypoglactics

· Endocrine disorders of the mother;

· Condition after cesarean section and after premature births, due to the lack of generic dominants;

· Concomitant complications of pregnancy and childbirth;

· Weakness of a sucking reflex from an immature child;

· Later applying to the chest.

5. Causes of secondary hypoglactics

· Mother's reluctance to feed the baby breasts, her insecurity is that it can do it;

· lack of experience;

· Stress, disadvantage in the family, overwork, the need to go to work;

· Eranny food of a pregnant and nursing woman;

· Rare attachment of the baby to the chest, feeding on a schedule, and not at the request of the child;

· Reducing the activity of sucking on the background of the disease transferred by the baby;

· Unreasonable introduction of discomfort in the form of substitutes for female milk and dishes of dust ("adults" products).

Aerophagia in newborns are essential in the development of hypoglactics. Powered air is observed in all children. However, in cases where the volume of the air of the air does not exceed 10% of the volume of the stomach filled with milk, Aerofagi is physiological. Switching a large amount of air is pathological. With a sharply pronounced aerophagy, the child does not suck the amount of milk, as it stretches the stomach due to air and creates a false feeling of satiety. Insufficient irritation of the mammary gland quickly leads to the oppression of lactation.

In the case of the detection of hypoglactics, individual and collective psychotherapy is very important - the method aimed at the formation of a resignant dominant to lactation, training and preparing a woman to the lactation process, i.e. Creating a psychological attitude to a long and full-fledged breastfeeding.

6. Signs of shortness of milk

· Insufficient weight gain in the kid; Anxiety of a child, especially immediately after feeding;

· Rare urination, the so-called symptom of "dry diapers"; Stool delay.

These are only indirect signs of hypoglactics, which, however, are a reason to appeal to the doctor. You are unacceptable for breast milk when suspected of a lack of breast milk. Only a doctor can state hypoglactic and resolve the issue of its drug treatment or the need to introduce a doctoctor, as well as pick up the mixture that is suitable to the baby.

7. Forecasting lactation disorders

The characteristic of the state of somatic and reproductive health of women has great practical importance for predicting lactation. 68.2% of women with hypoglactias have a history of somatic diseases (chronic tonsillitis, the pathology of the cardiovascular system, kidneys, anemia, juvenile uterine bleeding, allergic diseases, endocrine pathology).

Large practical importance is the identification of chronic infection foci, because The number and quality of sharp and chronic diseases in the girl is a future mother, significantly increases and reaches a maximum in active reproductive age.

The high percentage of women threatened to develop hypoglactic makes women after cesarean section. According to our data, the percentage of breastfeeding in women after cesarean section ranges from 25 to 30%. This can be explained by the following factors:

The character and severity of the obstetric and extragenital pathology, which appeared to the operational delivery;

The impossibility of the implementation of early applying to the chest;

Depressive influences on the fruit and newborn pharmacological agents used in childbirth and during operational intervention;

The presence of newborn border and / or pathological conditions, which make it difficult to implement an act of sucking;

Violation of the contractile activities of the postpartum uterus due to the presence of the scar;

It turns off the normal biomechanism of clans at the cesarean section, leading to a large voltage of adaptive reactions to maintain homeostasis.

8. High risk groups for hypoglactic development

Women with late menarche and later installed menstrual cycle;

Women with early menarche;

Women with ovarian dysfunction;

Women with endocrine pathology: obesity, thyroid pathology;

Women with chronic tonsillitis in history;

Women with anemia in history;

Women with pyelonephritis in history;

Women after cesarean sections;

Women with weakness of labor activities and receiving stimulation in childbirth (vitamin-hormonal therapy, oxytocin, estrogens, prostaglandins);

Women after premature and belated births;

Women after methyl ergometric bleeding prevention.

9. Stages of hypoglactia

4 stages of hypoglactics are isolated (according to the deficiency of milk to the needs of the child):

· 1 stage - the deficit does not exceed 25%;

· 2 Stage - the deficiency is 50%;

· 3 Stage - 75% deficiency;

· 4 Stage - the deficit exceeds 75%.

10. Prevention of hypoglactia

breastfeeding milk hypogalactium lactation

It is necessary to pay attention to the correct mode and nutrition of a nursing mother. Conduct a conversation with her and if possible to talk about it with the nearest relatives, explaining the importance of this issue.

Hygogalactia - The lack of milk in the mother is a relatively frequent interference to the proper conducting of breastfeeding. As an independent violation of the lactation of hypogalactium, it is caused by translating to 30% of children to artificial feeding.

Causes and risk factors for the development of hypoglactics are diverse. More often they are associated with the disease of the mother. To the "maternal factor" should include all the diseases that are aggravating the course of pregnancy, childbirth and postpartum period.

A lesser degree of hygogalactium depends on the state of the child ("Children's Factor"). These include: the insufficiency of the sucking reflex in the newborn, associated primarily with prematurity; Later attaching a child to the chest; Aerophagia - in those cases where the volume of the air of the air exceeds 10% of the volume of the stomach filled with milk, aerophagia is considered pathological, it leads to a violation of normal breastfeeding and lactation attenuation; Anomalies of the development of a newborn (the defects of the sky and the upper lip).

In addition to the listed factors affecting hypoglactic, the genetic cause should be noted. There is a "family" feature of lactation, transmitted by the inheritance from the mother to his daughter. Ultrasound examinations of representatives of family hypoglactics often show the insufficiency of the development of iron tissue of the breast.

Distinguish primary and secondary hypoglactic.
Primary hypogalactium is caused by nervous and hormonal disorders of the female organism. These include diseases of the endocrine system (diabetes mellitus, thyroid disease, etc.), the functional inferiority of the mammary glands with infantilism, "family" hygoglactic.

Secondary hypogalactium is caused by the diseases of the mother (except neuroendocrine), complications of pregnancy, childbirth and postpartum period.

The early form of hygoglactics is developing in the first 10 days of the postpartum period. Late arises after 10 days or more after childbirth.

Depending on the severity of the shortage of milk, 4 degrees of hypoglactics are distinguished.

1. Hygogalactium 1 degree - the shortage of milk in relation to the child's need does not exceed 25%.
2. With hygoglactic 2 degrees, milk deficiency is 50%;
3. At 3 degrees - 75%;
4. At 4 degrees, milk deficiency exceeds 75%.

To determine the daily amount of milk needed to a child in the first 7-8 days of life, it is advisable to use the formula of Finkelstein:

X \u003d (70 or 80) x (n-1),

where X is the daily need for milk, N is the day of the child's life.
With the mass of the child, 3200 and less use the coefficient 70, and with a greater mass - 80.

Starting from 2 weeks of the child's life, the daily amount of milk is determined by the volumetric method:

• aged 0-2 months - 1/5 body weight;
• at the age of 2-4 months - 1/6 body weight;
• at the age of 4-6 months - 1/7 mass body.

Organization of medical care

Since hypogalactium arises after the discrepancy of the parental from the obstetric hospital, the issues of prevention, diagnosis and treatment of this disease have to solve the polyclinic service. To overcome the disunity of the obstetric, pediatric service and ambulance service, specialized divisions are created as part of regional health care facilities or a lactation pathology office, which is part of the structure of multidisciplinary polyclinics. The office carries out both a guidelines for the prevention and therapy of lactation disorders and directly conducts prophylactic, diagnostic and medical measures. Unfortunately, there are still very few such cabinets, so surgeons, therapists, and oncologists, and gynecologists, and pediatricians are engaged in pathology, and no one is engaged in essentially, although the elimination of the etiological cause of secondary hypoglactics almost always gives a good effect, but Consequently, it allows you to maintain lactation and natural feeding.

Diagnostics

For diagnosis, first of all, a Uz-study of the mammary glands, it is necessary to ensure the visualization of the diagnosed object and obtaining a large amount of reliable information when identifying primary and secondary lactation, all stages of mastitis, symptoms of improvement or deterioration in the focus of inflammation in the process of treatment, initial mastopathy With the subsequent dispensary observation of women who have undergone postpartum mastitis. Uz-diagnosis makes it possible to identify the insufficiency of the development of iron tissue during primary hypoglactics.

The hypoglactic diagnosis should be made not earlier than 7-8 days of the postpartum period. At the same time, the detection of lactation deficiency after this period will give the worse the result in treating, the later it will be started. Therefore, women who have the initial period of the formation of lactation flows slowly, when discharge from the hospital should be transferred to the Cabinet of lactation pathology for treatment. Treatment should be carried out with a close contact with the precipice pediatrician.

Before starting treatment, ultrasound examination of the mammary glands should be carried out to assess the anatomical features of the iron tissue, the exclusion of lactostasis and mastitis.

Treatment of hypoglactia
For the treatment of hypoglactics, it is necessary to eliminate the causes listed above, to establish the power, sleep and rest.

• Frequent (after 2 hours) Applying a child to the chest.
• 15 minutes before feeding a warm compress on the milk gland.

Course 15 days:

1. Vitaminotherapy:
   • Folic acid - 0.0056, ascorbic and pantothenic acid of 0.3 in powders 3 times a day.
   • Vitamin E 1 capsule 2 times a day.
   • A solution of thiamine bromide 3% 1 ml 1 time per day.
   • Pyridoxine solution of hydrochloride 5% but 1 ml 1 time per day.
2. Apilak 1 tab. 2 times a day under the tongue.
3. The glutamic acid is 1.0 3 times a day in 1 hour before feeding. Appoint tablets covered with a shell, or pills soluble in the intestines (Acidi Glutaminici Abductae, Enterosolubiles).

Hormonal hypoglactic correction is possible.

Prevention of hypoglactia

In women's consultation, hypoglactic prevention is to eliminate diseases adversely affecting lactation.

• Detection and effective treatment of adolescent girls with signs of general and genital infancelism, treatment of women with endocrine disorders is the main means of preventing primary hypoglactics.
• Effective treatment of unbending, pregnant pregnant, warning, timely elimination of complications in childbirth and postpartum period is an effective means of preventing secondary hypoglactics.
• In psycho-philactic preparation of pregnant women, it is necessary:
  . To tell pregnant women about the physiological mechanisms of formation of lactation, possible complications during this period, their clinic and removal methods;
  . Specify the features of the rational nutrition of pregnant women and herds from the point of view of lactation;
  . Explain how to prepare the mammary glands and nipples to breastfeeding;

In the obstetric hospital, hypoglactic prevention is as follows:

• Early attachment of the child to the chest and the early start of the magnitude of the milk. Of particular importance, the early stitching acquires those pupils, which for various reasons is temporarily not allowed to feed. Singing milk during feeding hours in these women to a certain extent compensates for the absence of natural neurogormonal reflex of dairy and stimulates the process of lactation formation;
• TRAINING OF PUBLIC TECHNICATION SECRINCE OF FEEDING AND PUBLICATION OF MILK, CARE OF MILK IRMES directly in the ward of the postpartum separation into feeding hours;
• Timely identification and treatment of aerophagia. An effective way of treatment is the Fedorovich method, which is as follows: after feeding the child, the mother is the creation of his palm of his left hand. A thumb of the left hand records the left thigh of the child, the rest of the way - the right. The right mother's hand presses the back of the child to his breast so that the face of the child and the face of the mother is facing one way. At the same time, the four fingers of the mother's right hand are moving to the left axillary region of the child. Shortly after that, the child comes with air belching. Such a procedure should be carried out regularly after each feeding;

  In cases where the milk is a lot, it easily follows, and the child sucks with greed, chips, the Fedorovich method should be applied several times for feeding to give the child to abandon the shred large amount of air;

• Control of the formation of lactation and the timely correction of its violations of the maternity hospitals, especially those who constitute the 2nd group of risk of mastitis;
• Prevention and timely treatment of storage cracks during lactation period.

Dispensarization suggests:

• Control of the effectiveness of the treatment is - an estimate of the increase in the daily amount of milk, its quality;
• Uz-control of the status of the mammary glands to prevent the occurrence of lactation and mastitis;
• With the weakening of lactation, timely conducting re-courses of treatment;
• Drug termination of lactation according to indications (inefficiency of treatment, etc.);
• Evaluation of involutionary processes in lactic glands after the cessation of lactation in order to identify the initial processes of mastopathy and the timely beginning of the treatment of this disease;
• Allocation of a group of risk of the development of hypoglactics based on the results of treatment. Recommendations to women assigned to this group on breastfeeding in subsequent births;
• Inspection of these women in 2 half of the next pregnancy and the enactment of specific recommendations in the exchange card of pregnant

Does not affect the amount of milk: the age of mother and child, sex life, menstruation, returning to work (if the child continues to suck the chest), cesarean cross-section, largestness.

Signs of hypoglactia

1. Probable (subjective) signs.
   The child is worried after feeding, often crying. Feeding prolonged in time, very frequent. Complete breast devastation, with the feeling that the child is still hungry. Tight, dry chair. Mother cannot send milk. Milk glands did not increase during pregnancy. Milk "did not arrive" after delivery;
2. Reliable (objective) signs.
   Bad gain weight gain (less than 500 g per month). Rare urination (less than 3-4 times per day). results

Types of hypoglactia

1. By etiology:
   - primary - caused by hormonal changes in a woman (diabetes mellitus);
   - Secondary - associated with somatic diseases, after severe birth, mental injuries, as a result of irrational nutrition and regime, due to acute inflammatory processes in the breast.
2. By time of emergence:
   - Early - revealed in the first 10 days after delivery;
   - Late - revealed 10 days after childbirth.
3. By the degree of milk deficit:
   - I degree - shortage of milk no more than 25% daily needs;
   - II degree - 26-50%;
   - III degree - 51-75%;
   - IV degree - more than 75% daily needs.

Lactation crisis

In the first year of life, periods arise when the child may not have enough milk. These are the so-called lactation crises, they arise during the periods of the most intensive growth of the child. The lactation crises are most often appearing for 3 - 6 weeks of life, by 3 - 4 months and 7 - 8 months of life. The duration of the lactation crisis is about 3 to 5 days.

In these periods, you should increase the frequency of applying the chest. During feeding to apply a child to both breast glands. Necessarily night feeding. Also, mom should pay attention to itself, normalize day and nutrition mode.

Prevention of hypoglactia

1. Nursing mom needs to create satisfactory material and domestic, hygienic conditions, as well as the state of mental comfort;
2. Nursing Mother's Day and Nutrition Mode: Sleep at least 7 hours a day, daytime sleep, outdoor walks for at least 1.5-2 hours, full and diverse meals with the mandatory use of fermented dairy products. Stimulate the production of milk walnuts, mushroom suras, pike perch. It is possible to include special mixtures for nursing mothers in the diet, such as Galacton, Enefamil Mom, Femilak and others. 20-30 minutes before feeding, it is recommended to drink a glass of hot drink (faint tea, milk, green tea);
3. The correct feeding mode of the child. Further applying to the chest, night feedings. It should be continued to breastfeeding for so long as possible. If there is a need for a proceeding, then give the amount of breast milk substitute, which is necessary for adequate growth. Replays should be made from a cup, if possible, avoid bottles and nipples. Be sure to keep breasts;
4. Grinding breast milk. It is especially important to stirring in the first month of the child's life, when he sucks a small amount of milk. The stirring is carried out to the feeling of complete emptying of the chest. On average, it takes 10-15 minutes. The most efficient plotting of electrotrososos. After complaining, the milk gland should be rinsed with warm water;
5. Massage of the mammary glands. Massage is made by stroking movements, two hands for 3 - 5 minutes 2 times in time. Start with the top of the breast from the middle of the sternum towards the shoulder, then with the bottom of the chest towards the axillary region (these are the paths of the lymph outflow). You can make circular strokes, but without affecting the nipples and arolats. Also conduct light compression gland with two hands on top and bottom.

In the absence of effect, drugs are used.

Medicinal preparations for the treatment of hypoglactics

• Nicotinic acid 50 mg (0.05 g) 3-4 times a day 20-30 minutes before feeding. Course 7 - 10 days;
• Glutamic acid 0.5-1 grams 3 times a day after meals after 20 minutes. Course 20 - 25 days;
• Apilacl 10 mg 2 times a day under the tongue before resorption. Course 10 - 15 days;
• Vitamin and mineral complexes: "Gendevit", "Undevit", "Mantna", "Oligimit" and others;
• Vitamin E (in dragee) at 0.015 gr (1 drage) 2 times a day.

Not all drugs are applied immediately, and 1-2, guided by the greatest efficiency in each case.

The course of the prevention of hypoglactics is at least two weeks.

Phytotherapy

Using sprax of nettle (20 grams of dry leaves pour 1 liter of boiling water, insisted for 30 minutes, drink 1 tablespoon 3 times a day), extract of a blank color of 30 drops 3 times a day. Dandelion's decoction, dandelion roots, Eleutherokokka tincture. Also use tea for feeding mothers "Nutrition", "Hipp" and others.

Homeopathic remedies - Malkoin.

It is possible to use needleflexotherapy, UV irradiation, electrophoresis with nicotine acid, ultrasound to the dairy glands.