No discharge from hospital if women unable to breastfeed after delivery
TACKLING INFANT DEATHS From Sept new mothers will be discharged from govt hospitals after the approval of the consulting doctor and milk bank counsellor
Women delivering babies at government hospital in Rajasthan’s 18 districts will be discharged only after they are found fit to breastfeed the newborn babies.
According to a health department order, beginning September new mothers will be discharged only after the consulting doctor stamps the discharge form that they are capable of breastfeeding and the milk bank counsellor certifies it.
New mothers will also need to sign their commitment on the discharge ticket that they will exclusively feed the baby breast milk for six months.
However, women who insist on getting discharged despite their inability to breastfeed will be sent home but categorised as DOR (discharge of request) and LAMA (leave against medical advice) patients.
Doctors said common problems due to which women are unable to breastfeed their babies are engorgement, mastitis, breast abscess, less lactation, retracted and inverted nipples, sore nipples, cracked nipples. Babies born with cleft lip and palate are also unable to suckle at their mother’s breast.
Rajasthan has the biggest network of mother milk banks in Asia. Eighteen government hospitals in the state have the milk banks and the order applies to these 18 districts.
According to health department data, 389,565 deliveries took place at government hospitals in these districts – 25.18% of these (73,138 women) needed help from the breastfeeding clinic at the milk banks to feed their babies.
The government’s order is aimed at ensuring that all such women leave the hospital only when they become fully capable of breastfeeding, said Devendra Agarwal, an adviser to the state health department for mothers’ milk bank project.
He added that since the inception of mothers’ milk bank in 2015-16 in the state, 73,168 mothers have been trained to and helped with overcoming lactation problems through 165,000 sittings.
Agarwal said women who are unable to breastfeed their babies even after assistance from breast- feeding clinics , will be reported to the medical officer in charge of the milk bank, who will decide the future course of action.
Doctors said that exclusive breastfeeding for six months of birth is directly related to neonatal mortality rate (NMR) and malnutrition in children.
According to Health Index Report, released by the NITI Aayog in February 2018, 30 babies out of every 1,000 live births die in 1-28 days. As regards nutrition, 39.1% of children are stunted and 23% of children are wasted, as per National Family Health Survey-4 (2015-16). Among other initiatives to cut NMR, Rajasthan has banned the use of formula, dairy (packed and open), cow, goat and other milk at government hospitals in the 18 districts. If a woman is unable to breastfeed, her baby is given donated mother’s milk from the bank.
An estimated 7.8 crore newborns worldwide are not breastfed within their first hour of life. This lowers their chance of survival and meeting their growth, developmental and intellectual potential, according to a new Unicef and World Health Organization (WHO) report. Jalore Sirohi
Sawai Baran Madhopur Chittorgarh
Bhilwara
Banswara
Beawar
(Ajmer)
Udaipur
All banks have breastfeeding clinic services to help women who have difficulty in feeding their newborn babies.
Apart from this, breastfeeding clinic services will be set up at 25 high delivery load health facilities in the state by the end of this financial year.
JAIPUR:
NEW MOTHERS WILL ALSO NEED TO SIGN THEIR COMMITMENT ON THE DISCHARGE TICKET THAT THEY WILL EXCLUSIVELY FEED THE BABY BREAST MILK FOR SIX MONTHS
LESS LACTATION: If the mother has less milk, she is told about proper positioning of the baby and breastfeeding every two hourly to initiate proper lactation. She is also taught about back massage techniques. She is given repeated sittings at breastfeeding clinic at mothers’ milk bank (MMB) to improve lactation. ENGORGEMENT: It is situation, in which breast tissue overfills with milk, blood and other fluids. In such a situation, milk is extracted manually. The mother is advised to breastfeed every two hour for complete emptying of breasts. Mothers are also asked for repeated sittings at the breastfeeding clinic to relieve engorgement.
MASTITIS: It is an inflammation of breast tissues which sometimes involves infection resulting in pain, swelling and redness. In such a situation, milk is extracted manually with hands and given to baby every two hours. Doctors start oral anti-inflammatory drugs and antibiotics to treat the mother suffering from mastitis.
BREAST ABSCESS: Itisa condition in which pus forms in a breast due to infection and is painful. Doctors give oral antibiotics and anti-inflammatory. If required, surgical drainage is done. Manual extraction of milk is done.
SORE NIPPLES AND CRACKED NIPPLES: It is usually caused by improper latching of the baby during breastfeeding. It can be treated by proper positioning and attachment of the baby. In severe cases, if the mother is unable to feed due to pain, services can be taken from breastfeeding clinics to extract milk and feed the baby till soreness/cracks heal.
CLEFT LIP AND PALATE: If the baby has cleft lip and palate, there is difficulty in breastfeeding due to the baby’s inability to latch due orofacial deformities. The mother is told about different positions of breastfeeding for such babies. Mothers can also take help from breastfeeding clinics to express milk and feed babies till the baby learns to suckle.
RETRACTED AND INVERTED NIPPLES: Usually manually nipple protracted using finger pressure around areola and then immediately breastfeeding the baby. In case with moderate difficulties repeated services are provided at breastfeeding clinics in MBB for improvement of nipple retraction. In severe cases surgical interventions might be required.