‫‪Impact of Birthing Practices on‬‬
‫‪Newborn Baby Care and‬‬
‫‪Breastfeeding‬‬
‫دكتر محمود راوري‬
‫متخصص کودکان‬
‫عضوووووكم ت كشوووووري‬
‫ش رمادر‬
‫دانشکده علوم پزشكي ساوه‬
‫‪DR RAVARI 2014‬‬
WOMEN NEVER FORGET THEIR BIRTH DAYS

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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
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 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.
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 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”
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 Benefits
of normal vaginal delivery
For Babies
 BIRTH CANAL

Lowered risk of respiratory problems
As 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.
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What
physical effects may occur
in babies more frequently with
CESAREAN DELIVERY?
 Respiratory
distress syndrome
(TTN.HMD) elective CS
 Pulmonary
hypertension
 Not breastfeeding
 Neonatal mortality
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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.
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 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
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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 diabetes
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Obesity
Influences neonatal mucosal immunity
Increases the risk digestive , respiratory and
infectious disease
Increases the risk in adults for allergic
diseases(asthma)
Influences the acquisition time of cariogenic
Bactria in children.
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Endorphins in Childbirth:Body’s Natural Painkillers

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 mamababy 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
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likely to suckle optimally

 Benefits
of normal vaginal delivery For
Babies

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Human infants experience a catecholamine surge
immediately post birth secondary to compression of
the fetal head and intermittent hypoxia during
contractions.
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
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 Benefits
of normal vaginal delivery
For Babies

Newborns 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.
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Skin-to-Skin contact with their
mothers immediately following
birth and Early Breastfeeding
NINE INSTINCTIVE STAGES
STEP 4 BFHI
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 Benefits
of normal vaginal
delivery For Babies
 Babies born by normal delivery
demonstrate more interest in prebreastfeeding 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.
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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.
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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 mother’s abdomen the baby helps the mother’s
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
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mothers.
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
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SKIN-TO-SKIN CONTACT
 The
first hour or so after birth are crucial
for mother and baby in terms of
 their
wellbeing,
 the opportunity to bond with each
other and,
 the first breastfeed.
SKIN-TO-SKIN CONTACT
promotes all three of these things.
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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.
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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.
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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)
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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.
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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.

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RE-EVALUATING
CESAREAN BIRTH
Cesareans with regional anesthesia is an option
And mothers are able to breastfeed sooner
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