Efficacy of milk supply [simplified]

1-The look & satisfaction of the baby after feed:   if satisfied : sleep 3-4 hrs.

2-Gain in weight: the expected weight: ( age + 9 / 2 )

• * At birth: 3 - 3.5 kg.
• * 1st 4 m : 6 kg.
• * 2nd 4 m : 8 kg.
• * 3rd 4 m : 9 kg.

3- Stool:

4- Urine:

• * Constipation & small hard → under feeding.
• * Diarrhea & bulky offensive → over feeding.
• * Polyuria → over feeding.
• * Oliguria → under feeding.

5- Microscopical examination for colostrum corpuscles.:

6- Chemical examination of milk :

7- Test fed:

• * Weighting infant before & after having breast.
• * Normally wt (2.5 ounce / pound B.Wt /day).

8- +ve milk ejection reflex : good milk supply.

	Under feeding	Over feeding
Etiology	* Difficulties of br. Feeding. * Insufficient formula or diluted.	* Irregular feeding time * frequent feeding time * Prolonged feeding time * Excess formula or concentrated.

Clinical picture	* Crying & not sleep * Suckling his fists. * Fail to gain wt → loss wt. * Constipation. * Oliguria & dehydration. * Test fed. : Below normal. * Pale	* Crying due to colic & flatulence * Vomiting. * Over wt. * Diarrhea. * Polyuria. * Test fed.: Above normal. * Dyspneic & sweating
Treatment	* In breast fed : (TTT the cause – complementary feeding) *In artificially fed: correction of quantity & quality	* In breast fed.: ( Feeding time not > 20 min &not frequent). * In artific. fed.: correction of quantity & quality.