Obstetrics and Gynaecology
Lactation and Newborn Care
Breastfeeding physiology, attachment and newborn care for MBBS, including APGAR, vitamin K, jaundice and kangaroo mother care, mapped to NMC codes OG17 and OG18.
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Lactation and Newborn Care
Breastfeeding physiology, attachment and newborn care for MBBS, including APGAR, vitamin K, jaundice and kangaroo mother care, mapped to NMC codes OG17 and OG18.
This chapter covers the physiology and practice of breastfeeding together with the essentials of newborn care. It explains prolactin and oxytocin, correct attachment and common breast problems, then the APGAR score, immediate newborn care, vitamin K, jaundice, birth asphyxia, sepsis and the care of low birth weight babies including kangaroo mother care.
High-yield: Lactation and Newborn Care
- Prolactin drives milk production while oxytocin triggers the let-down reflex that ejects milk.
- Colostrum is the first milk, rich in immunoglobulin A and protective antibodies, and should not be discarded.
- Exclusive breastfeeding is recommended for the first six months, with initiation within the first hour of birth.
- Good attachment shows a wide-open mouth, more areola visible above than below and the chin touching the breast.
- Cracked nipples and engorgement usually stem from poor attachment and are managed by correcting positioning, not by stopping feeds.
- Lactational mastitis is treated with continued breastfeeding, analgesia and antibiotics; a fluctuant abscess needs drainage.
- The APGAR score assesses appearance, pulse, grimace, activity and respiration at 1 and 5 minutes after birth.
- Essential newborn care includes drying, keeping warm, initiating breastfeeding and delayed cord clamping.
- Vitamin K is given to every newborn to prevent haemorrhagic disease of the newborn.
- Physiological jaundice appears after 24 hours and peaks around day 3 to 5; jaundice within 24 hours is always pathological.
- Birth asphyxia is managed by the resuscitation sequence of warmth, airway, breathing and, if needed, chest compressions.
- Neonatal sepsis can present non-specifically with poor feeding, lethargy, temperature instability and needs prompt antibiotics.
- Low birth weight is a birthweight below 2,500 grams, from prematurity, growth restriction or both.
- Kangaroo mother care provides skin-to-skin warmth and supports breastfeeding for stable low birth weight babies.
Newborn care essentials
- **APGAR score:** Appearance, pulse, grimace, activity, respiration at 1 and 5 minutes.
- **Vitamin K:** Given to all newborns to prevent haemorrhagic disease of the newborn.
- **Jaundice timing:** Physiological after 24 hours; within 24 hours is always pathological.
- **Kangaroo mother care:** Skin-to-skin warmth and breastfeeding support for low birth weight babies.
NMC competencies in this chapter
- **OG17.1:** Physiology of lactation and advantages of breastfeeding
- **OG17.2:** Breastfeeding technique, breast care and common problems
- **OG17.3:** Lactation suppression and postpartum breast symptom control
- **OG18.1:** Normal newborn assessment, APGAR score and gestational maturity
- **OG18.2:** Essential newborn care at birth
- **OG18.3:** Common neonatal problems: jaundice, birth asphyxia and sepsis
- **OG18.4:** Low birth weight care and kangaroo mother care
Frequently Asked Questions
Which hormones control lactation?
Prolactin drives milk production and oxytocin causes the let-down reflex that ejects milk during suckling. Colostrum, the first milk, is rich in protective antibodies.
When is neonatal jaundice pathological?
Jaundice appearing within the first 24 hours of life is always pathological and needs investigation, unlike physiological jaundice which appears after 24 hours and peaks around day 3 to 5.
Why is vitamin K given at birth?
To prevent haemorrhagic disease of the newborn, since newborns have low vitamin K stores and immature clotting. It is a routine part of essential newborn care.
What is kangaroo mother care?
Continuous skin-to-skin contact between mother and a stable low birth weight baby, which maintains warmth, supports breastfeeding and improves survival.
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