laser basics for post partum motherslaser basics for post partum mothers dr marc funderlich...
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LASER BASICS FOR POST PARTUM MOTHERS Dr Marc Funderlich
DISCLAIMER
• Dr. Marc is not a medical doctor
• This is not medical advice
• Seek the advice of your medical provider before starting and treatment
• Dr. Marc is not an employee for Erchonia
• Erchonia had not part in the production of this webinar
• Erchonia does not have nor claim to treat any of the following information
• No financial disclosure to claim
BREAST FEEDINGBreast Milk
Protein
Carbohydrates
Vitamins
Minerals
Water
Bio active factors
FATS
• 3.5 g / 100 ml of milk
• ½ the energy
• Ramps up release
• Hindmilk → higher concentration
• High amounts of long chain polyunsaturated fatty acids
• DHA
• ARA
• Neurologic Development of the child
CARBOHYDRATES• Sugar lactose
• Disaccharide
• 7g lactose per 100ml
• Oligosaccharide
• Anti microbial
PROTEIN
• Breast Milk is much more suitable protein ratio than formula
• 0.9g per 100 ml
• Lower than many other animals
• Higher level proteins can over load a babies kidneys
• Low concentration of casein
• Different molecular structure
• Softer form, easily digested curds
• Whey
• Soluble proteins
• More alpha-lactalbumin
• Cows → beta-lactoglobulin → not in human milk → intolerant
VITAMINS & MINERALS
Sufficient vitamins
Unless mom is deficient
Exception is Vit- D
Low levels of Iron
Zinc
High bioavailability
Allowing the cord to stay intact
3 min
Stops pulsing
Better iron levels for 6M
ANTI-INFECTIVE FACTORS
• Immunoglobulins
• sIgA
• WBC
• Lactoferrin
• Whey proteins
• Oligosaccharides
BIOACTIVE FACTORS• Bile-Salt Stimulated Lipase
• Complete digestion
• Fat in artificial milk is less digested
• Epidermal growth factor
• Stimulates maturation of intestine
• Development of
• Nerves
• Retina
COLOSTRUM• Special milk
• 2-3 days after delivery
• 40-50ml on day 1
• Rich in WBC. Anti-Bodies, sIgA
• Larger percentage of protein, minerals
• Especially A,E,K
• Vit A → eye, barrier surfaces, immune protection
MILK TIME LINE
Day 1
Minimal milk production
Day 2-4
Milk starts to come in
“Come In”
Day 3
Infant takes 300-400ml
Day 5
500-800 ml
Day 7-14 “Transitional”
14 + Days “Mature
milk”
ANIMAL MILK
ANATOMY OF THE BREASTMammary tissue
alveoli (small sacs made of milk secreting
cells
ducts that carry the milk to the outside
Milk collects in lumen of alveoli
Nipple and Areola
avg 9 milk ducts passing through
muscle / nerve fibers
surrounded by areola
Montgomery's glands
secrete oily fluid that protects skin
scent to attract baby
HORMONES, PROLACTIN• Necessary for secretion of milk by alveoli
• Levels up in pregnancy = breast development
• Estrogen/ progesterone = block
• Suckles = prolactin in blood increase
• Highest 30 mins after starting feeding
• Important bc it stims milk for next feeding
HORMONES, PROLACTIN
• More prolactin is made at night
• So night feeding = more helpful for keeping up milk supply
• Stims other pituitary hormones
• GnRH
• FSH
• LH
• Suppression of ovulation / menstruation
• Frequent breastfeeding can help to delay a new pregnancy especially at night
HORMONES, OXYTOCIN• Makes alveoli contract
• Oxytocin reflex = letdown reflex
• Starts with the expectation of a feed
• Also when the baby is suckling
• Becomes a reflex
• Inhibited with pain
HORMONES, OXYTOCIN
• Oxytocin reflex
• Tingling sensation in breast before or during feed
• Milk flowing from breast when she thinks of the baby or hears the baby cry
• Milk flowing from the other breast during suckling
• Thirst during feeding
• Uterine pain or a flow of blood from uterus
• Show reflex is working
• Skin- skin
• Helps uterus contract after delivery and helps redue bleeding
REFLEX IN THE BABY
• Babies reflexes are key
• Reflexes• Rooting
• Suckling
• Swallowing
• At week 32 = sucking reflex
• 32-35 = coordination of above
• Majority can work at 36 weeks
LASER AND BREAST FEEDING
• Study of 6736 women and 592 babiesBreast Feeding Problem
17%
Milk deficiency / inadequate
weight gain
11%
lack of knowlage
13%
flat nipple
5%pain
3%
swelling
8%
redness
20%
crack / wound
19%
mastitis
4%
SIDE NOTE
Partial pressure of CO2
Eliminates tissue hypoxia
Normalizes tissue metabolism
Activates anti-inflammatory immune reactions
Reduces CRP
Raises complement activity
Increases plasma IG
Decreases thrombocyte aggregation
Enhances peripheral circulation
LASER BASICS BREAST FEEDING
• Some studies it stimulated • Serum Prolactin• Lactose• Protein
• Stimulated lactation
• A small, randomized study compared primiparous mothers who were supplementing their infants with formula during the first month postpartum and who received either 12 sessions of low-level laser light to the breasts over 3 weeks (n = 20) or no treatment (n = 20). All mothers received similar counseling by a blinded physician certified in lactation counseling. The treated group had greater increases in serum prolactin, and breastmilk lactose, protein and fat at 3 weeks and 3 months after the start of therapy
LASER BASICS FOR BREAST FEEDING
• Laser (630) plus antibiotics was significantly more effective than just antibiotics
This Photo by Unknown Author is licensed under CC BY
Breast infections are usually caused by common bacteria
(Staphylococcus aureus) found on normal skin. The bacteria
enter through a break or crack in the skin, usually on the nipple.
The infection takes place in the fatty tissue of the breast and
causes swelling. This swelling pushes on the milk ducts
WHAT DO WE WANT TO DO
• Optimal laser choice EVRL
PATIENT INDICATION
• Feeding / latching problem
• Milk production problem
• Sucking problem → laser baby and mom
• Pain / tenderness
• Optimize hormones
WHAT DO WE DO – BREAST DAMAGE / IRRITATION
• Laser each breast → 3 mins per breast
• Mix 2 mins on areola area with 1 min on rest of breast tissue
• Male Doc → have female staff run the laser, skin to skin is best
• Left to Right pattern for areola , up down on rest of breast tissue
• A1 – 9
• A2 – 16
• B1- 363
• B2- 8687
WHAT DO WE DO MASTITIS
• Laser each breast → 3 mins per breast
• All 3 mins on the areola
• Secondary scan for 1 min in the mouth and up the nose
• Male Doc → have female staff run the laser, skin to skin is best
• Left to Right pattern for areola , Left to right pattern for inside mouth, up and down pattern for nasal cavity
• A1 – 20
• A2 – 664
• B1- 1550
• B2- 2127
WHAT TO DO WITH LACK OF PRODUCTION
• Laser during stimulation
• Laser each breast for 3 mins
• Laser up nose and frontal lobe / palate for 1 min each
• A1 - 20
• A2 - 59
• B1 - 634
• B2 - 2600
INFANT ADD IN
• 1 min on infants jaw line
• 1 min on frontal lobe
• 1 min on cerebellum
• Stimulate suck reflex at the same time / if not possible use other reflexes