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Under six months management of SAM and MAM without medical complications

This question was posted the Management of small and nutritionally at risk infants under six months and their mothers (MAMI) forum area and has 8 replies.

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Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

11 May 2022, 19:49

Hello, While managing a child below six months with either SAM or MAM without any underlying medical complications, and you have counselled the mother on proper lactation practises ( from diet, positioning, attachment) is it advisable to give the mother supplement ( Example Fortified Blended Flour -Advantage) even though the mother is nutritionally Okay? 

Rosemary

MOH

Normal user

12 May 2022, 09:50

Hidden hunger is a common occurance in mothers with children having MAM or SAM which is often overlooked but by supporting these mothers with FBF you get better results rather than just leaving them without. I would encourage you to give FBF for pregnant and lactating mothers if you have access to it

hellena

nutrition intern

Normal user

12 May 2022, 14:50

Hello,since its a supplement,its not advisable to give FBF.Ask the mother if she has enough milk for the baby even if she is practicing proper lactation and make a follow up after every two weeks to see how the baby is progressing.

Pamela Morrison

Lactation consultant

Normal user

12 May 2022, 15:32

A baby who is falling down the percentiles on a weight chart is usually failing to get enough breastmilk during breastfeeding even if the mother is making enough.  But since poor breast drainage over time will lead to inadequate breastmilk production, this becomes a chicken-or-egg situation.  Feeding a mother more when her weight is already OK wont help the baby who is not breastfeeding effectively. Often a baby like this wants to breastfeed "all day" but what's really happening is that a weak baby is often just flutter-sucking for long times without ingesting an adequate quantity to thrive. To turn this around, it's often necessary to ensure that the mother breastfeeds 8-10 times in 24 hours, for short times, (she can use breast compression and switch-nursing to keep maximize the baby's intake with the least effort on his part) and then after breastfeeding have the mother manually express what the baby is _not_ taking, to use as a supplement. This milk can be stored to be cup-fed after the next breastfeed.  Over time, more efficient breast drainage leads to increased breastmilk production, and increased breastmilk intake for the baby leads to higher weight gain.  In my experience, a low weight gain baby may need to be helped to get enough milk in this way until he reaches the weight he should be for age on a weight chart.  This sounds time-consuming but the breastfeed-supplement-express routine can be over in an hour giving the mother an hour's break before she needs to start again. it does work!  It usually takes as long to "fix" this kind of breastfeeding problem as it took to occur.   

Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

13 May 2022, 05:00

Thanks Rosemary for your response

Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

13 May 2022, 05:01

Thanks Hellena for your response.

Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

13 May 2022, 05:02

Thanks Pamela Morrison for your response.

Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

13 May 2022, 05:03

Thanks Pamela Morrison for the response

Anonymous_A_W_40

Nutritionist/ M40Re Analytics

Normal user

13 May 2022, 05:06

I asked because in some instances when you supplement with FBF regardless of the mother's nutrition status you get better results the mother starts producing enough milk and the baby start gaining weight...... While in others just counselling, teaching on attachment and positioning, and proper follow up plan also works well.

So I was wondering which is the best recommended practise

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