Khwaja Ahmad Abbas, Ehsan Latif, Simana Ali, Shahida Parveen.
Role of Lactation Management Clinic in a Hospital.
Mother & Child Jan ;34(1):4-10.

In order to evaluate the performance of Lactation Management clinic of Children Hospital, Islamabad, records of 1088 mother infant pairs, who attended the clinic between May, 1990 and April 1992, were studied. Most of the mothers (44%) attended, when their babies were less than one month old; 25% of the mothers had babies in their second month. There was a gradual but expected decline in the number of cases with the increase in infant`s ages Majority of the mothers (4051o) started breast milk on first day and the rest on subsequent days upto fifth day post partum. Among those who initiated on the first day, a very small proportion did within the first hour. Between the time of delivery and the free `flow` of breast milk, a lot of prelacteal feeds of various kinds were used. Honey, `ghutti` (a herbal decoction) and water were mostly used as the first feed. Only 13% babies were given colostrum as their first feed Nearly 58% mothers presented with the complaint of insufficiency. However on closer observation of their feeding pattern, it was revealed that quite a large proportion of them had sufficient milk and it was only their perception that milk was not enough. True insufficiency was found in only 7.5% of all the mothers By far the commonest reason of lactation failure among infant given by mothers was a crying baby and/or refusal to feed (56.4%). Some of these infants had been fed on the bottle and most probable explanation was nipple confusion. Not all crying babies were hungry as perceived by many mothers More than half of the mothers (57.6%) did not return to the clinic as advised and were lost to follow-up. One can only make guess of their outcome. Four hundred sixty one mothers (42.4 % of the total) were fully followedup. Out of them, 448 improved satisfactorily, their immediate problem was solved and satisfactory lactation was established; only 13 mothers out of 461 did not improve and LMC failed to have any impact on them. We would regard this as good outcome and an exercise, which has been worthwhile.

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