laser basics for post partum motherslaser basics for post partum mothers dr marc funderlich...

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