Breastfeeding

BREASTFEEDING,
SUPPLEMENTARY/
ARTIFICIAL FEEDING AND
WEANING
PRESENTED BY:-
Ms. ENA SINGH
M.Sc. (N) Ist yr
SGRRU CON
BREASTFEEDING
 Breastfeeding is the best natural feeding and
breast milk is the best milk.
 The basic food of infant is mother’s milk.
 Bf is the most effective way to provide a baby
with a caring environment and complete food.
 It meets the nutritional as well as emotional
and psychological needs of the infant.
ADVANTAGES
1. NUTRITIVE VALUE
 Breast milk contains all the nutrients in the right proportion
which are needed for optimum growth and development of the
baby.
 Essential for brain growth of the infant because it has higher
percentage of lactose and galactose which are important
components of galacto-cerebroside.
 Facilitates absorption of calcium which helps in bony growth.
 Contains amino acids like taurine and cysteine which are
important as neurotransmitters.
 Breast milk fats are poly-unsaturated fatty acids which are
necessary for myelination of the nervous system.
 It has vitamins, minerals, electrolytes and water in the right
proportion for the infant which are necessary for the maturation
of the intestinal tract.
 Provides 66 calories per 100 ml, 1.2 gm protein, 3.8 gm fat, 7gm
lactose and vit. ‘A’ 170-670 IU, vit. ‘C’ 2-6 mg, vit. ‘D’ 2.2 IU,
calcium 35 mg, phosphorus 15 mg.
 Total amount of milk secretion per day is about 600-700 ml, which
is sufficient for the baby. Its composition is ideal for an infant.
 It provides specific nutrition for preterm baby in preterm
delivery.
2. DIGESTIBILITY
 Breast milk is easily digestable.
 The protein of breast milk are mostly
lactoalbumin and lactoglobulin which form
a soft curd that is easy to digest.
 The enzymes lipase in the breast milk helps
in the digestion of fats and provides free
fatty acids.
3. PROTECTIVE VALUE
 It contains IgA, IgM, macrophages, lymphocytes, bi-fidus factors,
unsaturated lactoferrin, lysozymes, complement and interferon.
 Thus breastfed body less likely to develop infections especially
gastrointestinal and respiratory tract infections, e.g. diarrhea and
ARI.
 Breastfeeding protects the infant from allergy and bronchial
asthma. It also protects against neonatal hypocalcemia, tetany,
necrotizing enterocolitis, deficiencies of vitamin E and zinc,
neonatal convulsions and sudden infant death syndrome.
4. PSYCHOLOGICAL BENEFITS
 Breastfeeding promotes close physical and emotional
bondage with the mother by frequent skin to skin contact,
attention and interaction. It stimulates psychomotor and
social development.
 It leads to better parent child adjustment, fewer behavioral
disorders in children and less risk of child abuse and
neglect.
 Breastfeeding promotes development of higher intelligence
and feeling of security in infant.
5. MATERNAL BENEFITS
 Breastfeeding reduces the chance of postpartum hemorrhage and helps in better
uterine involution.
 Lactational amenorrhea promotes in recovery of iron stores. It can protect from
pregnancy for first 6 months if exclusive breastfeeding is carried out.
 Breastfeeding improves metabolic efficiency and satisfaction with sense of
fulfillment of the mother.
 It reduces the risk of breast and ovarian cancer of the mother.
 It improves slimming of the mother by consuming extra fat which is accumulated
during pregnancy.
 It is more convenient and time saving for the mother. Mother can provide fresh,
pure, readymade, clean uncontaminated milk to her baby at right temperature
without any preparations.
6. FAMILY AND COMMUNITY
BENEFITS
 Breastfeeding is economical in terms of saving
of money, time and energy.
 Family has to spend less on milk, healthcare
and illness.
 Community expenditure on health care and
contraception are reduced. It is economical for
the families, hospitals, communities and for
countries.
PREPARATION FOR
BREASTFEEDING
 Must begins in the antenatal period.
 Mother-craft training should be provided and includes benefits of
breastfeeding which should be given in the prepregnant stage.
 In the antenatal period, examination of breast and identification of
problems, like retracted nipple, should be done with necessary
advice for interventions.
 Adequate diet in prenatal period should be consumed in terms of
energy and nutrients. Prevention of micronutrients deficiencies,
rest, regular exercise, hygienic measures, etc. should be advised for
better health in antenatal period.
BREASTFEEDING INITIATION
 Should be initiated within first half an hour to one hour of birth or

as soon as possible.
 It should also be initiated within one hour even after cesarean
section delivery, if the mother and baby, both are having no
problem.
 Early suckling provides warmth, security and colostrum, the baby’s
first immunization.
 Although little in amount, the first milk, colostrum, is most suitable
and contains a high concentration of protein and other nutrients, the
baby needs. Rich in anti-infective factors and protects the baby
fromrespiratory infections and diarrhoeal diseases.
 Mothers should be demonstrated about the technique of breast
feeding.
 Rooming-in or bedding-in should be done with infant and mother
as soon as possible to prevent separation.
 Mother should be advised for exclusive breastfeeding up to 6
months and as demand feeding.
 No food or drink other than breast milk should be given to
neonates. No water, glucose water, animal milk, gripe water,
indegenous medicines, vitamins and minerals drops or syrup
should be given.
 No bottle and pacifier are allowed.
 In case of preterm babies or sick babies, being in a special care
unit, they should be fed with expressed breast milk (EBM).
INDICATORS OF ADEQUACY OF
BREASTFEEDING
 Audible swallowing sound during the feed.
 Let down sensation in mother’s breast.
 Breast is full before feed and softer afterward.
 Wet nappies 6 or more in 24 hrs.
 Frequent soft bowel movements, 3-8 times in 24 hrs.
 Average weight gain of 18-30 gm/day.
 Baby sleeps well and does not cry frequently.
 Baby has good muscle tone and healthy skin.
DIFFERENT COMPOSITION OF
BREAST MILK
 The composition of breast milk varies at

different stages after birth to suit the needs of
the baby. Milk of a mother who had delivered a
preterm baby is different from milk of a mother
who has delivered a full term baby.
 1. COLOSTRUM :- Colostrum is the milk secreted
during first week after delivery. It is yellow, thick and contain
more antibodies and white blood cells. Though secreted only in
small quantities, it has higher protein content and is most suited
for the needs of the baby
 2. TRANSITIONAL MILK is the milk secreted during
the following two weeks. The immunoglobulin and protein
content decreases while the fat and sugar content increases.
 3. Mature milk follows transitional milk. It is
thinner and watery but contains all the nutrients
essential for optimal growth of the baby.
 4. Preterm milk is the breast milk of a mother who
delivers prematurely. It contains higher quantities
of proteins, sodium, iron, immunoglobulins that
are needed by her preterm baby.
 5. FORE MILK is the milk secreted at the start of a
feed. It is watery and is rich in proteins, sugar,
vitamins, minerals and water and satisfies the baby’s
thirst.
 6. HIND MILK comes later towards the end of a feed
and is richer in fat content and provides more energy,
and satisfies the baby’s hunger. For optimum growth
the baby needs both fore and hind milk. The baby
should therefore be allowed to empty one breast. The
second breast should be offered after emptying the first.
 Ensure exclusive breast feeding during first 6
months of life. Additional water is not necessary
even in summer.
 Exclusive breastfeeding should be given for
initial six months. The mother can continue
breastfeeding as long as she wishes but at least
during first year; complimentary food should
be started after six months of age.
TECHNIQUE OF BREAST
 FEEDING
Mother should be comfortable and relaxed physically and
mentally before giving breastfeed. She should wash her
hands and can have a glass of water or milk.
 Mother should have no due work in her hands. Baby
should be cleaned and dried before feeding.
 Correct positioning of baby and mother is an important
aspect of successful breastfeeding. Mother can be in sitting
or side lying position.
 Even mother can be lying flat with infant on top of the
mother, especially following LUCS.
 Baby should be supported by the
mother’s forearm in slight head
elevated position and with head,
neck and back in a straight line.
 Baby should be held close to mother
with trunk to trunk in touch and
facing towards breast.
 LATCHING:- After proper positioning, when baby’s
chin touches the breast, cheek touches the nipple, baby
will open the mouth in ‘rooting reflex’. Then the baby
will quickly move on to the breast with the lower lip
below the nipple, so that the nipple and most of the
areola go into the baby’s mouth.
 The suckling of breast stimulates the milk secretion or
prolactin reflex’, which promotes the milk production
and secretion. Then by the ‘milk ejection or oxytocin
reflex’, milk flows out from the glands into ducts and
then baby’s mouth.
 When baby suckles again and again in regular slow deep sucks
with good ‘sucking reflex’, the adequate milk flows out and then
baby’s cheeks become full with milk.
 The baby should have a good ‘swallowing reflex’ to take
adequate feed with sufficient flow of milk.
 If the baby fall asleep after few sucks, mother should arouse the
baby by gentle tap behind the ear or the sole of the foot.
 Initially the breastfeeding can be given at 1-2 hrs interval and
then on ‘self demand’ by the baby. A baby usually cries when
hungry.
 Duration of feed should be continued till the baby is satisfied.
One breast should be emptied completely before starting with
other breast. Next feeding should be started with another breast.
 Burping to be done gently. Usually not necessary, if the baby is
having good latching and attachment during feeding which
prevents air entry into the baby’s mouth.
 After feeding baby should be placed on the right side. Usually
the baby falls asleep. Mother should make the baby dry and
comfortable.
 Breastfeeding should be continued exclusively up to 6 months of
age if adequate breast milk is available.
 Complimentary foods can be started at 6
months, exact age may vary but breastfeeding
should be continued upto 2 yrs of age or
beyond and specially at night.
 Mother should maintain hygienic measures,
take daily bath and wash her breast during bath
and wear clean blouse to prevent
contamination.
CONTRAINDICATIONS
 NEONATAL :-  MATERNAL :-
 Galactosemia  Radiotherapy
 Phenylketonuria  Ergot therapy
 Anti metabolites therapy
 Lithium therapy
PROBLEMS IN BREASTFEEDING
 The baby who refused on breast
 Inverted nipples
 Sore nipple
 Breast engorgement
 Breast abscess
 Working mother
1. BABY WHO REFUSED ON
BREAST
 Baby should be held in comfortable
position with good attachment to the
breast and should be kept dry and warm.
 Avoiding pressure on potentially painful
areas during feeding.
 Express breast milk to maintain lactation
in both breast.
 Allowing the baby to feed only one breast.
2. INVERTED NIPPLES
 Treatment should be started after birth of the

baby.
 The nipple is manually stretched and rolled out
several times a day.
 A pump or a plastic syringe (10 ml) is used to
draw out the nipple and the baby is then put to
the breast.
3. SORE NIPPLE
 Correct positioning and latching of the baby to the

breast.
 Frequent washing with soap and water should be
avoided.
 Baby should not be pulled off the breast while still
suckling.
 Hind milk to be applied to the nipple after a feeding.
 Nipples should be aired and allowed to heal in between
feeds.
4. BREAST ENGORGEMENT
 Frequent feeding and correct attachment of the
baby to the breast during feeding to be done to
prevent engorgement.
 Treatment of this condition to be done with
local warm packs and analgesics to the mother
to relieve the pain.
 Milk should be expressed gently to soften the
breast and then baby to be put to the breast
with good latching.
5. BREAST ABSCESS
 Treatment to be done with analgesics and
antibiotics.
 Abscess may need incision and drainage.
 Breastfeeding must be continued.
6. WORKING MOTHER
 Mother should express her milk in a clean, wide
mouthed container and this milk should be fed to her
baby by the caretaker, in the absence of the mother.
 Express breast milk (EBM) can be stored at room
temperature for 8 hrs and in the refrigerator for 24
hrs.
 EBM feeding should be given with cup/bati and spoon.
 Expression of milk should be done by hands which is
more easier.

Breastfeeding

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BREASTFEEDING,

 Should be initiated within first half an hour to one hour of birth or

 The composition of breast milk varies at

 Treatment should be started after birth of the

 Correct positioning and latching of the baby to the

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