#. nursing #ABHIJITBHOYAR1 It includes the meaning of breastfeeding, advantages, steps, contraindication and the problems found while feeding to the baby.

2. Breastfeeding is the best
natural feeding and breast
milk is best milk.
The basic food of infant is
mother's milk.
Breastfeeding is the most
effective way to provide a
baby with a caring
environment and complete
food.
INTRODUCTION

3. It meets the
nutritional as well
as emotional and
psychological
needs of the
infant.
Recently there is
tendency to replace
the natural means of
infant feeding and
introduction of breast
milk substitutes
Breastfeeding
deserves
encouragement
from all concerned
in the welfare of
children.

4. INCIDENCE RATE
UNICEF stated that every year over
one million infants die and millions
of others are impaired, because they
are not adequately breastfed.
Everyday between 3000 to 4000
infants die from diarrhea and acute
respiratory infections because the
ability to feed them adequately has
been taken

5. Family and Community
Benefits
Maternal Benefits
Psychological Benefits
Protective Value
Digestibility
Nutritive Value A
D
V
A
N
T
A
G
E
S
Advantages of
Breastfeeding

6. • Breastfeeding is the safest, cheapest and best protective food for
infants.
• Superiority of human milk is due to its superior nutritive and
protective value.
• It is perfect food for infants and provides total nutrient requirements
for the first six months of life.
Advantages of Breastfeeding

7. NUTRITIVE VALUE
• Breast milk contains all the nutrients in the right proportion which are
needed for optimum growth and development of the baby up to 6 months.
• It is essential for brain growth of the infant because it has high percentage
of lactose and galactose which are important components of
galactocerebroside.
• It facilitates absorption of calcium which helps in bony growth.

8. • It contains amino acids like taurine and cysteine which are important as
neurotransmitters.
• Breast milk fats are polyunsaturated fatty acids which are necessary for
the 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.

9. • It provides 66 calories per 100 mL and contains 1.2 g protein, 3.8 g fat, 7
g lactose and vitamin A 170 to 670 IU, vitamin C 2 to 6 mg, vitamin D
2.2 IU, calcium 35 mg, phosphorus 15 mg in 100 mL.
• The total amount of milk secretion per day is about 600 to 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.

10. DIGESTIBILITY
• Breast milk is easily digestible.
• The proteins of breast milk are mostly lactoalbumin and
lactoglobulin which form soft curds that is easy to digest.
• The enzyme lipase in the breast milk helps in the digestion of fats
and provides free fatty acids.

11. PROTECTIVE VALUE
• Breast milk contains IgA, IgM, macrophages, lymphocytes, bifidus
factors, unsaturated lactoferrin, lysozyme, complement and interferon.
• Thus, breastfed baby is less likely to develop infections especially
gastrointestinal and respiratory tract infections, e.g. diarrhea and ARI.It
also provides protection against malaria and various viral and bacterial
infections like skin infections, septicemia, etc.

12. • 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.
• Exclusive breastfeeding baby has less chance of developing malnutrition,
hypertension, diabetes mellitus, coronary artery disease, arteriosclerosis,
ulcerative colitis, appendicitis,
• childhood lymphoma, liver disease; celiac disease and dental caries.

13. PSYCOLOGICAL
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.

14. 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.

15. • Breastfeeding improves metabolic efficiency and satisfaction with sense
of fulfilment 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
accumulated during pregnancy.

16. • 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.
• Mother feels comfortable to feed the baby especially at night.

17. FAMILY AND
COMMUNITY BENEFITS
• Breastfeeding is economical in terms of saving of money, time and
energy.
• Family has to spend less on milk, health care and illness.
• Community expenditure on health care and contraception are reduced.
• It is economic for the families, hospitals, communities and for countries.

18. PREPARATION
FOR
BREASTFEEDING
In the antenatal period,
examination of breast and
identification of problems,
like retracted nipple should
be done with necessary
advice for interventions.
Preparation for
breastfeeding must
begin in the
antenatal period.

19. Adequate diet in
prenatal period should
be consumed in terms
of energy and nutrients.
Prevention of
micronutrient
deficiencies, rest,
regular exercise,
hygienic measures, etc.
should be advised for
better health in
antenatal period.

20. • Antenatal counseling, family
support, mother support
group also should be
emphasized as the
preparation of mothers for
breastfeeding.
• Mother should be
psychologically prepared to
feed her baby immediate
after birth.

21. INITIATION OF BREAST FEEDING
• Breastfeeding 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.

22. CONTI….
• 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.
• It is rich in anti-infective factors and protects the baby from respiratory
infections and diarrheal diseases.

23. • Mothers should be demonstrated
about the techniques of breast
feedings.
• Rooming-in or bedding-in
should be done with infant and
mother as soon as possible to
prevent separation.

24. 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, indigenous 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 special care unit, they
should be fed with expressed breast milk EBM).
Nursing staff is responsible to ensure that nothing except breast milk is
given.

25. Mother should be instructed to assess the indicators of adequacy of
breastfeeding and importance of increasing her own dietary intake with extra
550 cal and to drink fluids in response to her thirst.
Rest and relaxation of mother are important for recovery from delivery and
successful lactation in postnatal period

26. 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
hours
Frequent soft
bowel
movements, 3
to 8 times in 24
hours
Average weight
gain of 18 to 30
g/day
Baby sleeps
well and does
not cry
frequently
Baby has good
muscle tone
and healthy
skin

27. Note: Passage of urine 6 to 8 times
per day and average weight gain are
considered as most important
criteria.

28. DIFFERENT COMPOSITION OF BREAST MILK
Transitional
Milk
Colostrum
Mature
Milk
Preterm
Milk
Hindmilk
Foremilk

29. Colostrum
• It is secreted during first three days after
delivery.
• It is thick, yellow and small in quantities.
• It contains more antibodies and cells with
higher amount of proteins and fat-soluble
vitamin (A, D, E, K).
• It is sufficient and protective for the baby and
should not be discarded.
Transitional Milk
• It follows the colostrum and secretes during
first two weeks of postnatal period.
• It has increased fat and sugar content and
decreased protein and immunoglobulin
content.

30. Mature Milk
• It is secreted usually from 10 to 12 days
after delivery.
• It is watery but contains all nutrients for
optimal growth of the baby.
Preterm Milk
• The breast milk secreted by a mother
who has delivered a preterm baby is
different from milk of a mother who has
delivered a full-term baby.
• This milk contains more proteins,
sodium, iron, immunoglobulins and
calories appropriate for the
requirements of the preterm neonates.

31. Foremilk
• It is secreted at the starting of the
regular breastfeeding.
• It is more watery to satisfy the baby's
thirst and contains more proteins,
sugar, vitamins and minerals.
Hindmilk
• It is secreted towards the end of
regular breastfeeding and contains
more fat and energy.
• The mother should feed the baby
allowing one breast to empty to
provide both foremilk and hindmilk,
before offering other breast.
• For optimum growth and to fulfil
adequate fluid and nutritional
requirements, both foremilk and
hindmilk are needed for the baby.

32. TECHNIQUE OF BREASTFEEDING
• 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; otherwise baby may
feel discomfort or may non-cooperate during feeding.

33. Correct positioning of mother and baby is
an important aspect of successful
breastfeeding.
Mother can be in sitting or side lying
position

34. • Even mother can be lying flat with infant on top of the mother, especially
following lower uterine cesarean section (LUCS) delivery.
• 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 hold close to mother with trunk-to-trunk in touch and
facing towards breast
• After proper positioning, when baby's chin touches the breast, cheek
touches the nipple; baby will open the mouth in 'rooting reflex.

35. • Then the baby will be quickly moved 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 the lactiferous sinuses and ducts and then to the 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.

37. • The mother may hear the swallowing sound and does not feel pain in the
nipple.
• All these indicate favorable signs of good attachment or latching and
breastfeeding.
• The baby should have good 'swallowing reflex' to take adequate feed with
sufficient flow of milk.
• Baby's rooting, sucking and swallowing reflexes help the baby to take
secreted milk from the breast successfully
• If the baby falls asleep after few sucks, mother should arouse the baby by
gentle tap behind the ear or on the sole of the foot.

38. • Initially breastfeeding can be given at 1 to 2 hours interval and then on
'self-demand' by the baby.
• A baby usually cries when feel hungry and then must be put into the
breast.
• Duration of feeding should be continued till the baby is satisfied.
• The duration of sucking depends upon the vigor of the baby and on the
'let-down reflex.
• One breast should be emptied completely before starting with another
breast.

40. • Next feeding should be started with opposite breast, i.e. which was fed
last in the previous feeding. Burping to be done gently.
• It is usually not necessary, if the baby is having good latching and
attachment during feeding which prevent air entry into the baby's mouth.
• Baby should be placed on right side after feeding. Usually the baby falls
asleep. Mother should make the baby dry and comfortable.
• Breastfeeding should be continued exclusively up to 4 months of age
or preferably may be up to 6 months if adequate breast milk is
available.

42. • The baby should be given only breast milk and nothing else, not even
water for first 4 months of life, even in summer months.
• Frequent suckling helps to have adequate amount of milk for the baby.
• Complementary foods can be started at 6 months, exact age may vary, but
breastfeeding should be continued up to 2 years of age or beyond and
especially at night.
• Mother should maintain hygienic measures, take daily bath and wash her
breast during bath and wear clean blouse during this period to prevent
contamination of breast milk.

43. CONTRAINDICATIONS OF
BREASTFEEDING
• The true contraindications of breastfeeding are galactosemia and
phenylketonuria.
• Maternal conditions which can be considered as 'REAL'
contraindications are Radiotherapy, Ergot therapy, Antimetabolites
therapy and Lithium therapy.
• Maternal illness should not result in interruption of breastfeeding.
Expressed breast milk (EBM) can be given to the baby, whenever needed,
from the mother or mother's substitute.

46. THE BABY WHO DOES NOT SUCKLE
• No unneeded drugs to be given to breastfeeding mothers
• No artificial food or water to be given to the baby.
• Breastfeeding to be given when the baby is alert and ready.
• Milk to be expressed into the nipple just prior to feed the baby.
• Nipple should be placed slightly upward towards the roof of the baby's
mouth.
• Keeping the baby's nose free during breastfeeding.

47. THE BABY WHO DOES NOT SUCKLE
• Baby should be hold 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 breasts.
• Allowing the baby to feed only one breast.

48. 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
• Precautions should be taken to prevent injury of breast and nipple during the traction with the syringe.

49. 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 pull off the breast while still sucking.
• Hindmilk to be applied to the nipple after a feeding.
• Nipples should be aired and allowed to heal in between feeds.