skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender 3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender 3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender 3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender 3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, because the areola can be too hard to grasp. A woman also may have difficulty breastfeeding her infant, because her breasts feel so tender 3-prevent or Relieve Engorgement:a common suggestion is to empty the breasts of milk by having the infant suck more often, or at least continue to suck as much as before.skin may appear red, tendernese, and shiny. This is primary engorgement, caused by vascular and lymphatic congestion arising from an increase in the blood and lymph supply to the breasts. Infants have difficulty sucking on engorged breasts, bec

1. Presenter to: Dr.Eqbal Farajat
Prepare by :
Alaa Mahmoud
Rahaf Zaid
Shahad Khalil
Nebal zeyad
Haneen Omar

2. BREASTFEEDING

3. Outline:
1. Introduction
2. Definition the breastfeeding
3. Anatomy and physiology of breast
4. Advantages of breastfeeding
5. Disadvantage of breastfeeding
6. What are the components of mother’s milk
7.Types of breast milk
8. Explain Techniques of breastfeeding
9. Breastfeeding positions
10. Breastfeeding problems
11.Nursing education for breastfeed
12.Comparison between breastfeeding and bottle feeding
13. Conclusion
14. Reference

4. Learning objective
At the end of this course, the students will be able to:
1.Define the breastfeeding.
2.Recognize physiology of breast milk production
3.Recognize advantages of breastfeeding for women and infants.

5. INTRODUCTION
It is universally agreed that breast milk is the preferred
method of feeding for newborns because it provides
numerous health benefits to both a mother and an infant;
it remains the ideal nutritional source for infants through
the first year of life Nurses are prime health care
professionals to teach women about the benefits of
breastfeeding and provide anticipatory guidance for
problems that may occur.

6. DEFINITION
Breastfeeding is the feeding of an
infant or young child with breast
milk directly from female human
breasts (i.e., via lactation) not from
a baby bottle or other container.

7. Physiology of breast milk production
•Breasts consistsof gland tissues (consisting lactiferous sinuses) that
make milk, which goes along milk ducts. towards the nipple. Suckling
stimulates nerve endings, Message is carried to anterior pituitary which
synthesizes prolactin.
•Prolactin stimulates gland cells to stimulate milk production. Oxytocin is
released from posterior pituitary, which helps in contracting the muscle
cells around the alveoli, resulting in milk ejection from nipple.

8. Anatomy of breast
•The breasts of an adult woman are milk-
producing, -shaped glands. They are
supported by and attached to the front of
the chest wall on either side of the breast
bone or sternum by ligaments. They rest
on the major chest muscle, the pectoralis
major.
•The breast has no muscle tissue. A layer
of fat surrounds the glands and extends
throughout the breast.

9. •The breast is responsive to a complex interplay
of hormones that cause the tissue to develop,
enlarge and produce milk. The three major
hormones affecting the breast are estrogen,
progesterone and prolactin, which cause
glandular tissue in the breast and the uterus to
change during the menstrual cycle.

10. •Each breast contains 15 to 20 lobes arranged in a
circular fashion. The fat (subcutaneous adipose tissue)
that covers the lobes gives the breast its size and shape.
Each lobe is comprised of many lobules, at the end of
which are tiny bulb like glands, or sacs, where milk is
produced in response to hormonal signals.
•Ducts connect the lobes, lobules, and glands in nursing
mothers. These ducts deliver milk to openings in the
nipple. The areola is the darker pigmented area around
the nipple

11. Advantages of breastfeeding

12. Advantages for Mother
A woman gains several physiologic benefits from breastfeeding:
•Breastfeeding may serve a protective function in preventing breast
cancer.
•The release of oxytocin from the posterior pituitary gland
aids in uterine involution.
•Successful breastfeeding can have an empowering effect, because it
is a skill only a woman can master.
•Breastfeeding reduces the cost of feeding and preparation
time.

13. Advantages for Infants
•With vir Advantages for Infants: Lactoferrin is an iron-binding
protein in breast milk that interferes with the growth of pathogenic
bacteria. The enzyme lysozyme in breast milk apparently actively
destroys bacteria
•By lysing (dissolving) their cell membranes, possibly increasing the
effectiveness of antibodies
•Leukocytes in breast milk provide protection against common
respiratory infectious invaders.
•Macrophages, responsible for producing interferon (a protein that
protects against viruses), help interfere with virus growth

14. Disadvantages of breastfeeding for women and
infants:
•You need to eat a balanced diet
•Some medications are passed through breast milk.
•Breastfed babies need to be fed more often

15. Breastfeeding is contraindicated in only a few circumstances, such as:
•An infant with galactosemia
•Maternal exposure to radioactive compounds
•Maternal diet is nutrient restricted, preventing quality milk
production
•Breast cancer

17. TYPES OF BREAST MILK
1. Colostrum
2. Transitionalmilk
3. true or Mature milk
4. Fore milk
5. Hind milk

18. 1.Colostrum: a thin, watery, yellow fluid
composed of protein, sugar, fat. Water.
Minerals, vitamins, and maternal antibodies, is
secreted by the acinar breast cells starting In
the fourth month of pregnancy. For the first 3
or 4 days after birth.
2.Transitional breast milk: secreted on the
second to fourth.
3.True or mature breast milk : is produced
by the 10th day.

19. 4.Fore milk :The constantly forming milk , Its
availability depends very little on the Infant’s
sucking at the breast
5.Hind milk: is higher in fat than fore milk, is the
milk that makes a breastfed infant grow most
rapidly

20. Techniques of breastfeeding

21. 1- Explain the procedure to the client.
2-Assemble equipment, including a clean towel and collection
container.
3-Wash your hands and put on clean gloves; have wash her hands.
4-Provide privacy and help the woman assume a comfortable sitting
position.
5-Help the woman place her right hand on her right breast, with her
right thumb on the top of the breast at the outer limit of the areola
and her right fingers underneath the breast. Tell the woman to press
inward toward the chest wall.

22. 6-Help the woman hold the collecting jar just under her
nipple.
7-Encourage the woman to move her thumb and fingers
around her breast, repeating the technique.
8-Caution the woman not use excess force at any point
when using the technique.
9-After collection, refrigerate milk fi it will be used within 24
hours; freeze if this time is longer.

23. Normal positions for breastfeeding

24. Side-lying position for breastfeeding:
When she is first attempting to breastfeed, lying on her
side with a pillow under her head is a good position to use
This relieves fatigue because it allows her infant to rest on
the bed

25. Sitting position for breastfeeding:
shows a sitting position with a pillow under the baby. Using a
football hold with the baby supported on a pillow also may be
helpful, especially if a mother had a cesarean birth.

26. Other position for breastfeeding

27. Breastfeeding problem

28. BREAST ENLARGEMENT
•On third and fourth day after birth , when breast milk forms
•Symptoms of engorgement:
1. Breast distention
2. Hardness
3. Tenderness
4. Perhaps
5. Heat in their breasts
6. The skin appears red, tense, and shiny
•Caused by vascular and lymphatic congestion arising from an increase in the
blood and lymph supply to the breasts.

29. BREAST ENLARGEMENT
Prevent or Relieve Engorgement:
•Emptying the breasts of milk by having the infant suck more often
•Warm packs applied to both breasts or standing under a warm shower for a few
minutes before feeding, combined with massage to begin milk flow
•Good breast support from a form fitting bra helps prevent a pulling, heavy
feeling

30. SORE NIPPLES
Painful nipples result from the strong sucking action of a newborn.
This may be worsened by:
•Improper positioning of an infant (failure to grasp the areola as well as
the nipple)
•Forcefully pulling an infant from a breast
•Allowing an infant to suck too long at a breast after the breast is
emptied
•Permitting a nipple to remain wet from leaking milk

31. SORE NIPPLES
To help prevent soreness:
1-Encourage a mother to position her baby slightly differently for each feeding.
2-Advise her to expose her nipples to air by leaving her bra unsnapped for 10 to 15 minutes
after feeding.
3-Discourage the use of plastic liners that come with nursing bras; it is preferable to have air
always circulating around the breasts.
4-Applying vitamin E lotion after air exposure may toughen the nipples and prevent further
irritation.
5-Advise women not to use a hand pump with sore nipples, because the pressure may cause
fissures to worsen.

32. BREAST ABSCESS
•If conditions like engorged breast, cracked nipples, blocked duct or
mastitis aren’t treated breast abscess develops
•High grade fever and tenderness in breast
TREATMENT:
1. Analgesic, antibiotics
2. Abscess must be incised & drained
• Breastfeeding continued on other breast

33. MASTITIS
•Infection of the breast may occur as early as the seventh
postpartal day or not until the baby is weeks or months old
•The organism causing the infection usually enters through
cracked and fissured nipples.
•Mastitis is usually unilateral, although epidemic mastitis,
because it originates with the infant, may be bilateral. The
affected breast is painful, swollen, and reddened. Fever
accompanies these first symptoms within hours, and breast
milk becomes scant.
•Mastitis requires a visit to the doctor to treat it with the
appropriate antibiotic

34. MASTITIS
Measures that prevent cracked and fissured nipples also help prevent
mastitis , these measures include:
•Making certain the baby is positioned correctly and grasps the nipple
properly, including both nipple and areola
•Releasing a baby’s grasp on the nipple before removing the baby from
the breast
•Washing hands between handling perineal pads and touching the
breasts

35. MASTITIS
•Exposing nipples to air for at least part of every day
•Using a vitamin E ointment to soften nipples daily
•If a woman has one cracked and one well nipple,
encourage her to begin breastfeeding (when the infant
sucks most forcefully) on the unaffected nipple.

36. Nursing diagnosis and related
intervention for newborn nutrition

37. Nursing Diagnosis: Pain related to breast engorgement or
sore nipples
Outcome Evaluation: Client states she is experiencing little or
no discomfort; breastfeeds without undue discomfort; infant
grasps nipple firmly.
1-On the third or fourth day after birth, when breast milk
forms, women often notice breast distention, accompanied
by hardness, tenderness, and perhaps heat in their breasts.

38. 2-heir skin may appear red, tendernese, and shiny. This is
primary engorgement, caused by vascular and lymphatic
congestion arising from an increase in the blood and
lymph supply to the breasts. Infants have difficulty sucking
on engorged breasts, because the areola can be too hard
to grasp . A woman also may have difficulty breastfeeding
her infant, because her breasts feel so tender
3-prevent or Relieve Engorgement:a common suggestion
is to empty the breasts of milk by having the infant suck
more often, or at least continue to suck as much as before.

39. Nursing Diagnosis: Health-seeking behaviors related to lack
of knowledge about lactation and breastfeeding techniques
Outcome.
Evaluation: Woman states correct information as to how
lactation Begins and is maintaining an adequate supply;
demonstrates effective positioning for baby and herself by 24
hours….
1. Promote Adequate Sucking.
2. Provide Immediate Support if Problems Arise.
3. Provide Information Regarding Techniques for Burping the
Breastfed Baby.

40. 4. Support for a Mother Who is Breastfeeding
Multiple Infants.
5. Provide Information Regarding Lactation and
Proper Positioning Techniques.

41. The role of the nurse in the success of breastfeeding in
health care facilities
•Educating all pregnant women about the benefits and
management of breastfeeding.
•Helping women initiate breastfeeding within half an hour
after birth.
•Assisting mothers to breastfeed and maintain lactation even
if they should be separated from their infant.
•Not giving newborns food or drink other than breast milk
unless medically indicated, so they are hungry to breast feed.

42. •Advise women they need not introduce solid food until at least
4 months.
•Not giving newborns pacifiers to quiet them as this can reduce
the sucking initiative.
•Supporting rooming-in (such as allowing mothers and infants
to remain together) 24 hours a day.
The role of the nurse in the success of breastfeeding in
health care facilities

43. What is Bottle feeding?
•Bottle feeding is an alternative to natural
breastfeeding through which the baby gets
milk from the mother’s breast, and in this type
of feeding the baby is given the appropriate
amount of milk according to his age, and it is
worth noting that Bottle feeding does not
provide the baby with all the nutrients he gets
from breast milk which is considered the ideal
food for him, so the mother can breastfeed in
addition to breastfeeding, or even rely on it
mainly to feed her child .

44. Compare between breastfeeding and bottelfeeding

45. Risks of Formula Feeding:
•lack of enzymes and hormones necessary for the child for good growth.
•Formula milk affects the health and safety of teeth directly, and the reason
for this is due to the presence of a percentage of sugars in formula milk
•The child loses his appetite for food, so he does not eat the three main
meals.
•The use of bottle feeding after the age of two years will affect the teeth of
the child, resulting in delayed speech and the inability to pronounce letters
properly.
•Higher risk of diabetes

46. Risks of Formula Feeding:
•Higher risk of heart disease
•Higher risk of chronic diseases
•Higher risk of ear infections
•Higher risk of allergy
•Higher risk of asthma
•Higher risk of diarrhea

47. Conclusion
•Anatomy and physiology of breast.
•Definition the breastfeeding
•The componentsof mother’s milk
•Advantages of breastfeeding
•Explain Techniques of breastfeeding
•Breastfeeding positions
•Comparison between breastfeeding and bottle feeding
•Breastfeeding problems

48. References
• Maternal Child Health Nursing Care of the
Childbearing chapter(19) page(492)

49. THANKS
FOR
ATTENTION