This Lesson Plan is regarding Breast Feeding-Introduction, Definition, Anatomy of Breast, Physiology of Lactation, Hormones, Reflexes in the baby, Advantages, Contraindications, composition of Human Milk, the types of milk,Breast Feeding Positions,Breast Feeding Pattern, Good and Poor attachment of the baby.

1. 1
LESSON PLAN
ON
BREAST FEEDING
SUBMITTED TO: SUBMITTED BY:
Mrs.K.Sunil Kumari Mrs.S.Tulasi
H.O.D,Child Health Department M.Sc (N) 1st
Year Student
EBM College of Nursing EBM College of Nursing
SUBMITTED ON: 04/12/2017

2. STUDENT PFOFILE
Name Of The Student Teacher : Mrs. S.Tulasi
Course : M.Sc (N) 1st
year
College : EBM College of Nursing
Name Of The subject : Child Health Nursing
Name Of The Topic : Breast Feeding
Unit : Unit- V
Name Of The Supervisor : Mrs K.Sunil Kumari
Group : B.Sc (N) III- Year
Venue : B.Sc (N) III - year class room
Date And Time : 14 /12 /2017 , 10:30 Am
Method Of Teaching : Lecture cum Discussion
A.V Aids : Black Board, Chart,
Flash Card, PPT
2

3. OBJECTIVES
GENERAL OBJECTIVES:
By the end of the session, the students will be able to gain in depth knowledge about
the Breast feeding.
SPECIFIC OBJECTIVES:
At the end of the session students will be able to
• Introduction of Breast Feeding
• Definition of Breast Feeding
• Explain the Anatomy of the Breast
• Explain the Physiology of Lactation
• Explain the role of hormones in milk production
• Reflexes in the baby
• List out the composition of Human Milk
• Know the types of milk
• Discuss the advantages and contraindications
• Know the Breast Feeding Positions
• Know the Breast Feeding Pattern
• Discuss the Good and Poor attachment of the baby
3

4. S.
No OBJECTIVE TIME CONTENT IN ENGLISH
TEACHER
ACTIVITY
LEARNER
ACTIVITY
AV
AIDS EVALUATION
1
2
To introduce
the topic
TO
Define the
Breast
Feeding
1min
½min
INTRODUCTION:
The basic food for infant is milk and
breast feeding is the most natural method. Breast
Feeding is must to meet the nutritional needs,
emotional needs and psychological needs of the
infant and child.
Breast milk is natural readymade food
which is the most suitable for the neonates because
of its nutritional value, protection from the infection
against diseases and the financial and social
implications it has for a poor.
Virtually all mothers can breastfeed,
provided they have accurate information, and the
support of their family, the health care system and
society at large.
DEFINITION:
According to WHO:
Breastfeeding is the normal way of
providing young infants with the nutrients they need
for healthy growth and development.
Lecture
cum
Discussion
Lecture
cum
Discussion
Listening
Listening
Black
Board
with
Chalk
Black
Board
with
Chalk
4

5. 3
Explain the
Anatomy of
the Breast
1min
2min
Exclusive breastfeeding is recommended
up to 6 months of age, with continued breastfeeding
along with appropriate complementary foods up to
two years of age or beyond.
ANATOMY OF THE BREAST:
Breasts are bilateral glandular structures.
The shape of breast varies among the women and
also in different periods of life. But the size of base
of the breast is fairly constant.
Human normally consists of two complex
mammary glands, one in each breast and each
complex mammary gland consists of 10-20 simple
glands or segments of glandular tissues
• The nipple- delivers breast milk to the baby
• The areola- supports the nipple, contains the
Montgomery’s gland and finally makes the
Lecture
cum
Discussion
Lecture
cum
Discussion
Listening
Listening
PPT
PPT
5

6. 2min
nipple visible to the baby during
breastfeeding.
• Montgomery’s glands- secrete an oily fluid
which moisturizes the nipple during
breastfeeding
• Alveoli- they are very small sacs and millions
in number made of milk-secreting cells.
Prolactin hormone makes these cells produce
milk.
• Milk-secreting Cuboidal cells - They
produce or secrete milk in the breast/lobules
• Myo epithelial cells- contract and squeeze
out the milk and oxytocin hormone makes the
myo epithelial cells contract.
• Lactiferous Ducts- also known as small tubes
carry milk from the alveoli to the outside. It
is vital to note that milk is stored in the
alveoli and small ducts between feeds.
• Lactiferous sinuses/Ampulla - they enlarge
or dilate during feeding and hold the breast
milk temporarily during the feed.
• Adipose tissue / fat- surround the alveoli and
ducts to give the breast its shape
PHYSIOLOGY OF LACTATION:
The milk producing reflex:
When the baby sucks the sensory nerve endings in
the breast are stimulated and impulses are carried by
Lecture
cum
Discussion
Listening PPT
6

7. 4
Explain the
Physiology of
Lactation
5min
the vagus nerve to the Hypothalamus.
This causes the anterior pituitary to release prolactin
in to the blood stream
Prolactin acts on the milk producing cells of the
breast
Milk is secreted
The milk ejection reflex:
Sensory nerve impulses that start when the baby
sucks on the nipple causes the posterior pituitary to
release oxytocin
Which makes the myo epithelial cells around the
alveoli and ducts contract
Milk ejection/let down reflex
This squeezes milk from the alveoli ducts and
sinuses towards the nipple
Lecture
cum
Discussion
Listening
Black
board
with
chalk /
PPT
7

8. 5
Explain the
role of
hormones in
milk
production
2min
HORMONAL CONTROL OF MILK
PRODUCTION:
There are two hormones that directly affect
breastfeeding: Prolactin- Helps in
production of milk
Oxytocin-Helps in ejection of milk
PROLACTIN:
The level of prolactin in the blood increases
markedly during pregnancy, and stimulates the
Lecture
cum
Discussion
Lecture
cum
Discussion
Listening
Listening
PPT/
Chart
8

9. 3min
growth and development of the mammary tissue, in
preparation for the production of milk. However,
milk is not secreted then, because progesterone and
oestrogen, the hormones of pregnancy, block this
action of prolactin. After delivery, levels of
progesterone and oestrogen fall rapidly, prolactin is
no longer blocked, and milk secretion begins.
OXYTOCIN:
Oxytocin starts working when a mother expects
a feed as well as when the baby is suckling. The
reflex becomes conditioned to the mother's
sensations and feelings, such as touching, smelling
or seeing her baby, or hearing her baby cry, or
thinking lovingly about him or her.
The posterior lobe secretes oxytocin. The
oxytocin reflex is also called the “letdown reflex”
or the “milk ejection reflex”.
Oxytocin makes the myoepithelial cells around
the alveoli muscle cells to contract. This makes the
milk, which has collected in the alveoli, flow along
and fill the ducts.
It makes the milk that is already in the breast
flow for the current feed, and helps the baby to get
the milk easily.
Oxytocin makes a mother's uterus contract
after delivery and helps to reduce bleeding.
Suckling affects the release of other pituitary
hormones, including gonadotrophin releasing
Lecture
cum
Discussion
Listening PPT/
Chart
9

10. 6
To know the
reflexes in
newborn
2min
hormone (GnRH), follicle stimulating hormone,
and luteinising hormone, which results in
suppression of ovulation and menstruation.
REFLEXES IN THE BABY:
The baby's reflexes are important for
appropriate breastfeeding.
The main reflexes are rooting, suckling
and swallowing.
ROOTING REFLEX:
When something touches a baby's lips or
cheek, the baby turns to find the stimulus, and
opens his or her mouth, putting his or her tongue
down
and forward. This is the rooting reflex and is
present from about the 32nd week of pregnancy.
SUCKING REFLEX:
When something touches a baby's palate,
he or she starts to suck it. This is the sucking reflex.
SWALLOWING REFLEX:
When the baby's mouth fills with milk, he
or she swallows. This is the swallowing reflex.
Coordination of suckling, swallowing and
breathing appears between 32 and 35 weeks of
pregnancy.
Lecture
cum
Discussion
Listening
Black
board
with
chalk
10

11. 7
8
List out the
composit-
on of human
milk
To know the
types of milk
1min
1min
COMPOSITION:
Human milk Nutrients/100ml
 Water - 88g
 Energy - 65kcal
 Protein - 1.1g
 Carbohydrates - 7.4g
 Fat - 3.4g
 Calcium - 28mg
 Phosphorous - 11mg
 Iron - _
 Carotene - 137µg
 Thiamine - 0.02mg
 Riboflavin - 0.02mg
 Vitamin C - 3mg
Caseinogens-lactalbumin ration - 1: 2
TYPES OF MILK:
Colostrum,Transtional milk, Mature milk
COLOSTRUM:
 First 2 or 3 days
 Most suitable food for new born
 It is either yellowish or creamy in colour
 It is much thicker than the milk that is
produced later.
 Aka: “First Milk”,” Immune Milk”,
“Beesting”.
 Contains all Immunoglobulin’s
e.g;IgA,IgM,IgG
Lecture
cum
Discussion
Lecture
cum
Discussion
Listening
Listening
Black
board
with
chalk
PPT
11

12. 9
Discuss the
Advantages
and contra-
indications of
breast feeding
1min
2min
TRANSITIONAL MILK :
 From 2nd
-5th
to 10th
-14th
day
 More amount of milk than colostrums
 Breasts will become larger and firmer during
this stage.
MATURE MILK:
 From 14th
day onwards
There are two types of mature milk:
Fore-milk: This type of milk is found during the
beginning of the feeding and contains water,
vitamins, and protein.
Hind-milk: This type of milk occurs after the initial
release of milk, rich in fat & provides energy.
ADVANTAGES OF BREAST FEEDING:
 Breast milk is the natural food, readily
available, warm and free from contamination
 Breast milk is an ideal food which is easily
digestible
 It boosts immunity, meets nutritional
requirement, provides immunoglobulin’s,
reduces malnutrition and increases IQ of the
baby
 Breast milk is available 24 hours a day and
requires no special preparation and without
any cost
 Psychological benefit of mother- child
Lecture
cum
Discussion
Lecture
cum
Discussion
Listening
Listening
PPT
Black
board
with
chalk
12

13. 3min
bonding
 Helps in involution of the uterus
 It acts as a natural contraception to the
mother
 Lessens the incidence of gastrointestinal
infections, allergies, etc,
 Nursing mothers are less prone to get ovarian
and breast cancer
 Breast feeding satisfies the emotional needs
which is essential for the growth of the
neonates
 Breast feeding is more convenient for the
mother and has a feeling of satisfaction and
sense of fulfilment
 The baby also feels warm and secure
CONTRAINDICATIONS:
In Infant:
 Gross Prematurity
 Galactosemia (a rare genetic metabolic
disorder)
 Cleft palate
 Biological mother(where child is passed on to
the another couple)
In Mother:
 Cracked nipples
 Active Tuberculosis
 Malignancy(breast abscess)
 HIV, Hepatitis B and C
Lecture
cum
Discussion
Listening Black
board
with
chalk
13

14. 10 To know the
breast feeding
positions
1min
 Herpes lesions on breast
 Mother on certain medications-Anticancer
therapy, radioactive isotope, etc
 Post partum Psychosis and Epilepsy
 Tobacco, Alcohol and Drug Abuse
BREAST FEEDING POSITIONS:
 Cradle hold
 Cross-cradle hold
Lecture
cum
Discussion
Listening
Flash
cards
14

15. 11
To know the
breast feeding
pattern
1min
• Clutch or Football hold
• Reclining or Side-lying
BREAST FEEDING PATTERN:
Lecture
cum
Discussion
Lecture
cum
Discussion
Listening
Listening
Flash
cards
Black
board
with
chalk
15

16. 1min
Depends mainly on:
 BABY’s Needs
 BABY’s Size
 BABY Suckling strength
 Mother’s milk supply
First Feed:
Normal Delivery: 1
/2 -1hour
Caesarean : 4 - 6hours
Time schedule:
First 24hrs, at an interval of 2-3hrs
3-4hrs pattern by the end of first week
Demand Feeding:
The baby is put to the breast as soon as the baby
becomes hungry. There is no restriction of the
number of feeds and duration of suckling time.
Duration of feed:
The initial feeding should last for 5-10min at
each breast. Thereafter, the time spent is gradually
increased.
Baby is fed from one breast completely so that
baby gets both the FORE MILK and the HIND
MILK.
AMOUNT OF FEED:
First Day 60ml/kg/24hrs
Third Day 100ml/kg/24hrs
Tenth Day 150ml/kg/24hrs
However the baby can take as much as he wants.
FEEDING AT FREQUENT INTERVALS ABOUT
6 - 8 TIMES A DAY
Lecture
cum
Discussion
Listening
Black
board
with
chalk
16

17. 12
To discuss
good and poor
attachment of
the baby
2min
How a baby attaches and suckles at the breast:
To stimulate the nipple and remove milk from
the breast, and to ensure an adequate supply and a
good flow of milk, a baby needs to be well
attached so that he or she can suckle effectively.
Good attachment – inside the infant's mouth:
 much of the areola and the tissues underneath
it, including the larger ducts, are in the baby's
mouth
 the breast is stretched out to form a long
‘teat’, but the nipple only forms about one
third of the ‘teat’
 the baby's tongue is forward over the lower
gums, beneath the milk ducts (the baby's
tongue is in fact cupped around the sides of
the ‘teat’)
 The baby is suckling from the breast, not
from the nipple.
Lecture
cum
Discussion
Lecture
Listening
Flash
card/
PPT
17

18. 1min Poor attachment – inside the infant's mouth:
 only the nipple is in the baby's mouth, not the
underlying breast tissue or ducts
 The baby's tongue is back inside his or her
mouth, and cannot reach the ducts to press on
them.
Good and poor attachment –external signs: The
four signs of good attachment are:
 more of the areola is visible above the baby's
top lip than below the lower lip;
 the baby's mouth is wide open;
 the baby's lower lip is curled outwards;
 The baby's chin is touching or almost
touching the breast.
The signs of poor attachment are:
 more of the areola is visible below the baby's
bottom lip than above the top lip – or the
amounts above and below are equal
 the baby's mouth is not wide open
 the baby's lower lip points forward or is
turned inwards;
 The baby's chin is away from the breast.
cum
Discussion
Listening Flash
cards
18

19. SUMMARY:
So Till Now We Have Discussed About The Breast Feeding Introduction, Definition, Anatomy Of The Breast, Physiology Of
Lactation, Hormones Control On Milk Production, Reflexes In The Baby, Composition Of Human Milk, Types Of Milk, Advantages
And Contraindications, Breast Feeding Positions, Breast Feeding Pattern, Good And Poor Attachments.
CONCLUSION:
Breast Feeding is an ideal food to meet the nutritional needs, emotional needs and psychological needs of the infant and child.
Breast milk is natural readymade food which is the most suitable for the neonates because of its nutritional value, protection from the
infection against diseases and the financial and social implications it has for a poor.
BIBLIOGRAPHY:
• D.C. DUTTA Text Book of Obstetrics, 7th
Edition 2011, New Central Book Agency (P) Ltd Pg.No:15,449-453.
• A PADMAJA Text Book of Child Health Nursing, 1st
Edition 2016, Jaypee Publishers, Pg.No:172,176,540
• MANOJ YADAV Text Book of Child Health Nursing, Edition 2013, Pee Vee Publishers, Pg No:148-150,235
• Web site : www.slideshare.org, wikipedia.breast
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