Basics for B.Sc Nursing students

2. BREAST FEEDING

3.  Forty thousand children die each day (28 every minute) in developing
countries, the victims of malnutrition and frequent illnesses made worse
by malnutrition. In many developing areas, 25% of all children die before
reaching their fifth birthday.
 In the last few years, it has become clear that seven simple techniques
can be effective in saving millions of these children’s lives.
Growth monitoring and promotion Family planning
Oral rehydration therapy Female education
Breastfeeding Food distribution
Immunization

4. Beneficial to the infant’s health.
Beneficial to the mother’s health.
Beneficial to bonding of mother and baby.
Economic advantages.
Ecological advantages.
Mother’s right to informed choice of how to feed her
baby.
Reduced levels of breastfeeding.
Initiatives of international organizations.

5. 1. PROLACTIN REFLEX
When a baby suckles, the level of prolactin in the blood increases, and stimulates
production of milk by the alveoli.
The prolactin level is highest about 30 minutes after the beginning of the feed,
so its most important effect is to make milk for the next feed.
During the first few weeks, the more a baby suckles and stimulates the nipple,
the more prolactin is produced, and the more milk is produced.
This effect is particularly important at the time when lactation is becoming
established.

7.  The oxytocin reflex is also sometimes called the “letdown reflex” or the “milk
ejection reflex”. Oxytocin is produced more quickly than prolactin.
 It makes the milk that is already in the breast flow for the current feed, and helps
the baby to get the milk easily.
 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. If a mother is in severe pain or emotionally upset, the oxytocin
reflex may become inhibited, and her milk may suddenly stop flowing well.
 Oxytocin makes a mother's uterus contract after delivery and helps to reduce
bleeding. The contractions can cause severe uterine pain when a baby suckles
during the first few days.

9. 1. FIRST FEED should begin soon after birth within half an hour.
2. The baby should be roomed in.
3. Baby should be breastfed on demand.
4. Ensure that baby gets both fore milk and hind milk by
finishing one breast at a time.
5. Alleviate fear/belief regarding dehydration that the baby have
first few days of life before the milk “comes in”
6. Prohibit prelacteal feed.
7. Ensure that the baby gets night feeds as it is essential for the
growth.

11. 1) Colostrum
 It is the first stage of breast milk. It occurs during pregnancy and
lasts for several days after the birth of the baby. It is either yellowish
or creamy in color. It is also much thicker than the milk that is
produced later in breastfeeding.
 Colostrum is high in protein, fat-soluble vitamins, minerals, and
immunoglobulins. Immunoglobulins are antibodies that pass from
the mother to the baby and provide passive immunity for the baby.
Passive immunity protects the baby from a wide variety of bacterial
and viral illnesses. Two to four days after birth, colostrum will be
replaced by transitional milk.

12. 2. Transitional milk occurs after colostrum and
lasts for approximately two weeks. The
content of transitional milk includes high
levels of fat, lactose, and water-soluble
vitamins. It contains more calories than
colostrum.

13. 3. Mature milk is the final milk that is produced. 90% of it is
water, which is necessary to keep your infant hydrated.
The other 10% is comprised of carbohydrates, proteins,
and fats which are necessary for both growth and energy.
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. It contains higher levels of fat and is necessary for
weight gain.

16. POSITIONS
FOR
BREAST FEEDING

26. “CALM” baby
 Chin touching mothers breast
 Areola in the mouth
 Lower lip turned outward
 Mouth wide open

27.  Chin seperated from the breast
 Mouth looks closed
 Lower lip pointed forward
 More alveola visble below the mouth and
lower lips.
 You feel nipple pain.

30. If the mother reports pain or difficulty while feeding.
Examine breast & nipple and look for:
Sore/cracked nipple
Blocked duct
Mastitis
Retracted nipple.
Treatment of sore nipple:
Apply hind breast milk for soothing- rich in fat
& antibodies.
Ensure correct positioning.
If severe discomfort feed EBM with cup and
spoon till nipple is less sore.
Breast engorgement Express a little milk to make the breast soft and
then put the infant to mother's breast.
Safe warm compress may help.

31. Blocked duct Teach correct feeding techniques after expression
of a little milk.
Mastitis Express the milk frequently.
Continue feed on the other breast.
Antibiotic
Warm compression.
If abscess formed: USG guided needle
aspiration only.(no incision & drainage.)
Restart breast feeding.
Retracted nipple. Inverted syringe technique can be taught.

32.  Advise her to eat well.
 Advise her to take iron & folic acid.
 Provide care for her breast problems if any.
 Counsel on family planning & prevention of aids.