Breast feeding initiation

1. Exclusive BreastfeedingExclusive Breastfeeding
&&
Baby friendly HospitalBaby friendly Hospital
InitiativeInitiative
Jeelani Saima HabeebJeelani Saima Habeeb
Ph.D (N) ScholarPh.D (N) Scholar

2. Global and National Recommendations forGlobal and National Recommendations for
Infant and Young Child FeedingInfant and Young Child Feeding
 Exclusive breastfeeding for 6Exclusive breastfeeding for 6
monthsmonths
 Introduce nutritionally adequateIntroduce nutritionally adequate
and safe complementary foodsand safe complementary foods
after the infant reaches 6 monthsafter the infant reaches 6 months
of ageof age
 Continuing to breastfeed for 2Continuing to breastfeed for 2
years or beyond.years or beyond.

3. What isWhat is
Exclusive Breastfeeding?Exclusive Breastfeeding?
 GivGivinging an infant onlyan infant only
breastmilk, with thebreastmilk, with the
exception of drops orexception of drops or
syrups consisting ofsyrups consisting of
vitamins, mineralvitamins, mineral
supplements, or drugssupplements, or drugs
 No food or drinkNo food or drink otherother
than breastmilk—notthan breastmilk—not
eveneven waterwater

4. Benefits to the BabyBenefits to the Baby
• Complete food for theComplete food for the
first six monthsfirst six months
• Perfect nutritionPerfect nutrition
• Higher IQHigher IQ
• Emotional bondingEmotional bonding
• Prevents infectionsPrevents infections
• Prevents chronicPrevents chronic
diseasesdiseases
• Easily digestedEasily digested

5. Benefits to the MotherBenefits to the Mother
• Reduces post deliveryReduces post delivery
bleeding and anemiableeding and anemia
• Helps delay nextHelps delay next
pregnancypregnancy
• Protective effectProtective effect
against breast andagainst breast and
ovarian cancerovarian cancer
• Helps to loose weightHelps to loose weight
• Emotional bondingEmotional bonding
• Needs no preparationNeeds no preparation

6. Benefits to the SocietyBenefits to the Society
• ReducesReduces
absenteeism ofabsenteeism of
mothers from work asmothers from work as
they are less prone tothey are less prone to
disease.disease.
• EconomicalEconomical
• Enhances BondingEnhances Bonding

7. Successful Breastfeeding…Successful Breastfeeding…
Exclusive breastfeedingExclusive breastfeeding
for the first six monthsfor the first six months

8. Successful Breastfeeding…Successful Breastfeeding…
Major HurdlesMajor Hurdles
• Lack of family supportLack of family support
• Lack of support by health professionalsLack of support by health professionals
• Commercial influenceCommercial influence
• Feeling of not enough milk among womeFeeling of not enough milk among womenn

9. Successful Breastfeeding…Successful Breastfeeding…
Important Do’sImportant Do’s
• Initiate breastfeeding as early as possible within one hourInitiate breastfeeding as early as possible within one hour
of birth.of birth.
• Do not give the baby any prelacteal feedsDo not give the baby any prelacteal feeds
• No bottles, artificial teats or pacifierNo bottles, artificial teats or pacifier
• Breastfeeding on demand at least 8-10 times in a day andBreastfeeding on demand at least 8-10 times in a day and
at a nightat a night
• Breastfeed in a correct positionBreastfeed in a correct position
• Build mother’s confidence to sustain good milk supply andBuild mother’s confidence to sustain good milk supply and
alleviate feeling of not enough milk.alleviate feeling of not enough milk.

10. Successful Breastfeeding…Successful Breastfeeding…
• Initiate Breastfeeding WithinInitiate Breastfeeding Within OneOne Hour of BirthHour of Birth

11. Successful Breastfeeding…Successful Breastfeeding…
No Prelacteal FeedsNo Prelacteal Feeds
• Replace colostrumReplace colostrum
• Reduce baby’s desireReduce baby’s desire
for breastfeedingfor breastfeeding
• Greater risk ofGreater risk of
infectioninfection
• Risk of intolerance,Risk of intolerance,
allergyallergy

12. Successful Breastfeeding…Successful Breastfeeding…
• No Bottles, ArtificialNo Bottles, Artificial
Teats or Pacifiers forTeats or Pacifiers for
Breastfeeding InfantsBreastfeeding Infants
It lead to nippleIt lead to nipple
confusionconfusion

13. Successful Breastfeeding…Successful Breastfeeding…
Breastfeed on demandBreastfeed on demand
• 8-10 times or more in 248-10 times or more in 24
hourshours
• Breastfeed at nightBreastfeed at night
• No restrictions on lengthNo restrictions on length
of breastfeedsof breastfeeds
• No restrictions onNo restrictions on
frequency of breastfeedsfrequency of breastfeeds
MORE SUCKLING MOREMORE SUCKLING MORE
MILKMILK

14. Successful Breastfeeding…Successful Breastfeeding…
Breastfeeding in the Correct PositionBreastfeeding in the Correct Position
Anatomy of the BreastAnatomy of the Breast
Milk producing glands
Lactiferous canaliculi
Lactiferous sinuses
Myoepithelial tissue
Adipose tissue

15. Signs of CorrectSigns of Correct
AttachmentAttachment
• Mouth wide openMouth wide open
• Lower lip is turned outsideLower lip is turned outside
• Chin touching the breastChin touching the breast
• Black part of the breast notBlack part of the breast not
visible below the lower lipvisible below the lower lip
• Large black portion of breastLarge black portion of breast
and nipple including milkand nipple including milk
collecting ducts are insidecollecting ducts are inside
baby’s mouthbaby’s mouth
• Tongue under the teatTongue under the teat

16. Incorrect Sucking PositionIncorrect Sucking Position
• Mouth is not wide openMouth is not wide open
• Chin is away from theChin is away from the
breastbreast
• Baby is sucking onlyBaby is sucking only
nipplenipple
• Most black portion of theMost black portion of the
breast is outside thebreast is outside the
baby’s mouthbaby’s mouth
• Tongue away from theTongue away from the
teatteat

17. Causes of Incorrect AttachmentCauses of Incorrect Attachment
• Use of feeding bottles. Leads to nippleUse of feeding bottles. Leads to nipple
confusionconfusion
• Inexperienced motherInexperienced mother
• Functional difficulty with the mother or theFunctional difficulty with the mother or the
babybaby
• Lack of skilled supportLack of skilled support

18. Successful Breastfeeding…Successful Breastfeeding…
Build Mother’s ConfidenceBuild Mother’s Confidence
• During prenatal periodDuring prenatal period
• During antenatal PeriodDuring antenatal Period
• During postnatal periodDuring postnatal period

19. • More prolactinMore prolactin
secreted at nightsecreted at night
• Secreted after feedSecreted after feed
to produce next feedto produce next feed
• SuppressesSuppresses
ovulationovulation
The Prolactin reflexThe Prolactin reflex
Baby
sucking
Sensory Impulses
from nippleProlactin
in blood
Breastmilk ProductionBreastmilk Production

20. The Oxytocin reflexThe Oxytocin reflex
Breastmilk TransferBreastmilk Transfer
• Works before or duringWorks before or during
feed to make milk flowfeed to make milk flow
• Makes uterus contract
Baby
sucking
Sensory Impulses
from nipple
Oxytocin
in blood

21. How does the mother’sHow does the mother’s
confidence play partconfidence play part
Breastmilk TransferBreastmilk Transfer
Thinks lovingly
of baby
CONFIDENCE
Sound of baby
Sight of baby
Pain
Worry
Stress
Doubt

22. The Feeling of “Not EnoughThe Feeling of “Not Enough
Milk”Milk”
Not True. Just a perceptionNot True. Just a perception
Reinforce mothers:Reinforce mothers:
Self confidence is mustSelf confidence is must
Ensure frequent sucklingEnsure frequent suckling
Ensure effective sucklingEnsure effective suckling

23. Good Breastfeeding TechniquesGood Breastfeeding Techniques

24. Breastfeeding PositionsBreastfeeding Positions
Cradle HoldCradle Hold
• This is the most commonThis is the most common
position used by mothers.position used by mothers.
• Infant’s head is supported inInfant’s head is supported in
the elbow, the back andthe elbow, the back and
buttock is supported by thebuttock is supported by the
arm and lifted to the breastarm and lifted to the breast..

25. Football Hold PositionFootball Hold Position
• The infant is placed under theThe infant is placed under the
arm, like holding a footballarm, like holding a football
• Baby’s body is supported with theBaby’s body is supported with the
forearm and the head isforearm and the head is
supported with the hand.supported with the hand.
• Many mothers are notMany mothers are not
comfortable with this positioncomfortable with this position
• Good position after operativeGood position after operative
proceduresprocedures
Breastfeeding PositionsBreastfeeding Positions

26. Side Lying PositionSide Lying Position
• The mother lies on her sideThe mother lies on her side
propping up her head andpropping up her head and
shoulder with pillows.shoulder with pillows.
• The infant is also lying downThe infant is also lying down
facing the mother.facing the mother.
• Good position after CaesareanGood position after Caesarean
section.section.
• Allows the new mother some rest.Allows the new mother some rest.
Most mothers are scared ofMost mothers are scared of
Breastfeeding PositionsBreastfeeding Positions

27. Cross Cradle HoldCross Cradle Hold
PositionPosition
• Ideal for early breastfeeding.Ideal for early breastfeeding.
• Mother holds the baby crosswiseMother holds the baby crosswise
in the crook of the arm oppositein the crook of the arm opposite
the breast the infant is to be fed.the breast the infant is to be fed.
• The baby's trunk and head areThe baby's trunk and head are
supported with the forearm andsupported with the forearm and
palm.palm.
• The other hand is placedThe other hand is placed
Breastfeeding PositionsBreastfeeding Positions

28. Australian HoldAustralian Hold
PositionPosition
• This is also called theThis is also called the
saddle holdsaddle hold
• Usually used for olderUsually used for older
infantsinfants
• Not commonly used byNot commonly used by
mothers.mothers.
• Best used in older infantsBest used in older infants
with runny nose, earwith runny nose, ear
Breastfeeding PositionsBreastfeeding Positions

29. ConclusionConclusion
Exclusive Breastfeeding for First SixExclusive Breastfeeding for First Six
MonthsMonths
Being Successful-Being Successful-
• Initiate breastfeeding as early as possible within one hour of birth.Initiate breastfeeding as early as possible within one hour of birth.
• Do not give the baby any prelacteal feedsDo not give the baby any prelacteal feeds
• No bottles, artificial teats or pacifierNo bottles, artificial teats or pacifier
• Breastfeeding on demand at least 8-10 times in a day and at night aBreastfeeding on demand at least 8-10 times in a day and at night a
• Breastfeed in a correct positionBreastfeed in a correct position
• Build mother’s confidence to sustain good milk supply and alleviateBuild mother’s confidence to sustain good milk supply and alleviate
feeling of not enough milk.feeling of not enough milk.

30. Newborn deserves the best Nutrition,
Improved Survival, Optimum Development
and Healthy Life
Breastfeeding can do
this miracle !!!

31. 3131
The Ten Steps of theThe Ten Steps of the
WHO/UNICEFWHO/UNICEF
Baby-FriendlyBaby-Friendly
Hospital InitiativeHospital Initiative
Launched in 1991, byLaunched in 1991, by
UNICEF and the World Health OrganizationUNICEF and the World Health Organization
To ensure that allTo ensure that all hospitals, maternity facilities andhospitals, maternity facilities and
communitiescommunities becomebecome
Centers of Breastfeeding SupportCenters of Breastfeeding Support

32. 3232
The Baby Friendly - 10 Steps
 Have a written breastfeeding policy that is routinelyHave a written breastfeeding policy that is routinely
communicated to all health care staff.communicated to all health care staff.
 Train all health care staff in skills necessary to implementTrain all health care staff in skills necessary to implement
this policy.this policy.
 Inform all pregnant women about the benefits andInform all pregnant women about the benefits and
management of breastfeeding.management of breastfeeding.
 Help mothers initiate breastfeeding within one half-hour ofHelp mothers initiate breastfeeding within one half-hour of
birth.birth.
 Show mothers how to breastfeed and maintain lactation,Show mothers how to breastfeed and maintain lactation,
even if they should be separated from their infants.even if they should be separated from their infants.

33. 3333
The Baby Friendly - 10 Steps
 Give newborn infants no food or drink other than breastmilk,Give newborn infants no food or drink other than breastmilk,
unless medically indicated.unless medically indicated.
 Practice rooming in - that is, allow mothers and infants toPractice rooming in - that is, allow mothers and infants to
remain together 24 hours a day.remain together 24 hours a day.
 Encourage breastfeeding on demand.Encourage breastfeeding on demand.
 Give no artificial nipples or pacifiers (soothers) toGive no artificial nipples or pacifiers (soothers) to
breastfeeding infants.breastfeeding infants.
 Foster the establishment of breastfeeding support groupsFoster the establishment of breastfeeding support groups
and refer mothers to them on discharge from the hospital orand refer mothers to them on discharge from the hospital or
clinic.clinic.

34. 3434
BFHI 10-Steps based on Research
If every baby were exclusively breastfed fromIf every baby were exclusively breastfed from
Birth forBirth for 6 months6 months,,
an estimated 1.5 million lives world-widean estimated 1.5 million lives world-wide
would be saved each year.would be saved each year.
Babies and Mother’s lives would be enhancedBabies and Mother’s lives would be enhanced
with implementing the 10-Steps because:with implementing the 10-Steps because:

35. • Immediate postpartum breastfeeding helpsImmediate postpartum breastfeeding helps Mother/ChildMother/Child bondingbonding
• BreastmilkBreastmilk AAlonelone is the perfect food foris the perfect food for BabyBaby’s first 6-months’s first 6-months
– Nutrients, antibodies, Hormones, Antioxidants, other factorsNutrients, antibodies, Hormones, Antioxidants, other factors
• Stimulates immune system – response to diseases & vaccinationStimulates immune system – response to diseases & vaccination
– Protects from diarrhea and acute respiratory infectionsProtects from diarrhea and acute respiratory infections
• Health and emotional benefits forHealth and emotional benefits for MotherMother
– Sense of empowerment and satisfactionSense of empowerment and satisfaction
• Decreased blood loss postpartumDecreased blood loss postpartum
• Delayed return to fertilityDelayed return to fertility
• Decreased risk of breast and ovarian cancerDecreased risk of breast and ovarian cancer
• Provides social/economic benefits to theProvides social/economic benefits to the FamilyFamily
• EnvironmentEnvironment BenefitsBenefits
BFHI 10-Steps based on Research

36. ThankThank
YouYou