this lecture is one of my lectures to the students of Lactation Diploma Specialist course at Benha University this lecture involves brief, simple and easy explanation of the measures and procedures that aid in breast feeding support in the postpartum period also the practices that decrease the chance of breast feeding support postpartum period it also involves explanation for the wide various and valuable range of benefits of breast feeding for the mother, benefits for the new born and also benefits for the family

1. Postpartum Breast-Feeding
support and benefits of breast
feeding
By
Dr. Ahmed Mohamed Amin Nasef
Assistant lecturer in Obstetrics & Gynecology department
Benha University

2. Objective
Postpartum Practices that Support
Breastfeeding
Why is Optimal Breastfeeding beneficial
to mothers and babies?

3. Postpartum Practices
that Support
Breastfeeding

4. Postpartum Practices that Support
Breastfeeding
• Skin to skin contact
• Early initiation of breast feeding
• Instructions for mother about breast feeding
• Ensure rooming-in is practiced
• Encourage EBF from birth up to six months
• Offer no bottle or formula in hospital or at home after delivery
• Health education about breast feeding
• Encourage making hospitals become Baby and Mother Friendly by abiding to the
Ten Steps to successful breastfeeding

5. Skin to skin
contact

6. Skin to skin contact
• Inform mother about the benefits of it
• Inform her about the way to do skin to skin contact
• It can be practiced by both mother and father from just after birth and throughout infancy
Correct way
(Dry newborn back and put him naked over his mothers bared chest)
Benefits
Promotes mother-infant bonding
Prevents hypothermia
Stimulates maternal lactation reflexes
Reduce neonatal mortality by 22%
Fathers' contribution to SSC found to improve child's IQ

7. Breast Crawl

8. Breast crawl
The breast crawl describes what
occurs when a newborn baby is
placed on their birth parent’s chest
or belly immediately after birth
and given time to find the parent’s
nipple and begin to feed on their
own
This phenomenon was first
described in Trusted Source in
1987 in Sweden at the Karolinska
Institute

9. Early initiation of breast
feeding

10. Early initiation of breast feeding
within the first hour or two hours after normal delivery
After recovery in cesarean or medicated deliveries (usually within 4-6 hours)
The first hour is the golden hour and every attempt should be done to protect
this hour and help the mother to initiate

11. Instructions for
mother about
breast feeding

12. Instructions for mother about breast
feeding
• Show mothers how to breastfeed
• Assisting her to choose comfortable positions
• Ensure correct positioning and attachment within 6 hours post-delivery
before discharge from the hospital using the foundation skills of counseling
with compassion
• Feeding must be unrestricted and with no limitations on duration of the feed
or frequency of feeding to increase milk intake, be able to develop their
suckling abilities and bond to the mother

13. Instructions for mother about breast
feeding
• The frequency of feeding as the following:
Feeding no less than 8-12 times or more over 24 hours in the first 2 weeks
Feeding no less than 6-8 times after the first month up to two years Preterm babies
may need to be breastfed at a higher frequency
• The gastric emptying time of HBM is 30 minutes, this allows infants to feed as
frequently as required
• In the first few days after delivery the baby should not be left more than 4 hours
without feeding

14. Instructions for mother about breast
feeding
• Mother should be instructed to wake the baby to feed if the baby sleeps
more than 4 hours
• If the mother feels her breasts are full or leaking, she should be encouraged
to breastfeed or empty her breasts to maintain HBM production
• Mothers are encouraged sensitively to offer both breasts in the same feed
particularly in the early days after birth

15. Instructions for mother about breast
feeding
• Instruct mother that more feedings help to:
Stimulate more milk production
Milk flow
Proper emptying of the breast
Hasten uterine involution
Bleeding cessation
Hasten mother’s ambulation
Builds secure bonding by assuring the baby that mother understands and responds to
his needs and is there for him/her

16. Rooming-in

17. Rooming-in
• Ensure rooming-in is practiced (i.e., mother and her baby should not be separated
for more than one hour for routine procedures)
• This allows the mother to
Observe her baby
Respond to her baby’s cues by touching, holding, cuddling, feeding and SSC
Eye-to-eye contact which reduces maternal anxiety replacing it by a long-
lasting loving relationship

18. UNICEF
recommendation

19. Exclusive breast feeding

20. EBF
Encourage EBF from birth up to six months by avoiding any prelacteals practices
(feeds other than HBM given before the first breastfeed) or supplements foods or
fluids (e.g., glucose or formula) given to the newborn or during the neonatal period
and in infancy unless medically indicated
The acceptable medical reasons for supplementation are described by WHO and
UNICEF
Early breastfeeding in the first hour “Golden Hour” through SSC and EBF are gold
standard that are used to measure optimal breastfeeding practices in a hospital or
country or in the different regions of the world

21. EBF
International guidelines recommend EBF for the first six months based on scientific evidence
of improved infant growth, development and survival
HBM provides all the energy and nutrients that an infant needs during the first six months of
life
Average daily fluid requirements for healthy infant ranges from 80 to 100 ml/kg in the first
week of life and from 140 to 160 ml/kg between 3 to 6 months of age. These amounts are
available from HBM alone as it contains 88% water
EBF reduces infant deaths caused by common childhood illnesses such as diarrhea and
pneumonia, hastens recovery during illness, and helps space births

22. Predominant breastfeeding
The practice of giving water and other liquids such as teas, sugar water, and
juices to breastfed infants in the first months is widespread throughout the
world
This practice often begins in the first month of life
Research conducted in the outskirts of Lima, Peru showed that 83 percent of
infants received water and teas in the first month
Studies in several communities of the Gambia, the Philippines, Egypt, and
Guatemala reported that over 60 percent of newborns were given sugar water
and/or teas increasing their risk to infections

23. No bottle or formula

24. No bottle or formula
Offer no bottle or formula in hospital or at home after delivery
Explain to mothers the hazards of bottle-feeding as they may interfere with
the development of suckling from the breast and lead to refusal to feed
Pacifiers are used to stimulate suckling in small preterm babies, as a result
mothers may think they are recommended to be used. Hence the hazards of
offering pacifiers to babies after discharge from the neonatal unit need to be
explained to them

25. Timing for
EBF

26. Timing for
EBF
Promote EBF for the first six months and
continued breastfeeding with introduction
of adequate complementary feeding at 7
months while continuing to breastfeed
without decreasing the frequency of day
or night feeds for up to two years or more
Follow-on milks and snacks of “cerelac”
drinks (in squizzy containers with a nozzle)
should be discouraged as they replace
breastfeeds and expedite weaning

27. Health
education

28. Health education
Teach health staff the skills of counseling mothers to increase herself-
confidence and alleviate her fears and worries
Teach family members and community support groups the practices that
promote successful breastfeeding
Encourage making hospitals become Baby and Mother Friendly by abiding to
the Ten Steps to successful breastfeeding and BFHI global criteria
recommended by the UNICEF and WHO and prohibit marketing or any
promotion of HBM substitutes

30. What about water
supplementation for the
newborn?

31. Why Water Supplementation is Not
Required for Newborns?
Water supplementation increases the risk of malnutrition
Displacing HBM with a fluid of little or no nutritional value can have a negative impact on an
infant’s nutritional status, survival, growth, and development
Water supplementation increases the risk of illness
• In mild dehydration increasing breastfeeding frequency provides extra water needed
• With moderate and severe dehydration oral rehydration solution is given as a medication
An infant’s stomach is small. When the baby drinks water, there is less room left for the
nourishing HBM that is necessary for the infant to grow strong and healthy

32. Breast
Feeding
benefits

33. There are many benefits for breast feeding
for:
The mother
The child
The sick child
The family

35. Benefits for
the mother

36. Benefits for the mother
• Prevent post-partum bleeding and anemia
by promoting rapid involution of the uterus through oxytocin release
• Assist in development of the prolactin receptors in the mammary gland and promotes maternal instincts of bonding
with her newborn for successful parenting
• Contraceptive Effect
EBF or predominant/full breastfeeding in the first six months in mothers with amenorrhea can prevent pregnancy in
up to 98%. This is called the Lactation Amenorrhea Method (LAM) of contraception
Frequent suckling inhibits and delays ovulatory cycles even after menstruation is resumed
• Decrease risk of breast cancer, ovarian cancer and osteoporosis
By continued breastfeeding for two years
It is estimated that the cumulative incidence of breast cancer in developed countries would be reduced by more than
half, from 6.3 to 2.7 per 100 women due to breastfeeding

37. Benefits for the mother
• Improve mother's psychological status and promotes mother-infant bonding
and eases parenting and care giving
• Help mothers to regain her pre-pregnancy weight and prevents breast
sagging

38. Benefits for
the Child

39. Benefits for the Child
• Breastfed babies have a higher IQ than artificially fed babies and more superior social and
cognitive development in controlled environment so early initiation of breastfeeding is
associated with higher IQ
• EBF infants in the first six months are 16 times less likely to die from diarrhea and four times
less likely to develop severe respiratory infections and ear infections.
• EBF babies of atopic families are protected from severe and recurrent illness related to
atopy as bronchial asthma and cow's milk allergy
• EBF babies are less likely to develop acute lymphoblastic leukemia, diabetes mellitus,
chronic inflammatory bowel disease, lymphoma and atherosclerosis related diseases as
hypertension, coronary heart disease and stroke, later in life

40. Benefits for
the Sick Child

41. Benefits for the Sick Child
• Preterm infants fed HBM are less likely to develop fatal septicemia, bacterial meningitis,
necrotizing enterocolitis and retinopathy or prematurity
• Neonates with inborn errors of metabolism are-protected from the deleterious effects of
these disorders as breastmilk is low in phenylalanine, methionine, tyrosine and protein
• Breastfed neonates with congenital hypothyroidism are less likely to manifest early delay in
development due to thyroxin in HBM
• Sick infants with acute infections are provided nourishment, hydration, antimicrobials and
comfort by HBM. SSC during breastfeeding warms, comforts and improves the breathing
and oxygenation of the sick baby thus speeding their recovery
• Sick infants on artificial formula when fed expressed milk from donors recover from illness
and can be saved from intractable illness. Mothers who donate their milk can save lives

42. Breast feeding
benefits to the
family

43. Benefits to the family
• Economical and readily available at any time
• Promotes family bonds
• Fathers’ contribution to childcare through SSC has been shown to
have an additive effect on attainment of higher intelligent
quotient (I.Q.) especially when these babies are nurtured through
breastfeeding and SSC