2. Breast Feeding Dr. Nahed Said Al-Nagger Assistant professor of Nursing Umm Al-Qura University

3. Intended Learning Outcomes (ILOs): Define breast Feeding. Recognize different terminology related to breasr feeding. Identify the Benefits of B.F for both mother &infants. Mention contraindications &difficulties of B.F. Describe technique of B.F. Is

4. Definition Breast Feeding : Is the best method of feeing for newborn and preterm baby’s health.

5. Exclusive Breast Feeding. Exclusive Breast Feeding means that: - No food or drink other than breast milk is offered to breast feeding baby for up to 6 months. - Baby is fed on self demand, - Day and night with no restrictions on the length or frequency of breast feeding.

6. Partial Breast Feeding. Partial Breast Feeding is defined as feeding the infant breast milk for some feedings while and supplementing or substituting feedings with formula or glucose water at other times.

7. Benefits of Breast Feeding to Mother Infant’s sucking promotes involution of the uterus after parturition. B.F saves time and is less of strain on family budget than buying fresh or evaporated milk.

8. Benefits of Breast Feeding to Mother (cont;) It lower the incidence of cancer breast. B-feed mothers are less liable to develop osteoporosis. It lose mother weight. B.F. protects mother from hip fractures.

9. Benefits of Breast Feeding to Mother (cont;) A dream of every woman … We are obliged to fulfil It fulfills the feminine role and motherly attitudes. B.F. helps the mother to relax and feel calm. B.F. help in providing healthy space between children, but it dose not provide complete contraception.

10. Benefits of Breast Feeding to infant Breast milk is warm, ready, sterile and balanced in protein, carbohydrates, fat and vitamins and does not cost anything. It is more easily digested than cow’s milk.

11. Benefits of Breast Feeding to infant Breast- fed infants have greater immunity to certain childhood diseases, such as chest infection, ear infection. Infants are less likely to have gastro-intestinal disorders, anemia and vitamin deficiency.

12. Benefits of Breast Feeding to infant Breast milk is important for the brain and CNS especially preterm. Infants who are not strictly breast- fed for at least two months double their risk of getting insulin –dependent diabetes.

13. Benefits of Breast Feeding to infant Breast feeding can protect the infant from allergies, such as enzyme and asthma. Breast milk is available all time. Infant is secure through constant with his mother and this has an effect on the child’s psychological development.

14. Colostrum Colostrum, a thin, yellowish fluid the breasts secretes it before milk production begins. It helps maintain the blood glucose level in the breastfeeding infant.

15. Breast feeding reflexes Maternal reflexes… Nipple erection reflex. Prolactine reflex from hypothalamus. Oxytoxic reflex from posterior pituitary gland.

16. Breast feeding reflexes Maternal reflexes… Prolactin initiates milk production and the breasts become full (engorged), as well as warm and tender, between postpartum days 3 and 4. Mothers often refer to this as having their milk "come in." There may be a slight elevation in body temperature during this time.

17. Breast feeding reflexes Neonatal reflexes… Rooting reflex. Sucking reflex. Swallowing reflex. Gagging reflex.

18. Criteria of Breast Feeding Adequacy of breast feeding…. Infant calm and satisfied after feed. Normal bowel motion. Normal weight gain. Under feeding…. Failure of weight gain. Dehydration, constipation, sleep ness, colic.

19. Criteria of Breast Feeding Over feeding…. Regurgitation, vomiting, colic. Large bulky stool, abdominal distension, excessive sweating.

20. Contraindications of breast feeding.. Related to mother….  Infectious disease (active T.B).  Mental disease (epilepsy, hysteria, toxic drugs).  Lung disease, cancer.  Pregnancy.

21. Contraindications of breast feeding.. Related to infant….  Inborn error of metabolism.  Allergy to breast milk.  Severe congenital anomaly (cleft lip/ palate).

22. Difficulties in Breast Feeding Defect in infant…. Stomatitis, soreness of mouth. Congenital anomalies, premature, facial palsy. Defect in mother…. Twins pregnancy. Poor development of breast, sore nipple, engorgement of breast, mastitis, abscess.

23. Technique of Breast Feeding Positioning for both the mother and the infant is important to facilitate the infant latch on to the breast and to make both the mother and infant comfortable during each breastfeeding.

24. Proper Positioning for Breast Feeding Foot- ball hold.. Side lying position.. Cradle position.. Cross cradle position.. Horizontal position..

25. Proper Positioning for Breast Feeding The infant is placed chest to chest with the mother at the level of the breast and the baby’s head and body are supported. The infant’s mouth is placed directly in front of the breast, and the infants nose, cheeks and chin should touch the breast.

26. Proper Positioning for Breast Feeding Position mother hand around the breast correctly, using the “C” or “V” (Scissor) hold to direct the nipple towards the infant’s mouth.

27. Proper Positioning for Breast Feeding The the “C” or “V” (Scissor) hold helps the mother support her breast and position it to promote latch-on. Using the “C” or “V” hold also helps the mother hold her fingers in a way that prevents obstruction of the lactiferous ducts.

28. Proper Positioning for Breast Feeding N.B…. No position can be labeled “ Ideal” the important thing is that the mother is relaxed an can hold her infant close to her breast comfortably for the time it takes…

29. Duration of the Feeding N.B…. Five to ten minutes in each breast…

30. Nurses role in breast Feeding Assess the breasts for signs of engorgement, including fullness around postpartum days 3 and 4; assess for hot, red, painful, and edematous areas, which could indicate mastitis; assess nipple condition for patients who are breastfeeding.

31. Nurses role in breast Feeding PATIENT TEACHING Breastfeeding patients should wear a comfortable support bra. Instruct mothers to gently rub colostrum or breast milk into their nipples and allow them to air dry after each feeding to "condition" the nipples.

32. Nurses role in breast Feeding PATIENT TEACHING Patients should avoid washing the nipples with soap. It is also extremely important to teach patients proper breastfeeding techniques to ensure a positive experience for both the patient and infant.

33. Nurses role in breast Feeding PATIENT TEACHING Teaching proper latch-on techniques and how to break the infant's suction after feeding can have a positive and lasting effect upon women's breastfeeding experiences.

34. Nurses role in breast Feeding PATIENT TEACHING Patients may have sore, cracked, and sometimes bleeding nipples, which can discourage the continuation of breastfeeding. Instruct bottle feeding patients to wear a tight-fitting bra and to avoid any type of nipple stimulation until lactation ends.

35. Nurses role in breast Feeding Patients who choose not to breastfeed will also experience their milk "coming in"; however, lactation can be suppressed through the use of a well-fitting bra.

36. Nurses role in breast Feeding Non-breastfeeding patients should also avoid any type of nipple stimulation or heat to the breasts, such as warm or hot showers in which the water is allowed to run continuously over the breasts.

37. Nurses role in breast Feeding Patients may use ice packs or cool cabbage leaves to ease breast discomfort until milk production ceases. It generally takes 5 to 7 days for the breasts to stop producing milk. Healthcare providers may consider prescribing mild analgesics if the patient has significant discomfort.

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