MOTHERS’ CLASS

BREASTFEEDING
WHY BREASTFEEDING?

 Breastfeeding is the optimal source of

nutrition.
 It provides all the essential nutrients
necessary for the growth and development of
the newborn infant.
 WHO recommend exclusive breastfeeding
for the first six months of life, and
continuous breastfeeding for at least 12
months of life.
 BENEFITS OF BREASTFEEDING
FOR BABY

1. Provides the best possible nutrition to the baby

2. Reduces the incidence of coughs and colds, ear
infections, bronchitis, pneumonia, meningitis and
diarrhea through its protective factors.
3. It protects the child from colic, asthma, eczema,
and allergies.
4. It is essential for the optimal physical,
emotional and mental development of the child.
 BENEFITS OF BREASTFEEDING
FOR BABY

1. Reduced risk of obesity later in life

compared to formula fed infants.
2. Reduced risk of sudden infant death
syndrome, Hodgkin's lymphoma, Leukemia
and Type 1 Diabetes.
3. Higher IQs
 BENEFITS OF BREASTFEEDING TO MOTHER

1. Promotes mother and child bonding

2. Prevents uterine bleeding after delivery
3. Reduces the risks of breast, uterine and
ovarian cancer in the mother
4. Promotes return to prepregnancy weight
5. SAVINGS! It saves time and money
FORMULA VS BREASTFEEDING

 Infant formula is not equal to or the same as

breastmilk.
 Formula does not change to meet your baby’s
growing needs.
 Babies may experience health problems or
illness due to formula feeding.
PROBLEMS FROM FORMULA FEEDING

 Mistakes made during preparation or storage at

home
 Contamination of formula during the
manufacturing process
 Powdered formula in particular is not sterile
and is not recommended for babies less than
two months of age
 PROBLEMS FROM FORMULA
FEEDING

 Any formula feeding requires extra time to

sterilize equipment for as long as you formula
feed.
 Overall, formula-fed babies are at higher risk of
health problems like infections, respiratory
illnesses and obesity
 10 STEPS TO SUCCESSFUL
BREASTFEEDING

1. Have a written breastfeeding policy that is routinely

communicated to all health care staff.
2. Train all health care staff in skills necessary to
implement this policy.
3. Inform all pregnant women about the benefits and
management of breastfeeding.
4. Help mothers initiate breastfeeding within half an hour
of birth.
5. Show mothers how to breastfeed, and how to maintain
lactation even if they should be separated from their
infants.
CONT…

6. Give newborn infants no food or drink other than

breast milk, unless medically indicated.
7. Practise rooming-in - that is, allow mothers and
infants to remain together - 24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no artificial teats or pacifiers (also called
dummies or soothers) to breastfeeding infants.
10. Foster the establishment of breastfeeding support
groups and refer mothers to them on discharge from
the hospital or clinic.
STRUCTURE OF THE HUMAN
BREAST
 The human breast are modified sweat glands
responsible for lactation (milk production).
 The breast contains fat tissue and connective
tissue.
 Different hormones are responsible for the
development of the breast and changes that occur
during pregnancy.
 The major hormones affecting breast
development and enlargement are estrogen,
progesterone and prolactin.
STRUCTURE OF THE HUMAN
BREAST

 Each breast contains about 20 lobes, each lobes

contains several lobules which at the end have
alveolar in which milk is produced.
 Milk production and secretion are responsive to
two major hormones – prolactin and oxytocin;
and the sucking reflex.
 After production of milk  ducts  stored
 When the infant latches on the breast, milk is
expressed.
SUCKLING HORMONAL REFLEX
ARC

Source: Lactation Education Program Nutrition Policy and Education

HOW BREAST MILK IS PRODUCED

 The let-down reflex

 How body responds to baby’s suckling:
Infant suckling stimulates the nerve endings in the nipple
and areola,  brain  prolactin and oxytocin.
 How Breast Responds to Baby’s Suckling:
 Prolactin  alveoli to take nutrients (proteins, sugars)
from blood supply  breast milk.
 Oxytocin  cells around the alveoli to contract  eject
milk down the milk ducts.
 This passing of the milk down the ducts is called the “let-
down” (milk ejection) reflex.
CON’T…

 Let-down is experienced in numerous ways

including:
 Infant begins to actively suck and swallow.
 Milk may drip from the opposite breast.
 Mother may feel a tingling or a full sensation (after
the first week of nursing) in breasts or uterine
cramping.
 May feel thirsty.
BEGINNING BREASTFEEDING

 Breastfeeding soon after birth (within the first

hour) provides many benefits for both mother
and baby.
 Baby’s sucking reflexes are strongest during
this period
 The quiet, alert state allows infants to learn to
breastfeed effectively
BEGINNING BREASTFEEDING

 Initially: small amounts of milk (“colostrum”)

 Easily digested yellowish fluid which is rich
in nutrients, protect your baby from
infections.
 2nd to 4th day: colostrum begins to change
into mature breastmilk.
BEGINNING BREASTFEEDING

 Breastfeed your baby as soon as you can after

birth.
 Newborns are often alert and ready to nurse
right away.
 Breastfeeding early will help your milk to come
in sooner.
 Breastfeeding is a skill and may take time to
learn.
 Your bare chest is the best place for your baby
to adjust to life outside the womb.
 Skin-to-skin contact means holding your bare
baby against your bare chest or tummy.
 Babies stay warmer, calmer and breastfeed
better than babies who are swaddled or
wrapped.
TYPES AND COMPOSITION OF
HUMAN BREAST MILK

 Colostrum or Early Milk – produced late in pregnancy

until 4-5 days after delivery; rich in antibodies
 Transitional Milk – day 4 to 10, lower in protein in
comparison to colostrum
 Mature Milk – produced from approximately 10 days
after delivery until termination of breastfeeding
 HOW LONG TO BREASTFEED

 Newborns can nurse for 5 to 10 minute per breast; every

2 to 3 hours. This comes to about 10 to 12 feedings per
day. In the beginning, there is only colostrum, and there’s
not very much of it, so be ready to feed often but for short
durations.
 One month or more: as baby gets older, his stomach will
get larger. He will nurse less frequently but for a longer
duration at each feeding session. For example, he may
nurse 20 to 40 minute per breast every 3 to 4 hours
 By 6 months, Baby may breastfeed for 20 to 40 minutes
per breast; 3 to 5 times per day.
 HUNGER CUES

 Hand to mouth movements, rooting

 Wiggling, moving arms and legs
 Sucking sounds and movements
 Soft cooing or sighing sounds
 Rapid eye movements during her light sleep
 HUNGER CUES

 Feed your baby before he is too upset.

 Crying is a late feeding cue.
 It is better to try to comfort a crying baby before
putting him to the breast.
 Undress the baby to the diaper and hold the
baby between mom’s breasts.
 STARTING THE FEED

 At the start of the feed, your baby will have

shallow and quick sucks.
 When your milk starts to flow the sucks should
become deep and slow.
 A pause during the suck when your baby’s
mouth opens the widest - baby is drinking milk
during this pause.
 STARTING THE FEED

 A baby should be allowed to breastfeed

until satisfied and your breast should feel
softer. When your baby no longer has
strong “deep and slow” sucks, offer the
second breast.
 Offer your second breast even though
your baby may be full after the first
breast.
 STARTING THE FEED

 He may nurse for 20-40 minutes (total for one

or both breasts) at a feeding.
 Ideally, in the first four to six weeks – direct
breastfeeding only
 Do not give pacifiers or bottles unless
medically indicated.
 This will also help to establish your milk
production
 CONTRAINDICATIONS TO
BREASTFEEDING

• Active / untreated TB
• Radioactive compound (cancer for
chemo)
• Illegal drug
• HIV infection
• Galactosemia, phenylketinuria, maple
syrup urine disease
PREPARING FOR BREASTFEEDING

 Take a daily shower or sponge bath.

 Keep breasts free of cream, lotions and
powder.
 Drink a glass of water, juice or any beverage
(except alcohol) before breastfeeding.
 Observe proper hand washing before
handling/breastfeeding your baby. Wear a
mask if you have colds, or cough.
BREASTFEEDING ISLAND

 Creating a space that resembles the hospital in

terms of convenience can make breastfeeding
easier.
 Gather everything you need for the day and keep it
within an arm’s reach in a place you would be
comfortable all day (couch, bed, reclining chair).
 Make sure you have diapers, wipes, remotes, cell
phone, water and snacks for mom, blankets, baby
seat, breastfeeding log, breastfeeding support
book from hospital
 Feed on demand and no less than 5 hours
THE FIRST LATCH

 Use one hand to hold baby’s neck and shoulders.

Your other hand should be on your breast
controlling how the nipple enters baby’s mouth.
Fingers on bottom thumb on top making a “C”
shape.
 Support your arms with pillows and set up in the
hold that suits your needs.
 Bring baby to you- NOT you to baby.
 Tickle baby’s lips to encourage him to open wide
THE FIRST LATCH
 Pull baby close so the chin and lower jaw
moves into your breast first
 Watch the lower lip and aim it as far from the
nipple as possible so the baby takes a large
mouthful of breast
 Top of head and nose should be titled back as
if slightly hanging off the breast. This gives
baby room to breathe and ensures a proper
latch.
DISLATCH BABY AFTER
BREASTFEEDING

 Used little finger press on the gum to

open the baby mouth to dislatch from the
nipple
BREASTFEEDING POSITIONS
Cradle Hold

 This is the most

common position used
by mothers.
 Infant’s head is
supported in the elbow,
the back and buttock is
supported by the arm
and lifted to the breast.
Adapted from AAFP Journal September 2001
CRADLE HOLD POSITION
BREASTFEEDING POSITIONS
Football Hold Position

 The infant’s is placed under

the arm, like holding a
football
 Baby’s body is supported
with the forearm and the
head is supported with the
hand.
 Many mothers are not
comfortable with this position
Adapted from AAFP Journal September 2001
 Good position after
operative procedures
FOOTBALL HOLD POSITION
 BREASTFEEDING POSITIONS
Side Lying Position

 The mother lies on her side

propping up her head and
shoulder with pillows.
 The infant is also lying down
facing the mother.
 Good position after Caesarean
section.
 Allows the new mother some
rest.
 Most mothers are scared of
crushing the baby. Adapted from AAFP Journal September 2001
SIDE LYING POSITION
 BREASTFEEDING POSITIONS
Cross Cradle Hold Position

 Ideal for early breastfeeding.

 Mother holds the baby
crosswise in the crook of the
arm opposite the breast the
infant is to be fed.
 The baby's trunk and head are
supported with the forearm
and palm.
 The other hand is placed
beneath the breast in a U-
shaped to guide the baby's Adapted from AAFP Journal September 2001

mouth to your breast.

CROSS CRADLE HOLD
POSITION
BREASTFEEDING POSITIONS
Australian Hold Position

 This is also called the

saddle hold
 Usually used for older
infants
 Not commonly used by
mothers
 Best used in older infants
with runny nose, ear
infection.
Adapted from AAFP Journal September 2001
SADDLE HOLD
 SIGNS THAT THE BABY IS
GETTING ENOUGH BREAST MILK
1. He is contented for 1-2 hours after a feed
2. He regains birth weight after 2 weeks

DAY NUMBER OF NUMBER OF

STOOLS URINE
OUTPUTS

1 1 1
2 2 2
3 3 3
4 4 3 to 4
5 3 to 5 3 to 5
6 3 to 6 3 to 6
BREAST MILK SUPPLY CAN BE
INCREASED BY:

1. Frequent feeds day and night

2. Allowing unlimited breastfeeding to satisfy
baby’s suckling needs
3. Mother to eat and drink sufficient quantities to
satisfy baby’s suckling her hunger and thirst
4. Cultural foods like ginger and rice wine are
compatible with breastfeeding.
 BREAST MILK
STORAGE/THAWING:

• Unless being used immediately, refrigerate it within 1

hour.
• Thaw/warm the milk in container of lukewarm water or
running water.
• Once milk is thawed, it should be used within 24
hours.
• Once milk is warmed and not used for the feeding, it
should be discarded.
Place of storage Temperature Maximum storage time

In a room 25°C 77°F Six to eight hours

Insulated thermal bag with Up to 24 hours

ice packs

In a refrigerator 4°C 39°F Up to five days

Freezer compartment -15°C 5°F Two weeks

inside a refrigerator

A combined refrigerator -18°C 0°F Three to six months

and freezer with separate
doors

Chest or upright manual -20°C -4°F Six to twelve months

defrost deep freezer
 PROBLEMS

 Breast Pain
 Biting
 Too much milk
 Mastitis
 Breast abscess
 Breast engorgement
 Sore nipple
RELIEF AND AVOIDANCE OF
ENGORGEMENT

o Try to feed baby every two hours

o Massage your breasts while baby is feeding
o You may pump after baby feeds but realize
that they more you demand of your body, the
more it will make.
o Increase your fluid intake, dehydration can
irritate swollen breast tissue.
CRACKED NIPPLES

o Mother’s milk is best- express a small amount and

leave it on your nipple only. Allow to air dry.
o Lanolin cream may be applied sparingly. It does
not need to be removed before baby feeds.
o It is okay to keep breastfeeding if your nipples are
bleeding.
o Make sure your latch is correct. An incorrect latch
can cause cracking and bleeding.
 NUTRITION WHILE
BREASTFEEDING

 Eat a well-balanced, varied diet

 Breastfeeding mothers burn 500+ calories daily
 Check with doctor about taking a multivitamin with
iron
 Drink at least eight glasses of fluid daily
 Avoid or limit caffeinated drinks to one to two cups
daily
 Avoid alcohol or limit to one serving (six ounces of
wine or 12 ounces of beer) on a special occasion
ROOMING-IN

 Moms who room in tend to:

 Produce milk sooner
 Producer larger volumes of milk
 Breastfeed exclusively
 Breastfeed for a longer period
 Experience better bonding with their babies
 Learn to respond to babies’ feeding cues better
 Usually gets more rest. She experiences less separation
anxiety, not wasting energy worrying about the newborn
separated from her
 have lower incidence of postpartum depression
ROOMING-IN

 Babies who room in tend to:

 Have a lower chance of developing jaundice
 Cry less often and are more easily consoled
 Gain weight more steadily
REMEMBER

 As challenging and daunting as the

newborn period may sound, ENJOY it.
 Learn to appreciate this gift!
 SMILE! You are amazing!