Breastfeeding

Breastfeeding 

Definition

​:​ ​A​ ​natural​ ​and​ ​simple​ ​way​ ​to​ ​feed​ ​a​ ​baby.  

Types: 

● Exclusive:

​ ​only​ ​breast​ ​milk 

● Artificial:

​ ​breast​ ​milk​ ​in​ ​a​ ​bottle. 

● Full:

​ ​both​ ​exclusive​ ​and​ ​artificial. 

● Mixed:

​ ​breast​ ​milk​ ​with​ ​animal​ ​milk​ ​in​ ​a​ ​bottle.  

Breast

​ ​milk​ ​elements: 

● Protein 

● CHO 

● Fat 

● Water 

● Minerals 

● Vitamins 

● Immunological

​ ​Substances 

● Enzymes 

● Hormones  

Stages

​ ​of​ ​human​ ​milk: 

● Colostrum:

​ ​1​ ​-​ ​3​ ​days​ ​postpartum 

● Transitional:

​ ​3​ ​-​ ​5​ ​days​ ​postpartum 

● Mature:

​ ​after​ ​5​ ​days​ ​postpartum  

Breastfeeding

​ ​Preparation: 

● Wash

​ ​hands 

● Wash

​ ​Nipples​ ​(with​ ​warm​ ​water,​ ​but​ ​not​ ​soap) 

Breastfeeding

​ ​positions: 

● The

​ ​Cradle​ ​Position:​ ​achieved​ ​by​ ​cradling​ ​the​ ​infant​ ​in​ ​one​ ​arm. 

● The

​ ​Lying​ ​Down​ ​Position:​ ​achieved​ ​by​ ​lying​ ​down​ ​on​ ​one​ ​side. 

● The Football Hold Position: achieved by putting a pillow below the mother’s arms

and

​ ​head,​ ​and​ ​a​ ​pillow​ ​below​ ​the​ ​infant’s​ ​buttocks. 

1

​ ​of​ ​4 

Breastfeeding

​ ​Method: 

● The mother hold her hand around her breast with the thumb on top behind the

areola

​ ​and​ ​the​ ​fingers​ ​against​ ​the​ ​chest​ ​wall.  

● Both breasts are used: the first breast for 10 minutes and the other breast for 6

minutes; at the next feeding infants start to feed on the breast used to finish the

preceding

​ ​feeling​ ​this​ ​way​ ​to​ ​balance​ ​between​ ​foremilk​ ​and​ ​hindmilk. 

● The neonate is nursed shortly after birth 1-2 hours and approximately every 2 or 3

hours

​ ​thereafter. 

● The

​ ​infant​ ​should​ ​be​ ​burped​ ​after​ ​each​ ​breast​ ​and​ ​at​ ​the​ ​end​ ​of​ ​the​ ​feeding.  

Advantages

​ ​of​ ​breastfeeding: 

● For

​ ​the​ ​Baby: 
○ Satisfies

​ ​the​ ​infant’s​ ​nutritional​ ​needs. 

○ Gives

​ ​greater​ ​immunity. 

○ Digest

​ ​easily,​ ​Fit​ ​the​ ​temperature,​ ​&​ ​Sterile. 

○ Psychological

​ ​bond​ ​between​ ​mother​ ​and​ ​baby.  

○ Lowers

​ ​allergic​ ​reactions. 

● For

​ ​the​ ​Mother: 
○ Psychological

​ ​relation​ ​between​ ​mother​ ​and​ ​baby. 

○ Easy. 

○ Decrease

​ ​risk​ ​of​ ​breast,​ ​ovary​ ​and​ ​cervix​ ​cancer. 

○ Decrease

​ ​blood​ ​loss​ ​after​ ​labor. 

○ Help

​ ​the​ ​uterus​ ​return​ ​to​ ​usual​ ​size​ ​rapidly​ ​(involution).  

● For

​ ​the​ ​Family: 
○ Economic. 

○ Strengthen

​ ​the​ ​relation​ ​between​ ​family​ ​members.  

Contraindications: 

● Mother

​ ​related: 

○ Mother

​ ​with​ ​malignancy​ ​(Breast​ ​Ca)  

○ Mother

​ ​with​ ​cytotoxic​ ​or​ ​radioactive​ ​exposure  

2

​ ​of​ ​4 

○ Mother

​ ​with​ ​psychosis  

○ Mother

​ ​with​ ​a​ ​viral​ ​infection,​ ​or​ ​an​ ​untreated​ ​bacterial​ ​infection.  

○ Mother

​ ​with​ ​areola/nipple​ ​lesion​ ​(mastitis) 

● Baby

​ ​related: 

○ Inborn

​ ​error​ ​of​ ​metabolism​ ​(e.g.​ ​Lactose​ ​Intolerance,​ ​Galactosemia)  

○ Fetal

​ ​Distress​ ​and​ ​Hypoxia  

○ Breastfeeding

​ ​Induced​ ​Jaundice  

○ Congenital

​ ​defect​ ​(e.g.​ ​Congenital​ ​Heart​ ​Defect)  

Important

​ ​Notes​ ​regarding​ ​breastfeeding: 

● For low birth weight and small for dates: breastfeeding is important for growth and

treatment

​ ​of​ ​hypocalcemia. 

● For

​ ​post​ ​mature​ ​babies:​ ​breastfeeding​ ​is​ ​important​ ​for​ ​treatment​ ​of​ ​hypoglycemia. 

● For

​ ​immunized​ ​babies:​ ​immunization​ ​to​ ​the​ ​infant​ ​has​ ​no​ ​side​ ​effects. 

● For Immunized mothers: immunization to the mother

is contraindicated if

immunised

​ ​with​ ​live​ ​attenuated​ ​substance​ ​as​ ​Rubella​ ​or​ ​hepatitis​ ​vaccine. 

● For

​ ​mothers​ ​with​ ​multiple​ ​births:​ ​mother​ ​can​ ​feed​ ​them​ ​if​ ​she​ ​is​ ​well​ ​nourished. 

● For Cesarean section Mothers: depend on type of anaesthesia (spinal or general)

also according to the type of substance of anaesthesia; usually fed when she's alert

or

​ ​within​ ​the​ ​first​ ​12​ ​hours. 

● For working mothers: this is not difficult if the mother prepare a place near her

work

​ ​and​ ​can​ ​feed​ ​her​ ​baby​ ​that​ ​time. 

Weaning

​: a process of changing from one method of feeding to another, starting at 4 - 6

months

​ ​of​ ​age,​ ​done​ ​gradually​ ​by​ ​introducing​ ​a​ ​new​ ​type​ ​of​ ​food. 

Common

​ ​problems​ ​in​ ​postpartum​ ​period: 

● Sore

​ ​nipple: 

○ Caused

​ ​by​ ​incorrect​ ​positioning. 

○ Result

​ ​in​ ​nipple​ ​damage​ ​and​ ​dermatitis. 

● Cracked

​ ​nipple: 

○ Caused

​ ​by​ ​abnormal​ ​positioning​ ​or​ ​excessive​ ​use​ ​of​ ​soap.  

3

​ ​of​ ​4 

○ Result

​ ​in​ ​pain​ ​on​ ​nursing. 

○ Treated

​ ​by​ ​application​ ​of​ ​lotion​ ​or​ ​mother’s​ ​milk. 

● Thrush

​ ​(Yeast​ ​Infection)  

○ Happens

​ ​at​ ​any​ ​time. 

○ Caused

​ ​by​ ​antibiotics. 

○ Associated

​ ​with​ ​vaginal​ ​thrush​ ​in​ ​the​ ​mother,​ ​and​ ​an​ ​oral​ ​thrush​ ​in​ ​the​ ​baby.  

○ Results

​ ​in​ ​itchy,​ ​irritable,​ ​pink​ ​nipple. 

○ Treated

​ ​by​ ​antifungal​ ​cream​ ​on​ ​the​ ​nipple. 

● Inverted

​ ​Nipple  

○ It

​ ​does​ ​not​ ​prevent​ ​breastfeeding. 

○ Treated

​ ​by​ ​breast​ ​shells​ ​and​ ​exercising​ ​uterine​ ​contractions. 

● Breast

​ ​Engorgement: 

○ Caused

​ ​by​ ​not​ ​feeding​ ​for​ ​a​ ​long​ ​time​ ​or​ ​incorrect​ ​positioning. 

○ Result

​ ​in​ ​milk​ ​build​ ​up;​ ​hence​ ​a​ ​painful​ ​swollen​ ​breast. 

○ Treated by frequent feeding, correct positioning, analgesia, and manually

expressing

​ ​milk.  

● Mastitis

​ ​(Red​ ​Inflamed​ ​Breast)  

○ Caused

​ ​by​ ​poor​ ​drainage​ ​or​ ​incorrect​ ​positioning  

○ Result

​ ​in​ ​red,​ ​hot,​ ​and​ ​tender​ ​breast;​ ​with​ ​fever​ ​and​ ​malaise. 

○ Treated by equal nursing on both sides, with feed pumping on the affected

side;

​ ​with​ ​bed​ ​rest​ ​and​ ​antibiotics. 

● Breast

​ ​Abscess  

○ Occurs

​ ​as​ ​a​ ​complication​ ​of​ ​mastitis,​ ​or​ ​as​ ​a​ ​result​ ​of​ ​inadequate​ ​treatment.  

○ Managed by rest, warm soaks and emptying of the breast; with antibiotics

and

​ ​surgical​ ​drainage. 

● Blocked

​ ​Duct​ ​(Milk​ ​Retention​ ​Cyst)  

○ Felt

​ ​as​ ​a​ ​smooth​ ​round-surface​ ​lump. 

○ Treated

​ ​by​ ​improving​ ​position​ ​and​ ​feeding​ ​on​ ​the​ ​same​ ​side​ ​of​ ​the​ ​lump. 

4

​ ​of​ ​4