BREAST FEEDING

Definition:

Breast feeding is the process of feeding breast milk to the infant, either directly from
the breast or by expressing (pumping out) the milk from the breast and feeding the
infant through various modes. (Feeding cup, paladai, spoon, NG tube)

Exclusive breast feeding:

It is defined as feeding the infant with breast milk (including milk expressed from the
breast) for 6 months of life, permitting no other food or drink, not even water except
allowing the infant to receive ORS, drops and syrups (vitamins, minerals and
medicines) when required.

Purposes:

 Breast milk is perfect food. It is easy to digest as it provides just the right
proportion of essential nutrients, proteins, fats and antibodies.
 Colostrums (initial milk is yellowish and creamy in consistency) promotes
maturation of the gut and strengthens immune system of the infant.
 Human milk contains both saturated and unsaturated fats and cholesterol an
important constituent of brain and nerve tissue. Vitamins and minerals in
breast milk enhance easy digestion.
 The immune protective components of human milk include lactoferrin,
lysozymes and milk leukocytes, secretory IgA, bifidus factor to prevent diarrhea,
food allergies and infections.
 Lactoferrin: it binds to iron, thus rendering it unavailable to viruses and
bacteria.
 Lysozymes and milk leukocytes: they destroy the viruses and bacteria.
 Secretory IgA: it is an immunoglobulin that destroys the viruses and
bacteria.
 Bifidus factor: it promotes the growth of beneficial bacteria in the gut and
limits the growth of disease causing bacteria.
 Breast feeding ensures the best possible health and best developmental and
psychosocial outcomes for the infant.

Articles:
Articles Purpose
Breast care tray:
A clean tray containing
Big bowl To provide breast care
Kettle with warm water To provide breast care
Bath thermometer To check the temperature of the water.
Sponge clothes To provide breast care
Towel To cover the breast
Small bowl containing gauze To clean the nipple and express the
colostrums.
Screen Provide privacy
Procedure:

S.NO NURSING ACTION RATIONALE

1. Arrange the necessary supplies near the To perform the procedure at ease.
mother’s bed.
1. Perform breast care To prevent infection.
2. Wash hands and cover the breast with clean To prevent infection.
towel
3. Assess the both breast for colour, shape, size To know the abnormality.
and consistency.
4. Assess then nipple for To rule out the breast abnormality.
Inverted nipple/ cracked nipples
Sore nipple
Breast engorgement
5. Palpate the farthest breast from center to To rule out the mass, tenderness
periphery by using the pad of fingers in a and axillary lymphnodes
circular motion and cover the entire breast and engorgement
end with the axilla and perform same steps for
the nearest breast.
6. Check the temperature of the water and pour To check the temperature
into a bowl.
7. Express the colostrums. To check the patency
8. Clean the nipple and areola in a circular To remove the crust
motion with the help of the wet gauze.
9. Clean the breast tissue in a circular motion Remove the dirt and enhances the
from center to periphery by using the wet cloth circulation
in a circular motion and cover the entire breast
and breast folding end with axilla.
10. Dry the breast with a clean towel. Moisture favors the growth of micro
organisms.
11. Expose and clean the other breast as
mentioned above.
12. Instruct the mother to position the baby
comfortably.
13. Cradle hold method:
Instruct the mother to sit in a straight position
with a pillow at the back or sit on the edge of
the bed.
14. Assist the mother to position the infant in her
arm, against her abdomen and the infant head
resting in the bend of her elbow. The infant’s
ear, shoulders and hips should be in a straight
line.
15. Instruct the mother to tuck the infant’s lower
arm out of the way with mouth close to the
breast.
16. Assist the mother to support her breast with
her free hand, place all the fingers underneath
it, and rest her thumb lightly on top of breast
above the areola.
17. Gently pull the infant quickly onto the breast As part of the rooting reflex his/ her
to latch on when the infant’s mouth is opened mouth will open wide.
wide, like a big yawn, and his/her tongue
down.
18. Cross- cradle hold: To feed the child.
Instruct the mother to follow the steps for
cradle hold except for step 2.
19. Position the infant on mother’s arm and
infant’s abdomen against the mother’s
abdomen and mother’s hand supporting the
head of infant at the back. The infant’s ears,
shoulders and hips should be in a straight
line.
20. Foot ball method: To feed the twin infants.
Instruct the mother to position the infant in
such a way that the infant’s legs and body are
under the mother’s arm and hold the infant’s
head (as if holding a foot ball)
21. Assist the mother to place her fingers below
the breast, allowing the infant to latch on while
gently pulling the infant close against the
breast.
22. Help the mother to keep the infant’s body
flexed at the hip with legs tucked under the
mother’s arm.
23. Nursing alert:
The foot ball hold is a good condition when:
The mother had a caesarean birth and wants
to avoid placing the baby against abdominal
incision.
24. The mother’s breasts are large.
25. Nursing a small baby, especially if premature.
26. Infants tend to slide down the areola onto the
nipple.
27. Infant is fussy, restless and hard to latch on.
28. Infant is sleepy; sitting upright may encourage
him/ her to remain alert for a longer period.
29. Mother has inverted nipples.
30. Two babies.
31. Side lying position: To provide nutrition based on the
Instruct the mother to position herself and the comfortable position of the mother.
infant on her sides, touching abdomen to
abdomen.
32. Assist mother to place fingers beneath the
breast and lift upward, and then gently pull
the infant in close with the other hand as the
infant latches on.
33. Nursing alert:
The side lying position is an especially good
choice for breast feeding when the mother les
down in supine position especially after a
cesarean birth with spinal anesthesia.
34. Using appropriate breast feeding techniques To promote the latching and prevent
and assisting the mother in latching the aspiration.
infant.
Instruct the mother to gently pull the infant
close to her breast
 35. Ask the mother to gently strike the nipple from
the lower lip of the infant toward the cheeks
laterally.
36. As the infant opens the mouth widely, assist
the mother to quickly pull the infant to the
breast in to latch on.
37. Look for the following things after the
infant is latched on to the breast.
Infant’s mouth should cover the nipple and
about the full of the areola.
The lips should be curled outward against the
breast.
Infant’s cheeks should touch the mother’s
breast.
The motion of the suck is along the jaw, not in
the cheeks.
38. Educate the mother to support the infant’s
head at the base of the neck throughout the
breast feeding session.
Encourage the mother to interact in soothing,
gentle voice during the feeding session.
39. To take off the infant from the breast, be sure To prevent aspiration
to break the suction by instructing the mother
to slip her little finger into the corner of the
infant’s mouth between the gums. Educate the
mother not to remove / pull the infant from
the breast until the sucking is released. As the
sucking is usually quite strong and it may
require some effort to release his/ her grip.
40. As the infant is removed from the breast, guide To prevent aspiration.
the mother in burping the infant after feeding
at each breast and at the end of the feeding.
Place the infant on the mother’s shoulder,
supporting the neck and back and ask the
mother apply gentle pressure at the back
below the shoulder level.
41. Once the infant has burped, clean the breast To provide adequate feeding from
with soft, clean cloth and position the mother both the breasts
and infant comfortably.
42. Document the date and time, position used for To provide the baseline data.
feeding, duration and response of the mother.
Benefits of breast feeding:

To infant:

 There is an increased resistance to infections and therefore fewer incidents

of illness and hospitalization.
 There is decreased risk of allergies and lactose intolerance
 Breast milk is sterile
 Infant is less likely to develop allergies.
 Infant experiences fewer chances of gastro intestinal upsets and
constipation
 Breast feeding promotes the proper development of infant’s jaw, teeth, joints
and bones.
  Breast fed infants tend to have higher IQ due to good brain development
early in life.
 Babies benefit emotionally, because they are held more by mother.
 Breast feeding promotes optimum regulation of body temperature as it
ensures skin- skin contact.
 In the long term, breast fed babies have a risk of mal nutrition, obesity and
heart disease compared to formula fed babies.

To mother:

 The baby’s sucking cause a mother’s uterus to contract and reduces the flow
of blood after delivery
 During lactation, menstruation ceases, offering a form of contraception to
the mother.
 Mothers who breastfeed tend to lose weight and achieve their pre pregnancy
figure more easily
 Mothers who breast feed are less likely to develop breast cancer later in life.
 Breast feeding is more economical than formula feeding.
 Breast feeding promotes mother – baby bonding.
 Hormones released during breast feeding create feelings of warmth and calm
in the mother.