Feeding of baby directly from female breast is called breast feeding. It is a normal way to provide young ones the nutrition they need for adequate growth and development. Remember- Breastfed babies are healthy and happy babies.
- Colostrum is the milk secreted during first week, it is thick yellow in colour , rich in protein and vitamins and it is secreted in small quantities.
- Foremilk– secreted at start of feed, it is thin watery, rich in protein, it satisfies baby ‘s thirst.
- Hind milk– comes towards end of feed, it is rich in fat, it gives energy and satisfy baby’s hunger.
for optimum growth, baby need both foremilk and hind milk.
It is good to let the baby empty one breast fully first.
Preparation of breast feeding starts before delivery, so that mother is fully prepared to breast feed after arrival of baby. For breast feeding select right place, initiate breast feeding soon after delivery. Give colostrum and avoid pre-lacteal feeds. Help baby suckle in good position. Do not wash nipple every time before and after feeding. Explain mother about breast engorgement.
Key points in position
baby’s head in line with body, whole body should be well supported. Baby is turned towards mother; baby’s abdomen should be touching mother’s abdomen.
To help the baby to attach
- Express a little milk on nipple
- Touch the baby ‘s lip with nipple
- Wait until baby’s mouth is wide open
- Move the baby quickly onto the breast, aiming nipple towards baby’s palate and lower lip well below nipple.
Signs of Good Attachment:
- more areola is visible above the babys mouth than below it.
- baby mouth is wide open.
- baby lower lip is turned outwards.
- baby’s chin is touching the breast.
If the baby takes several slow deep sucks followed by swallowing and then pauses- It means baby is sucking effectively
Breast feeding can be done in three positions- Cradle hold, football hold and lying down Positions.
Burping after every feed is very important.
signs of effective breast feeding
- Frequent feeding 8-12 times per day.
- Intermittent episode of rhythmic suckling with audible swallowing, baby should pass urine around 6-8 times.
- After feeding baby is sleeping well or playing well.
- Baby should regain birthweight by 10th day.
Breast milk has all the nutrients which baby needs for first 6 months.
Advantage to baby:
- lower rates of allergies
- avoid ear/lung infection
- improve immunity and IQ
- have better long term outcomes
Advantages to mother:
- reduces uterine bleeding
- burns calories
- reduces risk of breast / ovarian/ uterine cancer.
Breastfeeding help in better baby and mother bonding, child spacing, and it is cost effective.
Barriers of Breast Feeding:
- Lack of confidence
- belief that breast milk is not sufficient,
- lack of adequate support system,
- breast engorgement, cracked or sore nipple are barriers
Flat nipple which becomes prominent or pull out easily do not cause difficulty in breastfeeding.
For inverted nipple, nipple is manually stretched and rolled out several times a day, stimulate nipple before feeding and shaping breast by supporting underneath with finger and thumb above, or a plastic syringe is used to draw out nipple before breastfeeding.
Sore nipple is caused by incorrect attachment of baby to breast, A baby who sucks only at nipple does not get enough milk, so he sucks more vigorously resulting in sore nipple, hence pain or cracks on nipple, frequent washing with soap and water and pulling the baby off the breast while he is still sucking will worsen the situation. Treatment is correct positioning, correct attachment, apply butter, ghee or hind milk to nipple after feeds,
If feeding is delayed, infrequent, milk accumulates in the alveoli. As milk production increases the amount of milk in the breast exceeds the capacity to store, breast becomes swollen, hard, warm and painful- treatment is early and frequent feeding, correct attachment, local warm water packs, gently express milk to soften the breast.
If condition like engorged breast, cracked nipple, mastitis are not treated, breast abscess develops with high grade fever and pain in breast.
Treatment- analgesic, antibiotics, incision and drainage of abscess, breastfeeding continued on another breast.
mother often complaints of not producing enough milk- Reassurance and psychological support is needed. Treatment is to attach properly, treat painful conditions, increase fluid intake, massage breast, some medicines are also given.
