Breast Feeding

Breast feeding
Breast feeding
Dr Rania Hussein Dr Rania Hussein
Preparation for breast feeding should start
Preparation for breast feeding should start
during pregnancy
during pregnancy
.
.
Rooting
Rooting
is a natural reflex for babies.
is a natural reflex for babies.
The babys
The babys
mouth opens
mouth opens
wide and its
wide and its
head moves quicly from side to side!
head moves quicly from side to side!
searching
searching
for the nipple. To start a baby
for the nipple. To start a baby
rooting! the mother must lightly touch her
rooting! the mother must lightly touch her
nipple to the babys lower lip.
nipple to the babys lower lip.
Latching on
Latching on
is the expression used to
is the expression used to
describe how a baby
describe how a baby
grasps
grasps
the mothers
the mothers
nipple with his"her mouth. #t is a sill that
nipple with his"her mouth. #t is a sill that
baby must learn with a little help from
baby must learn with a little help from
mother.
mother.
To start breast feeding! mother has to lightly
To start breast feeding! mother has to lightly
touch her nipple to the babys lower lip $ baby
touch her nipple to the babys lower lip $ baby
will %
will %
root
root
& for breast $ rapidly lift her breast to
& for breast $ rapidly lift her breast to
its mouth ' pull the baby close $ baby can
its mouth ' pull the baby close $ baby can
latch onto the nipple.
latch onto the nipple.
(nce the baby is latched on and sucing!

(nce the baby is latched on and sucing!
receptors of the nipple and areola send a
receptors of the nipple and areola send a
message to the hypothalamus! which
message to the hypothalamus! which
stimulates prolactin and oxytocin release from
stimulates prolactin and oxytocin release from
the pituitary.
the pituitary.
Prolactin reflex= milk secreting reflex

Prolactin reflex= milk secreting reflex
)
)
prolactin maes the breast
prolactin maes the breast
produce
produce
mil
mil
Oxytocin reflex= milk ejection reflex= let-

Oxytocin reflex= milk ejection reflex= let-
down
down
reflex:
reflex:
oxytocin maes the mil
oxytocin maes the mil
move
move

from alveoli through duct system to the nipple
from alveoli through duct system to the nipple

(xytocin also produces uterine contraction
(xytocin also produces uterine contraction
How breast milk varies
How breast milk varies
?
?
1
1
.
.
:
:
*ellowish mil secreted in the first few days
*ellowish mil secreted in the first few days
after labor)
after labor)
+.
+.
rich in antibodies and growth factors
rich in antibodies and growth factors
,.
,.
laxative
laxative
-.
-.
prepares the babys gut for digestion and
prepares the babys gut for digestion and
absorption
absorption
.oremil)
.oremil)
lower fat mil released at the
lower fat mil released at the
beginning of a feeding
beginning of a feeding
Hindmil)
Hindmil)
Higher fat mil released toward
Higher fat mil released toward
the end of a feeding
the end of a feeding
#nitiate breastfeeding within one hour of

#nitiate breastfeeding within one hour of
birth.
birth.
/reastfeed exclusively for the first six

/reastfeed exclusively for the first six
months of age 0+12 days3.
months of age 0+12 days3.
Thereafter give nutritionally adequate and

Thereafter give nutritionally adequate and
safe complementary foods to all children.
safe complementary foods to all children.
4ontinue breastfeeding for up to two years

4ontinue breastfeeding for up to two years
of age or beyond.
of age or beyond.
5dapted from the 5dapted from the Global Strategy. Global Strategy.
EXCLUSIVE BREASTEE!I"#: EXCLUSIVE BREASTEE!I"#: the infant taes the infant taes
only breast mil only breast mil and no additional food! water! or and no additional food! water! or
other fluids with the exception of medicines and other fluids with the exception of medicines and
vitamin or mineral drops. vitamin or mineral drops.
$re%omi&a&t BREASTEE!I"# : $re%omi&a&t BREASTEE!I"# : the infant is the infant is

given predominantly breast mil !with some artificial given predominantly breast mil !with some artificial
feeds! either mil or cereal! or other food or water. feeds! either mil or cereal! or other food or water.
B'TTLE(EE!I"#: B'TTLE(EE!I"#: the infant is feeding from a the infant is feeding from a
bottle! regardless of its contents! including bottle! regardless of its contents! including
expressed breast mil. expressed breast mil.
C')$LE)E"TAR* EE!I"#: C')$LE)E"TAR* EE!I"#: the process of the process of

giving an infant giving an infant food food in addition to breast mil or in addition to breast mil or
infant formula! when either becomes insufficient infant formula! when either becomes insufficient
to satisfy the infant6s nutritional requirements. to satisfy the infant6s nutritional requirements.
ARTIICIAL EE!I"#:
ARTIICIAL EE!I"#:
the infant is
the infant is
given breast7mil
given breast7mil
substitutes
substitutes
and not
and not
breastfeeding at all.
breastfeeding at all.

+.
+.
#t is a unique food! and
#t is a unique food! and
nutritionally superior to any
nutritionally superior to any
alternative
alternative
,.
,.
/acteriologically safe and always
/acteriologically safe and always
fresh
fresh
-.
-.
4ontains many anti infectious
4ontains many anti infectious
factors
factors
8.
8.
#s the least allergenic of any infant
#s the least allergenic of any infant
food
food
9lide ,.+
:. /reast fed babies are less liely to be
:. /reast fed babies are less liely to be
overfed! and less liely to become
overfed! and less liely to become
obese! or develop #DD;
obese! or develop #DD;
<. Promotes bonding and development.
<. Promotes bonding and development.
=. (ptimi>es infant intelligence
=. (ptimi>es infant intelligence
5dapted from) /reastfeeding counselling) 5 training course. ?eneva! @orld Health
(rgani>ation! +AA- 0@H("4DR"A-.<3.
9lide ,.,
Nutrients in human and
animal milks
animal milks
.at
Protein
Bactose
Human 4ow ?oat
Diferences in the quality
Diferences in the quality
of proteins in diferent
of proteins in diferent
milks
milks 4ows mil Human mil
@hey protein
4urds
Casy to digest Difficult to digest
@hey protein
@hey protein
is the protein remaining in the
is the protein remaining in the
watery fraction of mil after the curd and cream
watery fraction of mil after the curd and cream
have been removed. 4ontains
have been removed. 4ontains
lactalbumin
lactalbumin
0an
0an
easy to digest protein3.
easy to digest protein3.
4asein)
4asein)
the principle protein in 4ow mil.
the principle protein in 4ow mil.
formula milks
formula milks
5ntistaphylococcus factor
5ntistaphylococcus factor
/ifidus factor) fights enteropathogens

/ifidus factor) fights enteropathogens
#mmnunoglobulins) secretory
#mmnunoglobulins) secretory
#g 5 which protects
#g 5 which protects
the immature infant gut from bacterial infections
the immature infant gut from bacterial infections
and foreign protein molecules
and foreign protein molecules
#nterferon 0antiviral3
#nterferon 0antiviral3
Byso>yme 0 en>yme which breas cell wall of

Byso>yme 0 en>yme which breas cell wall of
bacteria3
bacteria3
;acrophages) phagocytes that ill bacteria and

;acrophages) phagocytes that ill bacteria and
fungi
fungi
Bactoferrin 0iron binding protein

Bactoferrin 0iron binding protein
1. Helps reduce risk of uterine bleeding and
1. Helps reduce risk of uterine bleeding and
helps the uterus to return to its previous size
helps the uterus to return to its previous size
2. Reduces risk of breast and ovarian cancer
2. Reduces risk of breast and ovarian cancer

3. Helps delay a new pregnancy
3. Helps delay a new pregnancy

4. Helps a mother return to prepregnancy
4. Helps a mother return to prepregnancy
weight
weight

!. "onserves iron stores by prolonging
!. "onserves iron stores by prolonging
amenorrhea
amenorrhea
+.
+.
/etter health! nutrition! and well7being
/etter health! nutrition! and well7being
,.
,.
Cconomic benefits
Cconomic benefits
breastfeeding costs less than artificial

breastfeeding costs less than artificial
feeding
feeding
breastfeeding results in lower medical

breastfeeding results in lower medical
care costs
care costs

@armer and calmer emotional environment
@armer and calmer emotional environment
Do nurseries! more hospital space

Do nurseries! more hospital space
.ewer neonatal infections

.ewer neonatal infections
Bess staff time needed

Bess staff time needed
#mproved hospital image and prestige

#mproved hospital image and prestige
.ewer abandoned children

.ewer abandoned children
9afer in emergencies
9afer in emergencies
9lide ,.,1
+.
+.
Have a written breast feeding
Have a written breast feeding
+oli,-
+oli,-
that is
that is
routinely communicated to all health care staff
routinely communicated to all health care staff
..
..
Trai&
Trai&
all health care staff in the sills
all health care staff in the sills
necessary to implement this policy
necessary to implement this policy
-.
-.
#nform all
#nform all
+re/&a&t 0emales
+re/&a&t 0emales
about the
about the
benefits and management of breast feeding
benefits and management of breast feeding
8. Help the mother initiate breast feeding within 8. Help the mother initiate breast feeding within a 1al0 a 1al0
1o2r o0 birt1 1o2r o0 birt1
:. Practice :. Practice roomi&/(i& roomi&/(i& ) allow mothers and infants to ) allow mothers and infants to
remain together ,8 hours a day remain together ,8 hours a day
<. Cncourage breast feeding <. Cncourage breast feeding o& %ema&% o& %ema&%
=. ?ive =. ?ive "' arti0i,ial teats or +a,i0iers "' arti0i,ial teats or +a,i0iers to breast feeding to breast feeding
infants infants
1. ?ive newborn infants 1. ?ive newborn infants "' 0oo% or %ri&k "' 0oo% or %ri&k other than other than
breast mil unless medically indicated breast mil unless medically indicated
A. 9how
A. 9how
mot1ers
mot1ers
how to breast feed and
how to breast feed and
how to
how to
maintain
maintain
lactation! even if they
lactation! even if they
are separated from their infants
are separated from their infants
+2. .oster he establishment of
+2. .oster he establishment of
breast7
breast7
feeding support groups
feeding support groups
! and refer
! and refer
mothers to them on discharge from the
mothers to them on discharge from the
hospital
hospital
How to k&ow t1at breast 0ee%i&/
How to k&ow t1at breast 0ee%i&/
is /oi&/ well?
is /oi&/ well?
%igns of successful breastfeeding
:
:
1. #E"ERAL 1. #E"ERAL
;other relaxed and comfortable ;other relaxed and comfortable
/reasts loo healthy! no redness! /reasts loo healthy! no redness!

no swelling no swelling
/aby calm and relaxed /aby calm and relaxed
/aby reaches or roots for breast if /aby reaches or roots for breast if
hungry hungry

:
:

.. BAB*3S $'SITI'"
.. BAB*3S $'SITI'"
/abys head and body in line.

/abys head and body in line.
Dec and head not twisted to
Dec and head not twisted to
feed
feed
/aby held close to mothers

/aby held close to mothers
body
body
/abys whole body supported!

/abys whole body supported!
not supported by head and nec
not supported by head and nec
only
only
:
:
-.
-.
BAB*3S ATTACH)E"T
BAB*3S ATTACH)E"T
;ore areola seen

;ore areola seen
above
above
0than below3 the
0than below3 the
babys top lip
babys top lip
/abys mouth open wide

/abys mouth open wide
Bower lip
Bower lip
turned outwards
turned outwards
/abys
/abys
chin touches
chin touches
breast
breast
&ood attachment' Poor
&ood attachment' Poor
attachment
attachment
B
r
e
a
s
t
f
e
e
d
i
n
g

C
o
u
n
s
e
l
l
i
n
g
:

a

t
r
a
i
n
i
n
g

c
o
u
r
s
e
,

@
H
(
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4
H
D
"
A
-
.
8
!

E
D
#
4
C
.
"
D
E
T
"
A
-
.
,

&ood attachment Poor
&ood attachment Poor
attachment
attachment
:
:
4. SUC5I"#
4. SUC5I"#
9low! deep sucs with pauses

9low! deep sucs with pauses
4hees round when sucling

4hees round when sucling
@e can see or hear the baby swallowing

@e can see or hear the baby swallowing
/aby finishes sucing after +2 minutes

/aby finishes sucing after +2 minutes
;other notices signs of oxytocin reflex

;other notices signs of oxytocin reflex
:
:
6. I0 t1e bab-
6. I0 t1e bab-
1as 7( 8 wet %ia+ers a %a-9

1as 7( 8 wet %ia+ers a %a-9
+asses &ormal so0t stools9

+asses &ormal so0t stools9
seems ,o&te&%e%
seems ,o&te&%e%
is /ai&i&/ wei/1t9
is /ai&i&/ wei/1t9
-o2 ,a& be s2re t1at bab- is bei&/ well
-o2 ,a& be s2re t1at bab- is bei&/ well
0e%
0e%
!i00i,2lties wit1 breast 0ee%i&/
!i00i,2lties wit1 breast 0ee%i&/
can be reduced can be reduced
by fre*uent nursing or little milk e+pression by fre*uent nursing or little milk e+pression
treated by correcting treated by correcting
feeding positions, leaing milk drops to dry on the feeding positions, leaing milk drops to dry on the
nipple after feeding nipple after feeding
:
:
Treate% b- /e&tle +ress2re o& t1e
Treate% b- /e&tle +ress2re o& t1e
&i++les9 or weari&/ so0t %is+osable
&i++les9 or weari&/ so0t %is+osable
bra +a%s
bra +a%s
Can you store breast milk
Can you store breast milk
F
F
#reast emptying stimulates
#reast emptying stimulates
milk production. $hen an
milk production. $hen an
infant is unable to nurse%
infant is unable to nurse%
manual e&pression or
manual e&pression or
using a breast pump can
using a breast pump can
be used to maintain milk
be used to maintain milk
production
production
'tore milk in a sterile container
'tore milk in a sterile container
(p to 4) hours in refrigerator
(p to 4) hours in refrigerator
"*(+,-./ .ever heat on stove or put in

"*(+,-./ .ever heat on stove or put in
microwave.
microwave.
$ra,ti,es i&,om+atible wit1 la,tatio&
$ra,ti,es i&,om+atible wit1 la,tatio&
1
1
.
.
:
:
,ntense physical activity 0 1 lactic acid in
,ntense physical activity 0 1 lactic acid in
breast milk0 altered milk taste
breast milk0 altered milk taste
'o better to breast feed the baby before
'o better to breast feed the baby before
e&ertion
e&ertion
+.
+.
5lteration of mil taste
5lteration of mil taste
,.
,.
G
G
oxytocin secretion$ G mil eHection
oxytocin secretion$ G mil eHection
-.
-.
9leepy baby
9leepy baby
:
:
.
.
"affeine
"affeine
in coffee and cola can accumulate in
in coffee and cola can accumulate in
the infant causing irritability and wakefulness
the infant causing irritability and wakefulness
"affeine interferes with bioavailability of

"affeine interferes with bioavailability of
iron in breast milk
iron in breast milk
4. Smoking:
4. Smoking:
1.
1.
2
2
milk volume.
milk volume.
2.
2.
.icotine alters smell and taste of milk
.icotine alters smell and taste of milk
5
5
.
.
Particular foods
Particular foods
:
:
1.
1.
3ay alter the smell and taste of milk.
3ay alter the smell and taste of milk.
2.
2.
3ay cause colics 4especially vegetables and
3ay cause colics 4especially vegetables and
fruits% as garlic% onion% apricots% prunes5.
fruits% as garlic% onion% apricots% prunes5.
3.
3.
,n infants who develop food allergy%
,n infants who develop food allergy%
offenders in mother6s diet may be eggs% fish%
offenders in mother6s diet may be eggs% fish%
peanuts
peanuts
1 .ewborn with inborn error of metabolisms
1 .ewborn with inborn error of metabolisms
as galactosemia% or primary lactase
as galactosemia% or primary lactase
deficiency
deficiency
2,nfected mother with *,7'
2,nfected mother with *,7'
3 3others taking drugs as aspirin% sedatives%
3 3others taking drugs as aspirin% sedatives%
antiepileptics% radioactive isotopes% cancer
antiepileptics% radioactive isotopes% cancer
chemotherapeutic agents
chemotherapeutic agents
:
:
To prevent breast sagging! a nursing
To prevent breast sagging! a nursing
mother must give proper support! have
mother must give proper support! have
regular exercise ! and tae adequate
regular exercise ! and tae adequate
diet.
diet.
("2rse -o2r &ewbor& bab- 8 to 1; times
i& a .4(1o2r +erio%.
('00er o&e breast a&% t1e& t1e ot1er at
ea,1 0ee%i&/.
(A bab- will 2s2all- /et most o0 t1e milk
0rom a breast i& t1e 0irst 0ive to te&
mi&2tes o0 s2,ki&/.

Breast Feeding

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Breast Feeding

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Breast feeding

(nce the baby is latched on and sucing!

Prolactin reflex= milk secreting reflex

Oxytocin reflex= milk ejection reflex= let-

#nitiate breastfeeding within one hour of

/reastfeed exclusively for the first six

Thereafter give nutritionally adequate and

4ontinue breastfeeding for up to two years

$re%omi&a&t BREASTEE!I"# : $re%omi&a&t BREASTEE!I"# : the infant is the infant is

C')$LE)E"TAR* EE!I"#: C')$LE)E"TAR* EE!I"#: the process of the process of

/ifidus factor) fights enteropathogens

Byso>yme 0 en>yme which breas cell wall of

;acrophages) phagocytes that ill bacteria and

Bactoferrin 0iron binding protein

breastfeeding costs less than artificial

breastfeeding results in lower medical

Do nurseries! more hospital space

.ewer neonatal infections

Bess staff time needed

#mproved hospital image and prestige

.ewer abandoned children

;other relaxed and comfortable ;other relaxed and comfortable

/reasts loo healthy! no redness! /reasts loo healthy! no redness!

/aby calm and relaxed /aby calm and relaxed

/abys head and body in line.

/aby held close to mothers

/abys whole body supported!

;ore areola seen

/abys mouth open wide

9low! deep sucs with pauses

4hees round when sucling

@e can see or hear the baby swallowing

/aby finishes sucing after +2 minutes

;other notices signs of oxytocin reflex

1as 7( 8 wet %ia+ers a %a-9

+asses &ormal so0t stools9

"*(+,-./ .ever heat on stove or put in

"affeine interferes with bioavailability of

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