BREASTFEEDING

Breastfeeding provides optimal nutrition. It is the preferred method of feeding a newborn

because it provides numerous health benefits to both mother and child, and it remains the ideal
nutritional source for infants through the first year of life as reflected in the 3 E’s of
breastfeeding.

BENEFITS OF BREASTFEEDING

B - onding F - amily Planning

R - esistance E - nergy Giving
E - conomical E - rror Free Formula
A - llergy free D - igestible
S - afe I - nexhaustible Supply
T - ime Saving N – o Vitamins Needed
G - uaranteed
THE 3 E’S OF BREASTFEEDING

AS EARLY AS POSSIBLE

Immediately after delivery, suckling the breast may reduce the risk of postpartum hemorrhage.
Suckling stimulates release of hormones which help milk flow and cause contraction of the
uterus.
Immunoglobulin (Ig A) in colostrums provides anti-infective protection to the baby.

EXCLUSIVE FOR 4-6 MONTHS

For the first 6 months of life a well-nourished mother can provide through breast milk all the
nutrients and fluids an infant needs.
Full breastfeeding delays resumption of ovulation and the return of menstrual cycle, protecting
the mother from unplanned pregnancy through LAM.

EXTENDED UP TO 2 YEARS

Mothers can continue breastfeeding their baby as long as she feels comfortable doing it.
However, the baby needs other foods in addition to breast milk.
Breastfeeding offers important economic advantage to families. It costs more to use milk
formula than to give food supplements to a mother.
GUIDELINES OF BREASTFEEDING

1. Wash hands. Wash nipples with warm water. No soap.

2. There are 3 basic positions:
a. Cradle Position – achieved by cradling the infant in one arm, head resting in the bend of the
elbows. The infant’s lower arm is tucked out of the way and the infant’s mouth is close to
the breast. The mother can be sitting up in bed with pillows supporting the back or sitting in
a chair.
b. Lying Down Position – attained by having the mother lie on her side in bed with the infant
lying on his or her side also
c. Football Hold – the mother is seated in a chair and a pillow placed next to her on the nursing
side. The pillow supports the elbow and the infant’s buttocks, and should bring the infant’s
head up to the level of the breast.
3. Stroke the infant’s cheek with the nipple.
4. The infant’s mouth should be opened wide, as with a yawn, and should cover the entire areola
or a large amount of the areola. If necessary, apply pressure to the infant’s chin with your index
finger to open the infant’s mouth more widely. The breast needs to be placed far back into the
infant’s mouth to drain the breast adequately. Hold your hand in a “C” position around your
breast with the thumb on top behind the areola and the fingers against the chest. Wall
supporting the underside of the breast.
5. Both breasts are use – the first breast for about 10 minutes, the other breast for about 6
minutes. At the next feeding, the infant starts to feed on the breast used to finish the preceding
feeding.
6. Retract breast tissue from the infant’s nose during sucking. Break suction by placing a finger in a
corner of the infant’s mouth.
7. The neonate is nursed shortly after birth and approximately 2-3 hours thereafter.
8. Infants should be burped after each breast and at the end of the feeding.
9. Nipples often become tender during the first week of nursing. But should not become sore.
Soreness and prolonged feedings are most often the result of a baby who is not latched onto the
breast properly.
EXPRESSED BREAST MILK METHOD / EBM METHOD

If mothers will be separated from their babies the nurse may instruct them on the hand
expression or the “expressed breast milk” (EBM) method.

In preparing for the hand expression or EBM method, advise the mother to:

1. Wash hands with soap and water.

2. Gently massage her breast towards the nipple or apply a warm moist cloth a few minutes before
expressing to help milk flow.

3. Lean forward and support her breast with her hand.

4. Put her thumb on the areola above the nipple, and her first finger on the areola below the nipple.

5. Press her thumb and first finger inward towards the chest wall a little way. (usually about 1-2 cm)

6. Firmly press on the milk sinuses beneath the areola between the finger and thumb.

7. Press and release the thumb and forefinger several times until milk starts to drip out.

8. Rotate the thumb and forefinger around the areola so that milk is removed from all the milk
sinuses.

But make sure mothers do not squeeze the nipple itself and that they do not move their fingers
along the skin of the breast. Pressing or pulling the nipple cannot express milk, and it can
damage the nipple.

In storing expressed breast milk:

a. Prepare a clean container that can be covered for storing the milk. The container should be
washed in hot soapy water, and rinsed in hot clear water.

b. In hand expressing, the mother can express directly into the container.

c. Store only the amount of milk in one container that the baby will take at one feeding.

d. If the mother is storing several containers in one place, each container should be labelled with
date. The oldest milk should be used first.
 Storing of EBM and its period of consumption depends on its storage as shown in the table.

Storage Full term Pre-term

Room temperature 8-10 hours 4 hours
refrigerator 48 hours 24 hours
freezer 3 months 3 months
Deep freezer 6 months N/A

Table 1 – Storage of Expressed Breast Milk

In feeding expressed breast milk:

a. Place the container in a bowl of warm water if the milk needs to be warmed. Do not heat on the
stove, over a direct fire, or in a microwave oven.

b. Warm only the amount of milk that will be used at one feeding. Milk cannot be saved once it has
been warmed.

c. The fat may separate out in small globules. Gently shake it to re-combine the fat with the rest of
the liquid.

d. Feed the milk to the baby with a cup. A spoon may be used for small amounts.

Reference:

Community Health Nursing: An Approach to Families and Population groups, Rodolfo et al.