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I.INTRODUCTION
introduce Listening
the topic Flash
The nature has designed the provision that infants
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be feed upon their mother’s milk. They find their
food and mother at the same time. It is a
complete nourishment for them both for their
body and soul. Breastfeeding is the most effective
way to provide a baby with a caring environment
and complete food. It meets the nutritional well as
emotional and psychological needs of the infant.
Breastfeeding is now an endangered practice
around the world, in both rich and poor countries.
There is unanimous agreement on the need for,
and the route to, global support for breastfeeding
through various approaches and programs. Baby
Friendly Hospital Initiative is one of the
important interventions towards that goal.

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II.ADVANTAGES OF BREASTFEEDING

Breastfeeding is safest, cheapest and best

protective food for infants. Superiority of human
milk is due to its superior nutritive and protective
value. It is perfect food for infants and provides
total nutrient requirements for the first six months
of life. When combined with appropriate weaning
foods, it is an invaluable source of nourishment
until past the second birth day. It prevents
malnutrition and allow the child to develop fully.

1. Nutritive Value: Breast milk contains all

the nutrients in the right proportion which
are needed for optimum growth and
development of the baby up to 6 months. It
is essential for brain growth of the infant
because it has high percentage of lactose

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and galactose which are important

2. Imin
components of galactocerebroside. It
facilitates absorption of calcium which
helps in bony growth. It contains amino
acids like taurine and cysteine which
important as neurotransmitters. Breast milk
fats are polyunsaturated fatty acids which
are necessary for the myelination of the
nervous system. It has vitamins, minerals,
electrolytes and water in the right
proportion for the infant which are
necessary for the maturation of the
intestinal tract. It provides 66 calories per
100 ml and contains 1.2 g protein, 3.8 g fat,
7 g lactose and vitamin A 170 to 670 IU,
vitamin ‘C’ 2 to 6 mg, vitamin D 2.2 IU,
calcium 35 mg, phosphorus 15 mg in 100

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3.
ml, The total amount of milk secretion per
day is about 600 to 700 ml, which is
sufficient for the baby. Its composition is
ideal for an infant. It provides specific
nutrition for preterm baby in preterm
delivery.
2. Digestibility: Breast milk is easily
digestable. The protein of breast milk
mostly lactoalbumin and lactoglobulin
which form a soft curds that is easy to
digest. The enzyme lipase in the breast
milk helps in the digestion of fats and
provides free fatty acids.
3. Protective Value: Breast milk contains
IgA, IgM, macrophages, lymphocytes, bifidus
factors, unsaturated lactoferrin, Iysozyme,

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4.
complement and interferon. Thus breastfed body
less likely to develop infections especially
gastrointestinal and respiratory tract infections,
e.g. diarrhea and ARI. It also provides protection
against malaria and various viral and bacterial
infections like skin infections, septicemia, etc.
4. Psychological Benefits: Breastfeeding
promotes close physical and emotional bondage
with the mother by frequent skin to skin contact,
attention and interaction. It stimulates
psychomotor and social development. It leads to
better parent child adjustment, fewer behavioral
disorders in children and less risk of child abuse
and neglect. Breastfeeding promotes development
of higher intelligence and feeling of security in
infant.

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5. Maternal Benefits: Breastfeeding reduces
the chance of postpartum hemorrhage and
helps in better uterine involution.
Lactational amenorrhea promotes in
recovery of iron stores. It can protect from
pregnancy for first 6 months if exclusive
breastfeeding is carried out. Breastfeeding
improves metabolic efficiency and
satisfaction with sense of fulfillment of the
mother. It reduces the risk of breast and
ovarian cancer of the mother. It improves
slimming of the mother by consuming
extra fat which accumulated during
pregnancy. It is more convenient and time
saving for the mother. It is more
convenient and time saving for the mother.
Mother can provide fresh, pure,

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 readymade,

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clean uncontaminated milk to her baby at
right temperature without any preparations.
Mother feels comfortable to feed the baby
especially at night.
6. Family and Community Benefits:
Breastfeeding is economical in terms of saving of
money, time and energy. Family has to spend less
on milk, health care and illness. Community
expenditure on health care and contraception are
reduced. It is economic for the families, hospitals,
communities and for countries.

III.INITIATION OF BREAST FEEDING

Breastfeeding should be initiated within first half

an hour to one hour of birth or as soon as

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 possible. It should also be initiated within one
hour even after cesarean section delivery, if the

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mother and baby, both are having no problem.

Early suckling provides warmth, security and
colostrum, the baby s first immunization.
Although little in amount, the first milk,
colostrums, is most suitable and contains a high
concentration of protein and other nutrients, the
baby needs. It is rich in anti-infective factors and
protects the baby from respiratory infections and
diarrheal diseases.

Mothers should be demonstrated about the

techniques of breast feedings. Rooming-in or
bedding-in should be done with infant and mother
as soon as possible to prevent separation. Mother
should be advised for exclusive breastfeeding up

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 to 6 months and as demand feeding.

No food or drink other than breast milk should be

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given to neonates. No water, glucose water,

animal milk, gripe water, indigenous medicines,
vitamins and minerals drops or syrup should be
given. No bottle and pacifier are allowed.

In case of preterm babies or sick babies, being in

special care unit, they should be fed with
expressed breast milk. Nursing staff is
responsible to ensure that nothing except breast
milk is given. Mother should be instructed to
assess the indicators of adequacy of breastfeeding
and importance of increasing her own dietary
intake with extra 550 cal and to drink fluids in
response to her thirst. Rest and relaxation of
mother are important for recovery from delivery
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 and successful lactation in postnatal period.

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IV.COMPOSITIONS OF BREAST MILK

 Colostrum

Colostrum is the golden-yellow milk secreted

during the first three days after delivery. It is
yellow and thick and contains more antibodies
and white blood cells. Though secreted in small
quantities, it is hither protein content and is most
suited to serve the nutritional and immunological
needs of the baby. It is loaded with protective
secretory immunoglobulins and virtually works
like a “first vaccine shot” for the baby by
blocking the entry of pathogenic bacteria through
the gut. It should never be discarded and is
indeed the ideal first meal of the baby.

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  Transitional milk

It follows the colostrum and secretes during first

two weeks of postnatal period. It has increased fat

10 and sugar content and decreased protein and

immunoglobulin content
 Mature milk

It is secreted usually from 10 to 12 days after

delivery. It is watery but contains all nutrients for
optimal growth of the baby
 Hind milk

It is secreted towards the end of regular

breastfeeding and contains more fat and energy.
The mother should feed the baby allowing one
breast to empty to provide both fore milk and
hind milk, before offering other breast. For
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 optimum growth, the baby needs both fore as well
as the hind milk. The baby should therefore be

allowed to empty one breast completely before

being put on to the other breast

 Fore milk

Fore milk secreted at the starting of the regular

11 breast feeding. it is more watery to satisfy the
baby’s thirst and contains more proteins, sugar,
vitamins and minerals

 Preterm milk

The milk of a mother who delivers prematurely

contains more calories, higher concentration of
fat, protein and sodium which are needed by her
preterm baby. The concentrations of lactose,
calcium and phosphorus are lower as compared to
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milk produced by mothers of term infants.
During next 2-3 weeks, the composition of milk

gradually changes and assumes composition akin

to mature milk.

d.Establishment of Lactation

The motivation and preparation for breast

feeding should begin during antenatal period.
Awareness, willingness, keenness and confidence
on the part of mother are crucial for successful
establishment of lactation. Early bonding soon
after delivery promotes breast feeding. Healthy
infant should be roomed-in with the mother and
should never separate from the mother by keeping
him in the nursery. Early breast feeding in all

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babies. irrespective of the mode of delivery, and
avoidance of prelacteal and prolacteal feeds are
essential to establish successful breast feeding.

V.MANUAL BREAST MILK EXPRESSION

Manually expressing breast milk can

enhance milk production and ensure an adequate
supply. It’s especially helpful for mothers who
have problems with engorgement or those who
must be away from their infants for several hours.
(A mother who works outside the home or is
away on a regular basis may find and electric
pump quicker and more efficient.)

To help the mother manually express breast milk,

follow these steps:

 Make sure that a clean collection container

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is available and that you and the patient have
washed your hands.
 Explain the procedure to the patient, have
her sit in a comfortable position, and provide

privacy.
 Tell her to place her dominant hand on one
breast with the thumb positioned on the top and
the fingers below and at the outer limit of the
areola.
 Instruct her to press her thumb and fingers
inward toward her chest while holding the
collection container with her opposite hand
directly under the nipple.
 Tell the patient to move her thumb and
fingers forward, using a gentle pressure in a
milking type motion. Caution her not to use too
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 much pressure because this can injury to breast
tissue. Milk should flow out of the nipple and
into the collection container.
 Encourage the patient to move her thumb

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and fingers around the breast, using the same

motion, to ensure complete emptying.
 Advice the patient to cover the container
and place the milk in the refrigerator if it will be
used within 24 hours; if not, she should freeze it.

VI.CONTRAINDICATIONS OF BREAST
FEEDING
The true contraindications of breastfeeding are
galactosemia and phenylketonuria. Maternal
conditions which can be considered as ‘REAL’
contraindications are Radiotherapy, Ergot
therapy, Antimetabolites therapy and Lithium
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therapy. Maternal illness should not result in
interruption of breastfeeding. Expressed breast
milk (EBM) can be given to the baby, whenever
needed, from the mother or mother’s substitute.

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CONTENT

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