VENKETESHWAR COLLEGE OF NURSING

UDAIPUR

DEMONSTRATION -

BREAST FEEDING POSITION

SUBMITTED TO SUBMITTED BY

Mrs. Geetanjali Sharma Miss. Nanne Dhakar

HOD , Obstetrics and Gynaecology M.Sc Nursing Final Year

Submitted On :
 Demonstartion On

TECHNIQUES AND POSITIONS OF BREAST FEEDING:-

SL. SPECIFIC DURA CONTENT TEACHING A.V.AIDS EVALUATION

NO. OBJECTIVES TION LEARNING
ACTIVITY
1. To introduce 2 min. Introduction:- Lecture
the topic. The two vital considerations for the infants in the tropical cum
countries are breast feeding and avoidance of infection. Breast discussion
feeding is most effective and most important way to provide a baby
with a carrying environment and complete food.
It must the nutritional as well as emotional and psychological
need of the infant. So breast feeding deserves in the welfare of
children.
All the babies regardless of the type of delivery should be
given early and exclusive breast feeding upto 6 months of age.

2. To define the 2 min. Definition:-

breast Breast feeding:- Lecture PPT What is the
feeding. Breast feeding is the best natural feeding and breast milk is cum definition of
best milk. The basic food of infant is mother’s milk. discussion breast feeding
and exclusive
Exclusive breast feeding:- breast
Exclusive breast feeding means giving nothing other than feeding?
colostrums and breast milk.

3. To describe 5 min. Advantages of breast feeding:- Lecture PPT What are the
the Breast feeding is a safest, cheapest and best protective food cum advantages of
advantages of for infants. discussion breast
breast The advantages of breast feeding are as follows:- feeding?
feeding. A. Nutritive value:-
1. Breast milk contains all the nutrients in the right proportion
which are needed for optimum growth and development of the
baby upto 4 -6 months.
2. It is essential for brain growth of the infant because it has high
percentage of lactose and glactose which are important
component of galactocerebroside.
3. It facilitates absorption of calcium which helps in bony growth.
4. It contains amino acid like taurine and systeine which are
important as neurotransmeters.
5. Breast milk fats are polyunsaturated fatty acid which are
necessary for the myelination of the nervous system.
6. It has vitamins , minerals, electrolytes and water in the right
proportion for the infant which are necessary for the
maturation of the intestinal tract.
7. It provide specific nutrition for preterm baby in preterm
delivery.

B. Digestibility:- Lecture
1. Breast milk is easily digestible. cum PPT
2. The protein of the breast milk are mostly lactoalbumin and discussion
lactoglobulin which form a soft curds that is easy to digest.
3. The enzyme lipase in the breast milk helps in the digestion of
fats and provides free fatty acids.

C. Protective value:- Lecture

1. Breast milk contains IgA, IgM, macropphagus, lymphocytes, cum PPT
bifidus factures, unsaturated lactoferin, lysozyme, component discussion
and interferon.
2. Thus breast fed baby less likely to develop infections
especially gastro intestinal and respiratory tract infections, e.g.
diarrhea and ARI.
3. It also provides protection against malaria and various viral
and bacterial infections like skin infections, septicemia etc.
4. Breast feeding protects the infant from allergy and bronchial
asthma.
5. It also protects against neonatal hypoglycemia,tetany,
necrotizing enteroclitis, deficiences of vitamin E and zinc,
neonatal convulstions and sudden infant death syndrome.
6. Exclusive breast feeding baby has less chance of developing
malnutritions, hypertension, diabetes mellitus, coronary artery
disease, artetiosclerosis, ulcerative colitis appendicitis, child
hood lymphoma, liver disease, celiac diseases, and dental
caries.
 D. Psychological benefits:- Lecture
1. Breast feeding promotes close physical and emotional cum PPT
bondage with the mother by frequent skin to skin contact, discussion
attention and interaction.
2. 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.
3. Breast feeding promotes development of higher intelligence
and feeding of security in infant.

E. Maternal benefits:-
1. Breastfeeding reduces the chance of postpartum hemorrhage
and helps involution.
2. Lactational amenorrhea promotes in recovery of iron stores.
3. It can protect from pregnancy for first 6 months if exclusive
breast feeding is carried out.
4. Breast feeding improves metabolic efficiency and satisfaction
with sense of fulfillment of the mother.
5. It reduces the risk of breast and ovarian cancer of the mother.
6. It improves slimming of the mother by consuming extra fat
which accumulated during pregnancy.

F. Family and community benefits:-

1. Breast feeding is economical in terms of saving of money time
and energy.
2. Family has to spend less on milk, health care and illness.
3. Community expenditure on health care and contraception are
reduced.
It accompanies for the families, hospitals, communities
and for countries.

4. To enlist the 2 min. Compositions of colostrums and breast milk:- Lecture What are the
composition of Protein Fat CHO Water cum PPT composition of
colostrums Colostrum 8.6% 2.3% 3.2% 86% discussion colostrums
and breast Breast 1.2% 3.2% 7.5% 87% and breast
milk. Milk milk?
5. To explain 3 min. Management of breast feeding:- Lecture Explain the
about the Antenatal preparation:- cum PPT management
management 1. The preparation for breast feeding should actually be started discussion of breast
of breast from the middle of pregnancy. feeding?
feeding. 2. Any abnormalities in the nipple, like cracked or depressed
nipple should be adequately treated.
3. Massaging the breast, expression of the colostrums and
maintenance of cleanliness should be carried out during the
last four weeks of pregnancy.
4. The patient are to be counseled about the advantages of
breast feeding and be encouraged to breast feed.
5. The modern practice is to reduce nipple cleaning to a
minimum and to wash the breast once daily.
6. Teach the mother about the breast care and breast feeding
techniques . such as:-
 A clean supporting brassiere should be worn.
 The mother wash her hands prior to feeding.
 Mother and the baby should be in a comfortable
position during feeding.

First feed:-
1. In the absence of anatomical or medical complications, a
healthy baby is put to the breast ½ - 1 hour following normal
delivery.
2. Following cesarean section a period of 4-6 hours may be
sufficient for the mother to feed the baby.

6. To tell about 3 min. Frequency of feeding:-

the frequency Time schedule:- Lecture PPT
of feeding.  during the first 24 hours , the mother should feed the baby at cum
an interval of 2-3 hours. discussion
 Gradually the regularity becomes established at 3-4 hours
pattern by the end of first week.
 Baby should be fed more on demand.

Demand feeding:-
The baby is put on the breast feeding as soon as the baby
becomes hungry . there is no restriction of the number of feeds and
duration of suckling time.

Duration of feed:-
 The initial feeding should last for 5- 10 min. at each breast.
This helps to condition the let down reflexes.
 Thereafter, the time spent is gradually increased.
 Baby is fed from one breast completely so that baby gets both
the foremilk and the hindmilk. Then the baby is put to the
other breast if required.
 Hind milk is richer in fat and supplies more calories to the
infants.
 The next feed should start with the second breast.
What is
Night feed:- frequency
1. In the initial period a night feed is required to avoid ling feeding?
interval between feeds of over 5 hours.
2. It not only eliminates exessice filling and hardening of the
breast but also quietens and ensures sound sleep for the
baby.
3. However, as the days progress, the baby becomes satisfied
by the rhythmic 3-4 hourly feeding.

Amount of food:-
1. The average requirements of milk is about 100ml/kg/24hours
on 3rd day and increased to 150ml/kg/24 hours on the 10 th
day.
However the baby an take as much as he wants.
2. In dry tropical areas, specially for the first few days, additional
fluids may be given after each feed to correct dehydration in
the form of boiled water.

Amount of feeding Term normal baby Preterm baby

Day 1 60 ml/kg/day 90 ml/kg/day
Day 2 70 ml/kg/day 100 ml/kg/day
Day 3 80 ml/kg/day 110 ml/kg/day
Day 4 90 ml/kg/day 120 ml/kg/day
 Day 5 100 ml/kg/day 130 ml/kg/day
Day 6 110 ml/kg/day 140 ml/kg/day
Day 7 120 ml/kg/day 150 ml/kg/day
Day 8 130 ml/kg/day 160 ml/kg/day
Day 9 140 ml/kg/day 170 ml/kg/day
Day 10 150 ml/kg/day 180-200 ml/kg/day

On adequate feeding there will be weight gain of 20-30

gm/day.
Fortification of mother’s milk necessary in LBW<1.5 kg and 34
weeks of gestation.

7. To 10 Positions of breast feeding:- Demonstrati Video What are the

demonstrate min. 1. The cradle position:- on positions of
the positions  The cradle position is most commonly used after the first few breast
of breast weeks and gives you the most control of your baby. feeding?
feeding.  Your baby should be lying on his side, resting on his shoulder
and hip with his mouth level with your nipple.
 Use pillows to lift your baby and support your elbows so that
you can bring your baby up to nipple height.
 This is especially important during the first few weeks.
 Support your breast whole your baby’s head is on your
forearm.
 His back will be along your inner arm and palm.
 When you look down , you should see his side and his mouth
should be covering at least a half inch of the dark area around
your nipple.
 pBe sure his ear, shoulder, and hips are in a straight line.
 As a newborn , your baby’s head and bottom should be level
with each other.
To 2. The cross cradle position:- Demonstrati Video
demonstrate  This variation of cradle position involves your baby being on
the cross supported on a pillow across your lap to help raise him to your
cradle nipple level.
position.  Pillows should also supported both elbows so your arms don’t
hold the weight of the baby or they will tired before the feeding
is finished.
 If you are preparing to breast feed on the left breast, your left
hand supports that breast and you support your baby with the
fingers of your right hand.
 Do this by gently placing your hand behind your baby’s ear
and neck with your thumb and index finger behind each ear.
Your baby’s neck rests in the web between the thumb, index
finger and palm of your hand, forming a ‘second neck’ for
baby.
 The palm of your hand is placed b/w his shoulder blades.
 As you prepare to latch your baby on , be sure his mouth is
 very close to your nipple.
 When baby opens his mouth wide, you push with the palm of
your hand from between the shoulder blades. His mouth will
be covering at least a half inch from the base of your nipple.

To 3. Clutch position/ the football hold:- Demonstrati Video

demonstrate  This is an ideal position for women who have just had a on
the clutch / cesarean birth, since it keeps the child away from your
football hold incision. It is also used in situation when the mother has a
position. more forceful milk ejection because it allows the child to
handle the increased flow more easily.
 For this position you should support your baby’s head in your
hand and his back along your arm beside you. Your child
should be facing you, with his mouth at nipple height . your
baby’s legs and feet are tucked under your arm with his hips
flexed and his legs resting alongside your back.
 The soles of his feet are pointed toward the ceiling (this keeps
him from being able to push against your chair.) pillows will
help bring the baby to correct height.
To 4. Side lying position:- Demonstrati Video
demonstrate  This is a comfortable position , especially at night or when you on
the side lying are feeling tired.
position.  With this position , both mother and baby lie on their sides
facing each other.
 You can use pillows behind your back and behind or between
your knees to help get comfortable.
 A pillow or rolled blanket behind the baby’s back will keep him
from rolling away from you.
 The baby can be cradled in your arm with his back along your
forearm.
 Having his hips flexed and his ear, shoulder and hip in one
line helps your baby get milk more easily.
 Some mothers find that practicing with this position during the
day time is very helpful.
8. To 5 min. Preparation and position of the baby:-
demonstrate  The baby’s immediate preparation for breast feeding is to Demonstrati Video What are the
the position of have a clean , dry diaper and if necessary , to be swaddle on position of the
the baby. wrapped. baby during
 Swaddle wrapping when properly done, may be comforting breast
rather than confining to babies because they feel held close feeding?
and secure rather than bound.
 The wrapping is to be loose enough for freedom of motion of
the legs. What has to be achieved is control of waving arms.
 For new mothers who needs this initially, it will be just a few
feeding before they can cope without swaddle wrapping their
baby.
 Position the baby so that he/she will not be doubled up or
have a twisted neck when sucking and that the head and body
are supported.
 In bringing the baby and breast together , the following are
helpful:-
 let the baby find the breast and grasp the nipple. Do not
 thrust the breast in the baby’s mouth, as this is frightening
to the baby.
 Help the mother learn to hold her breast in such a way as
to guide and control the breast and facilitate the baby’s
grasping of it.
 Touch the baby’s cheek with the nipple so the baby will
turn towards the breast (use of rooting reflex).
 Express a few drops of colostrums /milk so they are on
the surface of the nipple . this provides the baby with
instant gratification and reinforces learning.
 As the baby grasp the nipple , the mother must make
sure that the infant has enough of it for proper positioning
in the mouth . the baby must grasp more than just the
end of the mother’s sinuses located beneath the areola
with his gums when sucking in order to obtain colostrums
or milk. The sequence of movements of compression
sucking and swallowing in rhythmic and the mother can
feel a steady pull.
 Once the baby’s mouth is properly positioned well on to
the areola, the mother releases her grasp of her breast.
She now provides breathing space for the baby if needed
by pressing with a finger on her breast where the baby’s
nose is. This may be needed during the learning period
only.
 Breast Nipple
suckling sucking

9. To enlist the 3 min. Contraindications of breast feeding;- Health Charts What are the
contraindicatio 1. HIV/AIDS. education. contraindicatio
ns of breast 2. Drugs used for cancer, certain hormones and radioactive ns?
feeding. isotopes.
3. Chronic medical illness, such as de compensated organic
heart lesions and pulmonary tuberculosis.
4. Puerperal psychosis.
5. Women receiving high dose antiepileptic , anti coagulant and
anti-thyroid drugs.
6. Breast feeding may be suspended when the mother is treated
with metronidazole and chloramphenical.
10. To enlist the 2 min. Difficulties in breastfeeding:-
difficulties in 1.difficulty due to mother:- Health Charts What are the
breast  Inadequate supply of milk. education. difficulties in
feeding.  The baby who will not suck. breast
 Sore, tender nipples. feeding?
 Traumatized, painful nipples.
 Engorgement.
 Plugged ducts.
 Mastitis.
 Blistered nipples.
  Poor attachments of breast.
 Short nipple.
 Abnormal large nipple.
 Inverted and flat nipples.

2.diffuclty due to baby:-

 Low birth weight baby.
 Temporary illness such as cerebral irritation, RTI, nasal
obstruction.
 Over-distention of the stomach with swallowed air.
 Cleft palate.
 Underfeeding and overfeeding.

Summary:-
In this demonstration I dealt with following points:-
1. Introduction.
2. Definition of breast feeding and exclusive breast feeding.
3. Advantages of breast feeding.
4. Composition of colostrums and breast milk.
5. Management of breast feeding.
6. Positions of breast feeding.
7. Contraindications of breast feeding.
8. Difficulties in breast feeding.
Bibliography:-

1. Diane M. Frasser, Margaret A. Cooper, Myles textbook for midwives; 14 th edition , h. 40 ; feeding, page no. 749-765.
2. D.C. Dutta; textbook of obstetrics; 6th edition, ch.30 , the term newborn infant, page no. 450-454.
3. Annamma Jacob; a comprehensive textbook of midwifery; 1 st edition ; ch; 41. Infant feeding, page no. 485-494.
4. Neeraj jain; vibha mangal jain; essential of newborn care, ch; 18 ; feeding and nutrition. Page no. 126-135.
5. Ronald S. Illing worth; the normal child, 10 th edition; ch.11- breast feeding; page no.137-141.
 DEMONSTRATION ON:-

TECHNIQUES AND POSITIONS OF BREAST FEEDING

NAME OF STUDENT : Mr. Ravin K. Bishnoi

NAME OF EVALUATER : MS. M. V. Christie

VENUE : Postnatal ward

GROUP : postnatal mothers

No. OF PERSON : 12

DURATION : 1 HOUR

DATE AND TIME :

MATHOD OF TEACHING : LECTURE AND DISCUSSION

A.V. AIDS : video, ppt, charts.

PREVIOUS KNOWLEDGE:-

Postnatal mothers have little previous knowledge regarding the

techniques and positions of breast feeding.

GENERAL OBJECTIVE:-

At the end of the demonstration the postnatal mothers will be able to

gain knowledge about the techniques and positions of breast feeding

SPECIFIC OBJECTIVES:-

At the end of the demonstration , postnatal mothers will be able to:-

1. To introduce the topic.

2. To define breast feeding and exclusive breast feeding.
3. To enlist the advantages of breast feeding.
4. To tell the composition of colostrums and breast milk.
5. To explain the management of breast feeding.
6. To demonstrate the positions of breast feeding.
7. To enlist the contraindications of breast feeding.
8. To describes the difficulties in breast feeding.