TIME SPECIFIC CONTENT TEACHER LEARNER’S EVALUATION

OBJECTIVES ACTIVITY
3min To introduce the topic. INTRODUCTION
Breast care during
pregnancy is very
important not only to
prepare the mother
physically and
psychologically for
breast feeding but also to
begin or to continue
regimen of regular breast
self examination. It
begins with educating
the woman regarding
advantages of breast
feeding. To give the
women confidence the
midwife should advice
her regarding preparation
for and general
management of breast
feeding. This will help
the woman to know how
to handle breasts, how it
will feel to have an
infant sucking and how
to express milk. It also
helps to toughen the
nipple and thus prevents
soreness of nipple during
feeding. This time can
also be utilized to teach
 the importance of good
nutrition during breast
feeding. Midwife must
record any previous
experiences of breast
feeding.

ANNOUNCEMENT
OF THE TOPIC
Today I am going to
demonstrate the
procedure of Breast
Care.

2min To define the breast BREAST CARE Student teacher will be Define breast care.
care. Breast care, including promotion of lactation able to define the breast
and nursing of child is one of the underlying care by the method of
principles in the management of normal lecture cum discussion
puerperium.
DEFINITION
Breast care is the care of breast during
puerperium to promote lactation and to
prevent complications.

3min To enlist the purpose of PURPOSES Student teacher will able Enlist the purpose of
breast care.  To clean the breast of dirt and bacteria. to enlist the purpose of breast care?
 To prevent gastrointestinal tract breast care by adapting
infection to the baby. lecture cum discussion
 To promote lactation. method.
 To ensure hygienic breast feeding.
 To prevent complications like breast
engorgement, nipple
Soreness.

2min To list out the indications
of breast care.
3min To describe the
principles of breast care.
10min To enumerates the steps
of procedure.
 To provide health education regarding
breast feeding, new born care, postnatal.
INDICATIONS Student teacher will able List out the
 Postnatal mothers to list out the indication indications of breast
 Breast engorgement of breast care by care?
 Cracked nipple adapting the lecture cum
 Retracted nipple discussion method.
 Failure of lactation
PRINCIPLES Student teacher will Describe the principles
 Before giving feed to the baby clean describe the principles of of breast care.
breast with plain water to prevent GI breast care by adapting
tract infection to the baby. lecture cum discussion
 After breast-feeding the baby, clean the method.
breast with plain water to prevent crust
formation around the nipple. Crust
formation leads to the blockage of nipple
opening.
 Cleaning should be done from outer to
inner, from cleanest area to less cleanest
area to prevent infection.
 Remove the soap completely to avoid
the drying effect of soap residue left on
the
 Do not apply soap over the nipple. soap
removes natural oil from the areola
which makes the nipple to become
cracked.
PROCEDURE Student teacher will be Enumerates the
Preliminary Assessment: able to enumerates the procedure of breast
 Assess the condition of breast preliminary assessment care.
 Assess the patient's ability for self care of the breast care
 Assess the positioning and attachment procedure by adapting
during breast feeding. lecture cum discussion
  Check for any retracted nipple. methods & demonstrate
Preparation of articles the procedure.
ARTICLES RATIONALE
 A screen To provide
privacy to the
patient.
 A draw To prevent
containing soiling of linen.
mackintosh
with draw
sheet.
 A bowel To clean the
containing breast.
clean cotton
swabs soaked
in plain
water.
 A clean bowl To remove the
with soap dirt from the
swabs. skin.
 A bowl To dry the skin.
containing
gauze piece.
 Kidney tray To discards the
and paper wastes.
bag.
2min To explain preparation of PREPARATION OF PATIENT Student teacher will be Explain preparation of
the patient.  Explain the patient regarding the able to explain the the patient during
sequence of procedure. preparation of the patient breast care?
 Bring the patient to the edge of the bed by conducting the
nearer to the nurse to prevent over demonstration.
reaching.
 Provide comfortable position to the
 patient-sitting position.
 Assemble equipments at the bed side.
 Provide privacy by means of screen
10min To enumerates the steps PROCEDURE RATIONALE Student teacher will be Enumerates the steps
of procedure of breast  Wash hand To prevent cross able to enumerates the of procedure of breast
care. infection. steps of procedure in care.
 Spread the To prevent soiling of breast care during
mackintosh linen. demonstration.
with draw
sheet after
exposing the
left breast.
 Clean the Cleaning is done
breast using from cleanest to less
wet cotton clean areas to
swabs from prevent spread of
outer to inner. infection.
 Apply soap on soap removes dirt
the breast and cleanses the
using soap skin.
swabs excepts
over the
nipple.
 Take the wet Remove the soap
cotton swabs completely to avoid
and clean the the drying effect of
area where the residue left on the
soap is skin.
applied.
Repeat the
procedure till
the area is
cleansed
 thoroughly.
 Dry the breast
thoroughly
with gauze
pieces.
 Clean the Applying soap on
nipple with the nipple can cause
wet cotton nipple soreness.
swabs.
 Observe for Helps in early
any management
complications complications.
like breast
engorgement,
cracked nipple,
retracted
nipple.

 Repeat the
same
procedure on
the right
breast.
 Instruct the Helps in preventing
patient to wear breast engorgement.
supportive
brassieres.
3min To explain the Importance of massaging the breast Student teacher will be Explain the importance
importance of the before and after feeding: explain the importance of breast care.
breast care.  Before breast feeding massaging the of breast care by the
breast will ease the flow of milk into the method of lecture cum
mouth of the baby and after feeding discussion methods.
massaging the breast will prevent
 engorgement.
Importance of expression of milk
after each feed:
After each feed, if there is any excess milk
because of improper sucking due to
premature baby, congenital anomalies like
cleft lip and cleft palate and jaundiced baby
and increased milk secretion, express the
milk manually in a cup and feed the baby to
prevent milk stasis with in the breast and to
increase milk secretion.
Procedure:
 Place the thumb and forefingers on
opposite sides of the breast just around
the areola and press downward into the
ribcage.
 Gently squeeze together and downward.
 The nipple should not be pulled
outward. Repeat the procedure moving
the thumb and forefinger around the
nipple as much milk as desired has been
expressed

Hoffman's maneuver
Hoffman’s maneuver makes flat or inverted
nipple to become more effective. The nipple
becomes erect with tactile stimulation from
the thumb and opposite forefinger in
horizontal plane. This procedure helps to
break adhesions in the nipple base and
makes it more suitable for grasping by the
baby during feeding.
 After care of the patient:
 Make the patient comfortable.
 Take the opportunity to teach the patient
about breast feeding, newborn during
breast care and postnatal wash hands.
Record the procedure in nurse’s record
regarding all observations made.
 After care of articles.
 Take al articles to the utility room, clean
with soap and water.
 Dry them and replace at their respective
places.
5min To explain the problems PROBLEMS IN BREAST Student teacher will be Explain the problems in
in breast feeding. FEEDING: able to explain the breast feeding.
 Inverted nipple or retracted nipple problems of breast
makes attachment to the breast difficult. feeding by adapting the
 Treatment is started soon after the birth lecture cum discussion
of the baby. The nipple is manually methods.
stretched and rolled out several times a
day. A pump or plastic syringe is used to
draw out the nipple and the baby is put
to breast.
Sore nipple:
 A sore nipple is caused by incorrect
attachment of the baby to the breast.
Frequent washing with soap and water,
pulling the baby off the breast while
she's still sucking may also result in a
sore nipple.
 Treatment consists of correct positioning
and latching of the baby to the breast.
Hind milk should be applied to the
nipple after a feed and the nipple should
 be aired and allowed to heal in between
feeds.
Breast engorgement
 Breast becomes swollen, hard, warm and
painful due to the accumulation of milk
in the alveoli. it is caused by delayed or
infrequent feeding or fi the baby is not
well positioned at the breast.
 Breast engorgement can be prevented by
early and frequent feeds and correct
attachment of the baby to the breast.
 Treatment consists of local warm water
packs, and analgesics to the mother to
relieve pain. Milk should be gently
expressed to soften the breast and then
the mother.
1min To summarize the topic. SUMMARY
The care of breast is
outmost importance to
women in both antenatal
and postnatal period. It
should be taken care of
with caution without any
risk of causing injuries to
the organ.
1min To conclude the topic. CONCLUSION
This demonstration
includes the definition of
breast, indication and
purpose of the breast,
principles, general
instruction and steps of the
procedure, preparation of
 the patient during breast
care and importance of the
breast care, problems in
breast care
BIBLIOGRAPHY
 Myles textbook for midwives,
 Publisher- Elsevier science,
 Editor –Diane M. Fraser & Margaret A.
Cooper, Foreword by-Gillian Fletcher,
 14th edition. Page no-365,221,29