BREASTFEEDING

BREASTFEEDING
is the feeding a neonate/infant
with breast milk directly from
female human breasts (i.e., via
lactation) not from a baby bottle
or other container.
RA 7600
“THE ROOMING-IN AND BREAST-FEEDING ACT OF 1992”
national policy to encourage, protect the practice of
breastfeeding.

RA 10028
“THE EXPANDED BREASTFEEDING PROMOTION ACT OF 2009”
An act expanding the promotion of breastfeeding, amending for
the purpose republic act no. 7600

THE PHILIPPINE MILK CODE OF 1986 OR E.O.51

Regulates the marketing of infant milk formula
 LACTATION
ANATOMY AND PHYSIOLOGY
Breast enlargement
• During pregnancy and lactation indicates the
mammary glands are becoming functional
• Breast size before pregnancy does not
determine the amount of milk a woman will
produce
 LACTATION
ANATOMY AND PHYSIOLOGY
• Hormones during pregnancy
• Estrogen stimulates the ductile systems to
grow, then estrogen levels drop after birth
• Progesterone increases the size of alveoli
and lobes
• Prolactin contributes to increasing the breast
tissue during pregnancy
 LACTATION
ANATOMY AND PHYSIOLOGY
• Alveoli secrete milk and contract when
stimulated
• Oxytocin stimulates milk secretion and is
released during the ‘let down’ or milk ejection
reflex
• After let down, milk travels into the ductules,
then to the larger – lactiferous or mammary
ducts
 LACTATION
ANATOMY AND PHYSIOLOGY
• Hormones during breastfeeding
• Prolactin levels rise with nipple stimulation
• Alveolar cells make milk in response to prolactin
when the baby sucks
• Oxytocin causes the alveoli to squeeze the newly
produced milk into the duct system
 LACTATION
ANATOMY AND PHYSIOLOGY
Latch On and sucking

Oxytocin Release

Releases Milk

Infant Empties Breast

Production Increases

Milk Production Occurs

Interference with this cycle decreases the milk supply.

HOW LONG TO BREASTFEED
Newborns can nurse for 5 to 10 minute per breast; every 2 to 3 hours. This
comes to about 10 to 12 feedings per day. In the beginning, there is only
Colostrum, and there’s not very much of it, so be ready to feed often but
for short durations.

One month or more: as baby gets older, his stomach will get larger. He will
nurse less frequently but for a longer duration at each feeding session. For
example, he may nurse 20 to 40 minute per breast every 3 to 4 hours.

By 6 months, Baby may breastfeed for 20 to 40 minutes per breast; 3 to 5

times per day.
 TYPES AND COMPOSITION OF HUMAN
BREAST MILK
COLOSTRUM or Early Milk is produced in the late stage of
pregnancy till 4 days after delivery; and is rich in antibodies.

TRANSITIONAL MILK produced from day 4 – 10 is lower in

protein in comparison to Colostrum.

MATURE MILK is produced from approximately ten days after

delivery up until the termination of the breastfeeding.
BREAST FEEDING BENEFITS
B- BONDING PROMOTION
R- RESISTANCE INCREASES

E- ECONOMICAL
A- ALLERGIC FREE
S- SAVE TIME
T- TIMELY
F- FAMILY PLANNING(LAM) LACTATION AMENORRHEA
METHOD
E- ERROR IN FREE FORMULA

E-EASY TO DIGEST
D- DIARREHA PREVENTION
I- INEXHAUSTIBLE SUPPLY
N- NO VITAMINS
G- GUARANTEED FRESH AND FREE
 BREASTFEEDING
INFANT HEALTH BENEFITS

• COLOSTRUM
• Small amount for the immature digestive system
• ‘paints’ the digestive tract
• Low fat for easy digestion
• Contains mothers antibodies which boost
infants’ immune system
• Acts as a laxative to ease passage of meconium
 BREASTFEEDING
INFANT HEALTH BENEFITS
• The milk comes in
• Transitional milk for up to 2 weeks
• May still have yellow appearance
• Amounts increase quickly as infant hungers and digestive
system matures
• Mother's" milk making” changes from endocrine to
autocrine system
• Mature milk
• Supply/demand system engorgement decreases
• Properties of fore milk and hind milk present
INFANT HEALTH BENEFITS
OF BREASTFEEDING
•Lower risk of
•Diarrhea
•Constipation
•Infections
•Ear, respiratory, meningitis, urinary
tract
•SIDS
•Allergic diseases
•Chronic digestive diseases
•Juvenile onset diabetes
•Acute leukemia
•Adult obesity
 INFANT HEALTH BENEFITS
OF BREASTFEEDING
• Provides immunologic protection while
the infant’s immune system is maturing
• Antimicrobial agents
• Anti-inflammatory agents
• Immunomodulating agents
INFANT HEALTH BENEFITS OF
BREASTFEEDING
• Preterm Infants
• Decreased necrotizing enterocolitis
• Decreased ROP
• Decreased infection rates
• Better able to tolerate feedings
• Increased IQ rates

• Contains long chain polyunsaturated fatty acids that

help the infant’s brain develop – these are normally
provided by the mother in late pregnancy, therefore
preterm infants miss this
MOTHER HEALTH BENEFITS
OF BREASTFEEDING
• Less postpartum bleeding
• More rapid uterine involution
• Weight loss
• Decreased premenopausal breast cancer rates
• Decreased ovarian cancer rates
• Lactational amenorrhea
• Should still use progesterone only contraceptives
• Combined contraceptives dry up milk
OTHER BENEFIT OF BREASTFEEDING

• Saves money
• Saves time
• Babies love it
 BREASTFEEDING
BARRIERS
• Early breastfeeding failures
deprive infants of the benefits,
and leave many mothers
disappointed
• It is a natural process, but many
mothers need a lot of help
BREASTFEEDING
BARRIERS
• Must educate mothers regarding:
• Positioning the baby
• Latching on
• Normal nipple soreness
• Cramping with breastfeeding
• How often to feed the baby
• Need to wake the baby
• Alerting techniques
• Rooting
• Sucking
• Listening for swallows
• Preventing engorgement
• Nutrition
• Supply and demand
• Infant cues
BREASTFEEDING
BARRIERS
• Breast Pathology
• Flat/inverted nipples, breast reduction surgery that
severed milk ducts, previous breast abscess,
extremely sore nipples (cracked, bleeding, blisters,
abrasions)
• Hormonal pathology
• Failure of lactogenesis, hypothyroidism
• Overall health
• Smoking, anemia, poor nutrition, depression
• Psychosocial
• Restrictive feeding schedules, mother without support
system, not rooming in with baby, bottle
supplementing when not medically required
• Other
• Previous breastfed infant who failed to gain weight
well, perinatal complication (hemorrhage, htn, infection
 BREASTFEEDING
TEACHING METHODS
• With infant in mother’s arms
• Consistent information
• Repeat information in a variety of ways
• Watch the mother feed the baby and help
• Let the mother know she may have difficulties at first
• Remind mom that baby is learning with her
• Praise the mother’s progress, help build confidence
• Provide discharge support
 HEALTHY OUTCOMES
• Baby gains weight
• No more than 7% weight loss
• Back to birth weight in 2 weeks
• 1oz per day weight gain for the first three months

• Mother is comfortable and satisfied

• If baby is still loosing weight on the 4 th day of life:
• Get feeding evaluation
• Remember to:
• 1. fed the baby
• 2. maintain the milk supply
• 3. continue breastfeeding
 COMPLICATIONS
• Infants at risk for poor weight gain
• Premature (less than 38 weeks)
• Difficulty latching on
• Ineffective or unsustained sucking
• Oral anatomic abnormalities (cleft lip/palate, short frenulum,
receding chin)
• Multiples
• Jaundice
• Cystic fibrosis
• Infection
• Cardiac disorders
• Neurologic problems – downs, hypo or hypertonia
• Poor apgars
• Long labor
• Sleepy, nondemanding, passive temperament
• Separation from mother early after delivery
• Infants less than 5 lbs
 HOSPITAL DISCHARGE
SUPPORT
• Mother breastfeed longer if they:
• Are confident at hospital discharge
• Have a good support system after discharge
• Receive follow up after discharge
• Upon discharge
• Give written information
• Recommend mom to keep breastfeeding record
• Give mom phone number for a telephone helpline
• Lactation consultant follow-up
 HOSPITAL DISCHARGE SUPPORT

• Support the mothers breastfeeding

efforts
• Provide accurate current
breastfeeding information
 DIFFERENT BREASTFEEDING POSITIONS

CRADLE HOLD
•Position your baby so his head rests in the
bend of your elbow of the arm on the side
you'll be breastfeeding, with the hand on that
side supporting the rest of the body.
•Cup your breast with your other hand,
placing your thumb above your nipple and
areola at the spot where your baby’s nose will
touch your breast.
•Your index finger should be at the spot where
your baby’s chin will make contact with the
breast. Lightly compress your breast so that
the nipple points slightly toward your baby's
nose. Baby’s now ready to latch.
CROSSOVER HOLD
• Hold your baby's head with the hand
opposite to the breast you’ll be
nursing from (i.e. if nursing from the
right breast, hold the head with your
left hand).
• Rest your wrist between your baby’s
shoulder blades, your thumb behind
one ear, your other fingers behind the
other ear.
• Using your free hand, cup your breast
as you would for the cradle hold.
FOOTBALL HOLD
• Also known as the clutch hold, the football hold
position is especially useful if you have:
• Had a C-section and want to avoid placing your
baby against your abdomen
• Large breasts
• A small or premature baby
• Twins

• Position your baby at your side, facing you, with

baby's legs are tucked under your arm (yes, like a
football) on the same side as the breast you're
nursing from.
• Support your baby’s head with the same hand,
and use your other hand to cup your breast as
you would for the cradle hold.
LAID-BACK POSITION “BIOLOGICAL
NURSING”
• Lean back on a bed or couch, well
supported by pillows in a semi-reclining
position, so that when you put your baby
tummy-to-tummy onto your body, head near
your breast, gravity will keep him molded to
you.
• Your baby can rest on you in any direction,
as long as the whole front of the body is
against yours and he can reach your breast.
• Your infant can naturally latch on in this
position, or you can help by directing the
nipple toward your little one's mouth.
• Once baby is set up at your breast, you
don’t have to do much besides lie back and
relax.
SIDE-LYING POSITION
• Both you and your baby should lie on
your sides, tummy to tummy.
• Use your hand on the side you’re not
lying on to cup your breast if you need
to.
• When using this position, there should
be no excess bedding around the infant
that could pose a suffocation hazard.
This position shouldn’t be used on a
recliner, couch or water bed for that
same reason.