BREAST

FEEDING
AWARENESS
DR. IQRA FAROOQUE

MBBS, FCPS

EX REGISTRAR ALLIED HOSPITAL

NATIONAL HOSPITAL
WHAT QURAN SAYS

• Mothers shall suckle their children for two whole years that
is for those who wish to perfect suckling.
NEGATIVE BELIEFS AND
PRACTICES REGARDING BREAST
FEEDING
• Pre lacteal feeding is common tradition
• Colostrum is considered dirty and discarded
• Breastfeeding is delayed for 2-3 days
• From birth breastmilk is supplemented with other milks
• Strong belief that water must be given from birth onwards
• According to UNICEF child mortality rate is 4-6 times
higher among ones that arent breastfed than those who are
breast fed.
• 7 fold increase risk of deaths from diarhea
• 5 fold increase risk of death from pneumonia
ADVANTAGE OF
BREASTFEEDING TO BABIES
• Meets nutrient needs perfectly
• Easily disgested
• Contains enough water
• Promote bonding with mother
• Always available at right temperature, fresh, free from
contamination
• Protects against diseases
• Prevent allergies
ADVANTAGE OF
BREASTFEEDING TO MOTHERS
• Initiation of breastfeeding in labour room after delivery
helps early expulsion of placenta
• Less chances of post partum hemorhage
• Promotes uterine involution
• Lactational amenorrhea leads to less iron loss and prevents
conception for 4-6 months
• Decrease mothers workload
• Helps mother to return to pre pregnancy weight and figure
• Reduces risk of breast cancer
• Promote attachment btw baby and mother
• Give pride, satisfaction, confidence
COMPOSITION OF BREAST MILK

• LOW PROTEIN
• Less stress on kidneys
• Easy to digest
• Less allergenic
• High ratio of whey to casein
• High lactose
• Early source of energy for brain development
• Fat composition
• Easily disgested
• High water content
 Fat Casein Whey Lactose

Human 3.8 0.4 0.6 7.0

Cow 3.7 2.8 0.6 4.8

Buffalo 7.4 3.0 0.7 5.5

IMMUNE FACTORS IM
BREASTMILK
• Breastmilk prevents infection and shorten duration of illness
• Secretory IgA
• Macrophage
• Lactoferrin
• Lysozymes
• Bifidus factor
• Anti viral factor
• Less chances of diarhea, pneumonia, otitis media and
meningitis in first year of life
• Reduce chances of developing allergic conditions like
atopic dermatits and asthma even in children having family
history
BENEFITS TO FAMILY

• Less expensive
• Less illnesses
• Birth spacing
• Less work for family
DISADVANTAGES OF NOT
BREASTFEEDING
• Increase cost
• Recurrent infections
• Composition is not optimal
• Swallowing air
• Nipple confusion
• Allergies to cow milk
• Dilution errors
• Inconvenience
OPTIMUM BREASTFEEDING
PRACTICES
• Early initiation
• No pre lacteal feeds
• Exclusive breastfeeding
• Feeding on demand
• Frequent breastfeeding
• Feeding at both breast
• Continue feeding for 2 years
ADVANTAGE OF EARLY
INITIATION
• The baby is alert and sucking reflex is strong
• Baby gets Colostrum
• Prevents hypothermia
• Promotes bonding
• Prolongs duration of breastfeeding
• Helps delivery of placenta
• Prevents PPH
HARMFUL EFFECTS OF PRE
LACTEAL FEEDS
• Can cause diarhea
• Ghutti act as purgativs
• More full so less hungry babies suck less breast milk takes
longer to come in
• Can cause nipple confusion
EXCLUSIVE BREASTFEEDING

• No pre lacteal feeds

• No additional water, herb water, sherbat, tea
• No supplemental fresh animal milk or formula milk
• No semi solid foods
ON DEMAND FEEDING

• Baby is fed whenever he cries or mother feels a need to feed

• Babies feed irregularly at first
• Within 2 weeks they settle into a routine
• Frequent suckling atleast 8-10 times a day ensures increased
milk production
• Prevents problems like engorgement and mastits
• Keep baby satisfied
NIGHT FEEDING

• Sustain milk supply

• Is useful for working mothers who have less chance to feed
during day
• Help ensure 8-10 feeds a dat
• Convenient than preparing bottles at night
LENGTH OF TIME AT
BREASTFEEDING
• It shoukd be according to baby demand
• Slow feeders can be stimulated to feed longer to make sure
they get hind milk
• Sore nipples are due to sucking in wrong positions rather
due to prolong sucking
KEY MESSAGE
MATERNAL BREASTFEEDING
PROBLEMS
• Engorgement
• Sore/cracked nipples
• Mastitis/breast abcess
• Insufficient milk syndrome
• Multiple births
• Sick mothers
• Working mothers
ENGORGEMENT

• Delayed initiation of breastfeeding

• Infrequently feeding
• Incomplete emptying of breast
• Results in accumulation of breast milk
MANAGEMENT

• Warm compression
• Hand expression
• Frequent nursing
• Supportive counseling
• Mild analgesics
SORE NIPPLES

• Incorrect position
• Vigorous suckling
• Chemical irritation
• Tight clothing
• Thrush
MANAGEMENT

• Correctly position
• Use alternative positions
• Avoid washing breast with soaps
• Start feeding on unaffected side first leaving affected side exposed
to air
• Apply breast milk
• Use finger to break suction of babys mouth after feeding
• Wear loose clothes
MASTITIS

• Obstructed duct
• Infection from cracks
• Engorged breast
• Incomplete emptying
MANAGEMENT

• Continue breastfeeding
• Try to empty breast frequently
• Apply moist warm packs
• Mild analgesics
• Antibiotics
INSUFFICIENT MILK SYNDROME

• Crying baby
• Breasts feel empty
• Baby restless during feeding
• Mother unsure of her ability to feed and not confident about
her milk supply
CAUSES

• Anxiety
• Exhaustion
• Psychosocial factors
• Delayed initiation of breastfeeding
• Infrequently feeding
• Supplemental feeding
MANAGEMENT

• Reassuring
• Discus indicators of sufficient milk intake
• Observe feeding for proper positioning
• Expression of milk
• Counselling
• Increase fluid and diet
• Frequently feeding
• Use local lactogogue
MATERNAL ILLNESS

• Continue breastfeeding with acute or chronic illness

• It will help prevent illness in baby
• The only illness for which breastfeeding is contraindicated
is active herpes simplex on areola
EARLY ONSET JAUNDICE

• Poor fecal excretion of bilirubin due to insufficient feeding

• Do not stop breastfeeding
• Follow optimal breastfeeding practices
• No supplemental fluids
NIPPLE CONFUSION

• Baby is fretful ay breast because baby has learned to suck on bottle nipple
• Keep baby and mother togather
• Put baby to breast when he is hungry
• Squeeze milk into baby's mouth
• Correct positioning
• Dont feed with bottles
• Give expressed milk with cup and spoon
• Dont use pacifier