is the feeding of an infant or young child with breast milk directly from

female human breasts (i.e., via lactation) rather than from a baby bottle
or other container. Babies have a sucking reflex that enables them to
suck and swallow milk. Most mothers can breastfeed for six months or
more, without the addition of infant formula or solid food.
Breast milk is made from nutrients in the mother's bloodstream
and bodily stores. Breast milk has just the right amount of fat, sugar,
water, and protein that is needed for a baby's growth and development. Because breastfeeding
uses an average of 500 calories a day it helps the mother lose weight after giving birth. The
composition of breast milk changes depending on how long the baby nurses at each session, as
well as on the age of the child. The quality of a mother's breast milk may be compromised by
smoking, alcoholic beverages, caffeinated drinks, marijuana, methamphetamine, heroin, and
methadone.
Human breast milk is the healthiest form of milk for human babies. There are few
exceptions, such as when the mother is taking certain drugs or is infected with Human T-
lymphotropic virus, HIV, or has active untreated tuberculosis. Breastfeeding promotes health,
helps to prevent disease, and reduces health care and feeding costs. Artificial feeding is
associated with more deaths from diarrhea in infants in both developing and developed
countries. Experts agree that breastfeeding is beneficial, but may disagree about the length of
breastfeeding that is most beneficial, and about the risks of using artificial formulas.

What You Should Know

Mother's milk is the best food a baby can have in the first 6 months of life.
Why Breastmilk is Best:
1. It helps protect the baby against:
o diarrhea o colds
o cough o malnutrition

Irene Joy R. Lubrino

BSN 4-2, Group 5
 o other common illnesse

2. There is no need to prepare breastmilk.

3. It is always available at no cost.
4. It helps babies grow up with close bond to their mother.
5. It is easy to digest.
6. It is clean and has the right temperature.
Breastfeeding should start within 30 minutes after birth. COLOSTRUM is the
initial yellowish fluid that comes out from the breast in the first 2-3 days after birth. It is
a yellowish, sticky breast milk produced at the end of pregnancy, is recommended by
WHO as the perfect food for the newborn, and feeding should be initiated within the
first hour after birth. It is good for babies and helps to protect them against infection.
When the baby is 6 months old, start giving other food in addition to breastmilk.
Continue to breastfeed sick babies. A sick mother can still breastfeed her baby.
Breastfeeding mothers should eat nutritious food to become stronger.

Breast feeding: benefits

B -best for baby
R -reduce allergy
E -economical
A -antibodies, greater immunity
S -stool inoffensive
T - temperature ideal
F - fresh / feeding milk never goes off
E - easy once established
E - emotionally bonding
D - digested easily
I - mmediately available, no mixing
N - nutritionally adequate
G - gastroenteritis greatly reduced

Irene Joy R. Lubrino

BSN 4-2, Group 5
A. Advantages
a. Psychologic value of closeness and satisfaction in beginning of mother-child relationship
b. Optimum nutritional value for infant
c. Economic and readily accessible
B. Prerequisites
a. Psychologic readiness of mother is a major factor in successful breastfeeding
b. Adequate diet must be available prenatally and postnatally to ensure high-quality milk
c. Suitable rest, exercise, and freedom from tension for mother will provide increased
satisfaction for both her and the infant
d. Infant’s sucking at the breast stimulates the maternal posterior pituitary to produce
oxytocin, the properties for which, in the blood system, constrict the lactiferous sinuses
to move the milk down through the nipple ducts: know as the let-down reflex; a poor
sucking reflex of the child will inhibit the let-down of milk; sucking also stimulates
prolactin production
e. Family support and the absence of emotional stress in the mother, because anxiety
inhibits the let-down reflex.

C. Contraindications
a. In the mother:
1. Active tuberculosis
2. Acute contagious desease; HIV positive
3. Chronic disease such as cancer, advanced nephritis, cardiac disease
4. Extensive surgery
5. Narcotic addiction
6. Pregnancy
b. In infant: cleft lip or palate or any other condition that interfere or prevents grasp of the
nipple is the only real contraindication

Irene Joy R. Lubrino

BSN 4-2, Group 5
 c. Many drugs are excreted in the breast milk and have harmful effects on the developing
infant; these drugs must be avoided or taken with care if they must be taken by the
mother; careful monitoring of the infant is required.
D.Danger Signs
Some Breastfeeding Problems:
1. SORE NIPPLES
- This is more common in mothers who have short nipples.
- This may develop when the baby bites on the nipple.
Prevention:
- In women with short or inverted nipples, squeeze the nipples several times a day.
2. BREAST ABSCESS
What to do as Community Health Worker
Encourage breastfeeding. Advise mothers that frequent sucking is needed to produce enough
breastmilk for the baby's needs. Advise mothers to keep their breasts always clean.

If the baby cannot suck or if the nipples are sore, teach the mothers the proper way to milk
the breast by hand.
1. Ask the mother to use both hands. Start at the base of the breast.
2. Then move your hands toward the nipple, squeezing the milk out of the nipple.
3. Place the breast milk in sterilized container.
4. Give it to the baby using a spoon or dropper.
Teach working mothers how to store breastmilk to be used for subsequent feedings.
1. Milk the breast by hand before going to work when the breast is full.
2. Place milk in a sterilized container.
3. Store in a cool place.
4. Give breastmilk within 24 hours.
Nursing Care of the Mother Who Is Breastfeeding
A. Assessment
1. Condition of nipples

Irene Joy R. Lubrino

BSN 4-2, Group 5
 2. Desire to breastfeed
3. Level of anxiety regarding breastfeeding
4. Knowledge of breastfeeding and breast care
5. Family support
B. Analysis/Nursing Diagnoses
1. Ineffective breastfeeding related to position, condition of nipples, and infant's sucking
ability
2. Altered family processes related to the amount of time required for breastfeeding
3. Risk for infection related to cracked nipples secondary to improper positioning on
nipples
4. Knowledge deficit related to feeding and maintenance of lactation

C. Planning/Implementation
1. Teach feeding schedule
a. Self-demand schedule (q 2 to 3 hrs) is desirable
b. Length of feeding time is usually 20 minutes, with greatest quantity of milk consumed
in first 5 to 10 minutes
2. Teach feeding techniques
a. Mother and infant in comfortable position, such as semireclining or in rocking chair. You
can choose any position you wish to nurse in, whether that be a seated or laying down position. It
should be one that gives you the best feeding position for your baby and their needs. This may vary
with the baby's age, your comfort level and even the time of day. Many people use the cradle hold,
with mom seated upright, holding baby like a cradle. This allows you to hold the baby with one hand
and use the other to support or move your breast.
b. Entire body of infant should be turned toward mother's breast; alternate starting breast
and use both breasts at each feeding. A nursing pillow or using couch or bed pillows to help hold
baby up will save strain on your neck and back. A good latch is one of the most important parts of
breastfeeding comfortably. This directly goes back to a good position of the baby. Your baby should
be belly to belly with you and chin to breast. If baby is twisted or has their head turned it can make it
not only more difficult for them to get milk, but it can make your nipples sore.

Irene Joy R. Lubrino

BSN 4-2, Group 5
 c. Initiate feeding by stimulating rooting reflex and direct nipple straight into baby's mouth
(stroking cheek toward breast, being careful not to stroke other cheek, because this will
confuse infant). Instuct to use your hand to cup the breast and offer it to baby. Baby should open
his or her mouth wide enough to take a good portion of the areola tissue (darker portion of the
breast) into the mouth. As baby does this pull them closer to the breast and watch them nurse.
If you didn't get a good latch the first time, don't be tempted to leave the baby on anyway. That
can be a source for sore nipples. Just remove the baby from the breast and try again. It may take
several tries before you get a good latch. As your baby learns to breastfeed, it will get easier.
d. Burp or bubble infant during and after feeding to allow for escape of air by:
(1) Placing infant over shoulder
(2) Sitting infant on lap, flexed forward
(3) Rubbing or patting back (avoid jarring infant)
e. Breast milk intake similar to formula intake
(1) 130 to 200 ml of milk per kilogram (2 to 3 oz of milk per pound) of body weight
(2) From one sixth to one seventh of baby's weight per day
f. After lactation has been established, occasional bottlefeeding can be substituted
g. Length of time for continuing breastfeeding is variable (may be discontinued when teeth
erupt, because this can be uncomfortable for mother)
3. Teach care of breasts
a. Cleanse with plain water once daily (soap or alcohol can cause irritation and dryness)
b. Support breasts day and night with properly fitting brassiere
c. Nursing pads should be placed inside bra cup to absorb any milk leaking between feedings;
allow nipples to air dry at intervals
d. Plastic bra liners should be avoided because they increase heat and perspiration and
decrease air circulation necessary for drying of the nipple
e. If breasts are engorged, teach mother to take warm showers and put baby to breast more
frequently

D. Evaluation/Outcomes
1. Infant receiving enough milk as evidenced by six or more wet diapers daily

Irene Joy R. Lubrino

BSN 4-2, Group 5
2. Infant sleeping between feedings
3. Mother has no signs of nipple cracking or infection

Irene Joy R. Lubrino

BSN 4-2, Group 5