J G COLLEGE OF NURSING

SUBJECT: PEDIATRIC NURSING TOPIC:HEALTH EDUCATION ON EXPRESSION OF BREAST MILK PROCEDURE

SUBMITTED TO PROF.ARPAN PANDYA PEDIATRIC NURSING J G COLLEGE OF NURSING SUBMITTED BY BINAL JOSHI S Y MSC NURSING J G COLLEGE OF NURSING

SUBJECT

: Child health nursing

TOPIC GROUP DATE OF LECTURE VENUE METHOD OF TEACHING

: expression of breast milk : Parents in the hospital : 10-1-2012 : feeding room of NICU : Lecture cum demonstration

INSTRUCTIONAL METHOD : live demonstration PREVIOUS KNOWLEDGE GENERAL KNOWLEDGE : Mothers have some knowledge about sputum collection : At the end of the class mother will have knowledge about the procedure of expression of breast milk OBJECTIVES Central objective At the end of demonstration the mother will have in depth understanding of the procedure of expression of breast milk

Specific objectives: To introduce with the topic

 To classify the types of method of expressing breast milk To enlist the equipments required for the procedure To describe the procedure of expressing breast milk To understand the storage procedure for EBM To learn about thawing and reheating the EBM

TIME MNS 1 mn

SPECIFIC OBJECTIVE To introduces myself and the group

CONTENT SELF INTRODUCTION : Myself Binal Joshi, M.Sc. Nursing student at. JG college of nursing, Ahmedabad. GROUP INTODUCTION : I would like to present Health education on expression of breast milk.

TEACHING LEARNING

A V AID

EVALUATION

Explanation Discussion

2 mn

To introduce with the topic

Introduction of the topic Expression of breast milk is getting milk from your breast without your baby sucking on it. Your breast milk can be expressed using your hands. This is called hand expression or manual expression. Hand expression may work well if you only need to express milk once in a while. You can

Explanation Discussion

What is expression of breast milk?

also use a breast pump to express milk from your breasts. A breast pump may work well if you are away from your baby. For example, you may be at work for several hours before you can breastfeed again. 2 mn To classify the method of expressing breast milk Hand expression: expressing the breast manually with hand Breast pump: Choose a breast pump that is comfortable and easy to use. There are many types of breast pumps to choose from. They can be manual (hand pump), battery-powered, or electric. 1 mn To collec needed equipments Equipments Clean wide mouth container Mechanical or electrical operated breast pumps Warm cloth Measuring glass Explanation Demonstration There are two main types Explanation By showing the poster on the types What are types of method to express breast milk

15 mn

To express the breast milk Procedure PREPARATION OF THE CONTAINER Choose a cup or jar with wide mouth Wash the cup in soap and water Por the boiling water into cup and empty before collecting the expressed milk. Allow the water to remain in cup for few minutes MASSAGING THE BREAST BEFORE EXPRESSION Take a warm towel and wrap it around the breast and allow it there for 5 minutes With two fingers massage the breast for circular motion with two fingers. Use pulp of the fingers. Massage the breast towards nipple only with moderate pressure. Massage for 5-10 mns

Explanation Demonstration

How to perform the proceure of expression of breast milk?

Hand Expression of Breast milk:

Wash your hands thoroughly with soap and water. Try to relax. The let-down reflex is delayed by anxiety, although it will eventually occur. It may help to have your baby close to you. If that is not possible, have a photograph nearby or think about your baby. Massage your breasts with the flat of your hands, working towards each nipple. Place a finger and your thumb either side of the nipple at the base and gently stretch and roll the nipple. Place your thumb above your nipple at the edges of the areola (dark area around the nipple) and the first finger below. Using your thumb and finger,

gently press your breast tissue back towards your chest wall and squeeze. By doing so, you are moving back along the milk ducts, gathering some milk (which is lying in the ducts) and then squeezing it forward. Drops of milk should soon appear on your nipple. Gently rub these first drops into your nipple. This will further stimulate your let-down reflex and increase the milk flow.

Continuously press and squeeze in a rhythmic massaging movement. The milk will soon begin to flow sometimes even squirting out. Sometimes your hand may become tired so, switch hands regularly. Once the milk dwindles to a few drops, move your finger onto another area of your breast and

continue to press and squeeze. Breast Pumping: Pump about 15 - 20 minutes at a time when using a single pumping kit Switch breasts when the. miik flow decreases (or about every 5 minutes). If double pumping, expect to pump for around 10-15 minutes. Electric double pumping is best because it is most effective in keeping good milk supply and the fastest in pumping milk from the breast Not all pumps are good. Ask your health care provider or lactation specialist which ones are good to use. 5 To store the expressed milk Store your breast milk right after you express it. Use any of the following ways:

Explanation Discussion by showing the poster

How to store expressed milk?

Room temperature: You can store breast milk for up to

six hours at room temperature.

Insulated cooler with ice packs: You can store breast milk in a cooler with ice packs for up to 24 hours.

Refrigerator: You can store breast milk in the refrigerator for 5 to 8 days. If you thaw frozen breast milk in the refrigerator, you can store the thawed milk for up to 24 hours.

Freezer: Refrigerator freezer compartment: If the freezer section has its own outer door, you can store milk in the freezer for 3 to 6 months. If the freezer

door is inside of the refrigerator, you can store the breast milk for two weeks. Keep the frozen breast milk on the bottom or at the back of the freezer.

Deep freezer: You can keep breast milk in a deep freezer at 0F for 6 to 12 months.

To understand the thawing and heating of the breast milk

Thawing and heating of breast milk Breast milk must be thawed and heated correctly to reduce the potential for bacterial growth.

Explanation Discussion

How to thaw and reheat the stored breast milk?

Thaw frozen breast milk by moving it from the freezer to the fridge for slow thawing over 24 hours.

You can also run cold water over the container and gradually increase the temperature of the water. Do not overheat the milk as it will destroy some of the nutrients and may burn the babys mouth. Never use the microwave. It is a potentially dangerous practice as it can cause hot spots in the milk that may burn your babys mouth. Frozen breast milk that is thawed in the fridge (but not heated) will last 24 hours in the fridge and four hours at room temperature. It cannot be refrozen. If milk has been thawed outside the fridge, using warm water

SUMMARY Introduction Purposes Types Equipments procedure Storage Thawing and reheating

CONCLUSION Breast milk, to be specific human milk, is the milk produced by the breasts (or mammary glands) of a human female for her infant offspring. Milk is the primary source of nutrition for newborns before they are able to eat and digest other foods; older infants and toddlers may continue to be breastfed, either exclusively or in combination with other foods.