breast feeding recommendations

8/6/2019 Breast Feeding Recommendations

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Breastfeeding Recommendations

Start breastfeeding within hour 1hr of birth

Breastfeed exclusively from 0 4month of age

Complementary foods can begin between 4-6mths

Give complementary foods to all children from

6mths

Continue breastfeeding up to 2 yrs of age or

beyond

Why must all mothers breastfeed their baby?


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Protection from allergy

A mothers milk is especially suited for her

own baby.

Colostrum is the perfect first for baby food Is thick, sticky and yellowish in color.

Has laxative properties which helps baby pass

meconium therefore prevents jaundice. Contains immunonoglobulins which provide

an anti-infective protection to baby


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Benefits of exclusive breastfeeding for 6

months

Protection against infection

Overall, there is less illness requiring health care

Provides the best infant nutrition and growth Protection against infection; bifidus factor helps

special bacteria to grow in babys intestine and

prevents other harmful bacteria from growing Has antibodies - protect baby against diseases

mother has been exposed to.


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The amount of protein is perfect for growth andbrain development

The foremilk contains more protein whereas

the hindmilk contains more fat The GI tract develops more quickly when

breastfed preventing foreign proteins from

entering his system

Emotional bonding results in less child neglect

and abuse


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Lower incidence of cot death and lower risk of

childhood diabetes, cancer and ear infection Better psychomotor, emotional and social

development

Mother oxytocin released during brestfeeding

contracts the uterus- helps stops the

bleeding after birth

- frequent feeding delays the return of

menses


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- post partum depression is reduced

- safe, no preparation needed, and ??? What

else- Benefits to society - ???


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Teach mothers how to keep prolactin

level high

Assist baby to attach effectively at the breast

never give dummies or teats

Baby breastfeed as frequently as he wants(every 1-3hrs) and as long as he wants

Offer night feeds


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Release of oxytocin can be temporarily inhibited

by:

extreme pain

Stress hormones resulting from doubt,

embarrassment, anxiety

Nicotine and alcohol


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Mother can reduce inhibition of oxytocin by:

Relaxing and getting comfortable for feeds

Avoid embarrassing or stressful situations

Express a little milk and gently stimulate the

nipple

Ask someone to massage her upper back


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Identifying women at risk for

breastfeeding difficulties

* Previous feeding practices

Family difficulties

Age, social status or state of mind

Regular separation from their babies


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Dealing with sleepy babies

Remove blankets and let the arms and legs

move

Breastfeed baby in a more upright position Gently massage the body and talk to him

Wait 1/2hr and try again

Allow baby to suckle until he releases the

breast.


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Help mothers learn how to respond to

babys need

Keep baby and mother day and night

(rooming in)

Show them how to watch for feeding signs

rather than waiting for babys cry

Explain that frequent suckling and milk

removal keeps milk production high


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Inform them to allow baby determine the

frequency and length of breastfeed

Relieve overfull or uncomfortable breasts bybreastfeeding or expressing milk


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Suckling and Attachment

Hold the baby close and facing the mothers breast

The baby needs a large mouthful of breast in order to

remove milk effectively

The nipple, areola and breast tissue form a teat within the

babys mouth

The tongue cups along the sides of the teat, and a wave

of compression moves along the tongue towards the backof the mouth

The baby swallows when the back of his mouth is full

Artificial teats can cause sucking confusion


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Positioning and Attachment

Positioning

Babys whole body to be turned towards

mother, with buttocks well supported

Attachment

Elicit the rooting reflex by touching babys lip

with the breast.

Wait until baby has a wide-open mouth

Bring baby to the breast, not the breast to the

breast


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Move the whole of babys body to the breast;

do not push his head

Make sure baby gets a large mouthful of breast.

Support the breast during the feed to help with

attachment

Feed until baby releases the breast

spontaneously.

If baby is not attached well, or if mother feels

pain, she should break sucking, remove baby

from breast and start again.


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Causes ofPoor Attachment

Use of feeding bottle before breastfeeding established- for later supplements

*Inexperienced mother first baby,

previous bottle feeder

Functional difficulty small or weak baby

- breast poorly protractile

- engorgement, late start


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Signs of good attachment

Babys mouth is open wide

Chin is touching the breast

Lower lip is curled outward

Slow deep sucks

Mother may hear baby swallowing


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Signs that a newborn is receiving

sufficient milk Breastfeed at least 8 times in 24hrs

During a feed swallowing and gulping may be

heard

Baby is alert, has good muscle tone and healthy

skin


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Baby is contented between feeds

Uses 6 or more diapers in 24hrs

Has 3-8 bowel movements in 24hrs butbecomes less as they grow older

Consistent weight gain 18-30gm in 24hrs


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Reasons why a baby may not get

enough breastmilk

These are Common Breastfeeding factors

Delayed start

Infrequent feeds

No night feeds

Short feeds

Poor attachment

Bottles pacifiers, complementary feeds


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Common: Mother psychological factors

Lack of confidence

Worry, stress

Dislike of breastfeeding

Tiredness

Rejection of baby


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These are not common

Mothers: physical condition eg

Contraceptive pills, diuretics

Pregnancy

Severe malnutrition

Alcohol, smoking, retained piece of

placenta(rare)

Babys condition

Illness

deformity


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Premature babies can breastfeed:

When

* they are able to coordinate suckle and swallow

Putting their fist to their mouth

Feeding with only occasional disruptions in

breathing and heart rhythm


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Skills for building confidence and

giving support

accept what a mother thinks and feels

Recognize and praise what a mother and baby

are doing right

Give practical help

Give a little, relevant information

Use simple language

Make 1 or 2 suggestions, not commands


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Treating breast engorgement

Correct any problems with attachment Breastfeed more frequently

Gently express some milk to soften the areola,

help the babys attachment Apply cold compress to the breasts after a

breastfeed for comfort


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Treating sore nipples

Check for poor attachment

Massage the breasts gently towards the

nipples. Express milk to stimulate milk flow

Begin each breastfeed on the least sore

breast

Avoid limitations on the frequency of feeds

Apply EBM to the nipples after a breast feed

Expose the breasts to air and sun


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If the mother has thrush on her

nipples

Apply medication to the mothers nipple, babys

mouth and diaper area

Expose nipple to air and sunlight after feeds

Take special care in washing clothing

Check for vaginal infection and treat


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Medication for breastfeeding mothers

Most medication pass through breastmilk invery small amounts.

For possible side effects; monitor the baby for

abnormal sleepiness, unwillingness to feed,jaundice

The following drugs may reduce milk supply;

oestrogen, thiazide diuretics (use alternative

drugs)


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Preparation for discharge

Refer to a mother to mother support group

Give written or verbal advice for breastfeeding

at home

Identify where mothers can receive help andsupport


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Roles of staff in upholding the

International Code

Breast-milk substitutes in the health facility

should be kept out of the sight of pregnant

women and mothers

Health facilities should not allow sample gift

packs with breast milk substitutes or relatedsupplies be distributed to pregnant women or

mothers


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Financial or material inducements to promote

products within the scope of the Code should not be

accepted by health workers

Manufacturers and distributors of products within

the scope of the Code should disclose to the

institution any contributions made to health workers

such as fellowships, study tours, research grants

conference. Similar disclosures should be made by

the recipient


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Ten steps to successful breastfeeding

Every facility providing maternity servicesand care for newborn infants should:

1. Have a written breastfeeding policy that is

routinely communicated to all health carestaff

2. Train all health care staff in skills necessary

to implement this policy


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3. inform all pregnant women about thebenefits and management of breastfeeding

4. Help mothers initiate breastfeeding within a

half-hour of birth

5. Show mothers how to breastfeed, and how tomaintain lactation even if they should be

separated from their infants


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6. Give newborn infants no food or drink otherthan breast milk unless medically indicated

7. Practice rooming in allow mothers and

infants to remain together 24hrs a day

8. Encourage breastfeeding on demand,

give no artificial teats or pacifiers to

breastfeeding infants


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9. Give no artificial teats or pacifiers to

breastfeeding infants

10. Forster the establishment of breastfeedingsupport groups and refer mothers to them

on discharge from the hospital.


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References

Palmer, G.(1998) The Politics of Breastfeeding. 3rd

ed. London. A Division of Harper Collins

Publishers.

Chetley, A. Allain, A. (1987) Protecting Infant

Health, a health workers guide to the

International Code of Marketing Breastmilk

Susbtitutes. 3rd ed. Penang

* Protecting, Promoting, and Supporting

Breastfeeding: the special role of maternityservices. A Joint WHO/UNICEF Statement,

Geneva: WHO/UNICEF, 1989.

breast feeding recommendations

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