Breast feeding is an art and a skill. It requires maternal confidence
and consistent information. Human milk is the most appropriate of all
available milks for the human infant because it is uniquely adapted to
his or her needs.
Exclusive Breast Feeding
Exclusive breast feeding means that except breast milk no other food or
fluid including water should be given to child from birth to four
months. It lowers the risk of diarrhoea and pneumonia.
Advantages of Breast Feeding
Benefits to Baby
Breast milk is the natural food specific for human babies. It is always
readily available at the proper temperature and needs no time for
preparation.
The milk is fresh and free of bacteria.
Breast milk contains anti infective factors which help baby to fight
against infections.
It protects against allergies, eczema and asthma.
Human milk iron is well absorbed by the infant.
Benefits to Mother
Breast feeding is beneficial for mother also as it has contraceptive
effect in first 6 months, it help in early involution of uterus and
protective effect against ovarian and breast cancer.
Breast feeding offers increased opportunity for close sensual contact
between the mother and infant. It creates a strong bond between mother
and the baby and helps in emotional, intellectual and social development
of child.
Preparation of Prospective Mother
Most women are physically capable of breast feeding, provided they
receive sufficient encouragement and are protected from discouraging
experiences and comments while the secretion of breast milk is becoming
established.
Nipple assessment should be made to determine nipple protractility and
nipple preparation should begin in the 28th week of pregnancy. Physical
factors conducive to a good breast feeding experience include
establishing and maintaining a state of good health, proper balance of
rest and exercise, freedom from worry early and sufficient treatment of
any intercurrent disease and adequate nutrition.
Initiation of Breast Feeding
Breast feeding should be started as soon as possible after birth
preferably within half an hour of birth. Early breast feeding stimulates
breast milk production. It serves as newborns first immunization and
food. It reduces maternal post delivery bleeding, initial milk
(Colostrum) contains high level of antibodies which prevent infection in
babies.
The baby should be nursed every 2-3 hours or on demand, whichever comes
first, during the day and on demand during night.
Both breasts should be used at each feeding, starting on the breast
that was used to end the previous feeding.
Nursing on each breast is recommended from 7-10 minutes with additional
time added to each feeding if it is comfortable for mother. Most of the
milk is obtained early in the feeding in 2 minutes and 80-90% in 4
minutes.
Position for nursing a baby
Several position are possible for nursing a baby comfortably. These
position include traditional "Madonna Position" and "Football
hold" both allow mother to sit, as well as lying down positions.
The baby's head should be in straight line with his body. The body of
baby should be against mother's stomach. Body should be supported at
bottom, head should be free to move. Baby should be facing the mother.
Mother should offer not only nipple to baby but also areola (the brown
area).
One or Both Breast per feeding
Baby should empty at least one breast at each feeding otherwise it will
not be stimulated to refill. Both breasts should be used at each feeding
in early weeks to encourage maximal milk production. After the milk
supply her been established the breast may be alternated at successive
feedings and infant will be satisfied from the amount received from one.
Adequacy of Milk Supply
If baby is satisfied after each nursing period, he sleeps for 2-4 hrs
and gains weight adequately ,it means milk supply is sufficient. Infants
who are light sleepers requires lot of body contact with the mother.
Sleepy Baby
This is a common complaint during first 1-2 days after birth. Sucking
urge is at its peak for first 2-3 hours after birth and then declines.
Most babies start nursing well again after 2-3 days. Other babies must
be awakened for every feeding by scratching on soles or ticking behind
the ears.
Not enough milk
This is the most common reason given by mothers for starting other
milks. But most of the time mothers have adequate milk supply.
Mother should be reassured. Position of feeding should be correct.
Mother should breast feed atleast 8 times a day. Night feeds should be
given. Frequent suckling by baby should be done in good position. If
supplementary feeds are given they should be reduced.
Early Problems with Breast feeding
Different shapes and size of the Breast.
Milk secreting glands are almost equal in all mothers therefore size
and shape of breast does not effect production of milk.
Flat or small nipples
Protractility rather than size of nipple are more important (If one
touches the nipple between two fingres it erects and this is called
probability). A Protractile nipple is normal. Length of nipple is not
important so long as it is protractile Nipple merely acts as a pointer
to show the baby where to take the breast.
Engorged Breast
If breasts are not emptied adequately, they will become engorged. Such
breasts are painful, look tight and milk may stop flowing. The baby is
unable to suck because of tightness of breast. Engorgement may be
prevented if mother is encouraged and supported to breast feed her baby
in good sucking position on demand from soon after birth. Treatment of
engorgement requires manually expressing the milk if baby is unable to
suck.
Cracked Nipple
If baby continues to suckle in poor position it may damage the nipple
skin and a fissure or crack appears. Treatment includes helping mother
to improve sucking position.
Multiple Birth
Woman can nurse multiple babies, since the supply of breast milk will
increase to meet the additional demands. In case of twin babies both
breast should be used at each feeding , each baby can have his or her
own breast, the babies can be fed simultaneously or the hungriest baby
can be fed first.