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.
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