BREAST FEEDING - NURSING ASSIGNMENT

INTRODUCTION

        Breast feeding is the natural and detriment for the infant. A well nourished mother can usually provide enough breast milk to satisfy the nutritional needs of the baby for a normal rate of growth during the first four to six months of life, without detriment to her own health, physique or figure. Thus all the babies regardless of the type of delivery should be given early and exclusive breast feeding upto six months of age. October 1^st week is celebrated as Breast Feeding Week.

MEANING OF BREAST FEEDING

        Breast feeding means “the feeding given by mother to her child through her breast”. The first milk is called colostrums. Secretion of colostrums lasts for 2-4 days after delivery. It has a deep lemon yellow colour and contains antibodies, proteins, minerals and less carbohydrates and fats.

Composition of Breast Milk

        Composition of the breast milk are;

·        Deep yellow serous fluid, alkaline in reaction

·        Higher specific gravity

·        High protein

·        Vitamin A

·        Sodium and Chlride

·        Low carbohydrate, fat and potassium level

·        Antibody IgA

·        Microscopically it contains fat globules, colostrums corpuscles and epithelial cells

Composition of the milk per 100 ml

Nutrients

·        Proteins                   :       1.2g/100ml

Casein                     :       0.4g/100ml

    Lactalbumin            :       8g/100ml

·        Lactose                    :       6.5g/100ml

·        Fat                           :       3.5g/100ml

·        Calcium/Phosphate         :       34g/15mg

·        Calories                   :       75k/100ml

TECHNIQUES OF BREAST FEEDING

·        The mother desire to feed is the first requirement for successful lactation. She should be psychologically prepared to feed.

·        She must wash her breast before feeding

·        She can sit comfortably with a support at the back. It is advisable to hold the baby in her lap.

·        If she is unable to sit, she may feed by lying on her side with pillow under the shoulder

·        She must check whether the baby has soiled the linen, if required the baby should be cleaned and dried to make the baby comfortable before feeding

·        The check of the baby should touch the nipples so that by rooting reflex, the baby can get to the nipple.

·        If the breast is firm and full, it should be pressed with the first finger to prevent pressing of the baby’s nose.

·        During the first few days most of the babies fall asleep after taking few sucks. He should be aroused by gentle tickle behind the ear or on the sole of the foot.

·        Before removal of the baby from the breast it is necessary to break sucking by putting a little finger into the corner of the baby’s mouth.

·         Every baby swallows some air during the feeding and should be kept upright and patted on the back, until the air is blenched.

·        After feeding if required, the diaper should be changed

·        After feeding the baby must be positioned on the right side or on the abdomen.

POSITIONS FOR BREAST FEEDING

        The nurse should assist the mother in finding comfortable and effective positions for nursing. The mother should try several positions, both to present nipple irritation and to enable the baby to become accustomed to different positions. The main positions are;

·        Cradle hold

·        Cross-cradle hold

·        Football hold

·        Laying down

·        Australian or back lying position

Cradle Hold

        The most common position is the cradle position and it is the traditional sitting position, where by the mother sits with her baby’s body across her abdomen. She places the baby’s head on her right hand and using the opposite hand to support the breast.

        The mother should be seated comfortably; a pillow can be placed on her lap to help support the infants weight and especially helpful tip for mothers recovering from a caesarean birth, since this helps to avoid pressure on the abdominal incision. It is important that the mothers back is upright and at a right angle to her lap.

Cross-Cradle Hold

        Lay your baby on pillows across your lap, then the baby facing to the mother. By reaching across the lap to support the baby’s back and shoulders with the palm of your hand. Supporting the breast from other hand to be guide it into the baby’s mouth.

Food Ball Hold

        Another common position is the football hold so called because the baby is tucked under the mothers arm on the side on which it is feeded. This position may also be comfortable for cesarean mothers. She placed her baby along her side and his feet towards her back, pillow will be needed to support the baby and the mothers arm.

        Holding the baby’s head in her right hand. She suppor his body with her right fore arm and raised the head to breast level.

Laying Down

        The side lying position is often comfortable in early house after birth and is especially useful at night. Both the mother and the baby should face each other pull the baby close to the mother by the side from which she is lying and from the opposite hand.

Australian or Back Lying Position

        In this, the mother lies on her back, holding the infant on her abdomen may be useful for mother whose milk flow more quickly that the infant can swallow, causing chocking. This position allows the infant to better control on the flow of milk to the back to the mouth.

Advantages of Breast Feeding

·        It is the best natural food for the baby

·        Ideal composition of fat, protein, carbohydrate and minerals

·        It fully meets the nutritional requirements of the infant and promotes optimal growth.

·        It protects the baby from infections

·        It is always safe, clean and cheap available to infant at correct temperature.

·        It is available 24 hours

·        It requires no preparations

·        Nursing mothers are less prone to breast cancer

·        Breast feed also helps the mother in slimming

·        Breast feed babies have less chance of allergy

·        It reduces infant mortality

CONTRAINDICATIONS IN BREAST FEEDING

        The following maternal or neonatal conditions contra indicate breast feeding either temporarily or permanently in cases of temporary contraindications, the baby should be put to the breast as soon as condition permits.

a) Maternal

·        Acute puerperal illness

·        Acute breast complications such as cracked nipples, mastitis or breast abscess

·        Cancer

·        Breast surgery

·        Breast injury

·        HIV infection

·        Chronic diseases such as tuberculosis, leprosy, malignancy

·        Antipsychotic medications

b) Neonatal

·        Very low birth weight baby

·        Asphyxia and intracranial stress

·        Acute illness

·        Several degree of cleft palate

Complications

·        Engorgement

·        Deep Breast Pain

·        Mastitis

·        Breast Abscess

·        Blocked Ducts

·        White Spots

CONCLUSION

        Breast milk is an ideal food for the baby which produced 500-900ml milk per day and provides 520 kcak/ day and by exclusive breast feeding the baby becomes happy, sleeps between feeds and at night, doesn’t vomit and passes urine at least six times/day and also have a good movements of limbs and cry and even the weight is also increases day by day.

BIBLIOGRAPHY

1.   D.C.Dutta, “A Text Book of Obstetrics”, 6^th edition, Page No.450-454, 439.

2.   Myles, “A Test Book for Midwives”, 13^th edition, Page No.707-723, 764.