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Taif University
Department of Nursing
Growth & Development
(Breast Feeding)
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Physiology of lactation
During pregnancy :
- Estrogen and progesterone secreted by the
placenta preparethe breast for lactation.
- The estrogen inhibits milk production until the
end of
pregnancy.- In the third trimester of pregnancy, colostrums
is present
and remains for the first 3 days postpartum.
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Colostrums
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Physiology of lactation
By 3rdstage of labor (delivery of placenta) :
- Production of milk is reduced and during the
next 48hours, the blood level of estrogen and
progesterone fall and
this stimulates the anterior pituitary gland to
produce thelactogenic hormone (prolactin hormone).
- The milk is pushed along the lactiferous ducts
and some is
stored in the lactiferous sinuses (milk reservoir
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Physiology of lactation
When the child sucks:
- the child takes the nipple and areola into his\her
mouth and
partly by vacuum, which is created mostly be achewing
action of his\her jaw, milk is pushed into his
mouth and he
swallow.- As the lactiferous sinuses (milk reservoir) and
lower ducts
are emptied, milk is pushed from the alveoli by
contraction
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Physiology of lactation
So the act of sucking by the baby is the stimulus,
which keeps lactation going on by some neuro-
hormonal reflex mechanism, which activates the
anterior pituitary gland to produce lactotrophin
and the posterior gland to produce oxytocin which
reaches the breast through the blood stream
leading to contraction of myoepithelial cells and
expulsion of milk results.
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Advantages of breast feeding
The infant sucking at the breast promotes
involution of the uterus after labor.
Many mothers find great satisfaction in feedingthe infant at the breast.
Save times and troubles appeals to some
women.
Breast milk is less of strain on the family budgetthan buying a fresh or even dried milk.
It fulfils the feminine role and motherly attitudes.
Lower incidence rate of cancer breast in women.
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Advantages to infant
Human milk is warm, sterile and perfectly balanced inproteins, carbohydrates, fats, and vitamins and
doesnt cost anything.
Breast fed infants have greater immunity to certain
childhood diseases (it provide immunological factorsto certain diseases).
It is available all times.
Infants less likely to have gastrointestinal disorders,
anemia, and vitamins deficiency. Infants are less likely to acquire infections in homes
where cleanliness.
Infant is secure through constant contact with his
mother and has an affect on the childs psychology
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Technique of breast feeding
Breast should be cleaned every day when the
mother takes a shower, otherwise breast is
washed with plain water and dries thoroughly.
Mothers clothes should not be too tight over the
breast and should be clean.
The mothers should wash hands before nursing
her infant. The infant should be hungry, dry, and warm.
The mother should be in comfortable position
either in sitting or lying position.
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Technique of breast feeding
Positioning of infant :
- Cradle position.
- Crosscradle position.
- Foot- ball position.- Horizontal position.
- Backwards position.
-position for two babies.
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Cradle position
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Cross-Cradle position
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Horizontal breastfeeding
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Football breastfeeding
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Technique of breastfeeding
The mother can gently support the breast ; she
can cup her breast with her hand from
underneath using four fingers underneath and
well behind the areola, her thumb should be
resting on the top of breast ( C-hold).
Rub the nipple or a finger gently against theinfants cheek or lips to stimulates rooting reflex
So the infant focus on breast.
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Technique of breastfeeding
Touch the infants lip with a nipple to evoke oral
searching reflex where the infant opens his mouth
widely and thrusts the tongue forward and hold
nipple apart of the areola. This is what we called
latching on. Remember that the infant who
should come to the breast , not the breast to the
infant.
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How often and how long ?
Unrestricted: self-demand. Give breastfeeding
when the infant shows signs of hunger during the
day and night.. Also, letting the infant finish a feed
and come off the breast spontaneously.
Exclusive : it means that no food , no drink other
than breastfeeding is offered to breastfeedingbaby up to 6 months and he\she is fed on
demand, day and night, with no restriction on
length or frequency of breastfeeding.
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Criteria for adequate
breastfeeding
Infant is calm and satisfied after feeds.
Infant sleeps well 3 -4 hours after feeds.
Normal bowel motions. Normal amount of urine.
Normal weight gain
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Factors that lead to breastfeeding
problems
Lack of mothers knowledge.
Improper attachment of baby to breast.
Separation of mother and baby. Psychological factors:
- Anxiety.
- Concern about nipple shape and size.
- Misbelieves about colostrums and her own ( not
enough,
deficient, diluted milk).
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Bottle Feeding
Types of form ulae feedings :
- Complementary feeding: each feed, the breast is
given firstuntil it is emptied then
formulae is
given to complete the
feed.- Supplementary feeding: formulae is given to
substitute one
or more feeds, where
some feeds are
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Bottle feeding
Substitutive feeding is only
indicated in cases of :- Death of the mother.
- Institutions.
- Contraindications of breast
feeding.
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Contraindications of
breastfeeding
Mothers with HIV virus.
Mother with cancer.
Under retarded treatment.
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Disadvantages of bottle feeding
Bottlefed infants get sick easily through :
- Starvation: infant may have diluted formulae,
where
mother do not put enough milk
powder to
water as a result of their ignorance
or theexpensiveness of milk powder.
Thus, marasmus
(severe protein energy malnutrition)
often
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Disadvantages of bottle feeding
- Infection: pathogenic microorganisms grow
quickly in milk
when not refrigerated. It also grows
quickly in
warm and dirty feeding bottles. to kill
these
microorganisms boil the bottles and allthe
equipment used in formulae
preparation for 15
minuets.
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Disadvantages of bottle feeding
- Difficulty to digest: the casein cows milk is
responsible for
the hard big cruds formed in
the infant
stomach, which interferes
with digestionof milk unless it is modifies.
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Techniques of feeding
The nurse should:
- Obtain the formulae from the refrigerator and
warm it.
- Check the patency of the nipples.
- Ensure safe infants positioning.
- Burping the infant.
- Discard the unused portion of formulae.
C
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Five Common mistakes in bottle
feeding
Leaving the newborn\infant with the feeding
bottle unattended.
Too large or too narrow hole in the teat. Use of any available bottles.
Over-diluted feed.
Frequent crying of baby because ofunderfeeding.
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