Growth & Development (Breast Feeding)

Taif University Department of Nursing

Physiology of lactation
During pregnancy :

- Estrogen and progesterone secreted by the placenta prepare the 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.

Colostrums

Physiology of lactation
By 3rd stage of labor (delivery of placenta) :

- Production of milk is reduced and during the next 48 hours, the blood level of estrogen and progesterone fall and this stimulates the anterior pituitary gland to produce the lactogenic hormone (prolactin hormone). - The milk is pushed along the lactiferous ducts and some is stored in the lactiferous sinuses (milk reservoir

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 a chewing 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

Physiology of lactation
So the act of sucking by the baby is the stimulus,

which keeps lactation going on by some neurohormonal 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.

Advantages of breast feeding

The infant sucking at the breast promotes

involution of the uterus after labor. Many mothers find great satisfaction in feeding the infant at the breast. Save times and troubles appeals to some women. Breast milk is less of strain on the family budget than buying a fresh or even dried milk. It fulfils the feminine role and motherly attitudes. Lower incidence rate of cancer breast in women.

Advantages to infant
Human milk is warm, sterile and perfectly balanced in

proteins, carbohydrates, fats, and vitamins and doesnt cost anything. Breast fed infants have greater immunity to certain childhood diseases (it provide immunological factors to 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

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.

Technique of breast feeding

Positioning of infant :

- Cradle position. - Cross cradle position. - Foot- ball position. - Horizontal position. - Backwards position. -position for two babies.

Cradle position

Cross-Cradle position

Horizontal breastfeeding

Football breastfeeding

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 the

infants cheek or lips to stimulates rooting reflex So the infant focus on breast.

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.

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 breastfeeding baby up to 6 months and he\she is fed on demand, day and night, with no restriction on length or frequency of breastfeeding.

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

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).

Bottle Feeding
Types of formulae feedings:

- Complementary feeding: each feed, the breast is given first until 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

Bottle feeding
Substitutive feeding is only

indicated in cases of : - Death of the mother. - Institutions. - Contraindications of breast feeding.

Contraindications of breastfeeding

Mothers with HIV virus. Mother with cancer. Under retarded treatment.

Disadvantages of bottle feeding

Bottle fed 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 the expensiveness of milk powder. Thus, marasmus (severe protein energy malnutrition) often

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 all the equipment used in formulae preparation for 15 minuets.

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 digestion

of milk unless it is modifies.

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.

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 of underfeeding.