BREASTFEEDING

Created by: PattyLDudley     Modified by: PattyLDudley

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Subjects: Nursing, Health Science

For students of 12th to graduate grade.

LESSON 1
OBJECTIVES

After completing this section, the student will be able to recognize the importance of breastfeeding and the composition of milk, including the three phases of human milk.

LESSON 1 BREASTFEEDING OVERVIEW

Breastfeeding promotes health, helps to prevent disease, and reduces health care and feeding costs.  Many medical authorities, including The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) emphasize the value of breastfeeding for mothers as well as children. The World Health Organization (WHO) recommends newborns be exclusively breastfed for their first six months of life, and breastfeeding should continue with the addition of complimentary foods for up to two years or more. 

Human breast milk is the healthiest form of milk for babies.  Human milk is species-specific, making it uniquely superior for infant feeding. All substitute-feeding preparations differ markedly from human breast milk. (Gartner, Morton, Lawerance, Naylor, O'Hare, Schanler, & Eidelman 2005). Breast milk is the natural first food for newborns, as it provides all the energy and nutrients that the infant needs for the beginning stage of life.  Not only does breast milk provide optimal nutrition for the first months of life, but it continues to provide vast nutritional needs for optimal growth. (World Health Organization, 2010). 

The composition of breast milk keeps pace with the infant's individual growth and changing nutritional needs. Breast milk experiences three changes to meet the nutritional needs of the newborn. These three phases of milk are colostrum, transitional milk, and mature milk. 

The first milk that the body produces is colostrum. The mother begins producing colostrum as early as mid-pregnancy and continues to produce it until 3-5 days postpartum. Colostrum is thick and yellow or creamy in appearance. It is very rich in proteins, fat-soluble vitamins, minerals, and immunoglobins. The transfer of these nutrients and antibodies provides a passive immunity to the newborn, which plays a significant role in protecting the newborn from numerous illnesses. The second type of milk is transitional milk. Transitional milk occurs after colostrum. Transitional milk is high in calories and full of high levels of fat, lactose, and water-soluble vitamins. The last type of milk is mature milk. It is the result of lactation. Mature milk is rich in carbohydrates, fats, and proteins. These nutrients are adequate for normal growth and energy required by the newborn.(Why Breastfeeding is Important, 2010).

LESSON 2
OBJECTIVES
After completing this section, the student will be able to list benefits associated with the baby, mother, environment, and society.

LESSON 2 BENEFITS OF BREASTFEEDING

Benefits of Breastfeeding for Baby

Breast milk provides ideal nutrition for infants. It has the complete combination of vitamins, protein, and fat, which is optimal for infant growth, and easily digested.  Breast milk contains antibodies that help the baby fight off viruses and bacteria. Breastfeeding reduces a baby's risk of having asthma or allergies. Babies who are breastfed exclusively for the first six months have fewer ear infections, respiratory illnesses, and bouts of colic and diarrhea. Breastfeeding reduces the risk of childhood diabetes and provides protection against meningitis, childhood lymphoma, and Crohn's disease. (Gartner, et al., 2005).

Breastfeeding plays an important role in the emotional development of babies, as breastfed babies enjoy a special bonding and emotional relationship with their mothers.  The physical closeness, skin-to-skin touching, and eye contact all help a baby bond with the mother and feel secure. Breastfed infants are more likely to gain the right amount of weight as they grow, rather than become overweight children. Some studies have also shown a link between breastfeeding and a lower risk of sudden infant death syndrome (SIDS), diabetes, obesity, and certain cancers. (Gartner, et al., 2005).

Breastfeeding Benefits for the Mother

Not only are there abundant advantages for the baby, but there are also benefits for the mother.  Breastfeeding requires approximately 500 extra calories a day, so it helps the mother's body return to its pre-pregnancy state faster.  It releases the hormone oxytocin, which helps your uterus return to its pre-pregnancy size and reduces uterine bleeding after birth. Breastfeeding lowers your risk of breast, ovarian, cervical, and endometrial cancers. There is a reduced risk of anemia.  It may also lower your risk of osteoporosis and hip fracture after menopause. (Gartner, et al., 2005).

Because there is no need to buy and measure formula, sterilize nipples, or warm bottles, breastfeeding saves you time and money. Deciding to breastfeed provides you with regular time for relaxing quietly with your newborn as you grow close and emotionally bond.

Most babies lose a small amount of weight in the first three to five days after birth. This is unrelated to breastfeeding. As your baby needs more milk and nurses more, your breasts respond by producing more milk. Even if you breastfeed less than the recommended six months, it's better to breastfeed for a short time than no time at all. 

Benefits to the Environment and Society

In addition to the numerous benefits for mother and child, breastfeeding also benefits society and the environment.  Breastfeeding reduces the cost of healthcare by promoting healthier children and mothers.  Breast milk is free, which eliminates or reduces the cost of breast milk alternatives.  Because breastfed babies get sick less, there are fewer doctor visits, hospitalizations, and prescription costs.  Therefore, insurance premiums for both parents and employers are decreased.  In addition, there is a reduction in absenteeism in the workplace due to children's illnesses.  Breastfeeding reduces global pollution by decreasing the use of resources and energy required to produce, distribute, promote, and dispose of materials for the use of artificial milk.(Gartner, et al., 2005).

LESSON 3
OBJECTIVES
After completing this section, the student will be able to identify signs of hunger and fulfillment, as well as various breastfeeding positions.

LESSON 3
Breastfeeding Management Skills

There are numerous breastfeeding techniques to promote successful breastfeeding.  Feeding cues, positions, and signs of fulfillment are essential management skills. Individuals who learn these skills will have a better understanding of breastfeeding. Mothers should be encouraged to have 8-12 feedings every 24 hours, offering the breast whenever the infant shows early signs of hunger. (Gartner, et al., 2005). Learning to identify newborn feeding signals allows prompt feeding initiation and attention. As a baby awakens from sleep, the mother should attempt to begin feeding. The feeding signals become more obvious as the baby grows more awake. The baby may begin to bring the fist to the mouth or by making a sucking or rooting motion with the mouth. They begin smacking their lips and try to suck or nozzle close objects. Crying is a late indicator of hungry. After reaching the crying point, babies tend to not breastfed well. After feeding, the baby will display indicators of satisfaction. A happily fed baby appears relaxed, the hands are open, and the body appears floppy. (Breastfeeding Your Baby, 2010)

Feeding positions are learned feeding skills, which promote comfort during feeding. Not all positions are beneficial to all mothers. Mothers must identify their personal comfort zone and work to achieve what position is best for them.

There are 4 positions deemed best for breastfeeding: cradle, cross-cradle hold, football, and side lying.

CRADLE HOLD: Support the head in the bend of the elbow, so the baby is facing your breast.(Breastfeeding Your Baby, 2010)

CROSS CRADLE HOLD: Similar to the cradle hold, the head should be in the bend of the elbow facing your breast.  With the other arm, support the head of the baby.  Your arms should be crossed below the breast.(Breastfeeding Your Baby, 2010)

FOOTBALL:  Tuck your baby under your arm like a football.  The baby is on your side, level with the waist and facing your breast.  Support the baby with your upper arm.  Support the head with your hand, holding the head up to the breast.(Breastfeeding Your Baby, 2010)

SIDE LYING: Lie on your side and cushion the baby next to you.  The mother and baby are chest to chest while lying down.(Breastfeeding Your Baby, 2010)

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References

Why Breastfeeding is Important. (2010). Retrieved November 15, 2010, from http://www.womenshealth.gov/breastfeeding/why-breastfeeding-is-important/
Gartner, L. Morton, J., Lawrence, R., Naylor, A., O’Hare, D., Schanler, R., & Eidelman, A. (2005). Breastfeeding and the use of human milk. Pediatrics, 115(2), 496-506.
WHO | Exclusive breastfeeding. (2010). Retrieved November 15, 2010, from http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/print.html
Breastfeeding Your Baby. (2010). Retrieved October 3, 2010, from http://www.acog.org/publications/patient_education/bp029.cfm