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Breastfeeding Mnemonics: Breast feeding: benefits ABCDEFGH:· Infant:Allergic condition reducedBest food for infantClose relationship with motherDevelopment of IQ, jaws, mouth· Mother:EconmicalFitness: quick return to pre-pregnancy body shapeGuards against cancer: breast, ovary, uterusHemorrhage (postpartum) reduced

A. Advantagesa. Psychologic value of closeness and satisfaction in beginning of

mother-child relationshipb. Optimum nutritional value for infantc. Economic and readily accessible

B. Prerequisitesa. Psychologic readiness of mother is a major factor in successful

breastfeedingb. Adequate diet must be available prenatally and postnatally to

ensure high-quality milkc. Suitable rest, exercise, and freedom from tension for mother will

provide increased satisfaction for both her and the infantd. Infant’s sucking at the breast stimulates the maternal posterior

pituitary to produce oxytocin, the properties for which, in the blood system, constrict the lactiferous sinuses to move the milk down through the nipple ducts: know as the let-down reflex; a poor sucking reflex of the child will inhibit the let-down of milk; sucking also stimulates prolactin production

e. Family support and the absence of emotional stress in the mother, because anxiety inhibits the let-down reflex.

C. Contraindications a. In the mother:

1. Active tuberculosis2. Acute contagious desease; HIV positive 3. Chronic disease such as cancer, advanced nephritis,

cardiac disease4. Extensive surgery5. Narcotic addiction 6. Pregnancy

b. In infant: cleft lip or palate or any other condition that interfere or prevents grasp of the nipple is the only real contraindication

c. Many drugs are excreted in the breast milk and have harmful effects on the developing infant; these drugs must be avoided or

taken with care if they must be taken by the mother; careful monitoring of the infant is required.

Nursing Care of the Mother Who Is BreastfeedingA. Assessment1. Condition of nipples2. Desire to breastfeed3. Level of anxiety regarding breastfeeding4. Knowledge of breastfeeding and breast care5. Family support

B. Analysis/Nursing Diagnoses1. Ineffective breastfeeding related to position, condition of nipples, and infant's sucking ability2. Altered family processes related to the amount of time required for breastfeeding3. Risk for infection related to cracked nipples secondary to improper positioning on nipples4. Knowledge deficit related to feeding and maintenance of lactation

C. Planning/Implementation

1. Teach feeding schedulea. Self-demand schedule (q 2 to 3 hrs) is desirableb. Length of feeding time is usually 20 minutes, with greatest quantity of milk consumed in first 5 to 10 minutes

2. Teach feeding techniquesa. Mother and infant in comfortable position, such as semireclining or in rocking chairb. Entire body of infant should be turned toward mother's breast; alternate starting breast and use both breasts at each feedingc. Initiate feeding by stimulating rooting reflex and direct nipple straight into baby's mouth (stroking cheek toward breast, being careful not to stroke other cheek, because this will confuse infant)d. Burp or bubble infant during and after feeding to allow for escape of

air by:(1) Placing infant over shoulder(2) Sitting infant on lap, flexed forward(3) Rubbing or patting back (avoid jarring infant)e. Breast milk intake similar to formula intake(1) 130 to 200 ml of milk per kilogram (2 to 3 oz of milk per pound) of body weight(2) From one sixth to one seventh of baby's weight per dayf. After lactation has been established, occasional bottlefeeding can be substitutedg. Length of time for continuing breastfeeding is variable (may be discontinued when teeth erupt, because this can be uncomfortable for mother)

3. Teach care of breasts

a. Cleanse with plain water once daily (soap or alcohol can cause irritation and dryness)b. Support breasts day and night with properly fitting brassierec. Nursing pads should be placed inside bra cup to absorb any milk leaking between feedings; allow nipples to air dry at intervalsd. Plastic bra liners should be avoided because they increase heat and perspiration and decrease air circulation necessary for drying of the nipplee. If breasts are engorged, teach mother to take warm showers and put baby to breast more frequently

D. Evaluation/Outcomes

1. Infant receiving enough milk as evidenced by six or more wet diapers daily2. Infant sleeping between feedings3. Mother has no signs of nipple cracking or infection