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Dr. Shashwat Jani
M. S. ( Obs – Gyn ), F.I.A.O.G.
Diploma in Advance Laparoscopy.
Consultant Assistant Professor,
Smt. N.H.L. Municipal Medical College.
S.V.P. Hospital , Ahmedabad.
Mobile : +91 99099 44160.
E-mail : drshashwatjani@gmail.com
Standard Techniques
Of Breastfeeding
INTRODUCTION
"The more we know
about human
breast milk the
more we discover
about its value in
human nutrition
and development”.
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Successful lactation is determined
by early initiation of breastfeeding
and continuation of lactation and
again that is determined by
positioning.
Positioning is key to get Latch on.
3
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Factors Influencing Breast Feeding
4
Position
Factors
Attitude
of the
Mother
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PHYSIOLOGY
The physiological basis of lactation is
divided into four phases :
1. Preparation of breasts (mammogenesis).
2. Synthesis and secretion from the breast
alveoli (lacto genesis).
3. Ejection of milk (galactokinesis).
4. Maintenance of lactation (galactopoiesis).
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GALACTOKINESIS
Milk let down reflex
Discharge of milk from the mammary
glands depends not only on the suction
exerted by the baby during sucking, but
also on the contractive mechanism which
expresses the milk from the alveoli into
the ducts.
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TECHNIQUE OF
BREASTFEEDING
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INITIATION
Breast feeding should be started within half
an hour of birth as soon as possible after
normal delivery where as in case of
caesarian section delivery, within 4 hours.
Rooming in and bedding should be done
with mother and baby to prevent separation
and promote breast feeding.
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• Bringing hands to mouth
• Rooting
• Suckling
• Licking
• Nuzzling
• Lip smacking
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TECHNIQUE
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TECHNIQUE
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TECHNIQUE
Here are the basic steps for breast feeding:
1. Make sure mother is comfortable and well supported with pillows. Lean
back rather than sit upright
2. Place baby on her bare chest between her breasts, facing her. Gravity will
help keep her in position. It’s best if her baby is awake but not crying – if
she’s crying, calm her first, perhaps by letting her suck mother’s finger.
1. When calm, baby will begin to follow his instincts. Baby will start to move
towards one breast. Support baby behind his shoulders and under his
bottom (hold his head only if he needs it). Let him move to where he’s
trying to go – towards nipple. He knows where to go. Mother’s job is to
keep him calm. Mother can help him by moving his whole body a little if
necessary.
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TECHNIQUE
4. Baby will most likely position himself on an angle, with
his mouth near mother’s nipple and his feet supported
by mother’s thigh or lap.
5. When baby is just below mother’s nipple, he’ll dig his
chin into the breast, reach up with an open mouth, attach
to the breast and start sucking.
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POSITIONS
 Baby’s head & body straight.
 Baby’s body turned towards the mother, nose opposite
the nipple.
 Baby’s body touching mother’s abdomen.
 Baby’s whole body well supported not just neck or
shoulders.
 Mother should than support her breast with her finger
flat against her chest wall under her breast.
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Explaining the POSITIONS
1.Cradle Hold (Tummy to Tummy)
 Sit as straight as possible with a pillow behind you, or sit
on the edge of the bed.
 Cradle your baby in your arm, her tummy against yours
and her head resting in the bend of your elbow. Her ear,
shoulders and hip should be in a straight line.
 Tuck your baby's lower arm out of the way, with her
mouth close to your breast.
 Support your breast with your free hand; place all
of your fingers underneath it, well away from the
areola.
 Rest your thumb lightly on top of your breast above your
areola.
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 Lift your breast upward and
lightly stroke your nipple on your
baby's lower lip. As part of the
rooting reflex, her mouth will
open wide.
 Pull her quickly onto the breast to
latch-on when her mouth is
opened wide, like a big yawn,
and her tongue is down. Do not
lean over your baby; keep your
back straight, and pull your baby
up to your breast.
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Cross Cradle Hold Position
• Same of cradle position
but just the opposite
hand is used to support
the infant and the same
side hand is used to hold
the breast.
• To learn Latching
• To maintain comfortness
of the mother
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2. Football hold
 Position your baby so her legs and body are
under your arm, with your hand holding her head
(as if you were holding a football).
 Place your fingers below your breast. Allow your
baby to latch-on while pulling her in close, holding
her head tightly against your breast.
 Keep your baby's body flexed at the hip with her
legs tucked under your arm.
Explaining the POSITIONS
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The football hold is a good position when:
- Patient had a caesarean birth and want to avoid placing
her baby against her abdominal incision.
- She needs more visibility in getting her baby to latch-on.
- Her breasts are large.
- Baby is premature
- Baby tends to slide down areola onto her nipple.
- Baby is fussy, restless and hard to latch-on.
- When baby is sleepy. Sitting upright may encourage her to
remain alert for a longer period.
- Inverted nipples.
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3 Side lying position
 First, position yourself and your baby on your
sides tummy – to - tummy.
 Bend your top leg and position with pillows
 Place your fingers beneath your breast and lift
upward, then pull your baby in close as she
latches-on.
Explaining the POSITIONS
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 The side-lying position is an especially good choice
for breastfeeding when:
You must be flat after a caesarean birth with spinal
anesthesia.
POSITIONS
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Various Other Positions To Feed Twins
26
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Latch on
• Mother holds the baby in upright position on
her lap.
• Mouth is wide open and the chin touches the
breast.
• Mother guide the nipple and areola into the
baby’s mouth for effective milk transfer
• Peristaltic action from the tip of the tongue to
the base.
27
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Step 1
28
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Step 2
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Step 3
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Step 3
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Step 4
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33
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How to find poor attachment
1. Mother feels pain
2. Clicking sound
heard by mother
3. Eager to suck
35
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Results Of Poor Attachment
• Painful nipples
• Damaged nipples
• Engorgement
• Baby unsatisfied & cries a lot
• Baby feeds frequently & for a long time
• Decreased milk production
• Baby fails to gain weight
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Basic Steps
• Sucks
• Swallow
• Pause
37
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 Baby suckles slowly and pauses in between
to swallow (suck, suck, suck.. and
swallow).
 One may see throat cartilage and muscles
moving and hear the gulping sounds of
milk being swallowed.
 Baby's cheeks are full and not hollow or
retracting during sucking.
Effective Suckling
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Cuddle and fiddle with the baby by
stroking and tickling behind his or her ears
or on the soles so that infant does not
lapse into sleep without adequate feeds.
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De latching
 Watch baby for cues that he
/she has finished
 May spontaneously come
off the breast
 May fall sleep
 If mother wants to stop the
feeding early, break suction
by inserting finger into
corner of infant’s mouth.
40
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Dr Shashwat Jani.
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Burping
• Propped up with baby’s tummy against
shoulder of the mother.
• Sitting up, leaning forward on one hand of the
mother with the other hand burps at back of
infant.
41
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Burping and de latching
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Importance Of Good Position & Attachment
43
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Dr Shashwat Jani.
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Signs of successful Breast feeding
• One or two wet diapers during the first few days.
• Six to eight wet cloth diapers (5 - 6 wet disposable diapers) per
day (24 hours).
• At least two to five bowel movements every 24 hours.
• 6 - 10 feedings per24-hours.
• Baby’s swallowing sounds are audible.
• Gain at least 120 – 210 g per week after the fourth day of life.
• Appear healthy, have good colour, firm skin, and will be growing in
length and head circumference.
• Sound sleep followed by feed.
44
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THANK YOU
1/29/2023
Dr Shashwat Jani.
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48

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STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptx

  • 1. Dr. Shashwat Jani M. S. ( Obs – Gyn ), F.I.A.O.G. Diploma in Advance Laparoscopy. Consultant Assistant Professor, Smt. N.H.L. Municipal Medical College. S.V.P. Hospital , Ahmedabad. Mobile : +91 99099 44160. E-mail : drshashwatjani@gmail.com Standard Techniques Of Breastfeeding
  • 2. INTRODUCTION "The more we know about human breast milk the more we discover about its value in human nutrition and development”. 1/29/2023 Dr Shashwat Jani. 9909944160 2
  • 3. Successful lactation is determined by early initiation of breastfeeding and continuation of lactation and again that is determined by positioning. Positioning is key to get Latch on. 3 1/29/2023 Dr Shashwat Jani. 9909944160
  • 4. Factors Influencing Breast Feeding 4 Position Factors Attitude of the Mother 1/29/2023 Dr Shashwat Jani. 9909944160
  • 5. PHYSIOLOGY The physiological basis of lactation is divided into four phases : 1. Preparation of breasts (mammogenesis). 2. Synthesis and secretion from the breast alveoli (lacto genesis). 3. Ejection of milk (galactokinesis). 4. Maintenance of lactation (galactopoiesis). 1/29/2023 Dr Shashwat Jani. 9909944160 5
  • 8. GALACTOKINESIS Milk let down reflex Discharge of milk from the mammary glands depends not only on the suction exerted by the baby during sucking, but also on the contractive mechanism which expresses the milk from the alveoli into the ducts. 1/29/2023 Dr Shashwat Jani. 9909944160 8
  • 10. INITIATION Breast feeding should be started within half an hour of birth as soon as possible after normal delivery where as in case of caesarian section delivery, within 4 hours. Rooming in and bedding should be done with mother and baby to prevent separation and promote breast feeding. 1/29/2023 Dr Shashwat Jani. 9909944160 10
  • 11. • Bringing hands to mouth • Rooting • Suckling • Licking • Nuzzling • Lip smacking 11 1/29/2023 Dr Shashwat Jani. 9909944160
  • 14. TECHNIQUE Here are the basic steps for breast feeding: 1. Make sure mother is comfortable and well supported with pillows. Lean back rather than sit upright 2. Place baby on her bare chest between her breasts, facing her. Gravity will help keep her in position. It’s best if her baby is awake but not crying – if she’s crying, calm her first, perhaps by letting her suck mother’s finger. 1. When calm, baby will begin to follow his instincts. Baby will start to move towards one breast. Support baby behind his shoulders and under his bottom (hold his head only if he needs it). Let him move to where he’s trying to go – towards nipple. He knows where to go. Mother’s job is to keep him calm. Mother can help him by moving his whole body a little if necessary. 1/29/2023 Dr Shashwat Jani. 9909944160 14
  • 15. TECHNIQUE 4. Baby will most likely position himself on an angle, with his mouth near mother’s nipple and his feet supported by mother’s thigh or lap. 5. When baby is just below mother’s nipple, he’ll dig his chin into the breast, reach up with an open mouth, attach to the breast and start sucking. 1/29/2023 Dr Shashwat Jani. 9909944160 15
  • 16. POSITIONS  Baby’s head & body straight.  Baby’s body turned towards the mother, nose opposite the nipple.  Baby’s body touching mother’s abdomen.  Baby’s whole body well supported not just neck or shoulders.  Mother should than support her breast with her finger flat against her chest wall under her breast. 1/29/2023 Dr Shashwat Jani. 9909944160 16
  • 17. Explaining the POSITIONS 1.Cradle Hold (Tummy to Tummy)  Sit as straight as possible with a pillow behind you, or sit on the edge of the bed.  Cradle your baby in your arm, her tummy against yours and her head resting in the bend of your elbow. Her ear, shoulders and hip should be in a straight line.  Tuck your baby's lower arm out of the way, with her mouth close to your breast.  Support your breast with your free hand; place all of your fingers underneath it, well away from the areola.  Rest your thumb lightly on top of your breast above your areola. 1/29/2023 Dr Shashwat Jani. 9909944160 17
  • 18.  Lift your breast upward and lightly stroke your nipple on your baby's lower lip. As part of the rooting reflex, her mouth will open wide.  Pull her quickly onto the breast to latch-on when her mouth is opened wide, like a big yawn, and her tongue is down. Do not lean over your baby; keep your back straight, and pull your baby up to your breast. 1/29/2023 Dr Shashwat Jani. 9909944160 18
  • 19. Cross Cradle Hold Position • Same of cradle position but just the opposite hand is used to support the infant and the same side hand is used to hold the breast. • To learn Latching • To maintain comfortness of the mother 1/29/2023 Dr Shashwat Jani. 9909944160 19
  • 20. 2. Football hold  Position your baby so her legs and body are under your arm, with your hand holding her head (as if you were holding a football).  Place your fingers below your breast. Allow your baby to latch-on while pulling her in close, holding her head tightly against your breast.  Keep your baby's body flexed at the hip with her legs tucked under your arm. Explaining the POSITIONS 1/29/2023 Dr Shashwat Jani. 9909944160 20
  • 22. The football hold is a good position when: - Patient had a caesarean birth and want to avoid placing her baby against her abdominal incision. - She needs more visibility in getting her baby to latch-on. - Her breasts are large. - Baby is premature - Baby tends to slide down areola onto her nipple. - Baby is fussy, restless and hard to latch-on. - When baby is sleepy. Sitting upright may encourage her to remain alert for a longer period. - Inverted nipples. 1/29/2023 Dr Shashwat Jani. 9909944160 22
  • 23. 3 Side lying position  First, position yourself and your baby on your sides tummy – to - tummy.  Bend your top leg and position with pillows  Place your fingers beneath your breast and lift upward, then pull your baby in close as she latches-on. Explaining the POSITIONS 1/29/2023 Dr Shashwat Jani. 9909944160 23
  • 24. 1/29/2023 Dr Shashwat Jani. 9909944160 24  The side-lying position is an especially good choice for breastfeeding when: You must be flat after a caesarean birth with spinal anesthesia.
  • 26. Various Other Positions To Feed Twins 26 1/29/2023 Dr Shashwat Jani. 9909944160
  • 27. Latch on • Mother holds the baby in upright position on her lap. • Mouth is wide open and the chin touches the breast. • Mother guide the nipple and areola into the baby’s mouth for effective milk transfer • Peristaltic action from the tip of the tongue to the base. 27 1/29/2023 Dr Shashwat Jani. 9909944160
  • 29. Step 2 1/29/2023 Dr Shashwat Jani. 9909944160 29
  • 30. Step 3 1/29/2023 Dr Shashwat Jani. 9909944160 30
  • 31. Step 3 1/29/2023 Dr Shashwat Jani. 9909944160 31
  • 32. Step 4 1/29/2023 Dr Shashwat Jani. 9909944160 32
  • 35. How to find poor attachment 1. Mother feels pain 2. Clicking sound heard by mother 3. Eager to suck 35 1/29/2023 Dr Shashwat Jani. 9909944160
  • 36. Results Of Poor Attachment • Painful nipples • Damaged nipples • Engorgement • Baby unsatisfied & cries a lot • Baby feeds frequently & for a long time • Decreased milk production • Baby fails to gain weight 1/29/2023 Dr Shashwat Jani. 9909944160 36
  • 37. Basic Steps • Sucks • Swallow • Pause 37 1/29/2023 Dr Shashwat Jani. 9909944160
  • 38.  Baby suckles slowly and pauses in between to swallow (suck, suck, suck.. and swallow).  One may see throat cartilage and muscles moving and hear the gulping sounds of milk being swallowed.  Baby's cheeks are full and not hollow or retracting during sucking. Effective Suckling 1/29/2023 Dr Shashwat Jani. 9909944160 38
  • 39. Cuddle and fiddle with the baby by stroking and tickling behind his or her ears or on the soles so that infant does not lapse into sleep without adequate feeds. 1/29/2023 Dr Shashwat Jani. 9909944160 39
  • 40. De latching  Watch baby for cues that he /she has finished  May spontaneously come off the breast  May fall sleep  If mother wants to stop the feeding early, break suction by inserting finger into corner of infant’s mouth. 40 1/29/2023 Dr Shashwat Jani. 9909944160
  • 41. Burping • Propped up with baby’s tummy against shoulder of the mother. • Sitting up, leaning forward on one hand of the mother with the other hand burps at back of infant. 41 1/29/2023 Dr Shashwat Jani. 9909944160
  • 42. Burping and de latching 1/29/2023 Dr Shashwat Jani. 9909944160 42
  • 43. Importance Of Good Position & Attachment 43 1/29/2023 Dr Shashwat Jani. 9909944160
  • 44. Signs of successful Breast feeding • One or two wet diapers during the first few days. • Six to eight wet cloth diapers (5 - 6 wet disposable diapers) per day (24 hours). • At least two to five bowel movements every 24 hours. • 6 - 10 feedings per24-hours. • Baby’s swallowing sounds are audible. • Gain at least 120 – 210 g per week after the fourth day of life. • Appear healthy, have good colour, firm skin, and will be growing in length and head circumference. • Sound sleep followed by feed. 44 1/29/2023 Dr Shashwat Jani. 9909944160
  • 48. THANK YOU 1/29/2023 Dr Shashwat Jani. 9909944160 48