Breast Feeding


General Information

Importance of Breast Feeding

Nothing can duplicate the Value of Breast Milk !!!!!!

Complete food for the infant

The nutritional profile of breast milk in terms of calories, vitamins, and minerals is the BEST for infants as it has the perfect proportion of them all, and is exclusively tailor made just for your baby.

Young mothers are often misled to believe that infant feeding formula does very well as a replacement for breast milk. However, nothing can duplicate the properties of breast milk, no matter how many vitamins, minerals and other supplements are added to what is basically a chemical formulation.

Colostrum

The Golden first feeds……….
  • This is the special milk that is secreted in first two to three days after delivery.  
  • Produced only in small amounts (40-50ml on the first day) – But is all that the baby needs
Property Importance
Antibody rich Protects against infection
Many white cells Protect against    infection
Purgative Clears meconium
Less jaundice
Growth factors Helps intestine to mature
Prevents allergy and intolerance
 Vitamin A rich Reduces severity of infection
Prevents eye disease

Protection against Infection

Psychological benefits of breastfeeding

Emotional bonding
  • Close, loving relationship between mother and baby
  • Mother more emotionally satisfied
  • Baby cries less
  • Mother behaves more affectionately
  • Less likely to abandon or abuse baby

Development
  • Children perform better on intelligence tests later on
  • Less behavioural problems

Harm of giving formula feeds

How Breast Milk is produced

Recommendations of breast feeding

Positioning
To achieve an effective suckling, correct positioning and good attachment are essential.

Positioning of mother

The mother can be seated or lying down or standing whichever make her comfortable.
Relaxed and comfortable.
Without strain particularly on her back.
Do not lean forward.

Positioning of the baby

Whatever the position of the mother, the baby’s general position should be in relation to the mother.
Baby’s body should be straight, not bent or twisted. So the baby’s head, back of the trunk and buttocks should be in a straight line.

How a baby attaches and suckles at the breast

For an adequate supply and a good flow of milk, baby needs to be well attached to the breast.

Good attachment

Much of the areolar (with blackish area around with nipple) should be in the baby’s mouth.
Nipple only forms only 1/3 of the teat. Rest is formed by the breast tissue.
The baby is suckling from the breast not from the nipple.

Signs of good attachment

More of the areola is visible above the baby’s top lip than below the lower lip.
Baby’s mouth is widely open.
Baby’s lower lip is curled outward. 
Baby’s chin is touching or almost touching the breast.

How to express breast milk by hand

Have a clean, dry, wide mouthed container for expression of breast milk.
Wash your hands thoroughly.
Sit or stand comfortably.
Hold the container under your nipple and areolar.
Put your thumb on top of the breast and your first finger on the underside of your breast.
Compress and release your breast between your first finger and thumb.
Compress and release all the way around your breast.
Express each breast until milk drips slowly.
Repeat expression from each breast 5 to 6 times.
Avoid rubbing, squeezing or pinching the nipple.
Avoid sliding the fingers along the skin.

Milk production and flow can be stimulated by

The sight of the baby – keeping the baby with you while expressing is important. 
Looking at a photograph of the baby.
Thinking of the baby.
Breast massaging.
Back massage.

Storing

Expressed breast milk can be stored until the baby needs it.
Colostrum can be stored in a similar manner
Express the milk into a cup, glass, jug or jar that has been thoroughly washed with soap and water.
Need to be covered tightly.

Expressed breast milk

Expressed breast milk can be kept at room temperature for 8 hours.
In a refrigerator for 24 to 48 hours.
In a deep freezer for 3 months.

Tips for working mothers

Breast feed the baby before you leave for work.
Keep expressed milk for the baby stored properly while you are away.
Express milk while at work. This helps to maintain a good flow of milk when you go home.
  • If you have facilities you can store this milk and use to feed the baby even on next day.
  • If no facilities available for storing, discard the expressed milk.

Policies

Lactation support

Lactation support activities begin before child birth; at pre-pregnancy counseling classes and awareness at pregnancy period. This continues during the hospital stay for the delivery and after the delivery as well.

Lactation Management centers

Lactation management center (LMC) is a special unit established in all major hospital in Sri Lanka in order to assist mothers who need support for breast feeding. Commonly encountered problems are;
  • Poor suckling
  • Refusal of breast feed
  • Painful nipple with suckling
  • Cracked nipple
  • Breast swelling
  • Mothers think, they do not have enough milk
  • Mothers think, the size of the breast affects breast feeding (too small or too big)
  • Worry about size of the nipple
Even without a referral or visiting to OPD, mothers can directly get the necessary assistance from this center. Hospital admission is not essential to get helped at LMCs. If the condition indicates hospital admission, the mothers are referred to the relevant unit through the OPD.
Usually the LMCs are functioning from 8.00 a.m. to 4.00 p.m. daily. 
Specially trained Nursing Officers and Hospital Midwives are attached to LMCs. They are provided with relevant educational materials to assist needy mothers.

Contact numbers of Lactation management centers

Western Province

Gampaha District

CNTH (Ragama)

0112959261-3

DGH Negambo

0312222261-2

DGH Gamapaha

0332222261-2

DH Wathupitiwala

0332280261-2

 

 

Kaluthara District

DGH Kaluthara

0342229128

DG Horana

0342261261

BH Panadura

0382232261

Colombo District

DMH

0112696224

CSHW

0112695529

LRH

0112693711-14

CSTH (Kalubowila)

0112764068-9

BH Homagama

0112855200

 

 

Southern Province

Galle District

TH Mahamodara

0912222261

BH Balapitiya

0912258261

Matara District

DGH Matara

0412222261

Hambanthota District

BH Thangalle

0472240261

 

 

North Central Province

Polonnaruwa District

DGH Polonnaruwa

0272222261

Anuradhapura District

TH Anuradhapura

0252222261

 

 

Uva Province

Monaragala District

DGH Monaragala

0552276261

Badulla District

PGH Badulla

0552222261

BH Diyathalwa

0572229061

 

 

North Western Province

Kurunegala District

TH Kurunegala

0372222261

DGH Kuliyapitiya

0372282553

BH Nikaweratiya

0372260261

Puttalam District

DGH Chilaw

0322222261

BH Puttalam

0322265261

 

 

Central Province

Kandy District

TH Kandy

0812233337, 0812234220, 0812222261

TH Peradeniya

0812388001, 0812387383, 0812388261

Matale District

DGH Matale

0662222261, 0662223627, 0662224361

 

 

Sabaragamuwa Province

Ratnapura District

PGH Ratnapura

0452222261

Kegalle District

BH Karawanella

0362266261

 

 

Eastern Province

 

Ampara District

Kalmunai South Hospital

067229496

Batticaloa District

TH Batticaloa

062222261

 

 

Northern Province

Jaffana Dsitrict

DH Point Pedro

0212263261

BH Chawakachcheri

0212270661

Vavuniya District

DGH Vavunuya

0242222761

Publications and Articles

Frequently asked Questions

Q) What to be given from birth to six (6) month?

A) Exclusive breast feeding- baby should be given only breast milk from birth to completion of six (6) months-180 days. Breast milk is superior to any form of fluid during first six months of life.

Q) Why only breast milk?

A) Breast milk has all the energy and nutrient needs of baby up to six (6) months. So no other foods or fluids are (water, coriander water, tea, fruit juice, formula milk, ratha kalkaya) necessary.
Baby does not need additional water during the first six (6) months when breast feeding is practicing even in hot climates.

Q) What can be happened if other fluids are given?

A) breast milk contain all the nutrient that an infant needs in the first six months of life including carbohydrates, fat, protein, vitamin, minerals, and water. If the baby is given any other fluid he may not get enough breast milk as its stomach that is very small, is filled with what you have given addition to breast milk.
Baby’s stomach capacity is only 20 ml at birth – if 5ml of orange juice is given by mother 25% of stomach is already filled and breast milk will fill the rest (75%). So baby is getting less amount of energy than he needs. This may cause poor weight gain resulting insufficient growth.

Q) What are the benefits children get from exclusive breast feeding?

A)
1) It is easily digestible and it gives all what baby needs.
2) It helps to protect infants from a variety of infections - diarrhea, respiratory tract infections, ear infections. 
Researchers have found that infants who are not breastfed are 6 to 10 times more likely to die in the first month of life than infants who are breastfed; due to diarrhea and pneumonia.
3) Formula-fed (artificial feeding) children have an increased risk of long term diseases like asthma, diabetes, allergies, and leukemia, obesity, cardiovascular diseases, high blood cholesterol, heart attacks in later life.
4) Exclusive breast feeding associated with greater intelligence in late childhood and adulthood.

Q) What are the benefits, mother gets from breast feeding?

A) It helps a mother and baby to bond - that is to develop a close loving relationship.
1) Mother gets mental satisfaction with breast feeding.
2) It protects mothers’ health – it helps the uterus to return to its previous size. This helps to reduce bleeding and contribute to prevent maternal anemia (condition of the blood caused by lack of red cells. People with anemia look pale and feel weak).
3) Reduces the risk of ovarian and breast cancers.
4) Exclusive breast feeding helps to delay a new pregnancy.

Q) What is colostrum?

A) 
This is the special milk that is secreted in first few days (first two to three days) after delivery. It is produced in small amounts about 40 – 50 ml on the first day but is all that an infant normally needs at this time.
Colostrum consists of larger percentage of protein, minerals, and vitamin which are important in immune protection (fighting against germs) to an infant when he or she is first exposed to the germs in the environment. 
Colostrum also helps to maturation of gut wall which is very smooth and susceptible to infection. So germs are not able to invade the gut wall easily.

Q) What are the dangers of formula / artificial feeding?

A)
Artificial feeding may interfere with bonding. The mother and baby may not develop such a close, loving relationship.
An artificially fed baby is more likely to become ill with diarrheal, respiratory, ear, and other infections.
Diarrhea may become persistent.
He may get too little milk and may become malnourished, because he gets too few feeds, or they are too dilute. He is more likely to suffer from vitamin A deficiency.
An artificially fed baby is more likely to suffer from infections and malnutrition than a breastfed baby.
He is more likely to develop allergic conditions such as eczema and asthma.
He may become intolerant of animal milk, so that milk causes diarrhea, rashes, and other symptoms.
The risk of some chronic diseases in child, such as diabetes is increased.
A baby may get too much artificial milk, and become obese.
He may not develop so well mentally, and score lower on intelligence tests.

Common myths and beliefs

  1. Mothers think that it is not good to breastfeed when they are ill (fever, cold, cough). Breast feeding can continue even the mother is not well
  2. Mothers usually do not breastfeed when their breasts are engorged. - Mother should continue breast feeding when they have engorged breast if not she will end up with breast abscess.
  3. Mother thinks that baby needs water when the climate is hot. - Breast milk has enough water content. So additional water is not needed.
  4. Some mothers worry about the effect, that breast feeding will have on their figure. - Breast feeding helps  to burn additional fat and lose weight so get good figure
  5. Mother who is having small breasts, flat inverted nipples thinks that she can’t breast feed successfully. - Babies can be breast-fed quit well from breast of any size with almost any shape of nipple because production of milk does not affect by size and shape of the breast.