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Breastfeeding Mnemonics:
Breast feeding: benefits ABCDEFGH:
· Infant:
Allergic condition reduced
Best food for infant
Close relationship with mother
Development of IQ, jaws, mouth
· Mother:
Econmical
Fitness: quick return to pre-pregnancy body shape
Guards against cancer: breast, ovary, uterus
Hemorrhage (postpartum) reduced

A. Advantages
a. Psychologic value of closeness and satisfaction in beginning of
mother-child relationship
b. Optimum nutritional value for infant
c. Economic and readily accessible
B. Prerequisites
a. Psychologic readiness of mother is a major factor in successful
breastfeeding
b. Adequate diet must be available prenatally and postnatally to
ensure high-quality milk
c. Suitable rest, exercise, and freedom from tension for mother will
provide increased satisfaction for both her and the infant
d. 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 tuberculosis
2. Acute contagious desease; HIV positive
3. Chronic disease such as cancer, advanced nephritis,
cardiac disease
4. Extensive surgery
5. 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 Breastfeeding

A. Assessment
1. Condition of nipples
2. Desire to breastfeed
3. Level of anxiety regarding breastfeeding
4. Knowledge of breastfeeding and breast care
5. Family support

B. Analysis/Nursing Diagnoses
1. Ineffective breastfeeding related to position, condition of nipples, and
infant's sucking ability
2. Altered family processes related to the amount of time required for
breastfeeding
3. Risk for infection related to cracked nipples secondary to improper
positioning on nipples
4. Knowledge deficit related to feeding and maintenance of lactation

C. Planning/Implementation

1. Teach feeding schedule

a. Self-demand schedule (q 2 to 3 hrs) is desirable
b. Length of feeding time is usually 20 minutes, with greatest quantity
of milk consumed in first 5 to 10 minutes
2. Teach feeding techniques
a. Mother and infant in comfortable position, such as semireclining or
in rocking chair
b. Entire body of infant should be turned toward mother's breast;
alternate starting breast and use both breasts at each feeding
c. 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 day
f. After lactation has been established, occasional bottlefeeding can be
substituted
g. 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 brassiere
c. Nursing pads should be placed inside bra cup to absorb any milk
leaking between feedings; allow nipples to air dry at intervals
d. Plastic bra liners should be avoided because they increase heat and
perspiration and decrease air circulation necessary for drying of the
nipple
e. 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 daily
2. Infant sleeping between feedings
3. Mother has no signs of nipple cracking or infection