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Breastfeeding is one of the most essential topics for pediatric and neonatology residents, and it consistently appears in NEET SS, DNB, and UPSD exams. In this blog, we break down the fundamental concepts taught by Dr. Anand Bhatia—clear, exam-focused, and clinically practical.
What Is Exclusive Breastfeeding?
Exclusive breastfeeding means:
- No food or drink (not even water)
- Except for medically indicated medicines
- Breastfeeding initiated within the first hour of life
- Continued for the first six months of life
Many parents ask whether they can give water, honey, jaggery, or “janam ghutti.” The answer is: No. Nothing except breast milk for 6 months.
Breast milk alone is more than sufficient.
Breastfeeding Week & Important Dates
- Breastfeeding Week: First week of August
- Doctors’ Day: 1st July
Note: These are frequently asked MCQs.
Complementary Feeding After 6 Months
At 6 months, breastfeeding continues, but you add complementary feeds:
- Mashed dalia
- Porridge
- Khichdi
- Mashed potato
Introduce one new food per week.
However, do NOT stop breastfeeding. According to the AIIMS protocol, breastfeeding should continue up to 2 years of age.
When a Mother Says “My Baby Is Not Feeding Well”
This is a common clinical scenario. Your first step:
1. Ask the mother to show how she is breastfeeding.
Why?
Because most issues arise from poor attachment or positioning, especially in primigravida mothers who may not know the technique.
Signs of Good Attachment (Very High-Yield)
- Chin touching the breast
- Mouth wide open
- Cheeks look full
- Lower lip everted outwards
- More of the upper areola is visible
These points are frequently asked in UPSD and MD exams.
Signs of Good Positioning
- Baby’s body is well supported
- The baby is turned towards the mother
- Body parts aligned in a straight line
- Occiput
- Shoulders
- Buttocks
- Baby’s abdomen touching mother’s abdomen
This also helps prevent apnea in newborns, especially preterm babies.
When to Start Breastfeeding After Delivery?
- Normal Vaginal Delivery: As soon as possible
- LSCS: Within 4 hours (after spinal anesthesia wears off)
Both of these are standard MCQs.
Reflexes Involved in Breastfeeding
In the Baby
- Rooting reflex – baby turns toward the nipple when cheek is touched
- Sucking reflex – baby sucks when nipple is in the mouth
In the Mother
- Milk Secretion Reflex – Prolactin
- Milk Ejection Reflex – Oxytocin
Prolactin vs. Oxytocin (Golden Points)
| Hormone | Function | Keyword |
| Prolactin | Produces milk | P = Produces (Milk Secretion) |
| Oxytocin | Oozes out milk | O = Oozes (Milk Ejection) |
- Prolactin is released from the anterior pituitary
- Oxytocin acts on smooth muscles around the breast
Night Feeds Are Very Important
Prolactin levels are highest at night (midnight–2 AM).
Skipping night feeds reduces milk production.
Galactopoiesis vs. Galactokinesis
- Galactopoiesis = Prolactin → Milk formation
- Galactokinesis = Oxytocin → Milk let-down
Easy mnemonic:
- P → Poiesis (production)
- Kinesis → movement (ejection)
Breastfeeding is a blend of physiology, technique, and patient counseling. Mastering these basics not only helps you in exams but also makes you a confident pediatric resident who can guide new mothers effectively.
