Question No 4: How will you inculcate the culture of breast feeding in

working class lactating mothers?

Breast feeding practices in working lactating mothers can be promoted by

these two ways:

1) Realization of importance or advantages of breast feeding

2) Providing appropriate ways that facilitate breast feeding in working
mothers

Realization of importance of breast feeding:

Realization of importance and benefits of breast feeding makes nursing

mothers aware about the necessity and sensitivity of breast feeding. Nurses
can convince the working mothers firstly by disseminating information
regarding following benefits of breast feeding:

1. Breast milk helps keep your baby healthy.

It supplies all the necessary nutrients in the proper proportions.

It protects against allergies, sickness, and obesity.
It protects against diseases, like diabetes and cancer.
It protects against infections, like ear infections.
It is easily digested no constipation, diarrhea or upset stomach.
Babies have healthier weights as they grow.
Breastfed babies score higher on IQ tests.

2. Breastfeeding Benefits for Mothers:

Reduces the risk of breast cancer. Women who breastfeed

reduce their risk of developing breast cancer by as much as 25
percent. The reduction in cancer risk comes in proportion to the
cumulative lifetime duration of breastfeeding. That is, the more
months or years a mother breastfeeds, the lower her risk of breast
cancer.

Reduces the risk of uterine and ovarian cancer. One of the

reasons for the cancer-fighting effects of breastfeeding is that
estrogen levels are lower during lactation. It is thought that the less
estrogen available to stimulate the lining of the uterus and perhaps
breast tissue also, the less the risk of these tissues becoming
cancerous.

Lessens osteoporosis. Non-breastfeeding women have a four

times greater chance of developing osteoporosis than breastfeeding
women and are more likely to suffer from hip fractures in the post-
menopausal years.
 Benefits child spacing. Since breastfeeding delays ovulation, the
longer a mother breastfeeds the more she is able to practice natural
child spacing, if she desires. How long a woman remains infertile
depends on her babys nursing pattern and her own individual baby.

Promotes emotional health. Not only does breastfeeding benefit a

mothers body, it also benefits her mind. Studies show that
breastfeeding mothers show less postpartum anxiety and depression
than do formula-feeding mothers.

Promotes postpartum weight loss. Breastfeeding mothers

showed significantly larger reductions in hip circumference and more
fat loss by one month postpartum when compared with formula-
feeding moms. Breastfeeding mothers tend to have an earlier return
to their pre-pregnant weight.

Costs less to breastfeed. It costs around $1,200 a year to formula-

feed your baby. Even taking into consideration the slight increase in
food costs to a breastfeeding mother, the American Academy of
Paediatrics estimates that a breastfeeding mother will save around
$400 during the first year of breastfeeding.

Providing appropriate ways that facilitate breast feeding in working

mothers

Working as well as breastfeeding is a challenging task for the women in this

modern world. Nurses can convince a mother by providing them appropriate
ways of breast feeding along with working as idea of milk refrigeration and etc.
Given as:

Get pumped:
The first step is to rent or buy a good-quality electric breast pump that empties
both breasts at once. Sure, they can be expensive, but the time you save will
be well worth it. Check with your health insurance provider. Some will cover the
cost of renting a high-power pump.
Learn how to use your pump before you return to work. Going back to work is
overwhelming enough; you don't want to spend your first day back at work
trying to figure out how to operate your pump. About two weeks before you go
back to work, practice using the pump and start storing your breast milk.

Stock Up:
Now that you know how to use your pump, it's time to start building a stash of
milk in the freezer that a caregiver can thaw and use to feed your baby while
you're at work. Start by pumping after each morning feeding, when your supply
is usually at its peak. In the beginning, it may be an effort to get as little as 2
ounces of milk from both breasts, since your baby just ate. But once you're
away from your baby, you may find that you can produce 5 to 8 ounces at a
time, assuming you are able to pump about three times during the workday.
Output can vary widely from mom to mom and depends on a number of
factors: the age of your baby, the time of day and how well you're able to
maintain your milk supply. Expect to pump for 15-25 minutes with a double
electric pump. It could take longer if you're not using a double pump.

You can freeze your breast milk in resealable plastic bags designed for single-
serving portions. Pick up these bags and other supplies, such as bottles,
nipples, and breast pads, where you find infant feeding items.

Before you freeze your milk, label the bag with the date you pumped the milk.
It's also OK to "layer" milk from different pumping sessions in the same bag as
long as you have expressed it on the same day and chill it before adding it to
the frozen milk. Breast milk can be refrigerated and used within 48 to 72
hours.

Introduce to Bottle:
At least two weeks before your maternity leave ends, have someone else, such
as Dad, Grandma or the new caregiver, give the baby a bottle. Practice this
new feeding techniqueonce a day to startso your baby gets used to it
before you actually have to be separated for a long period of time. When you
return to work, you may want your partner to give your baby a bottle during
the night so that you can have at least one solid block of sleep.

Thaw frozen breast milk in the refrigerator or place the bag in a bowl of warm
water. It's never a good idea to thaw or heat breast milk in a microwave. It will
destroy some of the immunity-building properties of the milk, which thwarts all
your efforts. Plus, a microwave can produce hot spots in the milk that can burn
your baby's mouth.

Get to work:

Expressed breast milk should be kept chilled, so if you're pumping at work,

you'll need a refrigerator or cooler to store it in until you go home. You'll also
need an insulated bag and cold pack to transport it during your commute.

Try to dress in clothing that eases pumping, such as blouses that unbutton in
the front or sweaters that pull up easily. You may find that your favorite one-
piece dress isn't worth the trouble of having to disrobe entirely to pump. It's
also a good idea to keep an extra neutral-colored blouse or sweater at work for
those days when you can't get to your pump fast enough and you start to leak.
Wearing a good set of breast pads at all times will cut down on such accidents.
It's a good idea to keep some spares in your desk or locker.

Be patient:
you may not master the art of being a breastfeeding working mom the first day
back at the office. A mere 7 percent of women find pumping at work extremely
easy, according to Bravado's research. Through this whole process, the best
advice might just be to exercise patience and give it time

https://www.health.ny.gov/prevention/nutrition/wic/breastfeeding/importance.htm

www.askdrsears.com/topics/.../breastfeeding/.../7-ways-breastfeeding-benefits-mothers

www.parenting.com/article/breastfeeding-working-moms

Question No 6: What is obesity? List the problems associated with it. Discuss comprehensive long term plan to
prevent the obesity in a high in a high socioeconomic class of Pakistan?

Plan for obesity prevention:

Obesity is a chronic problem and it demands time and multiple follow up sessions or visits of patients or healthcare
teams in the community.

1. Nursing assessment of community: