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  3. Feeding Expressed Milk to Infants
Course Content
Why Breastfeeding Matters (10 minutes)
Health and developmental benefits for infants Maternal benefits (physical and mental) Economic and community-level advantages Common myths and culturally specific misconceptions
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Health & Developmental Benefits for Infants from Breastfeeding
Maternal Benefits of Breastfeeding (Physical and Mental)
Economic and Community-Level Advantages of Breastfeeding
Common Myths and Culturally Specific Misconceptions about Breastfeeding
Newborn Feeding Cues & Anatomy (20 minutes)
Early vs. late hunger cues and what they mean Normal newborn feeding patterns and stomach capacity Brief breast anatomy (lobes, ducts, nipple, areola) in plain language Signs of effective feeding (swallowing, contentment, diaper output)
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Early vs. Late Hunger Cues in Infants
Normal Newborn Feeding Patterns and Stomach Capacity
Breast Anatomy (in Plain Language)
Signs of Effective Feeding in Breastfed Babies
Positions & Achieving a Good Latch (40 minutes)
Position options: cradle, cross-cradle, football/clutch, side-lying Stepwise approach to help baby latch (prepare — attach — assess) Signs of a good vs. poor latch (comfort, nipple shape, audible swallowing) Small-person adaptations (premature, small mouth, tongue-tie considerations) Safe positioning for mothers with C-section recovery
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Position Options for Breastfeeding
Stepwise Approach to Help Baby Latch
Signs of a Good vs. Poor Latch
Small-Person Adaptations in Breastfeeding
Safe Positioning for Mothers with C-Section Recovery
Protecting & Building Milk Supply (25 minutes)
Establishing supply in the first days and weeks (frequency, skin-to-skin) Night feeds and cluster feeding explained Lifestyle and medical factors that reduce supply (e.g., certain medications, stress) Relactation and increasing milk supply safely Nutrition and hydration myths vs. evidence
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Establishing Milk Supply in the First Days and Weeks
Night Feeds and Cluster Feeding
Lifestyle and Medical Factors That Reduce Supply
Relactation and Increasing Milk Supply Safely
Nutrition and Hydration Myths vs. Evidence in Breastfeeding
Expressing & Storing Breastmilk (20 minutes)
Hand-expression steps and common mistakes Choosing and using pumps (manual vs. electric) — practical tips Safe collection, labeling, storage, thawing and warming guidelines (low-resource options included) Cleaning and hygiene for bottles and storage containers Feeding expressed milk to infant (cup, spoon, paladai, bottle considerations)
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Hand-Expression Steps and Common Mistakes
Choosing and Using Breast Pumps (Manual vs. Electric)
Safe Breast Milk Handling
Cleaning and Hygiene for Bottles and Storage Containers
Feeding Expressed Milk to Infants
Common Problems & Practical Solutions (25 minutes)
Causes of sore nipples and immediate relief techniques Managing engorgement and preventing blocked ducts Recognising mastitis vs. normal engorgement and when antibiotics may be needed Low weight gain: assessment steps and feeding plan adjustments Non-judgmental approach to supplementation and safe short-term options
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Causes of Sore Nipples and Immediate Relief
Managing Engorgement and Preventing Blocked Ducts
Recognising Mastitis vs. Normal Engorgement
Low Weight Gain — Assessment and Feeding Plan Adjustments
Non-Judgmental Approach to Supplementation
Returning to Work or School; Feeding Outside the Home (15 minutes)
Creating an express-and-feed routine (timing, containers, transport) Practical storage and transport tips for different commute types Rights and workplace basics (general guidance; encourage local legal verification) Communicating with caregivers and preparing safe feeder notes Emotional coping and practical fallback plans
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Creating an Express-and-Feed Routine
Practical Storage & Transport Tips for Expressed Breast Milk by Commute Type
Rights and Workplace Basics for Breastfeeding Mothers
Communicating with Caregivers and Preparing Safe Feeder Notes
Emotional Coping and Practical Fallback Plans
Special Situations (20 minutes)
Feeding preterm or low-birthweight infants: kangaroo care, cup or tube feeding basics Managing twins/multiples: tandem feeding tips and time-saving routines Mothers on medication or with infectious illness: how to check drug safety and local guidelines (HIV, TB, etc.) Using donor milk or milk banks (where available) — safety basics
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Feeding Preterm or Low-Birthweight Infants
Managing Twins/Multiples — Tandem Feeding Tips and Time-Saving Routines
Mothers on Medication or with Infectious Illness — Drug Safety & Guidelines
Using Donor Milk or Milk Banks — Safety Basics
When to Seek Help & Building a Support Network (15 minutes)
Red flags for baby and mother (e.g., poor weight gain, fever, severe pain) Where to seek help: clinic, CHW, lactation consultant, emergency care Building a support network: partners, family, peer counsellors, community groups Using telephone/text supports, community groups, and referral pathways
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Red Flags for Baby and Mother
Where to Seek Help for Breastfeeding Challenges
Building a Support Network for Breastfeeding Mothers
Using Telephone/Text Supports, Community Groups, and Referral Pathways
Wrap-up, Resources & Final Assessment (15 minutes)
Key takeaways and common pitfalls to avoid Next steps: seeking local support, advanced training options How to use course materials beyond the course (groups, sharing, peer support) Final 20-question multiple-choice quiz (80% pass mark)
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Key Takeaways and Common Pitfalls to Avoid
Next Steps — Seeking Local Support & Advanced Training Options
How to Use Course Materials Beyond the Course
Final 20-question multiple-choice quiz (80% pass mark)
How to Breastfeed — Self-Paced, Evidence-Based Course for African Moms

Introduction

Expressed breast milk can be fed to infants when the mother is away, the baby cannot latch, or in special situations (prematurity, illness). Choosing the right method depends on the baby’s age, health, and family’s resources.

1. Feeding Methods

A. Cup Feeding

  • What it is: Baby drinks from a small, clean open cup.

  • Advantages:

    • Simple and low-cost.

    • Avoids nipple confusion.

    • Safe even for small or sick babies (with caregiver support).

  • How to do it:

    • Hold baby upright.

    • Fill cup with small amount of milk.

    • Gently tilt cup to baby’s lips — let baby lap/sip, do not pour.

B. Spoon Feeding

  • What it is: Using a small spoon to give milk.

  • Advantages:

    • Useful for small amounts (e.g., colostrum).

    • Good for premature or weak babies.

  • Limitations:

    • Time-consuming.

    • Wastes milk if baby dribbles.

C. Paladai Feeding (South Asian traditional cup)

  • What it is: A small spouted cup used in India and South Asia.

  • Advantages:

    • Easy for preterm babies.

    • Reduces spillage compared to spoon.

  • Limitations:

    • Not available everywhere.

D. Bottle Feeding

  • What it is: Feeding through a nipple/teat attached to bottle.

  • Advantages:

    • Familiar and convenient for many families.

  • Risks:

    • Requires thorough cleaning/sterilization to prevent infections.

    • May cause nipple confusion or preference if used early.

    • Higher risk of overfeeding.

2. Choosing the Right Method

  • Newborns and preterm babies: Cup, spoon, or paladai are safest alternatives if breastfeeding is not possible.

  • When hygiene is difficult (low-resource settings): Cup or spoon preferred — easier to clean than bottles.

  • Mothers planning to continue direct breastfeeding: Cup/spoon/paladai reduce risk of nipple confusion.

  • When frequent expressed feeding is required (e.g., working mothers): Bottle may be practical if hygiene can be maintained.

3. Practical Tips

  • Always wash hands before feeding.

  • Feed baby in upright position to prevent choking.

  • Use paced feeding (small amounts, baby-led pauses).

  • Discard leftover milk after feeding — do not re-use.

4. Common Mistakes to Avoid

  • Pouring milk forcefully into baby’s mouth with a cup/spoon (risk of aspiration).

  • Using bottles without sterilizing.

  • Feeding while baby is lying flat.

  • Forcing baby to finish the milk instead of responding to hunger/satiety cues.

End of Lecture Quiz

Q1. Which feeding method is safest in low-resource settings where sterilization is difficult?
A. Bottle
B. Cup
C. Spoon
D. Paladai

Answer: B. Cup
Rationale: Cups are easy to clean, low-cost, and reduce infection risk.

Q2. True or False: When cup feeding, the caregiver should pour milk directly into the baby’s mouth.
Answer: False
Rationale: The baby should lap or sip milk at their own pace — pouring risks choking.

Q3. What is one disadvantage of bottle feeding?
A. Too slow for older babies
B. Risk of infection and nipple confusion
C. Cannot be used for larger amounts
D. Milk loses nutrients in bottles

Answer: B. Risk of infection and nipple confusion
Rationale: Bottles require strict cleaning, and early bottle use may affect breastfeeding.

Curated Online Resources

Key Takeaways

  • Expressed milk can be fed by cup, spoon, paladai, or bottle — choice depends on age, context, and hygiene.

  • Cup feeding is simple, safe, and recommended in many low-resource settings.

  • Bottle feeding is common but carries risks without proper cleaning.

  • Feeding should always be baby-led, upright, and safe.

Call to Action

  • Mothers: Learn at least one alternative method (cup/spoon) before hospital discharge.

  • Health workers: Demonstrate cup feeding and explain risks/benefits of each method.

  • Communities: Support safe feeding practices with clean water, education, and alternatives to bottles in low-resource areas.

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