Tech Trg. HBNC_session I


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Tech Trg. HBNC_session I

  1. 1. TechnicalTraining on HBNC
  2. 2. Session ISession I
  3. 3. Session-I • Services to be provided during home delivery and home visits • Capacity building on – Hand washing – 5 cleans during delivery– 5 cleans during delivery – Correct method of wrapping the baby after birth – Kangaroo Mother Care (KMC) – Breastfeeding Technique – Expressing milk by hand – Everson of retracted and inverted nipple
  4. 4. Hand washing Step wise method
  5. 5. 5 Cleans during delivery Hand washing-Clean Hand Clean place Clean Cloth for wrapping the baby Clean Cord cut with a clean blade Clean Cord clamp with clean thread
  6. 6. ‘Five cleans’ to prevent infection
  7. 7. Keeping the Baby Warm
  8. 8. Steps in wrapping the baby • First fold one corner of the piece of cloth • Place the baby on the cloth • Right fold • Fold from below the foot • Left Fold
  9. 9. Kangaroo Mother Care
  10. 10. KMC • For preterm and Low Birth Weight Baby • Mild to moderate hypothermia • Skin to skin contact• Skin to skin contact
  11. 11. Clothing • During summer season the baby should only wear a nappy • In the winter season the• In the winter season the baby should wear a front-open sleeveless shirt, socks and a cap
  12. 12. Positioning • Put the baby between mother’s breast in up right position • Turn the head to the side in slightly extended positionposition • The hips and arms are flexed in “frog” position • Baby’s abdomen should be at the level of the mother epigastrium
  13. 13. Sleeping and resting • If the mother likes, she can rest and sleep with the baby in kangaroo position • She needs to lay in a semi-recumbent position, with several pillows under her upper body
  14. 14. Breastfeeding • The baby can be fed while in the sling • If the baby shows sign of hunger, use the same breastfeeding positionbreastfeeding position as you normally use without sling
  15. 15. Moving the baby in and out of the sling • Hold the baby with one hand placed behind the neck and on the back • Place the other hand under the baby’sunder the baby’s buttocks • Move the baby to put between mothers’ breast and tigh the sling
  16. 16. Carrying the baby • The mother can do what ever she likes: she can walk, stand or sit • Make sure that the sling is tight firmly enoughis tight firmly enough when the mother would like to change position
  17. 17. Breastfeeding Technique
  18. 18. Correct Breastfeeding Technique • While holding the baby, the mother also supports the baby’s bottom, and not just the head or shoulders. • The baby should be held close to the mother's body. • The baby’s face should face the mother's breast, with nose oppositemother's breast, with nose opposite the nipple. • The mouth should be wide open , well attached; upper and lower lips are averted and cover the areola completely with lower lip turned outwards with the nipple in the centre of the mouth orifice.
  19. 19. Incorrect Breastfeeding Technique
  20. 20. • If the baby is unable to suckle, or if the mother is unable to breastfeed the baby directly, she can express breast milk into a clean bowl and then feed Expressing milk by hand clean bowl and then feed the baby using a clean spoon. • Milk expressed after the first 72 hours can be kept at room temperature for about six-eight hours.
  21. 21. Step 1 • Wash hands with soap and water before expression. Hold handle or cuddle the baby.
  22. 22. Step 2 • Place a warm compress on the breast for a few minutes if desired. • Put thumb and index finger on the breast at rim of the areola opposite each other.areola opposite each other. Support the breast with other three fingers. • Press thumb and index finger slightly inwards towards the chest wall.
  23. 23. Step 3 • Gently massage the breast starting from the chest moving toward the nipple; do this in a circle (near the underarm, and then to the bottom of the breast), sobottom of the breast), so that all parts of the breast are massaged. • Lean forward and support the bottom of the breast with one hand.
  24. 24. Step 4 • Press the breast between the fore finger and thumb. Press and release, press and release until the milk drips out. This should not hurt • Use a clean bottle or a cup to collect the milk. Milk may drip at the beginning and then spray out after it starts flowing
  25. 25. Step 5 • Press the areola in the same way from the sides, this ensures that milk is expressed from all segments of the breastbreast • Do not squeeze the nipple • Avoid rubbing or sliding fingers along the skin
  26. 26. Step 6 • Express one breast for at least 3-5 minutes until the flow slows; then express the other side; and then repeat on both sidesboth sides • To express milk adequately it may take 20-30 minutes
  27. 27. Summary 1. Wash your hands well with soap and water 2. Place a clean container below your breast to collect milk 3. Massage the breast gently towards the nipple 4. Place your thumb and index finger4. Place your thumb and index finger opposite each other outside the areola 5. Now press back towards your chest, then gently squeeze to express milk 6. Repeat step 5 at different positions around the areola
  28. 28. Some facts • Cover the container of EBM with a clean cloth or lid • Milk expressed after the first 72 hours can be kept at room temperature for about six-eight hours and in a refrigerator for 24 hours. • EBM stays in good condition longer than animal milk • Do not boil EBM• Do not boil EBM • Before feeding gently shake the container mix fat globules with the rest of the milk • Feed with a cup or spoon or paladai • Never bottle fed
  29. 29. Everson of retracted and inverted nipple
  30. 30. • Encourage the mother to gently pull out the nipple and roll it, several times in a day. • A 10 cc or 20 cc disposable plastic syringes Correcting inverted nipples • A 10 cc or 20 cc disposable plastic syringes can also be used for correcting inverted nipples.
  31. 31. • Cut the barrel of the syringe from the end where the needle is attached. Step 1 needle is attached. • Take out the piston and put it in from the opposite end, which is the cut end of the syringe. • Push the piston forward fully, and gently place the open end of the barrel in such a way that it encircles the nipple and areola. Pull back the plunger, thus creating negative pressure.
  32. 32. • Push the piston forward fully, and gently place the open end of the barrel in such a way that it encircles Step 1 open end of the barrel in such a way that it encircles the nipple and areola. Pull back the plunger, thus creating negative pressure. • The nipple will be sucked into the barrel and pulled out in the process.
  33. 33. THANK YOU