BREAST FEEDING FRIENDLYGENERAL PRACTITIONER DR Varsha Atul Shah Senior Consultant Singapore General Hospital Dept NN and Devt Medicine Visiting Consultant, K K Hospital Dept of Child Development
Breastfeeding Data in SingaporeInitiation to breastfeeding 94.5 %Exclusive breastfeeding at 1 months 22% at 2 months 18% at 4 months 7% at 6 months near zero !!! Mean duration of breastfeeding 12.7 weeks Reference: Breastfeeding prevalence and practices among Singaporean Chinese, Malay and Indian mothers, L. L. FOO1, S. J. S. QUEK2, S. A. NG1, M. T. LIM2 and M. DEURENBERG-YAP1 Health Promotion International Advance Access published April 5, 2005
The Baby-Friendly Hospital Initiative(BFHI) The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding. assists hospitals in giving mothers the information, confidence, and skills needed to successfully initiate and continue breastfeeding their babies gives special recognition to hospitals that have done so.
Baby Friendly Hospital Initiatives More than 20,000 facilities in 152 countries have been certified Baby-Friendly In seven countries, 100% of facilities have been designated baby friendly: Sweden (66), Comoros Island (190), Ertrea (46) Maldives (5), Namibia (35), Iraq (23) and Oman (51) by 1999 Amongst developed countries, the highest rates of baby friendly facilities are in Scandinavian countries
Why GPs are important?Mother or baby will see a doctor at least six to seven times within the first year
Breastfeeding in Singapore The 2001 National Breastfeeding Survey found that although 94.5% of Singapore mothers initiated breastfeeding only 21% continued up to six months. Advice from health professionals, maternal awareness of breastfeeding benefits and maternal regard for bottle-feeding were significant predictors of continued breastfeeding at six months. Over 50% of mothers in the survey did not receive lactation advice from their physicians
10 Steps of successful Breast Feeding and Baby friendly Hospital Have a written breastfeeding policy that is routinely communicated to all he Train all health care staff in skills necessary to implement this policy. Inform all pregnant women about the benefits and management of breastfe Help mothers initiate breastfeeding within a half-hour of birth. Show mothers how to breastfeed and how to maintain lactation, even if the
10 Steps of successful Breast Feeding and Baby friendly Hospital Give newborn infants no food or drink other than breast milk unless med Practice rooming-in - allow mothers and infants to remain together - 24 h Encourage breastfeeding on demand. Give no artificial teats or pacifiers (also called dummies or soothers) to b Foster the establishment of breastfeeding support groups and refer moth
Why GPs are important? The World Health Organization and AAP, recommends exclusive breastfeeding for at least six months of an infant’s life breastfeeding practice among women in Singapore falls short of this standard. Exclusive breastfeeding offers a multitude of benefits to both mother and child. Family physicians are in an ideal position to influence should be equipped with practical knowledge to alleviate parental anxieties
10 Recommendations for a breastfeeding-friendly family practice-1 Avoid giving the patient samples of formula or literature from a formula company during pregnancy or after delivery Educate the patient on the differences between breastfeeding and bottle-feeding Avoid telling the patient that formula is better than breast milk Avoid promoting one formula over another Educate the patient before and after her pregnancy on the importance and benefits of putting the baby to the breast immediately Educate the patient about nipple confusion, and how to avoid this problem by not bottle-feeding, and instead using a cup, spoon or syringe
10 Recommendations for a breastfeeding-friendly family practice-2 Reassure the patient that she can and should continue to breastfeed when she is ill or if her baby is ill Praise the patient if she is still breastfeeding at six months and encourage her to continue for 2 years at least Remind the patient that breast milk still has nutritional value for the baby who is six months or older Suggest to the mother of a sick child warded in hospital that she stays with the child in the ward, so that she can continue to nurse and comfort her child
Common concerns:Regarding breastfeeding in a GP practice1. Is my baby getting enough to eat?2. How can I tell if Im making enough milk? NOT ENOUGH MILK? Usually baby feeds for 5 -30 minutes at most feeds and at the end of the feed the baby lets go spontaneously or does so when the breast is gently lifted and the baby is content after most feeds. The mother feels softening of their breast during the feed and her nipple shape is the same as when feed began or slightly elongated. When you feed, audible and visible swallowing, initial rapid sucking pattern which changes to slower sucks with pauses and soft swallowing, the infant is calm, the arms and hands are relaxed the mouth is moist . The regular soaked nappies, on days 1-2 - 1-2 or more, on days 3-4 - 3 or more, and on day 7+ - 6 or more are and steady weight gain is signs of enough breastfeeding
How can I increase breast milk output? All mum should feed early, frequently and feed only breast milk for 6 months. Do not use pacifiers and bottles. Sleep with your baby and bring your baby wherever you go for first several weeks. Feed your baby when shes hungry, on demand, not by clock!
My newborn wont latch on. What do I d If this happens after you leave the hospital, it generally requires immediate attention by a lactation consultant. If your baby has been crying hard, it may help to cuddle and perhaps burp her to calm her down first. If your breasts are overly full, your baby may not be able to get her mouth around your breast, just squeeze out a few drops of milk first, to soften the breast and let baby latch on.
Can I breastfeed if I am sick with flu? Generally, if you fall sick while breastfeeding, it is usually fine to continue to breastfeed your baby. Antibodies produce by you are passed on to your baby through your milk, are protective. Illnesses are most often transmitted through skin contact and secretions from the mouth and nose. Be sure to wash your hands often, and try to avoid face-to-face.
Do I have to eat a special diet while breastfeeding? No. Your body will make the perfect milk for your baby no matter what. For your own health, of course, it is best to eat a balanced diet regardless of how you feed your baby. Nursing mothers need to drink plenty of fluids 2-3 liters a day, enough so that you are never feeling thirsty. You may recommend that you continue to take your prenatal vitamins while you
If I have small breasts does this mean I will produce less milk? Breast size has nothing to do with milk production. It is due to the amount of fat tissue in the breast and not to the amount of milk producing tissue. Feeding on demand and having regular meals or snacks will ensure that mum produce just the right amount of milk to meet babys needs.