This document outlines the Ten Steps to Successful Breastfeeding as established by the Baby-Friendly Hospital Initiative. It discusses establishing breastfeeding within the first hour of birth, exclusive breastfeeding and feeding on demand, rooming-in, avoiding pacifiers and artificial nipples, and fostering breastfeeding support groups. The document also covers proper breastfeeding techniques, the benefits and adequacy of breast milk, common issues, and introducing complementary foods around six months of age.

1. Breast feeding and
Complimentary feeding

4. Ten steps in BFHI
• Have a written breastfeeding policy that is
routinely communicated to all health care staff.
• Train all health care staff in skills necessary to
implement this policy.
• Inform all pregnant women about the benefits
and management of breastfeeding.
• Help mothers initiate breastfeeding within one
half-hour of birth.
• Show mothers how to breastfeed and maintain
lactation,even if they should be separated from
their infants.

5. Ten steps in BFHI
• Give newborn infants no food or drink other than
breastmilk, unless medically indicated.
• Practice rooming in - that is, allow mothers and
infants to remain together 24 hours a day.
• Encourage breastfeeding on demand.
• Give no artificial teats or pacifiers (also called
dummies or soothers) to breastfeeding infants.
• Foster the establishment of breastfeeding support
groups and refer mothers to them on discharge
from the hospital or clinic.

6. Initiation of Breast Feeding
• Within half an hour after normal delivery and
within 4 hours after caesarean section
• No prelacteal feeds
• First 2-4 days: colostrum (10-40 mL)
• Practice ‘Rooming in’

7. Proper positioning

8. Reflexes that help in Breastfeeding

9. Role of oxytocin and prolaction

10. Reflexes in mother

11. Breastfeeding
• Exclusive and on-demand feeding
• Proper ‘burping’ after feeds
• Right lateral position after feeding

12. Breast milk – Is it sufficient?
• Adequate urine output (6-8 times/day)
• Passing 2-6 liquid stools per day
• Gaining adequate weight
• Sleeps 2-3 hours after feeds
• Proper positioning and breastfeeding technique

13. Contraindications
• Infant – Galactosemia, Congenital lactose
intolerance
• Mother – Antithyroid drugs,
Chemotherapeutic drugs (malignancy)
antipsychotic drugs

14. Common breast feeding problems
• Inverted nipples

15. Common breast feeding problems
• Sore nipples
• Breast engorgement
• Breast abscess

16. Complimentary feeding

17. Optimal Infant Feeding

18. Complimentary feeds
• Preferably home made feeds
• Cereals like rice is the best choice
• Locally available, economical and acceptable
• Cereal-pulse combination is better
(fortification of aminoacids)

20. Amount of complimentary feeds

21. Complementary bridge and safety net