This document discusses challenges to breastfeeding and interventions to promote breastfeeding. Some key challenges include faulty assumptions about breastfeeding, breastfeeding difficulties, and issues for working mothers. The WHO/UNICEF Baby-Friendly Hospital Initiative promotes breastfeeding within the first hour of birth and exclusive breastfeeding for six months. Other interventions discussed include workplace lactation support, peer counseling programs, and marketing campaigns that promote breastfeeding as normal. The goal is to provide support and education to help mothers overcome challenges and breastfeed successfully.

2.  INTRODUCTION
 CHALLENGES
 INTERVENTIONS

3.  Under any circumstances, breast milk is the
ideal food for infant
 Infant should be exclusively breast fed for 6
months
 IMR in developing countries- 5-10% higher in
children-not breast fed or breastfed for <6
months

4.  Faulty assumptions
 Reluctance or dislike to breast feeding,
Anxiety and Stress
 Cesarean section
 Breast ailments, Inadequate milk secretion
 Low birth weight and temporary illness of
baby, congenital malformations.

5.  Poor attachment of infant to breast
 Working mothers
 Embarrassment to feed in public places
 Fear about change in physical appearance

6.  Choosing the most appropriate intervention
for a given setting and population can be
challenging given the breadth of possibilities.

7.  Created and promoted by WHO and
UNICEF
 Care during intrapartum hospital stay
 Infants who are put to the breast within the
first few hours after birth continue
breastfeeding longer than those whose first
breastfeeding is delayed.

8. 1.Have a written breastfeeding policy.
2. Train all health care staff in skills necessary to
implement this policy.
3. Inform all pregnant women about the benefits
and management of breastfeeding.
4. Help mothers initiate breastfeeding within a
half-hour of birth.

9. 5. Show mothers how to breastfeed and how
to maintain lactation even if they should be
separated from their infants
6. Give newborn infants no food or drink
other than breast-milk, unless medically
indicated.
7. Practice rooming-in
8. Encourage breastfeeding
on demand.

10. 9. Give no pacifiers to breastfeeding infants.
10. Foster the establishment of breastfeeding
support groups and refer mothers to them on
discharge from the hospital or clinic.

11.  Working outside the home - shorter duration
of breastfeeding
 Barriers identified in the workplace
› lack of flexibility for milk expression in the work
schedule,
› lack of accommodations,
› concerns about support colleagues,
› real or perceived low milk supply.

12.  there is a strong need to establish lactation
support in the workplace.
 NMR is centrally located with adequate
lighting, ventilation, privacy, seating, a sink,
an electrical outlet, and possibly a
refrigerator

13.  The goal is “to provide a
positive work
environment that
recognizes a mother’s
responsibility to both
her job and her child.

14.  Psycho emotional support
 Encouragement
 Education about breast-feeding
 Help with solving problems.
 Because women’s social networks are highly
influential in their decision-making

15.  Peer mothers - similar sociocultural
background
 Peer counseling programs - community,
clinic, or hospital, with paid or volunteer
counselors.
 Contacts - by telephone, in the home, or in
the clinical setting.

16.  Benefits who lacks exposure to sources of
information
 Also influence attitude towards breast
feeding
 Intrapartum education about latch and
positioning, adequate milk removal, stability
of infant.
 Community centers, YMCA-type facilities,
schools, work sites

17.  By trained
professional
 Demonstrations
using doll ,
videos,
observing
newborn breast
feeding

18.  Women’s early experiences effect
continuation of breastfeed.
 Role of professionals is to help them
effectively initiate and continue breast
feeding
 Give consistent support during lactation
crisis

19.  International board certified lactation
consultant (IBCLC)
 International lactation consultant association
(ILCA) – international Find a Lactation
Consultant
directory

20.  Promotions and advertising
 Strengthen the perception of breast feeding
as a normal, accepted activity.
 Counteract advertising that markets infant
formulas.
 Media campaigns use televisions , radio,
printed materials, outdoor advertising.

21. o Babies were born to be breast fed
o Loving support makes breast feeding work

22.  No advertising of breast-milk substitutes directly
to the public.
 No free samples to mothers.
 No promotion of products in health care
facilities.
 No commercial product representatives to
advise mothers.
 No gifts or personal samples to health workers.
 No words or pictures idealizing artificial feeding,
including pictures of infants on the products.

23.  Herpes simplex infection of breast, mother
taking anti-epileptic, anti thyroid drugs,
puerperal psychosis, cleft palate in baby….
 Seek medical advice

24.  CDC guide to breast feeding interventions
 Park’s textbook of PSM
 Dutta’s textbook of obstetrics
 Eenadu newspaper district edition