This document outlines skills for health care workers to effectively counsel mothers on breastfeeding. It discusses the importance of: using active listening skills like maintaining eye contact and asking open-ended questions; accepting what mothers say without judgment; praising mothers for what they do right to build confidence; providing practical help rather than just information; giving relevant information and checking for understanding; using simple language; and making suggestions instead of commands to empower mothers' choices. The overall aim is for health workers to understand mothers' perspectives and support them in confidently breastfeeding.

1. PANEL DISCUSSION
ROLE OF HEALTH CARE WORKER IN PROMOTING
BREASTFEEDING AMONG WORKING WOMEN.
ARVIND JOSHI
NURSING TUTOR

2. COUNSELLING
• COUNSELLING IS A WAY OF WORKING WITH PEOPLE IN
WHICH YOU TRY TO UNDERSTAND HOW THEY FEEL AND HELP
THEM TO DECIDE WHAT TO DO.

3. COUNSELOR CHARACTERISTICS
• INTEREST AND ATTITUDE
• MOTIVATED
• KNOWLEDGE
• SKILLS

4. LISTENING AND LEARNING SKILLS
• MOTHERS DON’T TALK ABOUT THEIR FEELINGS EASILY BCZ
• THEY SHY
• TRUST ISSUES

5. WHAT A COUNSELOR CAN DO ?
• USE HELPFUL NON-VERBAL COMMUNICATION
• ASK OPEN QUESTIONS
• USE RESPONSES AND GESTURES, WHICH SHOWS INTEREST
• REFLECT BACK WHAT THE MOTHER SAYS
• EMPATHIZE- SHOW THAT YOU UNDERSTAND HOW SHE FEELS
• AVOID WORDS WHICH SOUND JUDGING

6. Helpful Non-verbal Communication
Keep your head level
Keep appropriate distance
Pay attention
Remove barriers
Take time
Touch appropriately

7. Listening and learning skills
Use helpful non-verbal communication
Aske open question
Use responses and gestures which shows interest
Reflect back what mother says
Empathize show that you understand how she feels
Avoid words which sound judging

8. BUILDING CONFIDENCE AND GIVING
SUPPORT
• LISTENING AND LEARNING SKILLS
• A BREASTFEEDING MOTHER EASILY LOSES CONFIDENCE IN
HERSELF.
• IT IS IMPORTANT NOT TO MAKE A MOTHER FEEL THAT SHE HAS
DONE SOMETHING WRONG.
• IT IS IMPORTANT TO AVOID TELLING A BREASTFEEDING MOTHER
WHAT TO DO.

9. INTRODUCE GROWTH CHART
• IMPORTANT TOOL TO BUILD MOTHERS CONFIDENCE.

10. SKILL 1. ACCEPT WHAT A MOTHER THINKS
AND FEELS
• SOMETIME MOTHERS SAYS SOMETHING WHICH IS NOT
CORRECT.
• MOTHERS COMPLAINTS ARE IRRELEVANT

11. LETS TAKE AN EXAMPLE
• MOTHER THINKS MY MILK IS THIN AND WEAK, SO I HAVE TO GIVE BOTTLE
FEEDS.
• OH NO MILK IS NEVER THIN AND WEAK. IT JUST LOOKS THAT WAY
• YES- THIN WEAK MILK CAN BE PROBLEM
• I SEE YOU ARE WORRIED ABOUT YOUR MILK.

12. SCENARIO 1
• THE MOTHER IN TEARS SAYS THAT
• “IT IS TERRIBLE ! SONU HAS COLD AND HIS NOSE IS COMPLETELY BLOCKED AND HE CANT
BREASTFEED HE JUST CRIES AND I DON’T KNOW WHAT TO DO!”
• RESPONSE
• 1. DON’T WORRY YOUR BABY IS DOING VERY WELL
• 2. YOU ARE UPSET ABOUT SONU AREN’T YOU ?
• 3. DON’T CRY IT IS NOT SERIOUS SONU WILL SOON BE BETTER!

13. SKILL-2 RECOGNIZE AND PRAISE WHAT A MOTHER
AND BABY ARE DOING RIGHT.
• WHY IT IS REQUIRED ?
• IT BUILDS MOTHERS CONFIDENCE
• ENCOURAGES HER TO CONTINUE THOSE GOOD PRACTICES
• IT MAKES EASIER FOR HER TO ACCEPT SUGGESTIONS LATER.

14. LETS TAKE AN EXAMPLE
• RAMA CAME TO LACTATION COUNSELLING ROOM WITH HIS SON SHYAM . SHYAM IS
EXCLUSIVELY BREASTFEED BUT HIS GROWTH CHART SHOWS THAT HE HAS GAINED A
LITTLE WEIGHT BETWEEN 1 AND 2 MONTH OF AGE AND HIS GROWTH LINE IS NOT
FOLLOWING THE REFERENCE CURVES. THIS SHOWS THAT THE BABY'S GROWTH IS
SLOW
• YOUR BABY'S GROWTH LINE IS GOING UP TOO SLOWLY
• I DON’T THINK YOUR BABY IS GAINING ENOUGH WEIGHT
• YOUR BABY GAINED WEIGHT LAST MONTH JUST ON YOUR BREASTMILK.

15. SKILL-3 GIVE PRACTICAL HELP
• PRACTICAL HELP IS ALWAYS BETTER THAN SAYING ANYTHING.
• EXAMPLE : MOTHER IS LYING ON THE BED SOON AFTER DELIVERY. SHE LOOKS
MISERABLE AND DEPRESSED. SHE IS SAYING “ NO I HAVEN’T BREASTFEED HIM YET.
MY BREAST ARE EMPTY AND IT IS TOO PAINFUL TO SIT UP.”
• YOU SHOULD LET THE BABY SUCKLE NOW, TO HELP YOUR BREASTMILK TO COME IN
• WHAT IS THE PROBLEM IN THIS YOU WILL HAVE PAIN BUT YOU SHOULD FEED YOUR
BABY ANYHOW
• LET ME TRY TO MAKE YOU MORE COMFORTABLE, AND THEN I WILL BRING YOU A
DRINK.

16. SKILL-4 GIVE RELEVANT INFORMATION AND CHECK
UNDERSTANDING.
• MOTHERS OFTEN NEED INFORMATION ABOUT BREASTFEEDING .
• BUT WAIT UNTIL YOU HAVE BUILT THE MOTHERS CONFIDENCE , BY ACCEPTING
WHAT SHE SAYS, AND PRAISING WHAT SHE DOES WELL.
• GIVE INFORMATION WHICH IS RELEVANT TO HER SITUATION NOW
• TELL HER THINGS THAT SHE CAN USE TODAY, NOT IN A FEW WEEKS TIME.
• TRY TO GIVE ONLY ONE OR TWO PIECES OF INFORMATION AT A TIME.
• GIVE INFORMATION IN A POSITIVE WAY.

17. • EXAMPLE:
• SONU IS 2 MONTHS OLD, BREASTFEEDING EXCLUSIVELY, AND GAINING WEIGHT HEALTHILY.
NOW HE SUDDENLY SEEMS HUNGRY, AND HE WANTS TO FEED MORE OFTEN. HIS MOTHER
THINKS THAT SHE DOES NOT HAVE ENOUGH MILK.
• OH SONU IS GROWING WELL. DON’T WORRY ABOUT YOUR BREASTMILK SUPPLY. IT IS BEST
TO BREASTFEED EXCLUSIVELY FOR 6 MONTHS AND THEN YOU CAN START COMPLEMENTARY
FOOD.
• SONU IS GROWING FAST. HEALTHY BABIES HAVE THESE HUNGRY TIMES WHEN THEY GROW
FAST. SONUS GROWTH CHART SHOWS THAT HE IS GETTING ALL THE BREASTMILK THAT HE
NEEDS. HE WILL SETTLE IN A FEW DAY.

18. CHECK UNDERSTANDING
• IF YOU TALKED ABOUT FEEDING FREQUENTLY YOU MAY NEED TO CHECK THE
UNDERSTANDING OF THE TERM FREQUENTLY.
• IT IS NOT ENOUGH TO ASK THE CAREGIVER WHETHER HE/SHE UNDERSTOOD.
• ASK OPEN QUESTION TO FIND OUT IF FURTHER EXPLANATION IS NEEDED.
• CHECKING UNDERSTANDING ALSO HELPS TO SUMMARIZE WHAT YOU HAVE
TALKED ABOUT.

19. SKILL-5 USE SIMPLE LANGUAGE
• STATEMENT 1 : “ YOUR BABY NEEDS TO BE ABLE TO REACH
THE LACTIFEROUS SINUSES TO GET YOUR BREASTMILK.”
• STATEMENT 2 : “YOUR BABY CAN GET YOUR BREASTMILK
MORE EASILY IF HE TAKES A BIG MOUTHFUL OF BREAST.”

20. SKILL-6 MAKE ONE OR TWO
SUGGESTIONS, NOT COMMANDS.
• WHEN YOU COUNSEL A MOTHER, YOU SUGGEST WHAT SHE
COULD DO. THEN SHE CAN DECIDE IF SHE CAN DECIDE IF SHE
WILL TRY OR NOT. THIS LEAVES HER FEELING IN CONTROL,
AND HELPS HER TO FEEL CONFIDENT.

21. • THANK YOU.