Medidas Medical Center INC Lactation Training Management Sesion 8 Session-8-Practices-that-assist-BF

1. Practices that assist
Breastfeeding
Steps 6,7,8,and 9
Session 8

2. SESSION OBJECTIVES
Describe their role in practices that assist rooming-
in.
Describe their role in practices that assist baby-led
(demand) feeding.
Suggest ways to awaken a sleepy baby and to
settle a crying baby,

3. SESSION OBJECTIVES
List the risks of unnecessary supplements.
Describe why it is important to avoid the use of
bottles and teats.
Discuss removing barriers to early breastfeeding.

4. Practice rooming in – allow mothers and infants
to remain together 24 hours a day.
Step 7
What can you say to explain
the importance of rooming-in ?

5. Benefits of Rooming-in
Babies sleep better, cry less
Continuation of sleep/awake rhythm
developed before birth,
BF is well established, continues longer, baby
gains weight quickly,

6. Benefits of Rooming-in
Feeding on cues is easier, develops good
milk supply,
Mother becomes confident in caring,
Baby exposed to fewer infection,
Promotes bonding,

7. Barriers to rooming-in
and possible solutions
1. Concerns that mothers are tired.
2. Taking the baby to nursery for
procedures.
3. Beliefs that newborn babies need to be
observed.
Cont.

8. Barriers to rooming-in and
possible solutions
4. No space in the ward for baby’s cot,
5. Staff do not know how to assist
mothers in learning to care for their
babies,
6. Mothers ask for their babies to be
taken to the nursery,

9. Encourage breastfeeding on
demand
“demand feeding” - “baby-led feeding”
This means that the frequency and
length of feeding is determined by
the baby’s needs and signs.
Step 8

10. Importance of
baby-led feeding
1. Baby gets more immune rich
colostrum,
2. Faster development of milk
supply,
3. Faster weight gain,
4. Less neonatal jaundice,

11. Importance of baby-led feeding
6. Less breast engorgement.
7. Mothers learn to respond to her
baby.
8. Breastfeeding established faster.
9. Less crying, less temptation to
supplement.
10. Longer breastfeeding duration.

12. Signs of hunger
The baby:
- Increases eye movements or opens
eyes.
- Opens his mouth, stretches out the
tongue
- Makes soft whimper sounds.
- Sucks or chews on hands.
Cont.

13. • If the baby is crying loudly, arches his or
her back.
• Some babies are very calm and wait or
go back to sleep if not noticed.
Other babies wake quickly and become
very annoyed.
Signs of hunger

14. What are the signs that
a baby has finished feeding?
Signs of Satiety :
• As they get full, their body relaxes.
• Let go of the breast.
• Take small gentle sucks until they are asleep
• Finish one breast before she offers
the other breast.

15. Feeding Pattern
 feed for a short time at frequent intervals.
 feed for a long time and then wait a few
hours.
 Very long feeds - more than 40 minutes,
 very short feeds - less than 10 minutes,
 very frequent feeds - more than 12 feeds/24
hrs,
Sore nipples are the result of poor attachment,
not the result of feeding too often.

16. The typical feeding pattern for a
full term healthy newborn:
 Every 1-3 hours in the first 2-7 days.
 Night feeds are important.
 Once lactation is established – 8-12 times /
24 hrs.
 During periods of rapid growth, a baby may
be hungrier.
 Let babies feed whenever they want.

17. Special Situations
o Baby is very sleepy due to
prematurity, jaundice, or the effects
of labor medication,
o Mother’s breasts are overfull and
uncomfortable
o Babies who are on replacement feed

18. Ways to wake a
sleepy baby
If the baby seems too sleepy to feed,
suggest that the mother:
 Remove blankets and heavy clothing.
 Breastfeed in a more upright position.
 Gently massage and talk to her baby.
 Wait half an hour and try again.
 Avoid hurting the baby.

19. Settle a crying baby
Baby is crying.
Baby who is ‘crying too much’.
Baby is crying frequently.
Build the mother’s confidence…
cont

20. Build the mother’s confidence in her
ability to care for her baby
and give her support:
cont
- Listen and accept what the mother is
feeling.
- Reinforce what the mother and baby are
doing right / what is normal.
- Give relevant information.
- Make one or two suggestions.
- Give practical help…

21. Suggestions and practical
help to settle a crying
baby can include:
 Make the baby comfortable.
 Put the baby to the breast.
 Put baby on the mother’s chest, skin to
skin.
 Talk, sing and rock the baby while holding
close.
 Gently stroke or massage.
cont

22. Suggestions and practical help …
 Give one breast at each feed; if overfull,
express.
 Reduce the mother’s coffee and other
caffeine drinks.
 Do not smoke.

23. Suggestions and practical help …
 Have someone else carry.
 Involve other family members.
 Pressure to give unnecessary supplemental
feedings.
 Hold the baby in a manner that wraps
around him.

24. Give newborn infants no food or drink
other than breastmilk unless
medically indicated.
Healthy full term babies rarely have a
medical need for supplements or prelacteal
feeds.
They do not require water to prevent
dehydration.
Step 6

25. Dangers of
supplements
Exclusive breastfeeding is recommended
for the first six months.
Supplements can:
- Overfill a baby’s stomach,
- Reduce milk supply,
- Can cause insufficient weight gains,
- Reduce protective effect of breastfeeding,
- Reduce the mother’s confidence,
- Be an unnecessary expense.
cont

26. - May indicate that mother is having
difficulties feeding and caring for her
baby.
- A health worker may lack of knowledge
and skill in supporting BF
- May indicate an overall stressful
atmosphere
cont

27. Prelacteal feeding or offering formula to an
infant of an HIV positive woman who will
breastfeed may alter the GI mucosa and
allow the transmission of the virus.
When we cannot test the HIV status of
mother, it is important to emphasize that
exclusive breastfeeding reduces the risk of
HIV transmission during breastfeeding

28. • Even if many mothers are giving
replacement feeds, this does not prevent a
hospital from being designated as baby-
friendly if those mothers have all been
counseled, tested, and made genuine
informed choices.

29. Give no artificial teats or pacifiers (also
called dummies or soothers) to
breastfeeding infants
Why is it recommended to avoid using
bottles and teats?
Baby may develop preference for it.
Pacifiers given instead of feed for
hungry baby.
May carry infection.
Step 9

30. Summary
Rooming in and baby-led feeding help
breastfeeding and bonding.
Help mothers to learn skills of mothering.
Prelacteal and supplemental feeds are
dangerous.
Artificial teats can cause problems.