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Paediatrics
The document discusses the Baby Friendly Hospital Initiative (BFHI) which was launched in 1991 by WHO and UNICEF to promote breastfeeding. It was introduced in India in 1993. The BFHI aims to protect, promote and support breastfeeding practices through 10 steps that health facilities should implement. These include having a written breastfeeding policy, training staff, helping mothers initiate breastfeeding within 30 minutes of birth, teaching positioning and latching, rooming-in, not providing supplements unless medically necessary, and fostering breastfeeding support groups. The BFHI helps encourage breastfeeding and address mothers' concerns. Its implementation can improve infant health and growth through breastfeeding.
Paediatrics
- 1.
- 2. Launched byWHO &UNICEF 1991 Introduced in INDIA-1993 To implement practices that PROTECT PROMOTE breast feeding SUPPORT
- 3. Industrialization Changein lifestyle More working women Marketing strategies of baby food manufacturers
- 4. launched in1993 there was resistance at first. Later on there was decline in its implementation. Revived in 2012.
- 5. Babies whoare breastfed are generally healthier and achieve optimal growth. By the implementation of this policy, mothers who lack confidence to breastfeed is encouraged. In the case of HIV positive mothers,they are helped to take an informed decision on which feeding option is best of her baby
- 7. Have awritten breast feeding policy that is routinely communicated to all health care staff.
- 8. Written breastfeeding policy-made available to all staff Visibly posted in all areas of the health care facility Displayed in local language why do you need a policy???????
- 9. 10 stepsof breastfeeding An institutional ban on breast milk substitutes A framework for assisting HIV positive mothers in infant feeding.
- 10. Train allhealth care staff in skills necessary to implement this policy
- 11. Training shouldinclude 1.Advantages of breast feeding 2.Mechanism of lactation &sucking 3.How to help mothers initiate and sustain breastfeeding 4.Positioning attachment 5.Risk of artificial feeding
- 12. Inform allpregnant women about the benefits and management of breast feeding
- 13. Emphasise onimportance of exclusive breast feeding, its benefits and technique in the antenatal period itself. Motivate the mother to breastfeed & allay her doubts.
- 14. Help mothers initiate breastfeedingwithin a half hour of birth.
- 15. skin toskin contact Vaginal delivery within 30 min CS-within half an hour being able to respond
- 16. Why to initiatesoon? 1.Emotional bonding 2.Provides colostrum 3.Increase duration of feeding 4.Mother will get necessary guidance from health care professional.
- 17. Show mothershow to breastfeed& how to initiate lactation, even if they should be seperated from their infants.
- 18. Teach themothers how to express milk Also teach them about positioning & attachment
- 19. POSITIONING Mothercan sit or lie down Her back should be well supported & shouldn’t lean over baby Position of baby-whole body should be supported. Baby’s head & body should be in one line Baby’s body turned towards mother(tummy to tummy) Baby’s nose at level of nipple
- 20. ATTACHMENT(LATCHING) Baby’scheek is touched & that initiates rooting reflex Allow the baby to open mouth widely Latch the baby to breast-nipple and most of areola must be in baby’s mouth.
- 21. Signs ofgood attachment Baby’s mouth wide open Most of nipple and areola in mouth—only upper areola is visible Baby’s chin touches the breast Baby’s lowerlip everted
- 22. EFFECTIVE SUCKLING Baby sucks slowly & pauses in between to swallow One can see throat cartilage& muscles moving Baby’s cheeks are full and not hollow or retracting.
- 23. Inverted nipples Makes latching difficult. Sucking on nipple will make them sore and excoriated. Treatment –manually nipples are everted stretched and rolled out several times a day. Plastic syringe used to draw out to correct problem.
- 24. Sore nipple Occurs in incorrect attachment. Frequent washing with soap and water, pulling the baby when he is still feeding can cause sore nipple Treatment-correct positioning & attachment. Apply hind milk Nipple should be aired and allowed to heal in between feeds
- 25. Breast engorgement Milk production increases on 2nd and 3rd day Delay in feeding will cause accumulation of milk in alveoli Breast becomes swollen hard warm & painful Treatment-early frequent feeds Correct attachment Local warm water packs Breast massage analgesics
- 26. Breast abscess Abscess occurs when mastitis,blocked duct cracked nipple are not treated promptly High grade fever Treatment-analgesics Anitibiotics I&D
- 27. NOT ENOUGHMILK Adequacy of breastmilk Baby sleeps-2-3hrs after feed Passing urine 6-8 times in 24hr Gaining weight Reason may be no night feeds any illness bottle feeds, maternal stress insufficient sleep
- 28. Can bestored in room temperature for 6-8 hours,in a refrigerator for 24hr and a freezer at -20 degree for 3months METHOD Wash hands thoroughly Make herself comfortable Gently massage the breast Hold container under the nipple Place her thumb on top of breast atleast 4cm from tip of nipple
- 29. Index fingeron undersurface Compress and release the tissue To maintain adequate lactation mothers should express milk atleast 8-10 times in 24 hours
- 30. Give newborn infantsno food or drink other than breast milk unless medically indicated
- 31. Decreased frequency oreffectiveness of suckling Decreased amount of milk removed from breasts Delayed milk production or reduced milk supply Some infants have difficulty attaching to breast if formula given by bottle Slide 4.6.4
- 32. Acceptable medicalreasons for supplementation 1.VLBW<1500g infants born before 32 weeks. 2.SGA with potentially severe hypoglycaemia 3.Infants whose mothers have severe illness 4.Infants with inborn errors of metabolism 5.Infants with acute water loss 6.Mothers taking drugs which is contraindicated during breast feeding- antimetabolites,antithyroid drugs
- 33. Practice rooming inallow mothers & infants to remain together-24 hours a day.
- 34. Benefits of roomingin Cost effective Requires minimal equipment Requires no additional personnel Reduces infection Facilitate bonding establish breast feeding
- 35.
- 36. Breastfeed ondemand results in 1.Earlier passage of meconium. 2.Lower maximal weight loss. 3.Breastmilk flow is established sooner. 4.Larger volume of milk intake. 5.Less of jaundice
- 37. Give no artificialteats or pacifiers to breastfeeding infants.
- 38. It willinterfere with suckling & the adjustment of breast milk supply to the baby’s requirement. Causes diarrhoea.
- 39. Foster establishment of breastfeedingsupport groups and refer mothers to them on discharge from the hospital or clinic.
- 40. Breast feedingsupport groups are often part of community nutrition strategy. Peer counsellors-women from the community who receive training in breastfeeding support. They often contact mothers in home. Increases exclusive breastfeeding.