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Sesi 5 Birth practices
This document discusses best practices for supporting breastfeeding from birth. It recommends placing babies skin-to-skin with mothers immediately after birth for at least one hour to promote bonding and breastfeeding. Barriers to early skin-to-skin contact like concerns over temperature or exams can be overcome by keeping the baby dry and warm on the mother's chest. The document also outlines birth practices that help breastfeeding like supportive labor positions and avoiding unnecessary interventions. It provides guidance for assisting breastfeeding after C-sections, such as early skin-to-skin contact and comfortable holding positions. Baby-friendly practices are said to benefit all mothers regardless of feeding method by promoting support and respecting their choices.
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Sesi 5 Birth practices
- 1. SESSION 5 BIRTH PRACTICESAND BREASTFEEDING - STEP 4 1 Breastfeeding Promotion and Support A Training Course for Health Professionals Adapted from Maryland Department of Health and Mental Hygiene
- 2. Objectives: 1.Describe how theactions during labour and birth can support early breastfeeding. 2. Explain the importance of early contact for mother and baby. 3. Explain ways to help initiate early breastfeeding. 4. List ways to support breastfeeding after a caesarean section. 5. Discuss how BFHI practices apply to women who are not breastfeeding . 22
- 3. Actions in Labourand Birth can support early Breastfeeding 3
- 4. • Step 4of the 10 Steps to Successful Breastfeeding : “Help mothers to initiate breastfeeding within half hour of birth.” 4
- 5. Current implementation inMalaysia : Place babies in skin to skin contact with mothers immediately following birth for at least 10 minutes, however longer period up to one hour is recommended and encourage mothers to recognise when their babies are ready to breastfeed, offering help if needed. 5
- 6. What practices mayhelp a woman to initiate breastfeeding soon after birth? 6
- 7. Mother Friendly BirthingRoom 7
- 8. Birth Practices ThatSupport Breastfeeding Support person or doula during labor Encourage comfortable birthing positions and ambulation Food or drink during EARLY labor Encourage non-medicated births Keep mother and baby together 8
- 9. Positions for restingduring labour 9 Session 5 : Birth Practices and Breastfeeding Ministry of Health Malaysia
- 10. Birth Practices ThatHinder Breastfeeding Pitocin use Lower Apgar scores Increased anxiety and pain Inhibits oxytocin release Fluid retention Overhydration with IV fluids Breast edema Difficulty latching Increased newborn weight loss 10
- 11. Labour Pain Management All pain relief medications cross the placenta Timing of analgesia is important Non-medicated pain relief 11
- 12. Other Procedures ThatCan Interfere With BF Forceps and vacuum extraction Episiotomy Gastric and vigorous suctioning Eye prophylaxis before the first hour Separating mother and baby Bathing newborn at delivery Swaddling and wrapping newborn Taking newborn to nursery for assessments/ procedures 12
- 13.
- 14. Skin-to-skin Place babies skin-to-skin Immediatelyfollowing birth Uninterrupted for first hour No clothing between mother and baby Dry infant while on mother’s chest Until first breastfeeding completed All infants, regardless of feeding plan 14
- 15. UNICEF/WHO Breastfeeding Promotionand Support in a Baby-Friendly Hospital – 20 hour Course 2006 First Skin to Skin Contact 5/3 DrNilsBergman,Cape Town,SouthAfrica 15First Skin to Skin Contact
- 16. Skin-to-skin contact: WHEN? •Vaginal delivery – Put the baby on mother’s abdomen while delivering placenta and stitching epi • LSCS – If under epidural/spinal, skin-to skin and breastfeeding initiated immediately after baby out – If under GA – once mother able to respond/recovery room 16
- 17. Skin-to-skin contact All babiesshould be dried off as they are placed on mother’s skin. Baby does not need to be bathed immediately after birth. Holding baby is not implicated in HIV transmission. For mother with HIV Babies, who are not stable immediately after birth can receive skin-to-skin contact later when they are stable. 17
- 18. Benefits of SkinTo Skin Contact Increases duration of breastfeeding Warms and colonizes baby More quickly stabilizes vital signs Provides antibody protection through colostrum Babies learn to suckle more effectively Facilitate bonding Improves developmental outcomes 18
- 19. What are barriersto early skin-to-skin contact? How could these barriers be overcome? 19
- 20. Barriers to skin-to-skincontact Concerns of cold stress Baby needs Exam Bath Insufficient staff Mother needs Tired Perineum repair
- 21. Overcoming barriers • Concernthat baby will be cold – Dry baby – Place naked on mother’s chest – Put dry cloth over both baby and mother – If room is cold, cover baby’s head to reduce heat loss – Skin to skin contact with mother provides better heat regulation than heater 21
- 22. Overcoming barriers • Babyneeds to be examined –Most examinations can be done with baby on mother’s chest • Baby likely to be lying quietly –Weighing can be done later 22
- 23. Overcoming barriers • Motherneeds to be stitched – baby can remain on mother’s chest for stitching of epi/ LSCS 23
- 24. Overcoming barriers • Babyneeds to be bathed –Delaying first bath allow vernix to soak into baby’s skin • Lubricating n Protecting –Delaying first bath prevents temp loss –Baby can be wiped dry after birth 24
- 25. Overcoming barriers • Labourroom is busy – Transfer mother and baby to the ward in skin-to- skin contact – Continue contact in ward • No staff available to stay with mother and baby – Family member/companion can stay 25
- 26. Overcoming barriers • Babyis not alert – More important to have contact – Sleepy baby due to pain medication needs extra support to bond and feed • Mother is tired – Mother rarely so tired, does not want to hold baby – Contact with baby helps mother relax – Review practices of withholding food/fluids 26
- 27. Overcoming barriers • Motherdoes not want to hold baby – If mother unwilling to hold baby • Indication mother is depressed • Greater risk of abandonment/neglect/abuse –Encouraging contact increases bonding potential • Reduce risk of harm to baby 27
- 28. Overcoming barriers • Twins –interval between births varies. – the first infant can have skin to skin contact until mother starts to labour for second birth. – First twin can be held in skin to skin contact by a family member for warmth and contact while second twin is born. – Then the two infants are held by mother in skin to skin contact and assisted to breastfeed when ready. 28
- 29. Skin To Skin 29 Session5 : Birth Practices and Breastfeeding Ministry of Health Malaysia
- 30. Helping to InitiateBreastfeeding 30
- 31. Initiating Breast Feeding Assistthe first feeding Pre-feeding behaviors Short rest periods Recognises feeding cues Hands to mouth Licking Sucking motions Touching nipple Moving towards breast Finding nipple 31
- 32. Helping to Initiatebreastfeeding • Help mother to recognise pre-feeding behaviours or cues. – When mother and baby are kept quietly in skin-to- skin contact, baby typically works through a series of pre-feeding behaviours. – may be a few minutes or an hour or more. 32
- 33. 33 Session 5 :Birth Practices and Breastfeeding Ministry of Health Malaysia
- 34. Further advantage Skin toskin and eye contact : •optimise oxytocin release •Coordinate suckling, swallowing and breathing 34
- 35. Helping to initiatebreastfeeding • There should be no pressure on mother or baby – how soon first feed takes place, – how long first feed lasts, how well – Consider as an introduction to breast rather than a feed. 35
- 36. Role of healthcare worker • Provide time and a calm atmosphere • Help mother to find comfortable position • Build mother’s confidence • Avoid rushing baby to breast or pushing breast into baby’s mouth. 36
- 37. Supporting breastfeeding after CaesareanSection 37
- 38. Caesarean Section Maternal disappointmentin birthing process Unexpected or unplanned Separation from newborn Impact on breastfeeding Delay in Lactogenesis II Newborn lethargic Suctioning of infant Delay in early contact Separation 38
- 39. Supporting BF afterCaesarean Section Assist mother with skin-to-skin as soon after delivery as possible Assist mother to find comfortable positions Laid-back (biological nurturing) Side lying Clutch/football 39
- 40.
- 41. Supporting BF afterCaesarean Section • Presence of supportive health worker Help initiate /Encourage skin to skin asap Spinal/epidural - immediate GA- contact in recovery room if mother responsive Skin to skin by father /family member while waiting for mother to return from OT Prem/unstable baby – contact when stable 41
- 42. Infants Who DoNot Self Attach Observe infants closely for feeding cues Assessment of infant by physician Limit visitors 42
- 43. BFHI practices andwomen who are not breastfeeding All mothers should be encouraged to let baby suckle at breast unless: – there is a known medical reason for not breastfeeding, (e.g HIV-positive woman ) – If a mother has a strong personal desire not to breastfeed 43
- 44. Summary Baby-friendly practices supportwomen whether or not they are breastfeeding Support during labor Skin-to-skin Limiting invasive interventions & pain relief Offering light food and fluids Respect a mother wishes Replacement feedings, if applicable 44 SUMMARY SESSION 5 BIRTH PRACTICES AND BREASTFEEDING - STEP 4
- 45. Session 5 KnowledgeCheck 1. Name three possible barriers to early skin-to- skin contact and how each might be overcome 2. List four labour or birth practices that can help mother and baby get a good start with breastfeeding. 3. List three ways to assist a mother following a caesarean section with breastfeeding. 45
- 46. Barriers to skin-to-skincontact Concerns of cold stress Baby needs Exam Bath Insufficient staff Mother needs Tired Perineum repair
- 47. Birth Practices ThatSupport Breastfeeding Support person or doula during labor Encourage comfortable birthing positions and ambulation Food or drink during EARLY labor Encourage non-medicated births Keep mother and baby together 47
- 48. Supporting BF afterCaesarean Section Presence of supportive health worker Assist mother with skin-to-skin as soon after delivery as possible Assist mother to find comfortable positions Laid-back (biological nurturing) Side lying Clutch/football 48
- 49.