Medidas Medical Center, INC. Promoting-Breastfeeding-During-Pregnancy

1. Promoting
Breastfeeding
during Pregnancy
90 min
Step 3

2. Session Objectives
1. Outline information that needs to be discussed
with pregnant women
2. Explain antenatal breast preparation, what is
effective and what is not
3. Identify women that needs extra attention
4. Outline information for HIV + pregnant women
5. Practice communication skills when
discussing with pregnant women

3. Fatima & Miriam
Fatima –
expecting her
first baby
Miriam –
expecting her
second baby
Discussion of breastfeeding with pregnant women

4. Step 3 – Inform all pregnant
women of the benefits and
management of breastfeeding.
CULTURE varies
Therefore it is important to EDUCATE
women about breastfeeding
 As early as possible
 Identify mothers and babies at risk of
breastfeeding (BF) difficulties

5. To make an
INFORMED DECISION …
a. INFORMATION
b. UNDERSTANDING
c. CONFIDENCE
d. SUPPORT

6. Informed decision
1. What Information?
 On the importance of breastfeeding
 Risk of replacement feeding
. Accurate and factual
. NOT opinion of HW nor
. marketing Information of milk
companies
cont

7. 2. UNDERSTANDING
In words that are suitable for the
woman
In the context of her situation
3. CONFIDENCE
Built woman’s confidence in her ability
to exclusively breastfeed

8. 4. SUPPORT
-To carry out her feeding
decision
-This includes support to
successfully feed her baby and
overcome any difficulties

9. Woman needs to BELIEVE that
she can carry out her decision
HW needs TO CHECK with the
woman that the information
and support needs are met

10. -Mother who breastfed can be asked to
share her experience
-Identify difficulties / How to prevent it
-Cultural issues
-Teach how to position and attach
-Use dolls / breast models
Group talk with pregnant women

11. Importance of breastfeeding
Breastfeeding
is important
to :
Children
Mothers
Families
Community

12. Risk to children who are NOT
breastfed
1. More likely to get sick or die from
diarrhea and GI infections or chest
infections
2. Become underweight, not grow well
3. Overweight and to have later heart
problems

13. Women who DO NOT breastfeed
are likely to:
1. Develop anemia, retain fat deposited
during pregnancy later obesity
2. Become pregnant soon
3. May develop breast cancer
4. May have hip fracture in older age

14. Benefits to the FAMILY
ECONOMICAL –
1. Readily available / no
preparation
2. Simple / no equipment
needed
3. Reduced absences of
parents from work
4. No lost of income

15. Mother’s milk IS ALL that a baby
needs
 Exclusive breastfeeding recommended 1st six
months (NO other fluids needed)
 Breastfeeding continues to be important after
the first 6 mos.
 Mothers milk is suited for her own baby
(changes to meet the needs of the baby)
 BM is unique - antibodies

16. What are the practices that can
help breastfeeding go well?
Hospital practices:
- Companion during labor
- Avoidance of labor & birth
interventions
- Skin to skin immediately after birth
- Rooming-in / bedding-in
- Know feeding signs / frequent feed
- Exclusive BF

17. What are the practices that can
help breastfeeding go well ?
TEACHING how to position
and attach the baby
correctly.
GIVING support when needed.

18. Information on HIV
- All women are offered voluntary
and confidential HIV counseling
and testing
- About 5-15% of babies born to
HIV infected mother will
become HIV + through BF
( 1 in 20 or 1 in7 )

19. Information on HIV
- Risk of illness & death from NOT
exclusively BF is higher than the risk of
HIV transmission from BF
- Majority of women are NOT infected
with HIV
- BF is recommended for women who :
do not know their status &
who are HIV negative

20. How can a pregnant
woman get counseling
and testing for HIV in
your local area?
?

21. How will a pregnancy
care provider find out if a
pregnant woman knows
the importance of
breastfeeding or has
a question?
Individual Discussion with
pregnant woman

22. Ask the pregnant woman:
“What do you know about
breastfeeding?”
- Practice communication skills
- Let her discuss her worries &
concerns
- 2 way discussion (focus)
- Reflect and Reinforce her knowledge
- Identify non-supporters in the family
- Motivate to join Antenatal check list

23. Antenatal breast preparation
- REASSURE that most women
breastfeed with NO problem
- Ears, nose, feet etc. comes in various
shape, sizes but still work perfectly well
- Practices like using creams, nipple
exercises does NOT assist BF

24. Breast examination during
pregnancy can be helpful if it is
used to :
- Built her confidence that her
breast is increasing in size
preparatory to BF
-Check for breast surgery scars,
lumps – give reassurance

25. The ideal antenatal preparation is
to use the time…
> to discuss woman’s knowledge,
beliefs and feelings about BF
> to built her confidence in her
ability to exclusively breastfeed
her baby.

26. Women who need extra attention
- Previous BF difficulty
- Has non-supportive family member
- Is depressed / isolated / without support
- Young, single, with intention to give baby
- for adoption
- Previous breast surgery / trauma
- Has chronic illness needing medication
- Has high risk baby / PT/ twins etc
- HIV + mother (tested)

27. Can you breastfeed an older baby
during a succeeding pregnancy?
 No need to stop
 Has history of premature labor/
uterine cramping - consult
 Should take care of herself – eat &
rest
 Breast tender in mid-trimester ?
 Shortage of family food ?
 HIV + ?

28. If mother is NOT breastfeeding…
tested and is HIV positive /
informed personal decision
has medical reason /
Discuss replacement feeding
Assist how to prepare feeds
(individual teaching)

29. Antenatal discussion with
women who are HIV positive
Assure
confidentiality
Individual
counseling
Privacy
Information on the risk
& benefits of various
feeding options
Guidelines in selecting
suitable option
Support to carry out the
choice

30. A woman who is not planning to
breastfeed needs to know:
- Feeding options and should be AFASS
- Her needs (milk, water, equipment,
cost, time)
- Type of formula suited for her baby
- Learn to prepare formula
“NEVER mix feed”

31. WHO/UNICEF Infant Feeding Recommendation
for HIV-positive Women
- When replacement feeding is
acceptable, feasible, affordable,
sustainable and safe, avoidance of all
breastfeeding by HIV-infected
mothers is recommended.
Otherwise, exclusive breastfeeding
is recommended during the first months
of life and then should be discontinued
as soon as it is feasible.
3/2

32. Breastfeeding and emergency
situations
- Mother does not need perfect
calm
- Be supportive, build
confidence
- Relaxation, if possible

33. GROUP
PRACTICE

34. Summary
- BF is important for her baby and
herself
Exclusive BF is recommended for 6
months & up to years and beyond
Frequent BF continues to be important
after complementary foods are added
Practices such as skin to skin, early
initiation of BF, rooming- in, frequent
baby-led feeding, good positioning /
attachment, exclusive BF

35. Summary
Support is available to her
Ideal antenatal preparation is that which
builds the woman’s confidence
Some woman needs extra attention
Offer all pregnant woman voluntary &
confidential HIV counseling and testing
WHO/UNICEF recommendation for infant
feeding of a HIV positive tested mother
(AFASS)

36. Session 3 Knowledge Check
List two reasons why exclusive breastfeeding is
important for the child.
 List two reasons why breastfeeding is important
for the mother
 What information do you need to discuss with a
woman during her pregnancy that will help her to
feed her baby.
 List two antenatal practices that are helpful to
breastfeeding and two practices that might be
harmful.
 If a woman is tested and found to be HIV-
positive, where can she get infant feeding
counseling?