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Session 5:
Birth Practices and
Breastfeeding
Step 4
UNICEF/WHO 20 hour Course 2006
OBJECTIVES
1. Describe how the actions during labour
and birth can support early breastfeeding.
2. Explain the importance of early skin to
skin contact for mother and baby;
3. Explain ways to help initiate early
breastfeeding;
4. List ways to support breastfeeding after a
caesarean section.
What practices
during labor and
immediately after
birth could help a
mother and her baby
to start
breastfeeding well ?
Step 4
Help mothers initiate
breastfeeding with half hour
after birth.
Step 4 – new interpretation
Place babies skin to skin contact
with their mothers immediately following birth
for at least an hour and
encourage mothers to recognize when their
babies are ready to feed,
offering help when needed.
Sige nanay,
kaunting ire
pa..
The care that
a mother
experiences
during labor
and birth
can affect
breastfeeding
and how she
cares for her
baby .
What practices HELPS
a woman initiate
breastfeeding soon
after birth ?
Practices that Helps
• Emotional support
• Attention on the effects of pain
medications on the baby
• Offering light foods and fluids
• Freedom of movement
• Avoidance of unnecessary CS
• Early mother-baby contact
• Facilitate the first feed.
Practices that Helps
What practices HINDERS
a woman initiate
breastfeeding soon
after birth ?
Practices that may HINDER
• Lying on bed during labor & delivery
• Lack of support
• Withholding food and fluids
• Pain medications / IV lines
• Episiotomy
• Wrapping baby tightly
• Separating the mother from the baby
What are the possible
differences it will have
on the mother and on
the baby if a doula stays
with the mother during
labour and delivery ?
Effect of Support to Mother
Increase
mothers’
confidence
Speed labor
& delivery
Reduce
stress
Reduce
perception
of pain
Encourage
mobility
Reduced
need for
intervention
Effect of Support to Baby :
• Increased alertness of baby
• Reduced risk of hypothermia and
hypoglycemia
• Early and frequent feeding
• Easier bonding with the baby
What support can the
doula give ?
 Encourage her to walk and move in labor
 Offer light nourishment and fluids
 Built mother’s confidence
 Suggest ways to lessen pain and anxiety
 Holding hands, massaging her
 Using positive words
Non-medication methods of pain relief
 Labor support
 Walking and moving around
 Massage
 Warm water
 Verbal and physical assurance
 Quiet environment with no bright lights,
few people around
 Labor and giving birth positioning of the
mother’s choice
Effects of pain medications
It can increase the risk of :
1. Longer labor
2. Operative
interventions
3. Delayed start to
mother - baby
contact and
breastfeeding
5. Separation of MOM &
baby after birth
6. Sleepy, hard to arouse
baby
7. Diminished sucking
reflex
8. Reduced milk intake
What effect might giving fluid or
withholding fluid have on
a woman in labor ?
• Labor and birth is hard work. Woman
needs energy to do this work.
• Gets hungry after a normal delivery.
• IV fluid only if there is a clear medical
indication
Birth Practices
When giving birth, all woman need:
• A skilled attendant present
• Minimal use of invasive procedure
• Universal precaution against infection
• Use of Interventions only when medically
indicated
Skin to Skin Contact and
Early Breastfeeding
5/1
©UNICEF
C107-2
Skin to skin contact
• ENSURE uninterrupted, unhurried skin to
skin contact
• Start immediately, even before cord
clamping,
• Arrange that this skin to skin contact
continue for at least one hour after birth.
Importance of
skin to skin contact
1. Calms the mother and baby
2. Keeps baby warm
3. Assist in metabolic adaptation and
blood glucose stabilization in the baby
4. Reduces baby crying and stress
cont
• Enables colonization of
baby’s gut with mother’s normal
body bacteria
• Facilitates bonding
• Allows the baby to find the breast
and self attach
Importanc e of STS
• Babies should be dried off as they are placed on the
mother’s skin.
Babies who are not stable at birth can receive STS
contact later when they are stable.
Skin to Skin Contact and Early Breastfeeding
UNICEF/HQ92-0369/ Roger Lemoyne, Thailand
Dr Nils Bergman, Cape Town, South Africa
What could be
BARRIERS to ensuring
early skin to skin
( STS) contact ?
?
Barriers to Skin To Skin contact
1. Concern that baby
will get cold
2. Baby needs to be
examined / bathe
3. Baby is not alert ,
sedated
4. Mother tired / needs
to be stitched
5. Mother does not
want to hold baby
6. Delivery room is
busy / No staff
available to stay
with mother and
baby
Barriers to Skin To Skin contact
• Twin births – interval of delivery
usually varies
• On mother’s labor/delivery
chart, record the time STS
started and finished
How to assist the first time
at the breast (initiation)
1. Help recognize pre-feeding
behaviors or cues :
• Taking a short rest in an alert state
• Bringing hands to his mouth
• Focusing on areola
• Moving towards breast
• Finding the nipple cont
How to assist the first time at the breast (initiation)
2. There should be no pressure
on the mother and baby
regarding
• how soon the first feed takes place,
• how long a first feed would last,
• how well attached the baby is or
• how much colostrum the baby takes
INTRODUCTION TO THE BREAST rather than A
FEED.
What are the Role of the Health Worker
during initiation of breastfeeding ?
• Provide time and calm environment
• Help mother find a comfortable
position
• Point out positive behaviors of the baby
such as alertness and rooting
• Build the mother’s confidence
• Avoid rushing the baby to the breast or
pushing the breast into the baby’s
mouth
What effects could a CESARIAN
section have on the mother ?
1. Frightened or stressed
2. Have IV drip/ urinary catheter
3. Confined to bed
4. Restricted fluid and food intake
5. Have received anesthetics
Possible Effect of cesarean section
6. Altered levels of hormones of
lactation
7. Higher risk of infection, bleeding
8. Separated from baby
9. Feel a sense of failure
10.Is a high risk of not breastfeeding
Possible Effect of cesarean section
11. May have more breathing problems
12. May need suction of mucus
13. Maybe sedated
14. Is less likely to have early contact
15. Is more likely to receive supplements
16. Is more likely to have nursery care
How can we help initiate BF
after a cesarean section ?
• Presence of a supportive health
worker / doula
• Encourage mother to have STS
contact as soon as possible
• Assist initiated breastfeeding
• Help find comfortable position
STS – skin to skin
Summary
Step 4 – help mothers initiate BF
within half-hour of birth.
New interpretation:
Place babies skin to skin contact with
their mothers immediately after birth for
at least an hour and encourage mothers
to recognize whether their babies are
ready to breastfeed, offering help when
needed.
SUMMARY
Competent woman,
in control,supported,
ready to interact with baby
Early STS contact
Alert baby
Search breast
Breastfeeding initiated
Good
supportive
practices
Health
Facility
Community
Family
Thank you very much
for your attention
my dear breast friends!!

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Session-5-Birthing-Practices-Breastfeeding (1).ppt

  • 1. Session 5: Birth Practices and Breastfeeding Step 4 UNICEF/WHO 20 hour Course 2006
  • 2. OBJECTIVES 1. Describe how the actions during labour and birth can support early breastfeeding. 2. Explain the importance of early skin to skin contact for mother and baby; 3. Explain ways to help initiate early breastfeeding; 4. List ways to support breastfeeding after a caesarean section.
  • 3. What practices during labor and immediately after birth could help a mother and her baby to start breastfeeding well ?
  • 4. Step 4 Help mothers initiate breastfeeding with half hour after birth.
  • 5. Step 4 – new interpretation Place babies skin to skin contact with their mothers immediately following birth for at least an hour and encourage mothers to recognize when their babies are ready to feed, offering help when needed.
  • 6. Sige nanay, kaunting ire pa.. The care that a mother experiences during labor and birth can affect breastfeeding and how she cares for her baby .
  • 7. What practices HELPS a woman initiate breastfeeding soon after birth ?
  • 8. Practices that Helps • Emotional support • Attention on the effects of pain medications on the baby • Offering light foods and fluids
  • 9. • Freedom of movement • Avoidance of unnecessary CS • Early mother-baby contact • Facilitate the first feed. Practices that Helps
  • 10. What practices HINDERS a woman initiate breastfeeding soon after birth ?
  • 11. Practices that may HINDER • Lying on bed during labor & delivery • Lack of support • Withholding food and fluids • Pain medications / IV lines • Episiotomy • Wrapping baby tightly • Separating the mother from the baby
  • 12. What are the possible differences it will have on the mother and on the baby if a doula stays with the mother during labour and delivery ?
  • 13. Effect of Support to Mother Increase mothers’ confidence Speed labor & delivery Reduce stress Reduce perception of pain Encourage mobility Reduced need for intervention
  • 14. Effect of Support to Baby : • Increased alertness of baby • Reduced risk of hypothermia and hypoglycemia • Early and frequent feeding • Easier bonding with the baby
  • 15. What support can the doula give ?  Encourage her to walk and move in labor  Offer light nourishment and fluids  Built mother’s confidence  Suggest ways to lessen pain and anxiety  Holding hands, massaging her  Using positive words
  • 16. Non-medication methods of pain relief  Labor support  Walking and moving around  Massage  Warm water  Verbal and physical assurance  Quiet environment with no bright lights, few people around  Labor and giving birth positioning of the mother’s choice
  • 17. Effects of pain medications It can increase the risk of : 1. Longer labor 2. Operative interventions 3. Delayed start to mother - baby contact and breastfeeding 5. Separation of MOM & baby after birth 6. Sleepy, hard to arouse baby 7. Diminished sucking reflex 8. Reduced milk intake
  • 18. What effect might giving fluid or withholding fluid have on a woman in labor ? • Labor and birth is hard work. Woman needs energy to do this work. • Gets hungry after a normal delivery. • IV fluid only if there is a clear medical indication
  • 19. Birth Practices When giving birth, all woman need: • A skilled attendant present • Minimal use of invasive procedure • Universal precaution against infection • Use of Interventions only when medically indicated
  • 20. Skin to Skin Contact and Early Breastfeeding 5/1 ©UNICEF C107-2
  • 21. Skin to skin contact • ENSURE uninterrupted, unhurried skin to skin contact • Start immediately, even before cord clamping, • Arrange that this skin to skin contact continue for at least one hour after birth.
  • 22. Importance of skin to skin contact 1. Calms the mother and baby 2. Keeps baby warm 3. Assist in metabolic adaptation and blood glucose stabilization in the baby 4. Reduces baby crying and stress cont
  • 23. • Enables colonization of baby’s gut with mother’s normal body bacteria • Facilitates bonding • Allows the baby to find the breast and self attach Importanc e of STS
  • 24. • Babies should be dried off as they are placed on the mother’s skin. Babies who are not stable at birth can receive STS contact later when they are stable. Skin to Skin Contact and Early Breastfeeding UNICEF/HQ92-0369/ Roger Lemoyne, Thailand Dr Nils Bergman, Cape Town, South Africa
  • 25. What could be BARRIERS to ensuring early skin to skin ( STS) contact ? ?
  • 26. Barriers to Skin To Skin contact 1. Concern that baby will get cold 2. Baby needs to be examined / bathe 3. Baby is not alert , sedated 4. Mother tired / needs to be stitched 5. Mother does not want to hold baby 6. Delivery room is busy / No staff available to stay with mother and baby
  • 27. Barriers to Skin To Skin contact • Twin births – interval of delivery usually varies • On mother’s labor/delivery chart, record the time STS started and finished
  • 28. How to assist the first time at the breast (initiation) 1. Help recognize pre-feeding behaviors or cues : • Taking a short rest in an alert state • Bringing hands to his mouth • Focusing on areola • Moving towards breast • Finding the nipple cont
  • 29. How to assist the first time at the breast (initiation) 2. There should be no pressure on the mother and baby regarding • how soon the first feed takes place, • how long a first feed would last, • how well attached the baby is or • how much colostrum the baby takes INTRODUCTION TO THE BREAST rather than A FEED.
  • 30. What are the Role of the Health Worker during initiation of breastfeeding ? • Provide time and calm environment • Help mother find a comfortable position • Point out positive behaviors of the baby such as alertness and rooting • Build the mother’s confidence • Avoid rushing the baby to the breast or pushing the breast into the baby’s mouth
  • 31. What effects could a CESARIAN section have on the mother ? 1. Frightened or stressed 2. Have IV drip/ urinary catheter 3. Confined to bed 4. Restricted fluid and food intake 5. Have received anesthetics
  • 32. Possible Effect of cesarean section 6. Altered levels of hormones of lactation 7. Higher risk of infection, bleeding 8. Separated from baby 9. Feel a sense of failure 10.Is a high risk of not breastfeeding
  • 33. Possible Effect of cesarean section 11. May have more breathing problems 12. May need suction of mucus 13. Maybe sedated 14. Is less likely to have early contact 15. Is more likely to receive supplements 16. Is more likely to have nursery care
  • 34. How can we help initiate BF after a cesarean section ? • Presence of a supportive health worker / doula • Encourage mother to have STS contact as soon as possible • Assist initiated breastfeeding • Help find comfortable position STS – skin to skin
  • 35. Summary Step 4 – help mothers initiate BF within half-hour of birth. New interpretation: Place babies skin to skin contact with their mothers immediately after birth for at least an hour and encourage mothers to recognize whether their babies are ready to breastfeed, offering help when needed.
  • 36. SUMMARY Competent woman, in control,supported, ready to interact with baby Early STS contact Alert baby Search breast Breastfeeding initiated Good supportive practices
  • 38. Thank you very much for your attention my dear breast friends!!