Medidas Medical Center INC Lactation Training Management Sesion 7 Session-7-Helping-with-a-Breastfeed-edited

1. HELPING WITH A BREASTFEED
Yummy ,Mommy
Lilibeth G. Espinosa MD DPPS

2. OBJECTIVES
I. Discuss Key Elements Of Positioning For
Successful And Comfortable Breastfeeding
II. Describe How To Assess A Breastfeed
III. Recognize Signs Of Positioning And
Attachment

3. OBJECTIVES
IV. Demonstrate How to Help And Learn to
Position and Attach Her Baby for Breastfeeding
V. Discuss When to Assist with Breastfeeding
Vi. Practice in a Small Group Helping a Mother
Vii. List Reasons Why A Baby May Have
Difficulty Attaching to the Breast.

4. Positioning for
Breastfeeding
- how the mother holds her baby
- to help the baby attach well to the
breast.
If baby is well attached- Do not interfere
- tell the mother what key points you are
observing to build her confidence & her
own ability to assess bf.

5. If sitting or lying down
she should be:
- Comfortable with
back supported.
- Feet supported (if
seated).
- Breast supported if
needed.

6. Breastfeeding Positions

7. Good Positioning
1. The baby’s body needs
to be in line with ear,
shoulder and hip in
a straight line, so that
neck is neither twisted nor
bent forward or far back
2. The baby’s body is close
to the mother’s body so
the baby is brought to the
breast rather than the
breast taken to the baby.

8. Good Positioning
1. The baby’s body is
supported at the head,
shoulders and if newborn,
the whole body supported
2. The baby is facing the
breast with the baby’s
nose to the nipple as she
or he comes to the
breast.

9. • Assessing a breastfeed can:
1. help identify and prove what /
mother & baby are doing well
2. information on current difficulties
with breastfeeding
3. highlight practices that may result
in problems later if not changed.

10. HOW TO ASSESS A
BREASTFEED
How ?
- watch what the mother is doing
- watch what the baby is doing
- listen what the mother tells you.

11. BABY’S ATTACHMENT
GOOD ATTACHMENT
More areola seen
above baby’s top lip
Baby’s mouth open
wide
Lower lip turned
outwards
Baby’s chin touches
breast
POOR ATTACHMENT
 More areola seen
below bottom lip
 Baby’s mouth not
open wide
 Lips pointing forward
or turned in
 Baby’s chin not
touching breast

12. BABY’S SUCKLING
GOOD SUCKLING
Slow, deep sucks
with pauses
Cheeks round when
suckling
 Mother notices
signs of oxytocin
reflex
POOR SUCKLING
Rapid shallow sucks
 Cheeks pulled in
when suckling
 Mother takes baby off
the breast
 No signs of oxytocin
reflex noticed

13. BREASTS
Breast or nipple painful
 Breasts look red, sore
or swollen
 Breasts held with fingers on areola

14. BABY’S POSITION
GOOD POSITION
Infant’s head and body should be straight.
Infant’s head and body should be facing the
breast.
Infant’s body should be close to the mother.
Mother should be supporting the infant’s
entire body.

15. BABY’S POSITION
POOR POSITION
Baby’s neck and head twisted
to feed
 Baby not held close
 Baby supported by head and
neck only
 Baby approaches breast, lower
lip/chin to nipple

16. Infant’s head
and body
straight
Infant’s head
and body
facing breast
Infant’s body
close to the
mother
Mother
supporting
infant’s entire
body




Recognizing Good Positioning

17. Infant’s head
and body
straight
Infant’s head
and body facing
breast
Infant’s body
close to the
mother
Mother
supporting
infant’s entire
body




Recognizing Good Positioning

18. Helping a mother to learn to position
& attach her baby.
1. Always observe a mother
BREASTFEEDING
before you offer help .
Offer help only when there’s
difficulty.
.

19. 2. Help as much possible in a “hands
off” manner so the mother
attaches her own baby.
3. Talk about key points
-in line, close, supported, and
facing
-so the mother is confident and
effective on her own.

20. Cup or C-hold
UNICEF
C-107-19
12/2

21. --Dancer’s
hold

22. It does not help the mother’s
confidence if the health worker will do
it for her
The aim of HELPING the mother is :
so SHE CAN position and attach her baby
BY HERSELF.

23. Demonstration:
Steps in Helping a mother:
1. Greet the mother. Introduce
yourself. Ask for the mother’s and
baby’s name.
2. Ask her how she is and ask 1 or
2 open questions about how
breastfeeding is going.

24. 3. Ask her if you may see how her
baby breastfeeds.
4. Sit down yourself so you will be
comfortable and relaxed.
5. Observe her breastfeeding for few
minutes.

25. STEPS…
• Observe: mother and baby in
general, mothers breast, baby’s
position and attachment, suckling.
• Ask the mother how breastfeeding
feels to her
• Say something encouraging

26. • Explain what might help and ask if
she would like you to show her.
• Notice how the mother responds to
the changes that you are suggesting.

27. When to assist breastfeeding?
First hour- may suckle. This should be a
relaxed time w/o much emphasis on
positioning or assessing a feed.
 when baby wakes again – help mother to
find a comfortable position.
 help the mother on correct positioning and
attachment.

28. How to attach the baby to the
breast
1.Touch the baby’s lips with the
nipple.
2.Wait until the baby’s mouth
open.
3.Then move the baby onto the
breast.

29. POINTERS
Aiming the baby’s lower lip well below
the nipple, so that her chin and lower
lip touch the breast first before the
upper lip. (nose to nipple technique)
Bring the baby to the breast, and NOT
her breast to her baby.

30. SIGNS OF GOOD ATTACHMENT
Chin touching
breast
Mouth wide
open
Lower lip
turned outward
More areola
showing above





31. Assessing Attachment
Chin touching breast
Mouth wide open
Lower lip turned
outward
More areola showing
above
not well attached





32. Assessing Attachment
Chin touching
breast 
Mouth wide open
Lower lip turned
outward
More areola
showing above




33. Assessing Attachment
Chin touching breast
Mouth wide open
Lower lip turned
outward
More areola showing
above





34. Assessing Attachment
Chin
touching
breast
Mouth
wide open
Lower lip
turned
outward
More
areola
showing
above



?

35. Recognizing Good Attachment

37. • WHAT POSITIVE SIGNS COULD
YOU TELL THE MOTHER?

38. WHAT POSITIVE SIGNS COULD
U TELL THE MOTHER?

39. • WHAT SUGGESTIONS COULD
U OFFER TO THE MOTHER?

44. 1. The baby may not be hungry at this
time.
2. The baby maybe cold, ill or small
and weak.
3. The mother maybe holding the
baby in a poor position.
RELUCTANCE TO FEED-
REASONS:

45. Reluctance to Feed...
4. Mother may move or shake a breast.
5. Breast maybe engorged & hard.
6. Milk may be flowing too fast.
7. Baby has a sore mouth or a blocked
nose.

46. Reluctance to Feed...
8. Baby may be in pain.
9. Baby may have learned to suckle
on an artificial teat.
10. Changes which upset the baby.
11. Difficulty coordinating with
suckling.

47. • Management of reluctance
to feed:
1. Remove or treat the cause if
identified
2. Encourage skin to skin contact.
3. Do not try to force the baby to the
breast when the baby is crying. He or
she needs to associate the breast
with comfort.

48. PREVENTION OF
RELUCTANCE TO FEED
• Early and frequent skin to skin
contact that helps the baby to learn
that the breast is a safe place from
first few hours.
• Helping the mother to learn the skill of
positioning and attachment in a calm,
unhurried environment.

49. • Being patient while the baby learns to
breastfeed.
• Caring for the baby in a gentle
confident manner.

50. SUMMARY
• POSITIONING AND
ATTACHMENT
• WHEN TO ASSIST
BREASTFEEDING
• HOW TO ASSIST
THE MOTHER IN
BREASTFEEDING
• CAUSES OF
RELUCTANCE TO
FEED
• PREVENTION OF
RELUCTANCE TO
FEED

51. Can u help now position and attach
the baby to the mother’s breast?

52. • Pair Practice: on
Breastfeeding Positioning and
attachment

53. • scenario: Mother Sara has difficulty
breastfeeding the baby . She says she
feels pain during breastfeeding and it
seems that the baby is not getting enough
milk. There seems to be a problem on
positioning and attachment. As a health
worker how are you going to help her?

54. I’m hungry Mommy…. Where are you ?