The document discusses the importance of breastfeeding and the support needed for women to breastfeed successfully. It outlines the global strategy for infant and young child feeding endorsed by the World Health Assembly, including exclusive breastfeeding for the first six months. The science supporting breastfeeding is presented, showing reduced mortality risks, improved long-term health outcomes, and reduced HIV transmission risk. For women to succeed at breastfeeding, they need accurate information, counseling during pregnancy and after birth, and support to address any problems that may arise. Workplace support is also important to allow women to continue breastfeeding.

1. Women Need Support to Breastfeed Successfully Write your Name /Organisation date and Place here 5/25/09 All About Breastfeeding Lori J. Isenstadt, IBCLC

2. Global Strategy for Infant and Young Child Feeding Adopted by the WHA and UNICEF Executive board in 2002

3. Life begins here ….

4. Optimal Infant and Young Child Feeding Starting breastfeeding within one hour of birth Exclusive breastfeeding for the first six months Introducing appropriate and adequate complementary feeding after 6 months along with Continued breastfeeding for two years or beyond

5. Science Support

6. Risk of neonatal mortality according to time of initiation of breastfeeding Pediatrics 2006;117:380-386 Six times more risk of death

7. Deaths attributed to sub-optimal breastfeeding among children

8. Impact of Suboptimum breastfeeding on child mortality and DALYs Due to Non- EBF Due to Non- EBF 1.4 million deaths due to suboptimum breastfeeding 43.5 million DALYs due to suboptimum breastfeeding

9. Long term effects Subjects who were breastfed experienced lower mean blood pressure and total cholesterol, as well as higher performance in intelligence tests. Prevalence of overweight/obesity and type-2 diabetes was lower among breastfed subjects. A 2007 WHO Publication

10. Exclusive breastfeeding Reduces HIV Transmission Risk Lancet , 31 March 2007

11. What women need to succeed? Breastfeeding education and support Accurate and un- biased information to all family members, community One to one counselling during pregnancy At birth support to begin breastfeeding Counselling, home visits, and support to maintain exclusive breastfeeding , like support on positioning and nutrition Counselling for complementary feeding Counselling to prevent breastfeeding problems and take care if they do arise Referral for breastfeeding problems like breast engorgement, sore nipples, not enough milk, and breast infection.

12. Women All Over the World Need Support

13. Women at work …need support Crèches etc.

14. What matters to succeed

15. Successful Breastfeeding… Breastfeeding in the Correct Position Anatomy of the Breast Milk producing glands Lactiferous canaliculi Lactiferous sinuses Myoepithelial tissue Adipose tissue

16. Signs of Correct Attachment Mouth wide open Lower lip is turned outside Chin touching the breast Black part of the breast not visible below the lower lip Large black portion of breast and nipple including milk collecting ducts are inside baby’s mouth Tongue under the teat

17. Incorrect Sucking Position Mouth is not wide open Chin is away from the breast Baby is sucking only nipple Most black portion of the breast is outside the baby’s mouth Tongue away from the teat

18. Causes of Incorrect Attachment Use of feeding bottles. Leads to nipple confusion Inexperienced mother Functional difficulty with the mother or the baby Lack of skilled support

19. More prolactin secreted at night Secreted after feed to produce next feed Suppresses ovulation The Prolactin reflex Baby sucking Sensory Impulses from nipple Prolactin in blood Breastmilk Production

20. The Oxytocin reflex Breastmilk Transfer Works before or during feed to make milk flow Makes uterus contract Baby sucking Sensory Impulses from nipple Oxytocin in blood

21. How does the mother’s confidence play part Breastmilk Transfer Thinks lovingly of baby CONFIDENCE Sound of baby Sight of baby Pain Worry Stress Doubt

22. The Feeling of “Not Enough Milk” Not true. Just a perception, this is not a disease entity, just a symptom of underlying problem. You need to know from the mother, why she feels that her baby is not getting enough, and can solve her problems by Reinstating mother’s confidence Ensure frequent, effective suckling

23. Women need help of this kind…

24. Which children grow healthy and achieve development potential? Well nourished mothers Exclusively breastfed for the first six months, begin breastfeeding within an hour Enough and right food to eat later Complementary feeding ,continued breastfeeding Cared well Hygiene and sanitary environment Treated when sick

25. One way to Support is to Sign up

26. Mum power: The friends from ante-natal class converge on McDonald's for the feed-in. Maddie Reynolds is fourth from the left

27. Make breastfeeding visible, and more widely available !! The First Lady of Timor Leste at 7 th Ministerial Consultation on Children Thank you