The Ten Steps to Successful Breastfeeding From A
The Ten Steps to Successful Breastfeeding From: A Joint WHO/UNICEF Statement Published by the World Health Organization
: Step 1 Have a written breastfeeding policy that is routinely communicated to all health care staff.
: Step 2 Train all health care staff in skills necessary to implement this policy.
: Step 3 Inform all pregnant women about the benefits and management of breastfeeding.
: Step 4 Help mothers initiate breastfeeding within the first half-hour after birth.
: Step 5 Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants.
: Step 6 Give newborn infants no food or drink other than breastmilk, unless medically indicated.
: Step 7 Practice rooming-in -- allow mothers and infants to remain together -- 24 hours a day.
: Step 8 Encourage breastfeeding on demand.
: Step 9 Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
: Step 10 Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
Breastfeeding Getting Started
: Step 3 Inform all pregnant women about the benefits and management of breastfeeding.
: Prenatal education should include n n n n The benefits of breastfeeding The benefits of early initiation The importance of rooming in The importance of feeding on demand How to assure enough milk Proper positioning and attachment The importance of exclusive breastfeeding The risk of using bottles and pacifiers “Prenatal education should not include formula preparation methods. ”
QUESTIONS
Advantages for the Baby n Less illnesses, diseases & disorders n Antibodies in breast milk n Always the right temperature n Nurturing benefits from skin to skin contact n Aids in development of baby’s brain and nervous system
Advantages for Mother n Decreased postpartum bleeding n Earlier return to pre-pregnancy weight n Delayed resumption of ovulation n Reduced risk of ovarian cancer n Reduced premenopausal breast cancer
Anatomy & Physiology During Pregnancy n Breast, areola, & nipple increase in size n Veins may be more noticeable n Milk glands & ducts increase n Colostrum is produced in the second trimester n Montgomery glands become numerous and prominent
How Does a Breast ? Produce Milk n Milk is made in grapelike structures deep in the breast n When milk “let’s down” it travels out of the “grapes” down the stems “ducts” and collects in the pools (sinuses) under the dark area (areola) behind the nipple n Baby’s gums press areola to release milk
Lactogenesis Illustration by Joyce Kopatch, USACHPPM
Before Delivery: Preparing for Breastfeeding n Massage breasts and rub nipples gently n Avoid using soap on nipples n Expose nipples to air and briefly to sunlight n Let nipples rub against clothing
Flat or Inverted Nipples n Begin treatment late in pregnancy n n Stop if causes uterine contractions Breast shells n Wear 1 hour a day and gradually increase to several hours n Dry area under nipple often
Breastfeeding: Getting Started
Is Your Baby Hungry? Infant Feeding Cues n Bringing hands to mouth or cheek and trying to suck on them n Rooting n Lip smacking, mouthing, tongue protrusion n Crying is a late feeding cue
The Side-lying Position n Lie on your side n Use pillows n Tummy-to-tummy n Baby’s mouth in line with nipple Illustration by Joyce Kopatch, USACHPPM
The Football Position n Baby’s legs are under your arm n Use pillows n Helpful for baby’s who are having trouble latching on Illustration by Joyce Kopatch, USACHPPM
The Cradle Position n Tummy-to-tummy n Baby’s head in crook of your elbow n Shoulders, hips, in straight line n Level with breast n Pillow in lap will help Illustration by Joyce Kopatch, USACHPPM
Offering Your Breast to Baby n Fingers underneath, thumb on top of breast n Fingers well behind areola Illustration by Joyce Kopatch, USACHPPM
…Open wide n Quickly center your nipple in his mouth and pull him toward you n Baby’s lower jaw far back from the nipple n Baby’s chin on breast n Nose may be on breast
Coming off the breast n n Watch baby for cues that he is finished n May spontaneously come off the breast n May fall asleep Allow baby to determine when he is done n n Foremilk and hindmilk If you need to stop the feeding early, break suction by inserting finger into corner of baby’s mouth
? Is baby getting enough to eat o Baby feeds frequently o 10 -15 on each breast per feeding o Adequate wet diapers o Adequate stools o Baby is gaining weight
Nursing Mothers: Stay Well Nourished n Follow same healthy diet you ate while pregnant n Breast feeding burns 300 -400 additional calories per day n If you are not well nourished, your supply of breast milk may decrease
REMEMBER Getting breastfeeding correct from the start is crucial to long-term !breastfeeding success
Infant Feeding Recommendation for HIVpositive Women When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIVinfected 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
“Prenatal education should not influce group education on formula preparation. ” “Prenatal education for those mothers who want information on formula preparation should take place on an individual basis. ”
Challenges
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