2. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Global Strategy for Infant and Young Child Feeding 1/1 The aim of the Global Strategy is to improve – through optimal feeding – the nutritional status, growth and development, health, and thus the survival of infants and young children. It supports exclusive breastfeeding for 6 months, with timely, adequate, safe and appropriate complementary feeding, while continuing breastfeeding for two years and beyond. It also supports maternal nutrition, and social and community support.
3. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 The aim of the Baby Friendly Hospital Initiative 1/2 To implement the Ten Steps to Successful Breastfeeding and to end the distribution of free and low-cost supplies of breastmilk substitutes to health facilities.
4. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Course Aims The aim of this course is that every staff member will confidently support mothers with early and exclusive breastfeeding, and that this facility moves towards achieving Baby-friendly designation. 1/3
5. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 3/1 Original illustration by Jenny Corkery
6. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Infant Feeding Recommendation for HIV-positive Women 3/2 When replacement feeding is acceptable, feasible, affordable, sustainable and safe (AFASS), 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.
7. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 4/1 Original illustration by Jenny Corkery
8. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 4/2 The overall aim of the International Code of Marketing of Breastmilk Substitutes is the safe and adequate nutrition of all infants.
10. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 5/2 Skin to Skin Contact and Early Breastfeeding UNICEF/HQ92-0369/ Roger Lemoyne, Thailand
11. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 First Skin to Skin Contact 5/3 Dr Nils Bergman, Cape Town, South Africa
12. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Parts of the Breast 6/1 Adapted from Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2
13. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Helping the Oxytocin Reflex 6/2 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2
14. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 What can you see? 6/3 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2 Good attachment Poor attachment
15. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 What can you see? 6/4 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2 Good attachment Poor attachment
16. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Breastfeeding Positions 7/1 In line Close Supported Facing Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2
17. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 7/2 BREASTFEED OBSERVATION AID Mother's name _______________________________ Date ___________________ Baby's name _________________________________ Baby's age ______________ Signs that breastfeeding is going well: Signs of possible difficulty: GENERAL Mother: Mother: Mother looks healthy Mother looks ill or depressed Mother relaxed and comfortable Mother looks tense and uncomfortable Signs of bonding between mother and baby No mother/baby eye contact Baby: Baby: Baby looks healthy Baby looks sleepy or ill Baby calm and relaxed Baby is restless or crying Baby reaches or roots for breast if hungry Baby does not reach or root BREASTS Breasts look healthy Breasts look red, swollen, or sore No pain or discomfort Breast or nipple painful Breast well supported with fingers away from nipple Breasts held with fingers on areola BABY’S POSITION Baby’s head and body in line Baby’s neck and head twisted to feed Baby held close to mother’s body Baby not held close Baby’s whole body supported Baby supported by head and neck only Baby approaches breast, nose to nipple Baby approaches breast, lower lip/chin to nipple BABY’S ATTACHMENT More areola seen above baby’s top lip More areola seen below bottom lip Baby’s mouth open wide Baby’s mouth not open wide Lower lip turned outwards Lips pointing forward or turned in Baby’s chin touches breast Baby’s chin not touching breast SUCKLING Slow, deep sucks with pauses Rapid shallow sucks Cheeks round when suckling Cheeks pulled in when suckling Baby releases breast when finished Mother takes baby off the breast Mother notices signs of oxytocin reflex No signs of oxytocin reflex noticed Notes:
21. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Assess a Breastfeed 7/6 UNICEF/HQ91-0168/ Betty Press, Kenya
22. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 8/1 9/1 Original illustration by Jenny Corkery
23. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Case study 9/2 Case study 2 weeks old Healthy at birth Discharged Day 2 “Sleeping all the time” “Refusing” the breast 3 stools in week 12% under birth weight Bottle with honey and water twice yesterday Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2 UNICEF/HQ91-0168/ Betty Press, Kenya
24. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 10/1 Kangaroo Mother Care Dr Nils Bergman, Cape Town, South Africa
25. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 10/2 Kangaroo Mother Care Dr Nils Bergman, Cape Town, South Africa
26. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Positioning a preterminfant 10/3 UNICEF/HQ93-0287/ Roger Lemoyne, China
27. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Twins Grow Well on Breastmilk 10/4 UNICEF/HQ92-0260/ Lauren Goodsmith, Mauritania
29. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Chin Support 10/6 Kay Hoover and Barbara Wilson-Clay, from The Breastfeeding Atlas
31. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Cup Feeding 11/2 Promoting breastfeeding in health facilities: A short course for administrators and policy makers WHO/NUT/96.3, Wellstart International
32. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 11/3 Supplementer Dr Ruskhana Haider, Dhaka, Bangladesh
33. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 12/1 Size and Shape There are many different shapes and sizes of breast and nipple. Babies can breastfeed from almost all of them. Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2
39. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Syringe method for inverted nipples 12/7 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2
43. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 13/1 Lactational Amenorrhea Method (LAM) Ask the mother or advise her to ask herself these three questions: YES 1. Have your menses returned? When the answer to ANY one of these questions becomes YESThe mother’s chance of pregnancy is increased. For continued protection, and to achieve child spacing, a complementary family planning method needs to be used, and breastfeeding continue. NO 2. Are you giving supplements or are there long periods without breastfeeding either day or night? YES NO 3. Is your baby more than six months old? YES NO There is only a 1-2% chance of pregnancy at this time. Institute for Reproductive Health, Georgetown, Washington, DC
44. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 UNICEF/WHO/UNAIDS Infant Feeding Recommendation for HIV-positive Women 13/2 When replacement feeding is acceptable, feasible, affordable, sustainable and safe, (AFASS)avoidance of all breastfeeding by HIV-infected mothers is recommended. Otherwise, exclusive breastfeeding is recommended during the first months of life and should be then discontinued as soon as it is feasible.
45. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 14/1 Original illustration by Jenny Corkery
46. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Course Aims The aim of this course is that every staff member will confidently support mothers to succeed with early and exclusive breastfeeding, and that this facility moves towards achieving Baby-Friendly designation. 15/1
47. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Developing a Plan: Step One 15/2 Where are we now?
48. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Developing a Plan: Step Two 15/3 Where do we want to be?
49. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 15/4 Developing a Plan:Step Three How will we get there?
50. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 15/5 Developing a Plan:Step Four How will we know if we are there?
51. UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 15/6 Developing a Plan:Step Five How will we sustain it?
