baby-friendly hospital initiative...fslow, deep sucks with pauses frapid shallow sucks fcheeks round...
TRANSCRIPT
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
BABY-FRIENDLY HOSPITAL INITIATIVERevised, Updated and Expanded for Integrated Care
“Mat
erni
ty”,
1963
, ©20
03 E
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), N
ew Y
ork
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Global Strategy for Infant and Young Child Feeding
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.
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
The aim of the Baby Friendly Hospital Initiative
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.
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
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.
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
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Orig
inal
illu
stra
tion
by J
enny
Cor
kery
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Infant Feeding Recommendation for HIV-positive Women
Exclusive breastfeeding is recommended for HIV-infected mothers for the first six months of life
unless replacement feeding is acceptable, feasible, affordable, sustainable and safe for
them and their infants before that time.
When replacement feeding is acceptable, feasible, affordable, sustainable and safe avoidance of all
breastfeeding by HIV-infected mothers is recommended.
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
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Orig
inal
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by J
enny
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
The overall aim of the International Code of Marketing
of Breast-milk Substitutes is the safe and adequate nutrition
of all infants.
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Skin to Skin Contact and Early Breastfeeding
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Skin to Skin Contact and Early Breastfeeding
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ICEF
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First Skin to Skin Contact5/3
Dr N
ils B
ergm
an, C
ape
Tow
n, S
outh
Afri
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Parts of the Breast6/1
Adap
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Helping the Oxytocin Reflex 6/2
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
What can you see?
Good attachment Poor attachment
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
What can you see?
Good attachment Poor attachment
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Breastfeeding Positions7/1
In lineCloseSupported Facing
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
BREASTFEED OBSERVATION AIDMother's name _______________________________ Date ___________________Baby's name _________________________________ Baby's age ______________Signs that breastfeeding is going well: Signs of possible difficulty:GENERALMother: Mother:
Mother looks healthy Mother looks ill or depressedMother relaxed and comfortable Mother looks tense and uncomfortableSigns of bonding between mother and baby No mother/baby eye contact
Baby: Baby:Baby looks healthy Baby looks sleepy or illBaby calm and relaxed Baby is restless or cryingBaby reaches or roots for breast if hungry Baby does not reach or root
BREASTSBreasts look healthy Breasts look red, swollen, or soreNo pain or discomfort Breast or nipple painfulBreast well supported with fingers away from nipple Breasts held with fingers on areola Nipples protractile Nipples flat, not protractileBABY’S POSITIONBaby’s head and body in line Baby’s neck and head twisted to feedBaby held close to mother’s body Baby not held closeBaby’s whole body supported Baby supported by head and neck onlyBaby approaches breast, nose to nipple Baby approaches breast, lower lip/chin to nipple
BABY’S ATTACHMENTMore areola seen above baby’s top lip More areola seen below bottom lipBaby’s mouth open wide Baby’s mouth not open wideLower lip turned outwards Lips pointing forward or turned inBaby’s chin touches breast Baby’s chin not touching breast
SUCKLINGSlow, deep sucks with pauses Rapid shallow sucksCheeks round when suckling Cheeks pulled in when sucklingBaby releases breast when finished Mother takes baby off the breast
Mother notices signs of oxytocin reflex No signs of oxytocin reflex noticedNotes:
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Assess a Breastfeed
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Wide Open Mouth
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Assess a Breastfeed
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Assess a Breastfeed
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ICEF
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Case study9/2
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ICEF
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“Sleeping all the time”
“Refusing” the breast
3 stools in week
12% under birth weight
Bottle with honey and water twice yesterday
2 weeks old Healthy at birth Discharged Day 2
Case study
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Kangaroo Mother Care
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Dr N
ils B
ergm
an,
Cap
e To
wn,
So
uth
Afric
a
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Kangaroo Mother Care
Dr N
ils B
ergm
an, C
ape
Tow
n, S
outh
Afri
ca
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Positioning a preterminfant
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ICEF
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Twins Grow Well on
Breastmilk
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ICEF
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dsm
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aurit
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DANCER Hand Position
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Chin Support 10/6
Kay
Hoo
ver a
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arba
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ilson
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om T
he B
reas
tfeed
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Atla
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Hand Expression
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©UNICEF 910164F
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Cup Feeding 11/2
Pro
mot
ing
brea
stfe
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g in
hea
lth fa
cilit
ies:
A
sho
rt co
urse
for a
dmin
istra
tors
and
pol
icy
mak
ers
WH
O/N
UT/
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, Wel
lsta
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Supplementer
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Dr R
uskh
ana
Hai
der,
Dha
ka, B
angl
ades
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Size and Shape
There are many different shapes and sizes of breast and nipple.
Babies can breastfeed from almost all of them.
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Full Breast
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Engorged Breast
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0-25
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Mastitis12/4
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Sore Nipple12/5
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Sore Nipple
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Syringe method for inverted nipples12/7
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Candida on the nipple12/8
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Candida on the nipple12/9
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Tongue-tie 12/10
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Lactational Amenorrhea Method (LAM)13/1
Institute for Reproductive Health, Georgetown, Washington, DC
1. Have your menses returned?
2. Are you giving supplements or are there long periods without breastfeeding either day or night?
3. Is your baby more than six months old?
Ask the mother or advise her to ask herself these three questions:
There is only a 1-2% chance of pregnancy at this time.
YES
NO
NO
NO
YES
YES
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.
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
UNICEF/WHO/UNAIDS Infant Feeding Recommendation for
HIV-positive Women
Exclusive breastfeeding is recommended for HIV-infected mothers for the first six months of life
unless replacement feeding is acceptable, feasible, affordable, sustainable and safe for
them and their infants before that time.
When replacement feeding is acceptable, feasible, affordable, sustainable and safe avoidance of all
breastfeeding by HIV-infected mothers is recommended.
13/2
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
14/1
Orig
inal
illu
stra
tion
by J
enny
Cor
kery
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
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.
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Where are we now?
Developing a Plan:
Step One
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Where do we want to be?
15/3Developing a Plan:
Step Two
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
Developing a Plan:Step Three
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How will we get there?
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2009
How will we know if we are there?
Developing a Plan:Step Four
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How will we sustain it?
15/6Developing a Plan:Step Five