Slide 1

Early initiation of breastfeeding and exclusive breastfeedingNew interpretation of Step 4 in the revised BFHI Global Criteria (2006): Place babies in skin-to-skin contact with their mothers immediately following birth for at least an hour and encourage mothers to recognize when their babies are ready to breastfeed, offering help if needed.Slide 4.4.22Other benefits of ONE hour !!!Skin to skin WarmthDevelopmentLess bleeding postpartum

2/1/2011WBW 20073

Increases duration of breastfeeding (UNICEF India: BREASTCRAWL Initiation of breastfeeding by breast crawl. UNICEF India 2007,Sose CIBA Symposium 1978, Kramer et al JAMA2001,VaidyaK et al. NepalMedical College Journal 2005)

Allows skin-to-skin contact for warmth ( Fransson A 2005; Bergman N, 2005, Bergstorm 2007) and colonization of baby with maternal organisms ( Hanson L 2004)

Early initiation of breastfeeding for the normal newbornWhy? RR and HR relative stable (Kroeger & Smith 2004)

Provides colostrum as the babys first immunization (Hanson L : Immunobiology of Human Milk. 2004)

Takes advantage of the first hour of alertness The baby is not crying use of energy (Kroeger & Smith 2004)

Babies learn to suckle more effectivelyImproved developmental outcomesIncrease bounding (UNICEF India: BREAST CRAWL Initiation of breastfeeding by breast crawl. UNICEF India 2007)

Early initiation of breastfeeding for the normal newbornHow?Keep mother and baby togetherPlace baby on mothers chestLet baby start suckling when readyDo not hurry or interrupt the processDelay non-urgent medical routines for at least one hour Slide 4.4.48

In the few minute , the baby can crawl to the mother breast , and then suck by her/himself (THE BREAST CRAWL )

Crawling loking for the breast : 5 behaviour steps before breastfed

1. In first 30 : rest, allert, . Sometimes looking to her/his mother and adaptation to the environment2. 30-40: make sound, suckling and put the hand in the mouth

4. The feet push toward to mothers abdomen and moving to the breast3. Produce saliva5. Licking the motherrs skin , touch the nipple with his/her hand, menghentak head to the mothers chest , turn the head to right and left, find the nipple, licking , mengulum puting susu, open the mouth widely and make a good attachment

Ten steps to successful breastfeeding Ten steps to successful breastfeeding Every facility providing maternity services and care for newborn infants should

Have a written breastfeeding policy that is routinely communicated to all health care staffTrain all health care staff in skills necessary to implement this policyInform all pregnant women about the benefits and management of breastfeeding Teaching Aids: ENCNF-1313Ten steps to successful breastfeeding (contd.) Help mothers initiate breastfeeding within half hour of birth Show mothers how to breastfeed, and how to maintain lactation even if they are separated from their infants Give no food or drink, unless medically indicatedPractice rooming-in : allow mothers and infants to remain together 24 hrs a dayTeaching Aids: ENCNF-1414Encourage breastfeeding on demandGive no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infantsFoster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital.

Teaching Aids: ENCNF-15Ten steps to successful breastfeeding (contd.) 15