Proper Positioning & Attachment2/10

BABYS ATTACHMENTMore areola seen above babys top lipBabys mouth open wideLower lip turn outwardBabys chin touches breast

BABYS POSITIONBabys head and body in lineBaby held close to mothers body Baby supported by head and neckBaby approaches breast, nose to nipple

CRADLE OR CUDDLE POSITIONPlace your baby across your stomach tummy to tummyHer face and knees should be close into, and facing your bodyHead should be in the bend of your elbow, with her mouth directly in front of your nippleHer body should be in straight line from ear to her shoulder and to her hipYou can tuck her lower arm around your waist

FOOTBALL OR CLUTCH POSITIONLie baby beside you (you may put her pillows to support her and your arm)Place her head in your palm,and her back will lay on your inner forearmTuck her feet slightly behind you

Cross-cradle or transverse POSITIONSame as in the cradle holdYou will be holding her in the arm opposite the breast from which she will latch intoMake sure she is at the level of your breast, her body turned toward you

Lying Down POSITIONLie on one side and support your head and bodyLine the baby up with her tummy to yours. Your nipple should be opposite to her mouth (lower breast)

Tailor POSITIONThe tailor position is great for older babies and toddlers. You can place a pillow on your lap to raise a smaller infant up to the right level.

Expressing Breastmilk

Expressing milk is useful to:

When his mother goes or goes to workFeed a low birth weight baby who cannot breast feedFeed a sick baby who cannot suckle enoughKeep up the supply of breast milk when a mother or baby is ill

Expressing milk is useful to:

Prevent leaking when a mother is away from her babyTo help with breast health conditions (e.g engorgment)

How to stimulate the oxytocin reflex

Help mother psychologically; - Build her confidence - Try to reduce sources of pain and anxiety - Help her to have good thoughts/feelings

How to stimulate the oxytocin reflex

Help mother practically. Advise her to; Sit quietly and privately or with a supportive friendHold her baby with skin to skin contact if possibleWarm her breastStimulate her nipplesMassage or strokes her breast slightlyAsk her to rub her back

How to express breast milk by hand

Wash hand thoroughlySit or stand comfortably in front of the container Put thumb on the breast above the nipple and areola and her first finger on the breast below the nipple and areola, opposite the thumbPress thumb and first finger slightly inwards towards the chest wall

Press and release, press and releasePress the areola in the same way from the sides to make sure that milk is express from all segments of the breats

Reminders:Not touch mothers breastHave PATIENCE and MORE practiceNot to squeeze nippleAvoid sliding or rubbing breastCan express both breast simultaneouslyExpressing should not hurtExpress one breast 3-5 minutes

JOEFFRY ESPIRITUHealth Education & Promotion OfficerProvincial Health OfficeTel. No. (036) 6210-6290929-840-5199/0917-625-5199

*Points to note: It is not necessary for the health worker to touch the mother's breasts when teachinghand expression. It may take a few tries before much milk is expressed. Encourage the mother not togive up if she gets little milk or no milk at the first try. The amount of milk obtainedincreases with practice. Explain to the mother that she should not squeeze the nipple itself. Pressing or pullingthe nipple cannot express milk, but it is painful and it can damage the nipple. Explain to the mother that she should avoid sliding or rubbing her fingers along thebreast when compressing. This can also damage the breast. With practice it is possible for a mother to express from both breasts at the same time If a mother is both expressing and breastfeeding an older baby (for example, if she isworking away from the baby), suggest that she express first and then breastfeed herbaby. The baby is able to get the fat rich hind milk from deep in the breast moreefficiently than expressing. Expressing should not hurt. If it does hurt, check the techniques listed above with themother and observe her expressing.