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Sess 8 Practices That Assist

This document discusses practices that support breastfeeding such as rooming-in and baby-led feeding. It describes the benefits of rooming-in and encourages feeding on baby's demands. The document warns against unnecessary supplements and artificial teats, and provides guidance on addressing issues like sleepy or crying babies. Barriers to early breastfeeding are discussed through a case study example.

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dave
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246 views

Sess 8 Practices That Assist

This document discusses practices that support breastfeeding such as rooming-in and baby-led feeding. It describes the benefits of rooming-in and encourages feeding on baby's demands. The document warns against unnecessary supplements and artificial teats, and provides guidance on addressing issues like sleepy or crying babies. Barriers to early breastfeeding are discussed through a case study example.

Uploaded by

dave
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Session 8

Session Objectives
 Describe their role in practices that assist rooming-in.
 Describe their role in practices that assist baby-led (demand)
feeding.
 Suggest ways to awaken a sleepy baby and to settle a crying
baby,
 List the risks of unnecessary supplements.
 Describe why it is important to avoid the use of bottles and
teats.
 Discuss removing barriers to early breastfeeding.
Step 7
Practice rooming in – allow mothers and infants
to remain together 24 hours a day.

What can you say to explain


the importance of rooming-in ?
Benefits of Rooming-in
 Babies sleep better, cry less
 Continuation of sleep/awake rhythm
developed before birth,
 BF is well established, continues longer,
baby gains weight quickly,
 Feeding on cues is easier, develops good
milk supply,
 Mother becomes confident in caring,
 Baby exposed to fewer infection,
 Promotes bonding,
Barriers to rooming-in and
possible solutions

1. Concerns that mothers are tired.

2. Taking the baby to nursery for


procedures.

3. Beliefs that newborn babies need


to be observed.
Cont.
Barriers to rooming-in and possible solutions

4. No space in the ward for baby’s cot,

5. Staff do not know how to assist


mothers in learning to care for their
babies,

6. Mothers ask for their babies to be


taken to the nursery,
Step 8
Encourage breastfeeding on
demand

“demand feeding” - “baby-led feeding”

This means that the frequency and


length of feeding is determined by
the baby’s needs and signs.
Importance of baby-led feeding

1. Baby gets more immune rich


colostrum,
2. Faster development of milk
supply,
3. Faster weight gain,
4. Less neonatal jaundice,
Importance of baby-led feeding

6. Less breast engorgement.


7. Mothers learn to respond to her
baby.
8. Breastfeeding established faster.
9. Less crying, less temptation to
supplement.
10. Longer breastfeeding duration.
Signs of hunger
The baby:

- Increases eye movements or opens


eyes.
- Opens his mouth, stretches out the
tongue
- Makes soft whimper sounds.
- Sucks or chews on hands.
Cont.
Signs of hunger

• If the baby is crying loudly, arches his or


her back.

• Some babies are very calm and wait or


go back to sleep if not noticed.

Other babies wake quickly and become


very annoyed.
What are the signs that a baby
has finished feeding?

Signs of Satiety :
• As they get full, their body relaxes.
• Let go of the breast.
• Take small gentle sucks until they are
asleep.
• Finish one breast before she offers
the other breast.
Feeding Pattern
 feed for a short time at frequent intervals.
 feed for a long time and then wait a few
hours.
 Very long feeds - more than 40 minutes,
 very short feeds - less than 10 minutes,
 very frequent feeds - more than 12 feeds/24
hrs,
Sore nipples are the result of poor attachment,
not the result of feeding too often.
The typical feeding pattern for a full term healthy
newborn:

 Every 1-3 hours in the first 2-7 days.


 Night feeds are important.
 Once lactation is established – 8-12 times /
24 hrs.
 During periods of rapid growth, a baby may be
hungrier.
 Let babies feed whenever they want.
Special Situations
o Baby is very sleepy due to
prematurity, jaundice, or the effects of
labor medication,

o Mother’s breasts are overfull and


uncomfortable

o Babies who are on replacement feed


Ways to wake a sleepy baby

If the baby seems too sleepy to feed,


suggest that the mother:

 Remove blankets and heavy clothing.


 Breastfeed in a more upright position.
 Gently massage and talk to her baby.
 Wait half an hour and try again.
 Avoid hurting the baby.
Settle a crying baby

 Baby is crying.

 Baby who is ‘crying too much’.

 Baby is crying frequently.

 Build the mother’s confidence…


cont
Build the mother’s confidence in her ability to
care for her baby and give her support:

- Listen and accept what the mother is


feeling.
- Reinforce what the mother and baby are
doing right / what is normal.
- Give relevant information.
- Make one or two suggestions.
- Give practical help…
cont
Suggestions and practical help to settle a
crying baby can include:

 Make the baby comfortable.


 Put the baby to the breast.
 Put baby on the mother’s chest, skin to
skin.
 Talk, sing and rock the baby while holding
close.
 Gently stroke or massage.
cont
Suggestions and practical help …

 Give one breast at each feed; if overfull,


express.
 Reduce the mother’s coffee and other
caffeine drinks.
 Do not smoke.
 Have someone else carry.
 Involve other family members.
 Pressure to give unnecessary supplemental
feedings.
 Hold the baby in a manner that wraps around
him.
Step 6
Give newborn infants no food or drink
other than breastmilk unless
medically indicated.

Healthy full term babies rarely have a


medical need for supplements or prelacteal
feeds.

They do not require water to prevent


dehydration.
Dangers of supplements
Exclusive breastfeeding is recommended
for the first six months.

Supplements can:
- Overfill a baby’s stomach,
- Reduce milk supply,
- Can cause insufficient weight gains,
- Reduce protective effect of breastfeeding,
- Reduce the mother’s confidence,
- Be an unnecessary expense.
cont
- May indicate that mother is having
difficulties feeding and caring for her
baby.

- A health worker may lack of knowledge


and skill in supporting BF

- May indicate an overall stressful


atmosphere

cont
Prelacteal feeding or offering formula to
an infant of an HIV positive woman who
will breastfeed may alter the GI mucosa
and allow the transmission of the virus.

When we cannot test the HIV status of


mother, it is important to emphasize
that exclusive breastfeeding reduces
the risk of HIV transmission during
breastfeeding.
If a mother has been counseled, tested and
found to be HIV-positive and has decided
not to breastfeed, this is an acceptable
medical reason for giving her infant other
milks in place of breastmilk.

• Even if many mothers are giving


replacement feeds, this does not prevent a
hospital from being designated as baby-
friendly if those mothers have all been
counseled, tested, and made genuine
informed choices.
Step 9
Give no artificial teats or pacifiers (also
called dummies or soothers) to
breastfeeding infants

Why is it recommended to avoid using


bottles and teats?

 Baby may develop preference for it.


 Pacifiers given instead of feed for
hungry baby.
 May carry infection.
Discussion – Removing Barriers to early
breastfeeding
Case study :

Read the Case Study aloud in class.


Ask participants to note practices that
may help and those which may
interfere with establishing
breastfeeding. What might be the
effect of this situation on
breastfeeding? Distribute Case Study
Case study
Carolina 33 has a long labor for her first baby
and no-one from her family was allowed to be
with her. When her baby is born, he is wrapped
in a blanket and shown to her briefly.
She sees that he has a birthmark between her
baby’s eyes. Then he is taken away to the
nursery because it is night-time. The staff gives
him a bottle of infant formula for the next 2
weeks.
Carolina wonders if the birthmark on the baby's
face was caused by something that she did
during the pregnancy.
 She is worried what her husband and his
mother will say about it. The nurses look very
busy and Caroline does not want to ask
questions of them.
 Her family will not be allowed to visit until the
afternoon.
 The nurse returns and takes the baby back to
the nursery. She comes back in a few minutes
and tells Carolina that she has weighed the
baby and finds that he took only 25 grams of
milk, and that this was not an adequate feed.
The nurse says, “How can you go home
 tomorrow if you can’t feed your baby
properly?”
Possible answers:

 No support during labor - longer labor - more


tired, stressed.
 No skin-to-skin contact – did not get the time to
be with her baby to notices his birthmark,
which worries her.
 Carolina and her baby are separated for many
hours - formula.
 Did not get colostrum - no breast stimulation
to make milk.
 Not given any help to breastfeed - sleepy,
-refuse to suckle. The nurse worries her about
sore nipples.
cont
 It is painful to sit down when feeding the baby.
- inhibit the oxytocin release.
 Carolina could be helped to feed lying down.
 Carolina feels alone and this caused her
stress.
 Nurse frightens Carolina to feed her baby or
she will not be able to go home.

The result is that Carolina is worried, sore,


frightened and lonely as well as not knowing
how to feed her baby. She is likely to go home
thinking that she is not able to make milk and
will feed her baby a breastmilk substitute.
Summary
Rooming in and baby-led feeding help
breastfeeding and bonding.

Help mothers to learn skills of mothering.

Prelacteal and supplemental feeds are


dangerous.

Artificial teats can cause problems.

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