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BFHI (Baby-Friendly Hospital Initiative) A.Mydlilová NARLAC – National Lactation Centre FTN Krč Prague.

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Presentation on theme: "BFHI (Baby-Friendly Hospital Initiative) A.Mydlilová NARLAC – National Lactation Centre FTN Krč Prague."— Presentation transcript:

1 BFHI (Baby-Friendly Hospital Initiative) A.Mydlilová NARLAC – National Lactation Centre FTN Krč Prague

2 Health 21 in CR

3 BFHI = 10 steps Implemented in CR in last 20 years Implemented in CR in last 20 years 1992-FTN Krč Prague – 1st Baby-Friendly Hospital in CR 1992-FTN Krč Prague – 1st Baby-Friendly Hospital in CR MoH prepares a directive on implementation of 10 steps into standards of health care MoH prepares a directive on implementation of 10 steps into standards of health care Guidelines on Baby-Friendly Hospitals should become the part of the assessment of the quality of a hospital (the WHO goal) Guidelines on Baby-Friendly Hospitals should become the part of the assessment of the quality of a hospital (the WHO goal)

4 Step 1. - policy Written policy based on 10 steps Written policy based on 10 steps Health staff should know it and practise Health staff should know it and practise

5 Step 2 – train the staff WHO Training Module (20 hour) WHO Training Module (20 hour) CR – 20 hour course for health workers CR – 20 hour course for health workers

6 Step 3 – inform pregnant women On benefits of BF, physiology, lactation management On benefits of BF, physiology, lactation management Encourage pregnat women to participate at antenatal courses, information on BF should be a part of the course Encourage pregnat women to participate at antenatal courses, information on BF should be a part of the course NARLAC Study (2008) NARLAC Study (2008) 38 % antenatal courses – no information on BF 38 % antenatal courses – no information on BF 41,8 % mothers not satisfied with the course content 41,8 % mothers not satisfied with the course content 9 %mothers - information form health profs 9 %mothers - information form health profs Most frequent source of information – internet, magazines, books Most frequent source of information – internet, magazines, books

7 Sources of information Books 39 % Books 39 % Magazines 26 % Magazines 26 % internet 15 % internet 15 % Health profs 9 % Health profs 9 %

8 Proposals for improvement Information on BF should be a part of antenatal courses Information on BF should be a part of antenatal courses Methodological guidelines (professional associations): Methodological guidelines (professional associations): 1. Breast examination 2. Explain consequences of separation (e.g. ICU) 3. Instruct on expressing milk within 6 hours after birth 4. Inform about consequences of using bottles, teats 5. Instruct on techniques of BF, expressing milk, alternative feeding methods Focus on women with lower education Focus on women with lower education

9 Step 4 – initiate BF within 1 hour Enable „skin to skin“ contakt as soon as possible Enable „skin to skin“ contakt as soon as possible „Skin to skin“ contakt important in first 24 hours „Skin to skin“ contakt important in first 24 hours Prevention of BF problems Prevention of BF problems Inform health profs and public Inform health profs and public

10 Practices to support BF after SC Early initiation of BF ( within 1 hour) Early initiation of BF ( within 1 hour) Choose the appropriate position Choose the appropriate position Early rooming-in Early rooming-in

11 Step 5 – show mothers how to breastfeed Correct positiong Correct attachment at the breast Requires practical knowledge and counselling skills, psychological support

12 Step 5 – show mothers how to maintain lactation if separated from their infants Start expressing milk as soon as possible ( 1. manual expression, 2. pumps) Start expressing milk as soon as possible ( 1. manual expression, 2. pumps) Train health staff Train health staff Health staff provides support to mothers Health staff provides support to mothers

13 Step 6 – no supplementation Give newborn infants no food or drink other than breast milk, unless medically indicated, then use alternative methods, no bottles Give newborn infants no food or drink other than breast milk, unless medically indicated, then use alternative methods, no bottles Stress the importance of colostrum Stress the importance of colostrum

14 Step 7 – Rooming-in 24 hours 24 hours Inform mothers on its importance Inform mothers on its importance Enables feeding on demand Enables feeding on demand Mothers learn to recognise fine signals of readiness to breastfeed in the child Mothers learn to recognise fine signals of readiness to breastfeed in the child RI – newborns cry less, mother sleep more RI – newborns cry less, mother sleep more Crying child – difficult to Crying child – difficult to breastfeed breastfeed

15 Step 8 – encourage breastfeeding on demand Do not restrict duration r frequency of BF Do not restrict duration r frequency of BF Do not encourage a common schedule of BF Do not encourage a common schedule of BF Respect individual rhythm and needs of the newborn Respect individual rhythm and needs of the newborn Number of breastfeeds should not drop below 8 in 24 hours Number of breastfeeds should not drop below 8 in 24 hours

16 Step 9 – no bottles or teats Give no artificial teats or pacifiers (dummies, soothers) to breastfeeding infants Give no artificial teats or pacifiers (dummies, soothers) to breastfeeding infants Interferes with suckling techniques Interferes with suckling techniques Inform mothers about its importance Inform mothers about its importance Do not promote bottles or pacifiers at the hospital Do not promote bottles or pacifiers at the hospital

17 Step 10 – continuing breastfeeding support WHO encourages continuing support in the community WHO encourages continuing support in the community Lactation counselling after discharge from hospital (lactation centres, lactation counsellors, self-help groups) Lactation counselling after discharge from hospital (lactation centres, lactation counsellors, self-help groups) Effective help, provides also emotional support Effective help, provides also emotional support

18 Primary health care (recommended preventive examinations) WHO Day 5-7 Week 3-4 Week 6 WHO, 2009 CR 48 hours after birth Week 2 Week 6 Month 3 Months 4-5 Directive on Preventive examinations, MoH, 2010


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