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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 BABY-FRIENDLY HOSPITAL INITIATIVE Revised, Updated and.

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Presentation on theme: "UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 BABY-FRIENDLY HOSPITAL INITIATIVE Revised, Updated and."— Presentation transcript:

1 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 BABY-FRIENDLY HOSPITAL INITIATIVE Revised, Updated and Expanded for Integrated Care Maternity, 1963, © 2003 Estate of Pablo Picasso/Artists Rights Society (ARS), New York

2 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 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. 1/1

3 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 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. 1/2

4 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 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. 1/3

5 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 3/1 Original illustration by Jenny Corkery

6 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Infant Feeding Recommendation for HIV-positive Women When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended. Otherwise, exclusive breastfeeding is recommended during the first months of life and then should be discontinued as soon as it is feasible. 3/2

7 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 4/1 Original illustration by Jenny Corkery

8 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 The overall aim of the International Code of Marketing of Breastmilk Substitutes is the safe and adequate nutrition of all infants. 4/2

9 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Skin to Skin Contact and Early Breastfeeding 5/1 ©UNICEF C107-2

10 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Skin to Skin Contact and Early Breastfeeding 5/2 UNICEF/HQ92-0369/ Roger Lemoyne, Thailand

11 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 First Skin to Skin Contact 5/3 Dr Nils Bergman, Cape Town, South Africa

12 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Parts of the Breast 6/1 Adapted from Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2

13 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Helping the Oxytocin Reflex 6/2 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2

14 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 What can you see? Good attachmentPoor attachment 6/3 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2

15 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 What can you see? Good attachmentPoor attachment 6/4 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2

16 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Breastfeeding Positions 7/1 In line Close Supported Facing Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2

17 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 BREASTFEED OBSERVATION AID Mother's name _______________________________Date ___________________ Baby's name _________________________________Baby's age ______________ Signs that breastfeeding is going well: Signs of possible difficulty: GENERALMother: Mother looks healthy Mother looks ill or depressed Mother relaxed and comfortable Mother looks tense and uncomfortable Signs of bonding between mother and baby No mother/baby eye contactBaby: Baby looks healthy Baby looks sleepy or ill Baby calm and relaxed Baby is restless or crying Baby reaches or roots for breast if hungry Baby does not reach or root BREASTS Breasts look healthy Breasts look red, swollen, or sore No pain or discomfort Breast or nipple painful Breast well supported with fingers away from nipple Breasts held with fingers on areola BABYS POSITION Babys head and body in line Babys neck and head twisted to feed Baby held close to mothers body Baby not held close Babys whole body supported Baby supported by head and neck only Baby approaches breast, nose to nipple Baby approaches breast, lower lip/chin to nipple BABYS ATTACHMENT More areola seen above babys top lip More areola seen below bottom lip Babys mouth open wide Babys mouth not open wide Lower lip turned outwards Lips pointing forward or turned in Babys chin touches breast Babys chin not touching breast SUCKLING Slow, deep sucks with pauses Rapid shallow sucks Cheeks round when suckling Cheeks pulled in when suckling Baby releases breast when finished Mother takes baby off the breast Mother notices signs of oxytocin reflex No signs of oxytocin reflex noticed Notes: 7/2

18 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Assess a Breastfeed 7/3 ©UNICEF C107-5

19 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 ©UNICEF C107-7 Wide Open Mouth 7/4

20 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Assess a Breastfeed 7/5 ©UNICEF C107-9

21 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Assess a Breastfeed 7/6 UNICEF/HQ91-0168/ Betty Press, Kenya

22 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 8/1 9/1 Original illustration by Jenny Corkery

23 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Case study 9/2 UNICEF/HQ91-0168/ Betty Press, Kenya 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 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2

24 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Kangaroo Mother Care 10/1 Dr Nils Bergman, Cape Town, South Africa

25 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Kangaroo Mother Care Dr Nils Bergman, Cape Town, South Africa 10/2

26 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Positioning a preterm infant 10/3 UNICEF/HQ93-0287/ Roger Lemoyne, China

27 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Twins Grow Well on Breastmilk UNICEF/HQ92-0260/ Lauren Goodsmith, Mauritania 10/4

28 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 DANCER Hand Position 10/5 ©UNICEF C107-21

29 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Chin Support 10/6 Kay Hoover and Barbara Wilson-Clay, from The Breastfeeding Atlas

30 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Hand Expression 11/1 ©UNICEF 910164F

31 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Cup Feeding 11/2 Promoting breastfeeding in health facilities: A short course for administrators and policy makers WHO/NUT/96.3, Wellstart International

32 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Supplementer 11/3 Dr Ruskhana Haider, Dhaka, Bangladesh

33 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Size and Shape There are many different shapes and sizes of breast and nipple. Babies can breastfeed from almost all of them. 12/1 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2

34 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Full Breast UNICEF C-107-19 12/2

35 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Engorged Breast © UNICEF C-10-25 12/3

36 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Mastitis 12/4 ©UNICEF C107-39

37 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Sore Nipple 12/5 ©UNICEF C107-31

38 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Sore Nipple 12/6 ©UNICEF C107-32

39 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Syringe method for inverted nipples 12/7 Breastfeeding Counselling: a training course, WHO/CHD/93.4, UNICEF/NUT/93.2

40 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Candida on the nipple 12/8 ©UNICEF C107-34

41 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Candida on the nipple 12/9 ©UNICEF C107- 33

42 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Tongue-tie 12/10 ©UNICEF C107-35

43 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 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 YES When the answer to ANY one of these questions becomes YES The mothers 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.

44 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 UNICEF/WHO/UNAIDS Infant Feeding Recommendation for HIV-positive Women When replacement feeding is acceptable, feasible, affordable, sustainable and safe, (AFASS) avoidance of all breastfeeding by HIV-infected mothers is recommended. Otherwise, exclusive breastfeeding is recommended during the first months of life and should be then discontinued as soon as it is feasible. 13/2

45 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 14/1 Original illustration by Jenny Corkery

46 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 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. 15/1

47 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Where are we now? Developing a Plan: Step One 15/2

48 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Where do we want to be? 15/3 Developing a Plan: Step Two

49 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 Developing a Plan: Step Three 15/4 How will we get there?

50 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 How will we know if we are there? Developing a Plan: Step Four 15/5

51 UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course 2006 How will we sustain it? 15/6 Developing a Plan: Step Five


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