Women Need Support to Breastfeed Successfully Write your Name /Organisation date and Place here

Global Strategy for Infant and Young Child Feeding Adopted by the WHA and UNICEF Executive board in 2002Adopted by the WHA and UNICEF Executive board in 2002

Life begins here ….

Optimal Infant and Young Child Feeding Starting breastfeeding within one hour of birthStarting breastfeeding within one hour of birth Exclusive breastfeeding for the first six monthsExclusive breastfeeding for the first six months Introducing appropriate and adequate complementary feeding after 6 months along with Continued breastfeeding for two years or beyondIntroducing appropriate and adequate complementary feeding after 6 months along with Continued breastfeeding for two years or beyond Starting breastfeeding within one hour of birthStarting breastfeeding within one hour of birth Exclusive breastfeeding for the first six monthsExclusive breastfeeding for the first six months Introducing appropriate and adequate complementary feeding after 6 months along with Continued breastfeeding for two years or beyondIntroducing appropriate and adequate complementary feeding after 6 months along with Continued breastfeeding for two years or beyond

Science Support

Risk of neonatal mortality according to time of initiation of breastfeeding Pediatrics 2006;117: Six times more risk of death

Deaths attributed to sub-optimal breastfeeding among children

Impact of Suboptimum breastfeeding on child mortality and DALYs Due to Non- EBF 1.4 million deaths due to suboptimum breastfeeding 43.5 million DALYs due to suboptimum breastfeeding

Long term effects Subjects who were breastfed experienced lower mean blood pressure and total cholesterol, as well as higher performance in intelligence tests. Prevalence of overweight/obesity and type-2 diabetes was lower among breastfed subjects.Subjects who were breastfed experienced lower mean blood pressure and total cholesterol, as well as higher performance in intelligence tests. Prevalence of overweight/obesity and type-2 diabetes was lower among breastfed subjects. A 2007 WHO PublicationA 2007 WHO Publication Subjects who were breastfed experienced lower mean blood pressure and total cholesterol, as well as higher performance in intelligence tests. Prevalence of overweight/obesity and type-2 diabetes was lower among breastfed subjects.Subjects who were breastfed experienced lower mean blood pressure and total cholesterol, as well as higher performance in intelligence tests. Prevalence of overweight/obesity and type-2 diabetes was lower among breastfed subjects. A 2007 WHO PublicationA 2007 WHO Publication

Exclusive breastfeeding Reduces HIV Transmission Risk Lancet, 31 March 2007

What women need to succeed? Breastfeeding education and support Accurate and un- biased information to all family members, communityAccurate and un- biased information to all family members, community One to one counselling during pregnancyOne to one counselling during pregnancy At birth support to begin breastfeedingAt birth support to begin breastfeeding Counselling, home visits, and support to maintain exclusive breastfeeding, like support on positioning and nutritionCounselling, home visits, and support to maintain exclusive breastfeeding, like support on positioning and nutrition Counselling for complementary feedingCounselling for complementary feeding Counselling to prevent breastfeeding problems and take care if they do ariseCounselling to prevent breastfeeding problems and take care if they do arise Referral for breastfeeding problems like breast engorgement, sore nipples, not enough milk, and breast infection.Referral for breastfeeding problems like breast engorgement, sore nipples, not enough milk, and breast infection. Breastfeeding education and support Accurate and un- biased information to all family members, communityAccurate and un- biased information to all family members, community One to one counselling during pregnancyOne to one counselling during pregnancy At birth support to begin breastfeedingAt birth support to begin breastfeeding Counselling, home visits, and support to maintain exclusive breastfeeding, like support on positioning and nutritionCounselling, home visits, and support to maintain exclusive breastfeeding, like support on positioning and nutrition Counselling for complementary feedingCounselling for complementary feeding Counselling to prevent breastfeeding problems and take care if they do ariseCounselling to prevent breastfeeding problems and take care if they do arise Referral for breastfeeding problems like breast engorgement, sore nipples, not enough milk, and breast infection.Referral for breastfeeding problems like breast engorgement, sore nipples, not enough milk, and breast infection.

Women All Over the World Need Support

Women at work …need support Crèches etc.

What matters to succeed

Successful Breastfeeding… Breastfeeding in the Correct Position Anatomy of the Breast Milk producing glandsMilk producing glands Lactiferous canaliculiLactiferous canaliculi Lactiferous sinusesLactiferous sinuses Myoepithelial tissueMyoepithelial tissue Adipose tissueAdipose tissue

Signs of Correct Attachment Mouth wide openMouth wide open Lower lip is turned outsideLower lip is turned outside Chin touching the breastChin touching the breast Black part of the breast not visible below the lower lipBlack part of the breast not visible below the lower lip Large black portion of breast and nipple including milk collecting ducts are inside baby’s mouthLarge black portion of breast and nipple including milk collecting ducts are inside baby’s mouth Tongue under the teatTongue under the teat Mouth wide openMouth wide open Lower lip is turned outsideLower lip is turned outside Chin touching the breastChin touching the breast Black part of the breast not visible below the lower lipBlack part of the breast not visible below the lower lip Large black portion of breast and nipple including milk collecting ducts are inside baby’s mouthLarge black portion of breast and nipple including milk collecting ducts are inside baby’s mouth Tongue under the teatTongue under the teat

Incorrect Sucking Position Mouth is not wide openMouth is not wide open Chin is away from the breastChin is away from the breast Baby is sucking only nippleBaby is sucking only nipple Most black portion of the breast is outside the baby’s mouthMost black portion of the breast is outside the baby’s mouth Tongue away from the teatTongue away from the teat Mouth is not wide openMouth is not wide open Chin is away from the breastChin is away from the breast Baby is sucking only nippleBaby is sucking only nipple Most black portion of the breast is outside the baby’s mouthMost black portion of the breast is outside the baby’s mouth Tongue away from the teatTongue away from the teat

Causes of Incorrect Attachment Use of feeding bottles. Leads to nipple confusionUse of feeding bottles. Leads to nipple confusion Inexperienced motherInexperienced mother Functional difficulty with the mother or the babyFunctional difficulty with the mother or the baby Lack of skilled supportLack of skilled support Use of feeding bottles. Leads to nipple confusionUse of feeding bottles. Leads to nipple confusion Inexperienced motherInexperienced mother Functional difficulty with the mother or the babyFunctional difficulty with the mother or the baby Lack of skilled supportLack of skilled support

More prolactin secreted at nightMore prolactin secreted at night Secreted after feed to produce next feedSecreted after feed to produce next feed Suppresses ovulationSuppresses ovulation The Prolactin reflex Baby sucking Sensory Impulses from nipple Prolactin in blood Breastmilk Production

The Oxytocin reflex Breastmilk Transfer Works before or during feed to make milk flow Makes uterus contract Baby sucking Sensory Impulses from nipple Oxytocin in blood

How does the mother’s confidence play part Breastmilk Transfer Thinks lovingly of baby CONFIDENCE Sound of baby Sight of baby Pain Worry Stress Doubt

The Feeling of “Not Enough Milk” Not true. Just a perception, this is not a disease entity, just a symptom of underlying problem. You need to know from the mother, why she feels that her baby is not getting enough, and can solve her problems by Reinstating mother’s confidenceReinstating mother’s confidence Ensure frequent, effective sucklingEnsure frequent, effective suckling Not true. Just a perception, this is not a disease entity, just a symptom of underlying problem. You need to know from the mother, why she feels that her baby is not getting enough, and can solve her problems by Reinstating mother’s confidenceReinstating mother’s confidence Ensure frequent, effective sucklingEnsure frequent, effective suckling

Women need help of this kind…

Which children grow healthy and achieve development potential? Well nourished mothersWell nourished mothers Exclusively breastfed for the first six months, begin breastfeeding within an hourExclusively breastfed for the first six months, begin breastfeeding within an hour Enough and right food to eat laterEnough and right food to eat later –Complementary feeding,continued breastfeeding Cared wellCared well Hygiene and sanitary environmentHygiene and sanitary environment Treated when sickTreated when sick Well nourished mothersWell nourished mothers Exclusively breastfed for the first six months, begin breastfeeding within an hourExclusively breastfed for the first six months, begin breastfeeding within an hour Enough and right food to eat laterEnough and right food to eat later –Complementary feeding,continued breastfeeding Cared wellCared well Hygiene and sanitary environmentHygiene and sanitary environment Treated when sickTreated when sick

One way to Support is to Sign up

Mum power: The friends from ante-natal class converge on McDonald's for the feed- in. Maddie Reynolds is fourth from the left

Make breastfeedin g visible, and more widely available !! The First Lady of Timor Leste at 7 th Ministerial Consultation on Children Thank you