ses 3- promoting breastfeeding during pregnancy

7/28/2019 Ses 3- Promoting Breastfeeding During Pregnancy

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Promoting

Breastfeeding

during Pregnancy

90 min

Step 3


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Session Objectives

1. Outline information that needs to be

discussed with pregnant women

2. Explain antenatal breast preparation, what iseffective and what is not

3. Identify women that needs extra attention

4. Outline information for HIV + pregnant women

5. Practice communication skills whendiscussing with pregnant women


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Fatima & MiriamFatima

expecting her

first baby

Miriam

expecting hersecond baby

Discussion of breastfeeding with pregnant women


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Step 3 In form al l pregnan t

women of the benefi ts and

management o f b reast feed ing .

CULTURE var ies

Therefore it is important to EDUCATE

women about breastfeeding

As early as possible Identify mothers and babies at risk of

breastfeeding (BF) difficulties


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To make an

INFORMED DECISION

a. INFORMATION

b. UNDERSTANDINGc. CONFIDENCE

d. SUPPORT


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Informed decision

1. What Information?

On the importance of breastfeeding

Risk of replacement feeding

. Accurate and factual

. NOT opinion of HW nor

. marketing Information of milk

companies

cont


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2. UNDERSTANDING

In words that are suitable for the

woman

In the context of her situation

3. CONFIDENCE

Built womans confidence in her ability

to exclusively breastfeed


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4. SUPPORT

-To carry out her feedingdecision

-This includes support to

successfully feed her baby and

overcome any difficulties


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Woman needs to BELIEVE that

she can carry out her decision

HW needs TO CHECK with thewoman that the information

and support needs are met


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-Mother who breastfed can be asked to

share her experience

-Identify difficulties / How to prevent it

-Cultural issues

-Teach how to position and attach

-Use dolls / breast models

Group talk with pregnant women


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Importance of breastfeeding

Breastfeeding

is important

to :

Children

MothersFamilies

Community

Ri k t hild h NOT


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Risk to children who are NOT

breastfed

1. More likely to get sick or die fromdiarrhea and GI infections or chest

infections

2. Become underweight, not grow well

3. Overweight and to have later heart

problems


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omen w o reas eeare likely to:

1. Develop anemia, retain fat depositedduring pregnancy later obesity

2. Become pregnant soon

3. May develop breast cancer

4. May have hip fracture in older age


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Benefits to the FAMILY

ECONOMICAL1. Readily available / no

preparation

2. Simple / no equipment

needed

3. Reduced absences ofparents from work

4. No lost of income


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Mothers milk IS ALL that a baby

needs

Exclusive breastfeeding recommended 1st sixmonths (NO other fluids needed)

Breastfeeding continues to be important afterthe first 6 mos.

Mothers milk is suited for her own baby

(changes to meet the needs of the baby)

BM is unique - antibodies


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What are the practices that can

help breastfeeding go well?

Hospital practices:

- Companion during labor

- Avoidance of labor & birthinterventions

- Skin to skin immediately after birth

- Rooming-in / bedding-in

- Know feeding signs / frequent feed

- Exclusive BF


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What are the practices that can

help breastfeeding go well ?

TEACHING how to position

and attach the baby

correctly.

GIVING support when needed.


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Information on HIV

- All women are offered voluntaryand confidential HIV counseling

and testing

- About 5-15% of babies born to

HIV infected mother willbecome HIV + through BF

( 1 in 20 or 1 in7 )


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Information on HIV

- Risk of illness & death from NOTexclusively BF is higher than the risk of

HIV transmission from BF

- Majority of women are NOT infected

with HIV

- BF is recommended for women who :

do not know their status &

who are HIV negative


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How can a pregnantwoman get counseling

and testing for HIV inyour local area?

?


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How w i ll a pregnancy

care pro vider f ind ou t i f apregnant woman knows

the impo rtance of

breastfeed ing or hasa quest ion?

Individual Discussion with

pregnant woman


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Ask the pregnant woman:

What do you know about

breastfeeding?- Practice communication skills

- Let her discuss her worries &concerns

- 2 way discussion (focus)

- Reflect and Reinforce her knowledge

- Identify non-supporters in the family

- Motivate to join Antenatal check list


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Antenatal breast preparation

- REASSURE that most womenbreastfeed with NO problem

- Ears, nose, feet etc. comes in various

shape, sizes but still work perfectly well

- Practices like using creams, nipple

exercises does NOT assist BF


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Breast examination during

pregnancy can be helpful if it is

used to :

- Built her confidence that herbreast is increasing in size

preparatory to BF

-Check for breast surgery scars,

lumps give reassurance


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The ideal antenatal preparation is

to use the time

> to discuss womans knowledge,

beliefs and feelings about BF

> to built her confidence in herability to exclusively breastfeed

her baby.

W h d t tt ti


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Women who need extra attention

- Previous BF difficulty

- Has non-supportive family member

- Is depressed / isolated / without support

- Young, single, with intention to give baby

- for adoption

- Previous breast surgery / trauma

- Has chronic illness needing medication

- Has high risk baby / PT/ twins etc- HIV + mother (tested)

C b f d ld b b


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Can you breastfeed an older baby

during a succeeding pregnancy?

No need to stop

Has history of premature labor/

uterine cramping - consult Should take care of herself eat &

rest

Breast tender in mid-trimester ?

Shortage of family food ?

HIV + ?


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If mother is NOT breastfeeding

has medical reason /tested and is HIV positive /

informed personal decision

Discuss replacement feedingAssist how to prepare feeds

(ind iv idual teaching)

Antenatal discussion with


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Antenatal discussion with

women who are HIV positive

Assure

confidentiality

Individual

counseling

Privacy

Information on the risk

& benefits of various

feeding options

Guidelines in selecting

suitable option

Support to carry out the

choice

A woman who is not planning to


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A woman who is not planning to

breastfeed needs to know:

- Feeding options and should be AFASS

- Her needs (milk, water, equipment,

cost, time)

- Type of formula suited for her baby

- Learn to prepare formula

NEVER mix feed

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WHO/UNICEF Infant Feeding Recommendation

for HIV-positive Women

- When replacement feeding isacceptable, feasible, affordable,sustainable and safe, avoidance of all

breastfeeding by HIV-infectedmothers is recommended.

Otherwise, exclusive breastfeeding

is recommended during the first monthsof life and then should be discontinuedas soon as it is feasible.

B tf di d


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Breastfeeding and emergency

situations

- Mother does not need perfect

calm

- Be supportive, build

confidence

- Relaxation, if possible


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GROUP

PRACTICE

Summary


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Summary

- BF is important for her baby and

herselfExclusive BF is recommended for 6

months & up to years and beyond

Frequent BF continues to be important

after complementary foods are added

Practices such as skin to skin, earlyinitiation of BF, rooming- in, frequent

baby-led feeding, good positioning /

attachment, exclusive BF

Summary


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Summary

Support is available to her

Ideal antenatal preparation is that which

builds the womans confidence

Some woman needs extra attentionOffer all pregnant woman voluntary &

confidential HIV counseling and testing

WHO/UNICEF recommendation for infant

feeding of a HIV positive tested mother

(AFASS)


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ses 3- promoting breastfeeding during pregnancy

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