summary report on world breast feeding week 2010 report

(1-7 August 2010)

.

2010

NIPI, Sr. SPO , Madhya Pradesh

NIPI SNCU of Hoshangabad

Distict.

DCHM of Betul

start Breastfed

within one

hour of

Delivery

Workshop of

Betul district

on World

Breastfeedin

g Week

Work Shop

Updates

2010

On WBA

Workshop at

Betul District

Hospital to

all Health

Staff

Yashoda

counseling

for Early

Breastfeed by

Yashoda Flip

Chart

Yashoda

wrapping

the infants

Yashoda

looking after

Hygiene care

of Newborn &

Mother.

�ORWAY I�DIA PART�ERSHIP I�ITIATIVE

Sr. SPO, Madhya Pradesh.

Successful World Breastfeeding Week 2010 • 1-7 August 2010

NIPI FOCUS DISTRICT’s Madhya Pradesh.

Hoshangabad, Raisen, Narsinghpur & Betul

Under NIPI Assisted Programs.

Submitted To: Mission Director, RCH-�RHM, Madhya Pradesh.



Exclusive Breastfeeding:

Babies who are breastfed are generally healthier and achieve optimal growth and development compared to those who are fed formula milk.

If the vast majority of babies were exclusively fed breast milk in their first six months of life – meaning only breast milk and no other liquids or solids, not even water – it is estimated that the lives of at least 1.2 million children would be saved every year. If children continue to be breastfed up to two years and beyond, the health and development of millions of children would be greatly improved.

Infants who are not breastfed are at an increased risk of illness that can compromise their growth and raise the risk of death or disability. Breastfed babies receive protection from illnesses through the mother's milk.

Breastfeeding is the natural and recommended way of feeding all infants, even when artificial feeding is affordable, clean water is available, and good hygienic conditions for preparing and feeding infant formula exist.

Almost every mother can breastfeed successfully. All mothers, particularly those who might lack the confidence to breastfeed, need the encouragement and practical support of the baby's father and their families, friends and relatives. Health workers, community workers, women's organizations and employers can also provide support.

Everyone has the right to information about the benefits of breastfeeding and the risks of artificial feeding. Governments have a responsibility to provide this information. Communities as well as media and other channels of communication can play a key role in promoting breastfeeding.

Dr Rajan Dubey, Sr. SPO, M.P… on Exclusive Breastfeeding:

Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers. A recent review of evidence has shown that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants. Thereafter infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond. To enable mothers to establish and sustain exclusive breastfeeding for 6 months, NIPI recommend: Initiation of breastfeeding within the first hour of life.

Exclusive breastfeeding –

-The infant only receives breast milk without any additional food or drink, not even water

-Breastfeeding on demand – that is as often as the child wants, day and night

-No use of bottles, teats or pacifiers.



Breast milk is the natural first food for babies, it provides all the energy and nutrients that the

infant needs for the first months of life, and it continues to provide up to half or more of a

child’s nutritional needs during the second of the first year, and up to one-third during the

second year of life.

Breast milk promotes sensory and cognitive development, and protects the infant against

infectious and chronic diseases. Exclusive breastfeeding reduces infant mortality due to

common childhood illnesses such as diarrhoea or pneumonia, and helps for a quicker recovery

during illness.

These effects can be measured in resource-poor and affluent societies (Kramer M et al

Promotion of Breastfeeding Intervention Trial (PROBIT): A randomized trial in the Republic of

Belarus. Journal of the American Medical Association, 2001, 285 (4): 413- 420).

Breastfeeding contributes to the health and well-being of mothers; it helps to space children,

reduces the risk of ovarian cancer and breast cancer, increases family and national

resources, is a secure way of feeding and is safe for the environment.

While breastfeeding is a natural act, it is also a learned behavior. An extensive body of

research has demonstrated that mothers and other caregivers require active support for

establishing and sustaining appropriate breastfeeding practices.

Successful Breastfeeding:

The Norway India Partnership Initiative ( NIPI ) has covered the following basic points during World Breastfeeding week 2010:

Step1) Breastfeeding policy that is routinely communicated to all health care staff .

Step2). Trained all health care staff in skills necessary to implement this policy.

Step3) Motivate and Support pregnant women about the benefits and management of breastfeeding.

Step4) Initiate breastfeeding within a half-hour of birth.

Step5) Orientation of mothers how to breastfeed & Supporting in Proper Positioning and latching of infants.

Step6) Counseling to mothers & family members by taking sessions for early breastfed & exclusive breastfed & Enforce education on the risk of artificial feeding and bottle-feeding.

Step7) Community awareness for exclusive breastfed & Encourage breastfeeding on demand.

Step8) Feeding of LBW babies



Step9) Counseling and make implement after discharge of mothers for Basic Newborn Care of newborn & Exclusive breastfed.

Step10) Helps to implement and maintain breastfeeding in community.

Successful Breastfeeding Week August 2010

Step 1) Breastfeeding policy that is routinely communicated to all health care staff. The benefits

of breastfeeding for mothers and children are the focus of World Breastfeeding Week (WBW), August 1-7,

2010. Revitalize activities within health systems, and among healthcare providers and communities to

support women to achieve their breastfeeding intentions.

Objectives of the Workshop

• To reorient the mothers about the exclusive breastfeeding.

• To change the myths and misconception of mothers on breastfeeding for the infants.

• To aware the mothers of infants for exclusive breastfeeding up to 6 months.

• Onsite technical correction for proper positioning of breastfeeding.

• To provide counseling on the optimal duration of exclusive breastfeeding;

• To ensure the practice on the optimal duration of exclusive breastfeeding;

• Demonstrate proper positioning of BF through toy models.

• To satisfy the queries of participants on BF.

• To introduce flipchart on BF for the service providers.

• To disseminate calendars to the mothers about good infant care.



Workshop for Breastfeeding Week 2010 NIPI Focus Districts in Madhya Pradesh .

S.No Location Date & Time Workshop Description Participant

A

Betul @ District Hospital (DH).

2-August-2010,

Vishwa Istanpan Diwas

Oriented By: Child Health Supervisor & Deputy Child Health Supervisor

Chief guest : 1) Distrct Betul Collector 2) S.P Betul 3) CEO Betul

Participants Members 4) Officers of WCD 5) Groups of NGO 6) AWW 7) ASHA 8) Staff Nurse, ANM, 9) Doctors, 10) Betul DCHM 11) CHS, DCHM Betul, 12) Mothers.

B

Ghodadongri Block, Betul

2-August, 2010

Vishwa Istanpan Diwas Oriented By: Block Child Health Manager (BCHM), Mr. Rajesh Singh Thakur.

Block Medical Officers, Block Child Health Manager (BCHM), Staff Nurse, ANM, ASHA & others staff members of BPMU. Mothers

C

Multai, Block Betul

2-August, 2010

Vishwa Istanpan Diwas Oriented By: Block Child Health Manager (BCHM),


D Amala

2-August, 2010

Vishwa Istanpan Diwas Oriented By: Block Child Health Manager (BCHM),


1 Hoshangabad A

Hoshangabad @ District Hospital

3-August-2010


Chief Medical & Health Officers Dr. R Neemat, Dr, R Gangrade Civil Surgeon, Dr V K Dubey Nodal Officers, Dr S K Prohit District Training Officers, District Program Manager , Mr. Hemant Sharma IEC Consultan, Doctors Dr Jiterndra Khare Child Specialist & Dr Danshree Harne Gynecologist , Staff Nurse , Deputy Child Health Supervisor (NIPI), Yashodas, ANM, AWW, ASHA & Mothers

B Babai, Block 4-August-2010 Oriented By: Block Child Health Manager (BCHM), Mr. Vishesh Dubey. NIPI

Block Medical Officers, Block Child Health Manager, Staff Nurses, ANM & ASHA, & Male MPW, Other members of BPMU.

C Seoni-Malwa 3-August-2010 Oriented By: Block Child Health Manager (BCHM), Mr. Vineet Agnihotri, NIPI

Block Medical Officers, Block Child Health Manager, Staff Nurses, ANM & ASHA, & Other members of BPMU.

D Pipariya 2-Ausgust-2010 Block Medical Officers, Block Child Health Manager, Staff Nurses, ANM & ASHA, & Other members of BPMU.

1 Narsinghpur A Narsinghpur @ Dr. O. P. Gautam – CMHO & Civil



District Hospital 5-August-2010


Surgeon, Dr. R. K. Mehra – DIO, Dr.

Manjari Singh – Gynecologist, Mrs.

Anand, Dy. CHS, Mr. Manish Kumar

Agarwal – DCHM, Mrs. Yogita Gambhir -

CHS, Deputy Child Health Manager,

Yashodas and Staff Nurses.

B

c

1 Raisen A Raisen at District

Hospital

3-August-2010

Orientation By Block Miss Sunita Chobey Child

Health Supervisor NIPI

Chief Medical & Health Officers Dr Sudhir Jaisani. Gynecologist Dr Kalpana Saxena., Child Health Supervisor , Deputy Child Health Supervisor, Staff Nurse , ASHA & Mothers

B Udaipura, Block 2-August-2010 Oriented By: Block Child Health Manager (BCHM), Mr. Kuwar Pal Singh, NIPI

Block Medical officers, Block child Health Manager , ANM, ASHA, MPW and BPMU Units health members.

Objectives of the Workshop:

To reorient the mothers about the exclusive breastfeeding.

• To change the myths and misconception of mothers on breastfeeding for the infants.

• To aware the mothers of infants for exclusive breastfeeding up to 6 months. • Onsite technical correction for proper positioning of breastfeeding. • To provide counseling on the optimal duration of exclusive breastfeeding; • To ensure the practice on the optimal duration of exclusive breastfeeding; • Demonstrate proper positioning of BF through toy models. • To satisfy the queries of participants on BF. • To introduce flipchart on BF for the service providers. • To disseminate calendars to the mothers about good infant care.

Step 1) Breastfeeding policy that is routinely communicated to all health care staff and Trained & all health care staff in skills necessary to implement this policy. The benefits of breastfeeding for mothers and children are the focus of World Breastfeeding Week (WBW), August 1-7, 2010. Revitalize activities within health systems, and among healthcare providers and communities to support women to achieve their breastfeeding intentions.

Inform people everywhere that protection, promotion and support of breastfeeding is a mother’s right, a child’s right, and a human right. Enable women and all who care about human rights to advocate for healthcare systems which support breastfeeding. Ensure that health workers who care for mothers and babies are adequately trained to counsel and support them in optimal infant feeding.



Fig1.1 Betul Districts Workshop August 2010 of health worker Fig1.2 Participants of workshop of Betul Districts august 2010

Fig 1.3 Narsinghpur District Workshop August 2010 of Health Workers Fig.1.4 CHS NIPI, DCHS NIPI & DCHM NIPI & Doctors Orientation on WBA.

Fig 1.5 Amla Block, Betul District, BMO, BCHM NIPI, Staff Nurse. WBA. Fig. 1.6 Staff Nurse, BMO community awareness in Mothers & ASHA.



Fig 1.7 Raisen District Orientation of Mothers & Family Members. Fig 1.8 Workshop at Raisen of ASHA for community awareness .

Fig 1.9 Workshop at Hoshangabad District on WBA Fig 2.0 The DCHS NIPI, Yashoda and mothers & there family members

In Betul Districts: the work shop Tiltle: Vishwa Istanpan Diwas, on 2-August-2010, the Special Cheif Guest

SHRI ARUN KUMAR BHATT, Betul CEO: & WCD Officers & Members of NGO, Child Health

Supervisor (NIPI), Block Child Health Manager (NIPI) has address the importance of Breastfeeding, in

which they address Breast milk contains all the nutrients in the right proportion which are needed for

optimum growth and development of the baby during the first six months. All health professionals must

be equipped with scientific information regarding the superiority of breast milk and make practice in

regular routine to delivery best service quality in their facility.

In Hoshangabad Districts: the work shop Tittle Vishwa Istanpan Diwas 2010, on 3-August-2010, the District Chief Medical & Health Officers Dr. R Neemat, Dr, R Gangrade Civil Surgeon, Dr V K Dubey Nodal Officers, Dr S K Prohit District Training Officers, District Program Manager , Mr. Hemant Sharma IEC Consultan, Doctors Dr Jiterndra Khare Child Specialist & Dr Danshree Harne Gynecologist , Staff Nurse , Deputy Child Health Supervisor (NIPI), Yashoda, ANM, AWW, ASHA & Mothers conduct the workshop and address the importance of Early Breastfeeding week and Exclusive Breastfeeding week and community awareness in Hoshangabad Districts.



In Narsinghpur Districts: the work shop Tittle Vishwa Istanpan Diwas 2010, on 5-August-2010, Dr. O. P. Gautam – CMHO & Civil Surgeon, Dr. R. K. Mehra – DIO, Dr. Manjari Singh – Gynecologist, Mrs. Anand – Dy. CHS, Mr.

Manish Kumar Agarwal – District Child Health Manager (DCHM) �IPI , Mrs. Yogita Gambhir – Child Health

Supervisors(CHS) �IPI , Yashodas and Staff Nurses.

In Raisen Districts: the workshop tittle Vishwa Istanpan Diwas 2010, on 3-August-2010, the District Chief Medical & Health Officers Dr Sudhir Jaisani, Doctors Dr Kalpana Saxena Gynecologist , Staff Nurse, Child Health Supervisor (NIPI), Deputy Child Health Supervisor (DCHS, NIPI), ASHA & Mothers conduct the workshop and address the importance of Early Breastfeeding week and Exclusive Breastfeeding week and community awareness in Raisen District.

Key Points covered during workshop on WBA

The Doctors address: Breast milk contains all the nutrients in the right proportion which are

needed for optimum growth and development of the baby during the first six months. It has a

high percentage of lactose. Galactose, an important component of galactocerebroside , is

essential for brain growth. It also facilitates absorption of calcium. It contains amino acids like

taurine and cysteine which are important neurotransmitters. The fats are mostly

polyunsaturated fatty acids which are necessary for the myelination of the central nervous

system. It contains vitamins, minerals and electrolytes in the right proportion. Breast milk also

contains various hormones and growth factors, some of which are necessary for the maturation

of the intestinal tract. The enzyme lipase in the breast milk helps in the digestion of fats. The

Infants should breastfed within one hour of birth & regular interval of time up to six months, no

other things should be given to child like honey, water, etc. Exclusive Breastfed Only Mothers

milk.!

Staff Nurse address: the Protective factors of breastfed & babies are less likely to develop

infections. Other benefits it’s for the baby Breastfeeding protects against allergies, including

asthma. It enhances emotional bonding between mother and baby. Breastfeeding soon after

birth helps in uterine involution thus reduces chances of post partum hemorrhage.

Child Health Supervisor Address: The Proper Positioning and latching of Infants during

breastfeeding, the more the baby sucks at the breast, the greater is the stimulus for milk

production, It is therefore important for a mother to feed the baby early, frequently and ensure

complete emptying of the breasts at each feed. She also address about the Rooting, Sucking &

Swallowing reflex during breastfed of child. The types of Milks were also discuss. The

composition of breast milk varies at different stages after birth to suit the needs of the baby,-

� Colostrum is the milk secreted during the first week after delivery. It is yellow, thick

and contains more antibodies and white blood cells. Though secreted only in small

quantities, it has higher protein content and is most suited for the needs of the baby. It

should NEVER be discarded.

� Transitional milk is the milk secreted during the following two weeks. The immunoglobulin

and protein content decreases, while the fat and sugar content increase.



� Mature milk follows transitional milk. It is thinner and watery but contains all the

nutrients essential for optimal growth of the baby.

� Preterm milk is the breast milk of a mother who delivers prematurely. It contains more

proteins, sodium, iron, immunoglobulins and calories that are needed by her preterm baby

� Fore milk is the milk secreted at the start of a feed. It is watery and is rich in

� Proteins, sugar, vitamins, minerals and water and satisfies the baby's thirst.

� Feeding of LBW babies & Kangaroo Mother Care

The WCD & ANM Address: The basic problem identified for the Breastfeeding while counseling the

mother

� The myths and misconception of family on breastfeeding for the infants. � The Traditional systems followed by Older women of the house � Low level of awareness among family for colostrum feeding and Exclusive Breastfeeding. � Poor PNC follow-ups resulting in drop-outs in Exclusive Breastfeeding. � The Traditional System is insisted by family elder women.

The solution and case study and field experience were share among all the health workers.

At the end of workshop the Cheif Medical & Health Officers & DPMU Staff address: Review all the

important points again and decided to implements breastfed within one hour of birth and promote

exclusive breastfed practices in community in all facility and field level.

Train staff to implement it, all health care staff who have any contact with mothers, infants and/or

children must receive instruction on the implementation of the breastfeeding policy. Training in

breastfeeding and lactation management should be given to various types of staff including new

employees, A policy is of no use unless it is implemented, nurses in skills necessary to implement this

policy. It ensures that the majority of the staff members are trained in breastfeeding counseling.

Key Points: covered during training:

� Advantages of breastfeeding � Risks of artificial feeding � Mechanisms of lactation and sucking � How to help mothers initiate and sustain breastfeeding � How to assess a breastfeeding session � How to resolve breastfeeding difficulties � Orientation and education on hospital breastfeeding policies and practices � Importance of feeding on cue � Positioning and attachment � Risks of artificial feeding and using bottles

� Counseling’s and primary care workers to support breastfeeding.



Step 2)

Motivation and Support to the mother is the most important corner stone’s for successful

breastfeeding and help mothers initiate breastfeeding within a half-hour of birth along with

show mothers how to breastfeed, Feeding practices in the first few days influence the mother's

breastfeeding performance. Three prerequisite for successful Breastfeeding are a willing and

motivated mother; a active and sucking newborn ; a motivator who can bring mother and

newborn together ( health professional or relative ).The following steps must be practiced.

Fig1.7 Counseling Mothers about breastfeed & wrapping child properly Fig.1.8 Yashoda helping mother to start breastfed within one hour of delivery &

Supporting in Proper Positioning and latching of infants

Fig 1.9 Proper Positioning and latching of infant’s breastfed within one hour of delivery. Fig 2.0 Yashoda Motivate & support to mother and making her relax

IEC & BCC

During training the role plays and discussion were included which help the staff members to

understand, PowerPoint presentations, Breastfeeding Films and Flip Chart , Calendars, Posters,

Banners, Books in Local Language and experts comments were taken in consideration while

conduction the workshop.



In facility in Maternity wings the sessions and counseling & orientations were given to mothers

and there in In-Laws & family in which more than 60% mothers were given session &

counseling. In which the following key points were covered.

Prenatal education:

H Proper positioning and attachment

H The benefits of early initiation

H How to assure enough milk

H The importance of exclusive breastfeeding

PNC Care Increase duration of breastfeeding

H Advantages of breastfeeding

H Risks of artificial feeding

H Mechanisms of lactation and sucking

H How to help mothers initiate and sustain breastfeeding

H How to assess a breastfeeding session

H How to resolve breastfeeding difficulties

H Orientation and education on hospital breastfeeding policies and practices

H Importance & Exclusive Breastfeed , Importance of breastfed to LBW

H Positioning and attachment

H Risks of artificial feeding and using bottles.

H Babies learn to suckle more effectively

H Help mothers learn to breastfeed on cue

H Facilitate proper positioning during feedings with the help of a health care professional nearby

H Enforce education on the risk of artificial feeding and bottle-feeding.

Initiate breastfeeding within a half-hour of birth:

Mothers in the maternity ward who have had normal vaginal deliveries should confirm that within a

half-hour of birth they were given their babies to hold with skin contact, for at least 30 minutes, and

offered help by a staff member to initiate breastfeeding.

Mothers who have had caesarean deliveries should confirm that within a half-hour of being able to

respond, they were given their babies to hold with skin contact.

It is now well established in NIPI Focus Districts at facility and field that mothers who are supported to

initiate breastfeeding soon after the baby is born are more likely to have a successful breastfeeding

experience. Work to increase community awareness of the importance of early initiation of

breastfeeding and exclusive breastfed. Key Points Covered & Implemented for Early Initiation can

also: Provides colostrum as the baby's first immunization. Takes advantage of the first hour of alertness,

Increase duration of breastfeeding, Facilitate proper positioning during feedings with the help of a health

care professional nearby.

Orientation mothers & family members by taking sessions for early breastfed & exclusive breastfed & Enforce education on the risk of artificial feeding and bottle-feeding, Community awareness for exclusive breastfed & Encourage breastfeeding on demand. Feeding of LBW babies.



Community Awareness sessions in Facility to Mothers –In –Law & Family Community Awareness sessions by showing breastfeeding films.

World Breastfeeding Week 2010 • 1-7 August 2010

NORWAY INDIA PARTNERSHIP INITITATIVE ( NIPI )

S

N

o Districts 01-

Aug-10

02-

Aug-10

03-

Aug-10

04-

Aug-10

05-

Aug-10

06-

Aug-10

07-Aug-

10

Day-1 Day-2 Day-3 Day-4 Day-5 Day-6 Day-7

DISTRICT Hospital BETUL DISTRICTS TOT

AL

1 Total Number of Delivery BETUL (DH) 7 6 7 7 14 7 12 60

2 Total Number of Live Birth BETUL (DH) 6 6 7 7 14 7 11 58

3

Total Number of Infants Breast Feed

Within 1 Hrs BETUL (DH) 6 6 7 7 14 7 11 58

4 Total Infants Regular Breastfeed Interval of every 2

Hours BETUL (DH) 6 6 7 7 14 7 11 58

5 Total Number of Mother was not aware about

Exclusive Breast Feed BETUL (DH) NA# NA# NA# NA# NA# NA# NA# 0

6 Total Number of Mother Agree about Exclusive

Breast Feed BETUL (DH) NA# NA# NA# NA# NA# NA# NA# 0

BLOCK Data

1 Total Number of Delivery Ghodadongri 8 7 10 4 6 4 7 46

2 Total Number of Live Birth Ghodadongri 8 7 10 4 6 4 6 45

3


Within 1 Hrs Ghodadongri 8 6 9 4 5 4 6 42


Hours Ghodadongri 8 6 10 4 6 4 0 38


Exclusive Breast Feed Ghodadongri 5 5 7 0 0 0 3 20


Breast Feed Ghodadongri 8 7 10 4 0 2 3 34

NARSINGHPUR DISTRICTS

1 Total Number of Delivery Narsinghpur 9 17 15 19 13 19 18 110

2 Total Number of Live Birth Narsinghpur 9 17 15 18 12 19 17 107



3


Within 1 Hrs Narsinghpur 8 14 12 16 12 14 15 91


Hours Narsinghpur 9 17 15 18 12 19 17 107


Exclusive Breast Feed Narsinghpur 3 7 5 7 3 9 6 40


Breast Feed Narsinghpur 6 10 10 12 10 10 12 70

RAISEN DISTRICTS

1 Total Number of Delivery Raisen 4 7 10 4 5 7 10 47

2 Total Number of Live Birth Raisen 4 7 10 4 6 7 10 48

3


Within 1 Hrs Raisen 2 1 5 2 4 5 6 25


Hours Raisen 4 7 10 4 6 7 10 48


Exclusive Breast Feed Raisen 0 0 0 0 0 0 0 0


Breast Feed Raisen 4 7 10 4 5 7 0 37



Fig Comparison of Live Birth Vs Breastfeed within One Hour

Conclusion:

� The Live Birth in the facility in districts hospitals and block level facility were breastfeed within one hour is

about 95% .

� Awareness in the community like Mothers & Relatives -Mother in law & Husband were given in the facility

and decided to implement the counseling on regular basis in future at facility.

� Mother to feed the baby early, frequently and ensure complete emptying of the breasts at each feed.

� Orientation and education on hospital breastfeeding policies and practices

� Awareness among family for colostrum feeding and Exclusive Breastfeeding.

� Community awareness of the importance of early initiation of breastfeeding and exclusive breastfed.

� The NIPI Focus Districts has started follow up in the Breastfeed within one Hour in Districts Hospital and Block Level Facility and ensuring regular Breastfeed and counseling after regular interval of time.

summary report on world breast feeding week 2010 report

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