Transcript Global Strategy for Infant and Young Child Feeding

BABY-FRIENDLY HOSPITAL INITIATIVE
“Maternity”, 1963, © 2003 Estate of Pablo Picasso/Artists Rights Society (ARS), New York
Revised, Updated and Expanded for Integrated Care
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.
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
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The aim of the
Baby Friendly Hospital Initiative
1/2
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.
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2006
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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.
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Original illustration by Jenny Corkery
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Infant Feeding Recommendation
for HIV-positive Women
3/2
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.
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Original illustration by Jenny Corkery
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
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The overall aim of the
International Code of Marketing
of Breastmilk Substitutes
is the safe and adequate nutrition
of all infants.
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Skin to Skin Contact and
Early Breastfeeding
©UNICEF C107-2
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Skin to Skin Contact and
Early Breastfeeding
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
UNICEF/HQ92-0369/ Roger Lemoyne, Thailand
5/2
2006
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Town, South Africa
First Skin to Skin Contact
Dr Nils Bergman, Cape
5/3
6/1
Adapted from Breastfeeding Counselling: a training course,
WHO/CHD/93.4, UNICEF/NUT/93.2
Parts of the Breast
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Helping the Oxytocin Reflex
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
WHO/CHD/93.4, UNICEF/NUT/93.2
Breastfeeding Counselling: a training course,
6/2
Good attachment
Poor attachment
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
WHO/CHD/93.4, UNICEF/NUT/93.2
What can you see?
Breastfeeding Counselling: a training course,
6/3
Breastfeeding Counselling: a training course,
What can you see?
Good attachment
Poor attachment
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
WHO/CHD/93.4, UNICEF/NUT/93.2
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Breastfeeding Positions
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
Breastfeeding Counselling: a training course,
In line
Close
Supported
Facing
2006
WHO/CHD/93.4, UNICEF/NUT/93.2
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BREASTFEED OBSERVATION AID
Mother's name _______________________________
Date ___________________
Baby's name _________________________________
Baby's age ______________
Signs that breastfeeding is going well:
Signs of possible difficulty:
GENERAL
Mother:
Mother:
 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 contact
Baby:
Baby:
 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
BABY’S POSITION
 Baby’s head and body in line
 Baby’s neck and head twisted to feed
 Baby held close to mother’s body
 Baby not held close
 Baby’s whole body supported
 Baby supported by head and neck only
 Baby approaches breast, nose to nipple
 Baby approaches breast, lower lip/chin to nipple
BABY’S ATTACHMENT
 More areola seen above baby’s top lip
 More areola seen below bottom lip
 Baby’s mouth open wide
 Baby’s mouth not open wide
 Lower lip turned outwards
 Lips pointing forward or turned in
 Baby’s chin touches breast
 Baby’s 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:
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Assess a
Breastfeed
©UNICEF C107-5
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Wide Open
Mouth
2006
©UNICEF C107-7
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
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©UNICEF C107-9
Assess a
Breastfeed
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
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2006
Assess a
Breastfeed
2006
UNICEF/HQ91-0168/ Betty Press, Kenya
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Original illustration by Jenny Corkery
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9/1
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Case study
Case
study
2 weeks old
Healthy at birth
Discharged Day 2
3 stools in week
12% under birth weight
Bottle with honey and
water twice yesterday
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
UNICEF/HQ91-0168/ Betty Press, Kenya
“Refusing” the breast
WHO/CHD/93.4, UNICEF/NUT/93.2
Breastfeeding Counselling: a training course,
“Sleeping all the time”
10/1
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Dr Nils Bergman,
Cape Town,
South Africa
Kangaroo
Mother Care
Dr Nils Bergman, Cape Town, South Africa
Kangaroo
Mother
Care
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
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2006
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
UNICEF/HQ93-0287/ Roger Lemoyne, China
Positioning a
preterm
infant
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UNICEF/HQ92-0260/ Lauren Goodsmith, Mauritania
Twins Grow
Well on
Breastmilk
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
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©UNICEF C107-21
DANCER Hand
Position
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Chin Support
2006
Kay Hoover and Barbara Wilson-Clay, from The Breastfeeding Atlas
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
10/6
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Hand
Expression
©UNICEF 910164F
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
A short course for administrators and policy makers WHO/NUT/96.3, Wellstart International
Promoting breastfeeding in health facilities:
Cup Feeding
11/2
11/3
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Dr Ruskhana Haider, Dhaka, Bangladesh
Supplementer
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Breastfeeding Counselling: a training course,
There are many
different shapes and
sizes of breast and
nipple.
Babies can breastfeed
from almost all of them.
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
WHO/CHD/93.4, UNICEF/NUT/93.2
Size and Shape
Full Breast
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
UNICEF C-107-19
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© UNICEF C-10-25
Engorged Breast
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2006
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©UNICEF C107-39
Mastitis
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2006
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
©UNICEF C107-31
Sore Nipple
2006
12/6
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
©UNICEF C107-32
Sore
Nipple
12/7
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
WHO/CHD/93.4, UNICEF/NUT/93.2
Breastfeeding Counselling: a training course,
Syringe method for inverted nipples
12/8
©UNICEF C107-34
Candida on the nipple
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
12/9
©UNICEF C107- 33
Candida on the nipple
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Tongue-tie
©UNICEF C107-35
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UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
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Lactational Amenorrhea Method (LAM)
Ask the mother or advise her to ask herself these three questions:
1. Have your menses returned?
YES
NO
2. Are you giving supplements or
are there long periods without
breastfeeding either day or night?
YES
NO
3. Is your baby more than six
months old?
NO
There is only a 1-2% chance of
pregnancy at this time.
YES
When the answer to ANY
one of these questions
becomes YES
The mother’s 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.
Institute for Reproductive Health, Georgetown, Washington, DC
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
13/2
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.
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Original illustration by Jenny Corkery
14/1
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
15/1
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.
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
15/2
Developing a Plan:
Step One
Where are we
now?
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006
Developing a Plan:
Step Two
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Where do we
want to be?
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2006
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Developing a Plan:
Step Three
How will
we get
there?
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2006
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Developing a Plan:
Step Four
How will we know if
we are there?
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2006
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Developing a Plan:
Step Five
How will we sustain it?
UNICEF/WHO Breastfeeding Promotion and Support in a Baby-Friendly Hospital – 20 hour Course
2006