Early initiation of

breastfeeding and
exclusive breastfeeding

New interpretation of Step 4 in the

revised BFHI Global Criteria (2006):

Place babies in skin-to-skin contact

with their mothers immediately
following birth for at least an hour and
encourage mothers to recognize when
their babies are ready to breastfeed,
offering help if needed.

Slide 4.4.2

Other benefits of ONE hour !!!

Skin to skin
Warmth
Development
Less bleeding postpartum

10/12/15

WBW 2007

Early initiation of
breastfeeding
for the normal newborn
Why?

Increases duration of breastfeeding (UNICEF India:

BREASTCRAWL Initiation of breastfeeding by breast
crawl. UNICEF India 2007,Sose CIBA Symposium 1978,
Kramer et al JAMA2001,VaidyaK et al. NepalMedical
College Journal 2005)

Allows skin-to-skin contact for warmth ( Fransson

A 2005; Bergman N, 2005, Bergstorm 2007) and
colonization of baby with maternal organisms
( Hanson L 2004)

RR and HR relative
stable
2004)

(Kroeger & Smith

Provides colostrum as the babys first

immunization (Hanson L :
Immunobiology of Human Milk. 2004)
Takes advantage of the first hour of
alertness The baby is not crying
use of energy (Kroeger & Smith 2004)

 Babies learn to suckle more

effectively
Improved developmental
outcomes
Increase bounding (UNICEF India:
BREAST CRAWL Initiation of breastfeeding by
breast crawl. UNICEF India 2007)

Early initiation of breastfeeding

for the normal newborn
How?

Keep mother and baby together

Place baby on mothers chest
Let baby start suckling when ready
Do not hurry or interrupt the
process
Delay non-urgent medical routines
for at least one hour
Slide 4.4.4

Crawling loking for the breast :

5 behaviour steps
before breastfed
In the few minute , the baby
can crawl to the mother breast ,
and then suck by her/himself
(THE BREAST CRAWL )

1. In first 30 : rest, allert, .

Sometimes looking to her/his
mother and adaptation to the
environment

2. 30-40: make sound,

suckling and put the hand in
the mouth

3. Produce saliva

4. The feet push

toward to mothers
abdomen and
moving to the breast

5. Licking the motherrs skin , touch the nipple

with his/her hand, menghentak head to the
mothers chest , turn the head to right and left,
find the nipple, licking , mengulum puting susu,
open the mouth widely and make a good
attachment

Ten steps
to
successful
breastfeedi
ng

Ten steps to successful breastfeeding

Every facility providing maternity services
and care for newborn infants should
1.

Have a written breastfeeding policy that is

routinely communicated to all health care
staff

2.

Train all health care staff in skills necessary

to implement this policy

3.

Inform all pregnant women about the

benefits and management of breastfeeding

Teaching Aids: ENC

NF-

13

Ten steps to successful breastfeeding

(contd.)

4.

Help mothers initiate breastfeeding

within half hour of birth

5.

Show mothers how to breastfeed, and

how to maintain lactation even if they
are separated from their infants

6.

Give no food or drink, unless medically

indicated

7.

Practice rooming-in : allow mothers and

infants to remain together 24 hrs a day

Teaching Aids: ENC

NF-

14

Ten steps to successful breastfeeding

(contd.)
8. Encourage breastfeeding on demand
9. Give no artificial teats or pacifiers (also
called dummies or soothers) to
breastfeeding infants
10. Foster the establishment of
breastfeeding support groups and refer
mothers to them on discharge from the
hospital.
Teaching Aids: ENC

NF-

15