Anda di halaman 1dari 31

Session 8

Session Objectives
 Describe their role in practices that assist rooming-in.
 Describe their role in practices that assist baby-led (demand)
feeding.
 Suggest ways to awaken a sleepy baby and to settle a crying
baby,
 List the risks of unnecessary supplements.
 Describe why it is important to avoid the use of bottles and
teats.
 Discuss removing barriers to early breastfeeding.
Step 7
Practice rooming in – allow mothers and infants
to remain together 24 hours a day.

What can you say to explain


the importance of rooming-in ?
Benefits of Rooming-in
 Babies sleep better, cry less
 Continuation of sleep/awake rhythm
developed before birth,
 BF is well established, continues longer,
baby gains weight quickly,
 Feeding on cues is easier, develops good
milk supply,
 Mother becomes confident in caring,
 Baby exposed to fewer infection,
 Promotes bonding,
Barriers to rooming-in and
possible solutions

1. Concerns that mothers are tired.

2. Taking the baby to nursery for


procedures.

3. Beliefs that newborn babies need


to be observed.
Cont.
Barriers to rooming-in and possible solutions

4. No space in the ward for baby’s cot,

5. Staff do not know how to assist


mothers in learning to care for their
babies,

6. Mothers ask for their babies to be


taken to the nursery,
Step 8
Encourage breastfeeding on
demand

“demand feeding” - “baby-led feeding”

This means that the frequency and


length of feeding is determined by
the baby’s needs and signs.
Importance of baby-led feeding

1. Baby gets more immune rich


colostrum,
2. Faster development of milk
supply,
3. Faster weight gain,
4. Less neonatal jaundice,
Importance of baby-led feeding

6. Less breast engorgement.


7. Mothers learn to respond to her
baby.
8. Breastfeeding established faster.
9. Less crying, less temptation to
supplement.
10. Longer breastfeeding duration.
Signs of hunger
The baby:

- Increases eye movements or


opens eyes.
- Opens his mouth, stretches out
the tongue
- Makes soft whimper sounds.
- Sucks or chews on hands. Cont.
Signs of hunger
• If the baby is crying loudly,
arches his or her back.

• Some babies are very calm and


wait or go back to sleep if not
noticed.

Other babies wake quickly and


become very annoyed.
What are the signs that a baby has
finished feeding?
Signs of Satiety :
• As they get full, their body relaxes.
• Let go of the breast.
• Take small gentle sucks until they
are asleep.
• Finish one breast before she
offers
the other breast.
Feeding Pattern
 feed for a short time at frequent intervals.
 feed for a long time and then wait a few
hours.
 Very long feeds - more than 40 minutes,
 very short feeds - less than 10 minutes,
 very frequent feeds - more than 12 feeds/24
hrs,
Sore nipples are the result of poor
attachment, not the result of feeding too
often.
The typical feeding pattern for a full term
healthy newborn:

 - Every 1-3 hours in the first 2-7 days.


 - Night feeds are important.

 - Once lactation is established – 8-12


times / 24 hrs.
 - During periods of rapid growth, a
baby may be hungrier.
 Let babies feed whenever they want.
Special situations
o Baby is very sleepy due to
prematurity, jaundice, or the
effects of labor medication,

o Mother’s breasts are overfull and


uncomfortable

o Babies who are on replacement


feed
Ways to wake a sleepy baby
If the baby seems too sleepy to feed,
suggest that the mother:

 Remove blankets and heavy clothing.


 Breastfeed in a more upright position.
 Gently massage and talk to her baby.
 Wait half an hour and try again.
 Avoid hurting the baby.
Settle a crying baby
 Baby is crying.

 Baby who is ‘crying too much’.

 Baby is crying frequently.

 Build the mother’s confidence…

cont
• Build the mother’s confidence in her
ability to care for her baby and give her
support:

- Listen and accept what the mother is


feeling.
- Reinforce what the mother and baby
are doing right / what is normal.
- Give relevant information.
- Make one or two suggestions.
- Give practical help…
cont
Suggestions and practical help to
settle a crying baby can include:
 Make the baby comfortable.
 Put the baby to the breast.
 Put baby on the mother’s chest, skin to
skin.
 Talk, sing and rock the baby while holding
close.
 Gently stroke or massage.
cont
Suggestions and practical help to
settle a crying baby can include:
 Give one breast at each feed; if overfull,
express.
 Reduce the mother’s coffee and other caffeine
drinks.
 Do not smoke.
 Have someone else carry.
 Involve other family members.
 Pressure to give unnecessary supplemental
feedings.
 Hold the baby in a manner that wraps around
him.
Step 6
Give newborn infants no food or drink
other than breastmilk unless
medically indicated.

Healthy full term babies rarely have a


medical need for supplements or
prelacteal feeds.

They do not require water to prevent


dehydration.
Dangers of supplements
Exclusive breastfeeding is
recommended for the first six
months.

Supplements can:
- Overfill a baby’s stomach,
- Reduce milk supply,
- Can cause insufficient weight gains,
- Reduce protective effect of
breastfeeding,
- Reduce the mother’s confidence,
- Be an unnecessary expense.
cont
More reasons why supplement use is
not recommended:

- May be indicating that mother is


having difficulties feeding and caring
for her baby.

- A health worker may lack of


knowledge and skill in supporting BF

- Frequent use of supplements may


indicate an overall stressful
atmosphere
cont
Prelacteal feeding or offering formula
to an infant of an HIV positive
woman who will breastfeed may alter
the GI mucosa and allow the
transmission of the virus.

When we cannot test the HIV status of


mother, it is important to emphasize
that exclusive breastfeeding reduces
the risk of HIV transmission during
breastfeeding.
If a mother has been counseled, tested
and found to be HIV-positive and has
decided not to breastfeed, this is an
acceptable medical reason for giving
her infant other milks in place of
breastmilk.

• Even if many mothers are giving


replacement feeds, this does not
prevent a hospital from being
designated as baby-friendly if those
mothers have all been counseled,
tested, and made genuine informed
choices.
Step 9
Give no artificial teats or pacifiers (also
called dummies or soothers) to
breastfeeding infants
Why is it recommended to avoid using
bottles and teats?

 Baby may develop preference for it.


 Pacifiers given instead of feed for
hungry baby.
 May carry infection.
Discussion – removing Barriers to
early breastfeeding
Case study :
Read the Case Study aloud in class.
Ask participants to note practices
that may help and those which may
interfere with establishing
breastfeeding. What might be the
effect of this situation on
breastfeeding?
Distribute Case
Study
Possible answers:

 No support during labor - longer labor - more


tired, stressed.
 No skin-to-skin contact - not get time to be with
her baby to notices is his birthmark, which
worries her.
 Carolina and her baby are separated for many
hours - formula.
 Did not get colostrum - no breast stimulation
to make milk.
 Not given any help to breastfeed - full from
formula - sleepy, -refuse to suckle. The nurse
worries her about sore nipples.
cont
 It is painful to sit to feed the baby. - inhibit
the oxytocin release.
 Carolina could be helped to feed lying
down.
 Carolina feels alone - caused her stress.
 Nurse frightens Carolina - feed her baby or
will not be able to go home.

The result is that Carolina is worried, sore,


frightened and lonely as well as not
knowing how to feed her baby. She is likely
to go home thinking that she is not able to
make milk and to feed her baby a breastmilk
substitute.
Summary
Rooming in and baby-led feeding help
breastfeeding and bonding.

Help mothers to learn skills of mothering.

Prelacteal and supplemental feeds are


dangerous.

Artificial teats can cause problems.

Anda mungkin juga menyukai