1 Promoting Breastfeeding & Risks of NOT Breastfeeding Birth & Beyond California: Breastfeeding Training and QI Project

2 Objectives Name two reasons why breastfeeding is considered the normal infant feeding method Describe the AAP’s recommendation on exclusive breastfeeding Identify two reasons for validating a woman’s feelings about breastfeeding

Breastfeeding used to be the cultural norm How did we get from there to here? 3

4 Breastfeeding is the Normal Method of Feeding and Nurturing Species Specific – Most complete form of infant nutrition – Composition changes over time Protects infant from diseases Improves maternal health Social and economic benefits Ip, AHRQ, 2007 Kramer, Arch Gen Psychiatry, 2008

Activity: What Are the Risks of NOT Breastfeeding? AHRQ Report: Executive Summary Worksheet: “The Role of Human Milk in Enhancing Outcomes” Ip, AHRQ,

What are the results of this large uncontrolled artificial baby milk experiment? Increased infant/child morbidity Increased infant/child mortality Increased maternal morbidity and mortality Increased health care costs for all Weimer, U.S. Dept.of Agriculture, 2001 AAP, Breastfeeding and the Use of Human Milk,

Exclusive Breastfeeding Recommended for the first 6 months – Is just one bottle of formula a problem? – Even in hot weather? Add complementary foods gradually beginning at around 6 months Continue breastfeeding for at least the first year of life and beyond for as long as mutually desired by mother and child AAP, Breastfeeding and the Use of Human Milk,

Breastfeeding Promotion Preconception Care Prenatal Education In Hospital – Enthusiastic support – Consistent information Post Discharge – Follow up Options – Resources Persad, J Community Health,

How to Counsel Women About Breastfeeding L: Listen to the woman’s concerns O: Ask Open-ended questions V: Validate the woman’s concerns E: Educate, targeting her specific concerns Best Start, 1995 Taveras, Pediatrics, 2004 Smith, Coach’s Notebook,

Explore and Address Concerns Common concerns – Lack of confidence – Fear of not producing enough milk – Dietary restrictions & health concerns – Loss of freedom – Embarrassment – Return to work – Fear of pain 10

Open-Ended Questions “What have you heard about breastfeeding?” “What do you know about breastfeeding?” 11

Validate Feelings Establishes rapport Tells the mother you are really listening to her Increases the effectiveness of your teaching 12

13 L O V E Activity

Effective Breastfeeding Education & Support Sharing of concerns & experiences Teaching hands on skills Watching other mothers breastfeed Appropriate for culture & literacy level Guise, Ann Fam Med,

Key Messages Breastfeeding is desirable and achievable Professional help and community support are available Breastfeeding should be comfortable Exclusive breastfeeding is important 15

Skin-to-Skin + Exclusive and Extensive Breastfeeding = Optimal Outcomes AAP, Breastfeeding and the Use of Human Milk, 2005 Raisler, Am J Pub Hlth,

A parent cannot make a good decision unless it is an informed decision 17

Photo Credits Slide 1 – Motherhood by Petrov Vodkin circa