Best Practice:Counseling in Breast Feeding and Complementary Feeding Dr. Merina Shrestha Secretary Nepal Breast Feeding Promotion Forum (NEBPROF)

Tribhuvan University Teaching Hospital General Hospital – Total beds: 650 Maternity: Tertiary care Pediatric 56 beds PICU: 4 NICU: 6 Neonatal Ward: 6 General/ Sub-speciality OPDs

Infant Young Child Feeding Strategies Training for under graduate and post graduate students Lactation Management Clinic Well Baby Clinic Birthing Centre and Maternity ward

IYCF Training Master Trainer Faculties, Nursing In-charges Training of Middle Level Doctors, Residents, Nursing Staffs Field workers

Lactation Management Clinic Started in August 1 st, 2012 Nursing staffs supported by faculties Twice a week Group sessions( 6-8) for mothers, fathers, grandparents Individual sessions Counseling about breast feeding and complimentary feeding IEC material, dummies and live demonstrations

Challenges in the clinic Resource Space Timing Issues: engorged breast, nipple sore, working mothers, support form the family

Postnatal Care Total deliveries: /months Initiation of Breast Feeding – As early as possible within 1 hour – No pre-lacteal feed – Teats and bottles not allowed – For preterm: expressed breast milk

Birthing Centre 18 beds ( NVD and LSCS) Every morning 1 hour class that includes IEC, discussions by nursing students and nursing staffs Individuals counseling

Maternity beds: 30 Post cesarean section: 4 Neonatal ward : 6 NICU: 6 Intermediate neonatal ward: 6

Challenges Visitor Control Refresher Training Cesarean section Provision of formula from the hospital itself when required Human resource

Thank you