1. Child Health Training May 2013
Breastfeeding
Child Health Training
May 2013

2. Reasons for promotion U.N.I.C.E.F Research cost saving.
Benefits to mum
Benefits to baby
Benefits to environment.

4. Great for Premature babies
Eyes – Retinopathy of prematurity
Guts - NEC
Brains – early cognitive benefits
Lasting cognitive benefits.
Protection from infection.
Skin to skin contact and its benefits.
Healthier outcomes generally.

5. Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative
Separation and stress
Preterm baby receiving high-tech care
Term baby, separated for 6 hours
Normal stress hormone level 10 9 8 7 6 5 4 3 2 1
One hour of skin contact can reduce stress hormone levels by 75%
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

6. Bottle fed babies
Trying to make their experience similar to that of a breastfed infant

8. Multi –Tasking - a benefit no one talks about.

10. ‘Instant’ protection from infection
Broncho-mammary pathway
Pathogens inhaled
Antibodies incorporated into breastmilk
Antibodies produced and sent to breasts
Milk-producing cells in breast
Pathogens ingested
Entero-mammary pathway
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

11. How it works technical stuff
Both breasts receive message
Baby suckles
NERVE IMPULSES
HORMONES
Pituitary gland stimulated
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

12. A unique relationship Breastfeeding Breastmilk is much more
than a method
of feeding
Breastmilk
than food
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

14. The suck/swallow pattern of a feed
Beginning of feed - short, rapid sucks
Active feeding - long, slow, rhythmic sucking and swallowing, with pauses
End of feed - ‘flutter sucking’ with occasional swallows
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

15. ‘Seeing’ what the baby is getting
Active feeding
(1:1 or 1:2 swallowing)
‘Flutter sucking’
(fewer swallows)
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

16. Principles of Positioning
Baby’s head and body in line (with freedom to tilt head back)
Baby held close
to mother
Nose to nipple
Sustainable
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

17. Effective attachment – external view
This is what we need to see when a baby is attached correctly at the breast !
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

18. Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative
Poor positioning.
Baby not close to mum.
Baby on nipple centrally.
Mouth not wide open. Clothes getting in way of close contact.
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

19. Effects of poor attachment
Mother
Sore nipples
Engorgement
Mastitis
Poor milk supply
Loss of confidence
Baby
Feeding very frequently
Frustrated
Poor weight gain
Jaundiced
Hypernatraemia
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

20. Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative
Nipple trauma
This nipple is damaged on the tip and at the base. What has caused this trauma?
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

21. Early detection of Problems
Prevention better than cure.
Positioning very important.

22. Failure to gain weight Most commonly problems with Positioning.
Mums expectations re feeding….
Feed length and quantity.
Lack of rest for mum.
minimal impact Maternal diet.
Less that 2% of mothers can breastfeed.

23. BNF says re Medications
Many medications have very little information on effects on the infant.
Drugs which have known effects - Details are listed under the relevant drug in the BNF

24. Medications and BF Thomas Hale Medications and mothers milk.
Drugs in Breast milk
B.N.F. suitability of breastfeeding with details of drug. Also research based medication details aimed at General Practitioners.

25. Common Problems and solutions
What would you say is most common Breast feeding problem?

26. Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative
Mastitis – treatment
Effective breast drainage – (always get mum to have attachment checked)
Hand expression
Anti-inflammatory therapy
Analgesics
Fluids
Rest
Antibiotics
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

27. Mastitis (inflammation of the breast)
Caused by stasis of milk
Begins with a blocked duct
Affects one or two lobes of one breast
May or may not be infected
Can produce flu-like symptoms (with or without infection)
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

28. Mastitis What may have caused this condition?
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

29. Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative
Thrush (Candida)
Symptoms seen in mothers who have had or regularly suffer Thrush. In BF circles we are encouraged to treat mum and baby.
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

30. Ductal Thrush
Examination and enquiry into signs and symptoms, in Baby café prior to request for treatment.

32. Tongue tie can lead to poor milk transfer and damaged nipples
Breastfeeding Training Pack © UNICEF UK Baby Friendly Initiative

34. Breastfeeding training for General Practitioners
One line 25 min training suitable for CPPE / CPD portfolio.
Unicef Baby Friendly training

35. Sources of support……
Midwives, Health Visitors. Assistant Practitioners. Peer supporters. Baby Café Lactation consultants National suitable web sites for self help

36. BFN Breastfeeding Network Bumps to breastfeeding _ best beginnings
BFN Breastfeeding Network Bumps to breastfeeding _ best beginnings. Small wonders. NHS Choices – Breastfeeding. Baby friendly website.BFI Unicef

39. Dietetics.

40. Dietetics web address.
rts/training/modules/module3/text/module3 print.pdf

41. Local support. Sure start centres. Active kids programmes
Local support. Sure start centres ? Active kids programmes ? Dieticians Healthy food input from school nurse. Upbeat kids, upbeat families. School nurses. Start 4 Life.

42. Cream, cheese added to meals which should be all full fat foods.
Check iron levels. Orange juice with meals increases uptake of iron.
Healthy start vitamins.
Behaviour management ?