1. Session 8 Baby Friendly Hospital practices

2. Where prevention of PTCT and infant feeding decisions can be integrated into MCH services Health education activities Treatment of sexually transmitted diseases Family planning services Antenatal care Delivery and postpartum care Well baby clinics, Immunization programme and ICDS programme Voluntary Counselling and Testing Centres 8/1

3. Antenatal preparation for breastfeeding With mothers groups: Explain benefits of breastfeeding Give simple information on how to breastfeed Explain what happens after delivery Discuss mothers’ questions With mother individually: Ask about previous experience Ask if any questions or worries Examine breasts if she is worried Build her confidence 8/2

4. 8/3

5. 8/4

6. 8/5

7. Dangers of prelacteal feeds They replace colostrum - greater risk of infection - risk of intolerance, allergy They interfere with suckling - artificial feeds satisfy hunger - bottles interfere with attachment - baby suckles less - more difficult to establish breastfeeding 8/6

8. 8/7

9. 8/8

10. Advantages of rooming-in Mother can respond to baby, helps bonding Baby cries less, less temptation to give bottle feeds Mother more confident about breastfeeding Breastfeeding continues longer 8/9

11. Demand feeding (‘unrestricted’ or ‘baby-led’ feeding) No restrictions on frequency of breastfeeds No restrictions on length of breastfeeds Finish the first breast first 8/10

12. Advantages of demand feeding Breastmilk ‘comes in’ sooner Baby gains weight faster Fewer difficulties such as engorgement Breastfeeding more easily established 8/11

13. 8/12

14. 8/13

15. Help with an early breastfeed Avoid hurry and noise Ask mother how she feels, how breastfeeding is going Observe a breastfeed Help with positioning if necessary Give relevant information about: - demand feeding - signs baby ready to feed - how milk ‘comes in’ Answer mother’s questions 8/14

16. 8/15

17. 8/16