1. Session 51

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4. 4 Activity Looking Toward The Future As you look towards the future, think about the best part of being a Peer Counselor. Draw a picture or write down 3 words that best describe your feelings. Share with the group

5. Session 55 Review and Preview  Hand expression sharing  Review Session 4 topics  3-Step Counseling Sharing  Preview of Session 5 What questions do you have?

6. Session 56 Challenges to Breastfeeding

7.  What do you think are the challenges and barriers to breastfeeding?  List identified challenges and/or barriers

8. Session 58 Discussion  How did you prepare for your hospital stay?  What do you wish you had done differently?  How could a peer counselor have helped you?

9. Session 59 Hospital Practices  Hard to get breastfeeding off to a good start if:  Mother doesn’t get to breastfeed within 1st hour  Mother and baby are separated  Baby given formula, sugar water, or pacifier  Free formula is given  Advice not based on latest information

10. Session 510 Discussion A positive breastfeeding experience in the hospital makes it easier to continue breastfeeding!  How can you help a pregnant mother prepare for her hospital stay?  Compare your list to the one in your handbook  See birth plan in Appendix

11. Session 511 Lack of Confidence Mothers may:  Worry they won’t be able to breastfeed  Feel unsure they can make enough milk  Have family members that weren’t able to breastfeed

12. Session 512 Lack of Support Family/friends comments - Not supportive  Mother may doubt her ability to breastfeed  Mother may stop breastfeeding

13. Session 513 Discussion What comments did you hear from family & friends? Did you have family members or friends who made negative comments about breastfeeding? How did you handle these situations? What could you say to a mother whose family & friends are not supportive?

14. Session 514 Body Changes  Worries about body not looking the same  What would you say to a mother who says:  “My breasts will be too large”  “My breasts will sag”  “I want to diet to lose weight quickly”

15. Session 515 ACTIVITY Counseling Mothers Experiencing Challenges Part 1 Divide into groups of threes Practice role-playing using the Best Start 3 - Step Counseling Strategy Use worksheet entitled “Observer’s Checklist found in handbook

16. Session 516 Scenario 1  Wants formula  “I don’t think I’m making enough milk.”  Baby cries and wakes up at night Scenario 3  Pregnant mother  Not sure she wants to breastfeed  “I want to go on a diet after I have the baby. I’ve gained a lot of weight…” ACTIVITY Counseling Mothers Scenario 2  Wants formula  “You are starving that baby! He’s still hungry. Give him a bottle of formula.”

17. Session 517 Not Eating Right? Let mothers know:  She can make “good” milk even if not eating “right” everyday  Breastmilk from moms who eat “junk food” is far better than formula  She does not have to drink milk to make milk  Eat the way she ate during pregnancy  Eating poorly – tired/sick more often

18. Session 518 Worried About Not Eating Right  Mothers can eat all types of foods without baby getting an upset stomach  If mother thinks that baby is fussy/colicky after she eats a certain food…  Suggest that she stop eating it for a week  See if it makes a difference

19. Session 519 Foods Thought to Cause Baby to Fussy Common foods that may upset baby’s tummy:  cabbage, broccoli,  cauliflower,  brussels sprouts  chocolate  garlic  milk  spicy foods  drinks with caffeine

20. Session 520 Drink to thirst  Drinking more will not increase milk supply  Whenever breastfeeding, have something to drink  Limit caffeine  Caffeine passes to breastmilk and may cause baby to be fussy and/or not sleep well Beverages

21. Session 521 Embarrassment  Some mothers are embarrassed about breastfeeding in public  If a mother is worried…  Affirm her feelings  Show her to breastfeed without showing breasts  California Law - Mothers can breastfeed in public anywhere babies are allowed to be!

22. Session 522 What suggestions could you give a mother worried about breastfeeding in public?  Share answers in a larger group  Compare to list in your handbook Suggestions for Breastfeeding In Public

23. Session 523 Returning to Work or School If mother is worried about breastfeeding successfully…  Affirm her feelings:  There are ways to continue breastfeeding  Special closeness -“makes up” for time spent away  Allows for more time with her baby when home

24. Session 524 More suggestions…  Mother should talk to employer before baby is born about:  Breastfed baby sick less often - miss less school/work  Her right to have (CA Law): Adequate break-time to pump A private place to pump (other than a bathroom)

25. Session 525 Busy Lifestyles Mother worried breastfeeding will “tie her down”…  Affirm her feelings  Quicker & easier - less supplies than bottle feeding  Mothers need rest (rest when baby naps)  “Stressed” - may have trouble producing milk  Focus on her & baby for 1 st few weeks  Someone to help with housework

26. Session 526 Busy Lifestyles (cont’d) More suggestions:  Get breastfeeding going well, then gradually add other activities  Pump for times when away  Breastfeed most of the time, give breastmilk in the bottle if necessary  Give breastfeeding a try! It works great with a lot of busy mothers’ schedules!

27. Session 527 Activity Counseling Mothers Experiencing Challenges Part 2 Divide into groups of threes Practice role-playing using the Best Start 3 - Step Counseling Strategy Use worksheet entitled “Observer’s Checklist” found in handbook

28. Session 528 Scenario 1  6 week old baby  “I have to go back to work. But I don’t have a job yet.”  Doesn’t know about the law or pumping at work Scenario 3  Pregnant mother  Doesn’t think she can breastfeed  All she can afford is inexpensive foods  Doesn’t have money to spend on expensive “breastfeeding” foods ACTIVITY Counseling Mothers Scenario 2  Pregnant mother  Doesn’t want to expose her breasts in public  Too busy  Formula would be easier

29. Session 529 Referring to a Lactation Specialist or Health Care Provider

30. Session 530  Listen to mother’s concerns  Affirm feelings  Provide basic breastfeeding education  Do not give medical advice  Refer to a lactation specialist or health care provider when necessary Role of a Peer Counselor

31. Session 531 Activity To Refer or Not To Refer, That is the Question  In your table groups  Listen to the statements and decide as a group whether or not you would refer to a lactation specialist  Hold up your “refer” or “not to refer” card  Compare with lists in your handbook “Reasons for Referral”

32. Session 532 Documentation & Confidentiality

33. Session 533 Documentation  Improves communication  Saves time  Prepares for next counseling session  Keeps track of work done Documentation is very important!

34. Session 534 Confidentiality WIC clients share personal info when enrolled DO NOT:  Share info with partner and/or friends  Leave out forms that participant fills out  “Gossip” about mothers

35. Session 535 Confidentiality  Your agency will have you sign a “Confidentiality Agreement”  Sharing personal info about a mother you are helping with non-WIC staff is illegal and could cause you to lose your job!

36. Session 536 Activity Confidentiality: Yes or No? In your table groups:  Listen while your facilitator reads four scenarios  When the table group has determined their answer, all STAND UP  Your facilitator will ask you to call out your answers

37. Session 537 Telephone Manners

38. Session 538 Role Play: Telephone Manners Watch facilitators role play two telephone calls  What did the “counselor” do well?  What could the “counselor” have done differently? Review “Telephone Counseling Suggestions for Peer Counselors" found in your handbook

39. Session 539 Activity Topics to Cover When Talking to Mothers  Review in your handbook – “Suggestions for Topics to Cover”

40. Session 540 Activity Topics to Cover When Talking to Mothers Circle one topic in each section as instructed:  1 st section: Prenatal  What topic was the most important in your personal experience?  2 nd section: 1 st Weeks  Which topic would be the most uncomfortable to talk about?  3 rd section: Next Follow-Up  What topic are you excited to talk to mothers about?

41. Session 541  Discuss what you circled in your table groups Activity Topics to Cover When Talking to Mothers

42. Session 542 Optional Activity  Listen as your facilitators demonstrate a phone call regarding one of the topics in the Follow-Up section  What questions do you have about topics to be covered when talking to a mother? Topics to Cover When Talking to Mothers

43. Session 543 Activity Practicing Counseling Divide into groups of threes Practice role-playing using the Best Start 3 - Step Counseling Strategy Use worksheet entitled “Observer’s Checklist” found in handbook

44. Session 544 Discussion What other questions do you have?

45. Session 545 Activity Closing  Tree Chart  What topics were covered  Move Post-it Notes

46. Session 546 Final Bits and Pieces  Steps for applying to become a peer counselor…  Please fill out the evaluation form in your handbook Thank you!

47. Session 547 Closing Activity & Celebration

48. Session 548 Standing in a big circle…  What have you gained from this training?  How has this training changed (or will change) your life?  Share your thoughts Activity

49. Session 549 Congratulations!