breast
(info from IMCI chart/booklet) Slow, d
• eep sucks • Chin not touching
and s wallowing b
reast
sounds
Breastfeeding Assessment:
● Has the baby breastfed in the previous
hour? TEACH CORRECT POSITIONING AND
○ Ifbabyhasnotfedinthelasthour, ATTACHMENT
ask mother to put baby to the
breast. ● Seat the mother comfortably
○ Observe the breastfeed for 4 ● Show the mother how to hold her infant:
minutes. (If the baby was fed ○ with the infant’s head and body
during the last hour, ask the straight
motherifshecanwaitandtellyou ○ facing her breast, with infant’s
when the infant is willing to feed nose opposite her nipple
again). ○ with infant’s body close to her
● Is the baby able to attach? body
○ not at all poor attachment good ○ supporting infant’s whole body,
attachment not just neck and shoulders.
● Is the baby suckling well (that is, slow ● Show her how to help the infantattach.
deep sucks, sometimes pausing)? She should:
○ not at all ○ touch her infant’s lips with her
○ not suckling well nipple.
○ suckling well ○ wait until her infant’s mouth is
● Clear a blocked nose if it interferes with opening wide.
breastfeeding ○ move her infant quickly onto her
breast,aimingtheinfant’slowerlip
well below the nipple.
Good attachment Poor attachment
● Look for signs of good attachment and
More areola visible •
• Babysuckingonthe effective suckling. If the attachment or
above than below nipple, not the areola suckling is not good, try again.
baby’s mouth ● Most of the common breastfeeding
• Mouth wide open • Rapid shallow sucks problems expressed by mother are
related to poor positioning and
• Lower lip turned •
Smacking or attachment.
utwards
o clicking sounds
• Chin touching • Cheeks drawn in
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TIPS TO HELP A MOTHER BREASTFEED HER BABY ● Release the pressure then repeat,
➔ Expressafewdropsofmilkonthebaby’s building up a rhythm. Try nottoslidethe
lip to help the baby start breastfeeding. fingers
➔ For low birthweightbabygiveshortrests ● over the skin. At first, only drops will
during a breastfeed; appear, but if she keeps going this will
➔ If the baby coughs, gags, or spits up help
whenstartingtobreastfeed,themilkmay ● build up her milk supply. With practice
be letting down too fast for the baby. and a little time, milk may flow freely.
Teach the mother to take the baby off ● When no more drops come out, let her
the breast if this happens. moveherfingersroundandtryadifferent
➔ Holdthebabyagainstherchestuntilthe section of the breast.
baby can breathe wellagainthenputit ● When the flow slows down, swap to the
back to the breast after the let-downof otherbreast.Keepchangingbreastsuntil
milk has passed. the milk drips very slowly or stops
➔ Ifthemotherwillbeawayfromthebaby altogether.
for some time, teach the mother to ● Ifthemilkdoesn’tflow,lethertrymoving
express breastmilk her fingers slightly towards the nipple or
➔ Make sure that the person whowillfeed further away, orgivethebreastagentle
the baby has been taught to cupfeed massage.
correctly. ● Hold a clean (boiled) cup or container
below the breast to catch the milk as it
SUPPORT ON EXPRESSING BREASTMILK AND CUP flows.
FEEDING SUCCESSFULLY
EXPRESSING BREASTMILK:
● Wash hands with soap and water
● Make sure motherissittingcomfortably–
a little forward
● Show her how to cup the breast just
behind her areola
● Squeeze the breast gently, using thumb STORING AND USING EXPRESSED BREASTMILK
and the rest of fingers in a Cshape.This ➔ Fresh breastmilk has the highest quality.
shouldn’t hurt (don’t squeeze the nipple ➔ If breastmilk must be stored, advise the
directlyasyou’llmakeitsoreanddifficult mother and family to:
to express). ◆ Use either a glass or hard plastic
container with a large opening
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and a tight lid to store the
breastmilk.
◆ Boil the container and lid for 10
minutes before use.
◆ If the mother is literate, teach her
towritethetimeanddatethemilk
was expressed (or morning,
afternoon, evening) on the
container before storing.
◆ Defrost frozen breastmilk in a
fridge or at room temperature
over 12 hours or by letting the
container with frozen breastmilk
stand in cold water to defrost.
➔ Make sure that the person whowillfeed
the baby has been taught to cupfeed
BENEFITS OF BREASTFEEDING
correctly.
● Breastfeeding is the perfect food for the
baby. It contains many antibodies and
How long can breast milk be stored
substances that fight infection, mature
Temperature Duration
the gut andbody,andpromoteoptimal
Room temperature Up to 8 hours growth, development and healthforthe
baby
Fridge Up to 6 days
● The risk of not breastfeeding is a much
Ice box freezer (-18°C) 3-6 months higher chance of the baby becoming ill
with, or even dying from, diarrhea,
pneumonia or malnutrition.
● If the mother is HIV positive, with ART
prophylaxis the risk of HIV transmission is
much less than in the past.
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