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Step 3: Inform all pregnant women about the benefits and management of breastfeeding.
Every facility providing maternity services and care for newborn infants should:
Step 3: Inform all pregnant women about the benefits and management of breastfeeding.
If the hospital has an affiliated antenatal clinic or antenatal ward...breastfeeding counseling [should be] given to most
pregnant women using those services...The antenatal discussion should cover the importance of exclusive breastfeeding
for the first 4-6 months, the benefits of breastfeeding, and basic breastfeeding management...Pregnant women of 32
weeks or more gestation...should confirm that the benefits of breastfeeding have been discussed with them...[including]
at least two of the following benefits: Nutritional, protective, bonding, health benefits to the mother...and that they
have received no group education on the use of infant formula. They should be able to describe at least two of the
following breastfeeding management topics: importance of rooming-in, importance of feeding on demand, how to
assure enough milk, and positioning and attachment.
By the time a baby is born, the new mother must be comfortable about breastfeeding, understand its benefits, and what she has to do.
The third step is to have sessions with pregnant women to motivate them for breastfeeding and to remove all their doubts.
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- General
By the time a baby is born, the new mother must be comfortable about breastfeeding, understand its benefits and what she has to do.
- Health System
Advocate for breastfeeding information and discussion opportunities to be available for all women, individually and in groups as part of all antenatal care.
Talk to women about their care, and learn if they have been informed about the dvantages of breastfeeding and the risks of not breastfeeding; about how they will be helped at the time of delivery, how to hold the baby and how to ensure that the baby gets plenty of milk.
Make sure that they have relevant and accurate literature on these topics.
- Community
Arrange Promotional activities to raise community awareness of the importance of breastfeeding and the support that new mothers need.
- National / Global
Work to make breastfeeding an accepted norm in all sectors based on up-to-date evidence of the risks of artificial feeding;
and an understanding that women need active support from the health service and community to enable them to breastfeed effectively.
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Key Points:
Prenatal education should include:
- The benefits of breastfeeding
- The benefits of early initiation
- The importance of rooming in
- The importance of feeding on demand
- How to assure enough milk
- Proper positioning and attachment
- The importance of exclusive breastfeeding
- The risk of using bottles and pacifiers
"Prenatal education should not include formula preparation methods."
- Advantages of breastfeeding
- Risks of artificial feeding
- Mechanisms of lactation and sucking
- How to help mothers initiate and sustain breastfeeding
- How to assess a breastfeeding session
- How to resolve breastfeeding difficulties
- Orientation and education on hospital breastfeeding policies and practices
- Importance of feeding on cue
- Positioning and attachment
- Risks of artificial feeding and using bottles
- Increase duration of breastfeeding
- Babies learn to suckle more effectively
- Help mothers learn to breastfeed on cue
- Facilitate proper positioning during feedings with the help of a health care professional nearby
- Enforce education on the risk of artificial feeding and bottle-feeding
HIV Issues to Consider
 Step 3: Inform all pregnant women about the benefits and management of breastfeeding.
Issues to consider while implementing this step in relation to feeding recommendations for children of HIV-infected mothers and for settings with high HIV prevalence.
- WHO/UNAIDS recommends that pregnant women be offered VCT during antenatal care.
- Where VCT services do not yet exist, this will involve additional equipment, space, reagents, and staff time.
- Mothers may be HIV-infected but not know their status. They need to know their HIV status in order to make informed infant feeding choices.
- Pregnant women who are HIV-positive should be counselled about the benefits and risks of locally appropriate infant feeding options so they can make informed decisions on infant feeding.
- Mothers have to weigh the balance of risks: Is it safer to exclusively breastfeed for a period of time or to replacement feed, given the possibility of illness or death of a baby if not breastfed.
- Counsellors must be knowledgeable about the local situation relative to what replacement feeds are locally appropriate. They should be able to help mothers assess their own situations and choose feeding options.
- Counsellors need to recognize that the social stigma of being labelled as being "HIV-positive or having AIDS" may affect some mothers' decisions on infant feeding.
- Counselling should be individual and confidential.
15 August, 2013
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