Step 8: Encourage breastfeeding on demand. - Ten Steps to Successful Breastfeeding

Every facility providing maternity services and care for newborn infants should:

Step 8: Encourage breastfeeding on demand.

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Mothers of normal babies (including caesareans) who are breastfeeding should have no restrictions placed on the frequency or length of their babies' breastfeeds. They should be advised to breastfeed their babies whenever they are hungry or as often as the baby wants and they should wake their babies for breastfeeding if the babies sleep too long or the mother's breasts are overfull.

Babies should feed according to their needs, not a schedule decided by the hospital or mother. Understanding her infant’s feeding cues improved breastfeeding and the mother-child relationship.

According to the eighth step the mother is encourage to breastfeed whenever the baby wants to. This is called demand feeding. It helps in increased production and prevents undue engorgement of breasts.

What You Can Do.

Step 8: WABA Action Chart

What You or Your Organisation Can Do >> click here
World Breastfeeding Week Action Folders

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General
Babies should feed according to their needs, not on a schedule decided by the hospital or mother. Understanding her infant's feeding cues improves breastfeeding and the mother-child relationship.
Health System
Encourage maternity facilities to support breastfeeding on demand, and not on a schedule. Health workers should know infant feeding cues (signs) and teach families about them.

Signs of hunger are the baby opening the mouth, rooting, sucking hands, and moving arms and legs. Crying is a distress call and a late sign.

Signs that a baby is full, are turning away, closing the mouth, and not suckling. Breastfeeding in response to feeding cues encourages appropriate intake and growth.
Community
Make families aware of feeding cues, and the importance of responding to them. They should feed a baby when it is hungry and not wait for it to cry; but not over feed a child and risk obesity.
National / Global
Advocate with government for breastfeeding on demand in all maternity facilities; and for development partners to include feeding cue recognition and responsive feeding in nutrition programmes.

Key Points:

Breastfeed on demand results in:

Earlier passage of meconium
Lower maximal weight loss
Breast milk flow is established sooner
Larger volume of milk intake on day three
Less of jaundice

Mothers should be instructed to:

Recognize early hunger cues
Assess adequate feed
Monitor wet and soiled diapers
Recognize normal feeding patterns of a newborn
Recognize changes in the infants feeding patterns as the infant goes through growth spurts and starts solids

HIV Issues to Consider

Step 8: Encourage breastfeeding on demand.
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.

This step applies to breastfeeding mothers regardless of their HIV status.
Babies differ in their hunger. The individual needs of both breastfed and artificially fed infants should be respected and responded to.