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4.6.2. Talleres de capacitación TALLER DE CAPACITACIÓN

Assessing a Breastfeed

Objectives

After completing this session participants will be able to:

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explain the 4 key points of attachment

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assess a breastfeed by observing a mother and baby

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identify a mother who may need help

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recognize signs of good and poor attachment and positioning

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explain the contents and arrangement of the BREASTFEED OBSERVATION JOB AID

Introduction

Assessing a breastfeed helps you to decide if a mother needs help or not, and how to help her. You can learn a lot about how well or badly breastfeeding is going by observing, before you ask

questions. There are some things you can observe when a baby is not breastfeeding. Other things you can only observe if a baby is breastfeeding.

24 Session 4: Assessing a Breastfeed

Infant and Young Child Feeding Counselling: An Integrated Course. Participant’s Manual

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Mother's name _______________________________ Date ____________________ Baby's name _________________________________ Baby's age ______________

Signs that breastfeeding is going well: Signs of possible difficulty:

GENERAL

Mother: Mother:

F Mother looks healthy F Mother looks ill or depressed

F Mother relaxed and comfortable F Mother looks tense and uncomfortable

F Signs of bonding between mother and baby F No mother/baby eye contact

Baby: Baby:

F Baby looks healthy F Baby looks sleepy or ill

F Baby calm and relaxed F Baby is restless or crying

F Baby reaches or roots for breast if hungry F Baby does not reach or root

BREASTS

F Breasts look healthy F Breasts look red, swollen, or sore

F No pain or discomfort F Breast or nipple painful

F Breast well supported with fingers F Breast held with fingers on areola away from nipple

BABY’S POSITION

F Baby’s head and body in line F Baby’s neck and head twisted to feed

F Baby held close to mother’s body F Baby not held close

F Baby’s whole body supported F Baby supported by head and neck only

F Baby approaches breast, nose to nipple F Baby approaches breast, lower lip/chin

to nipple

BABY’S ATTACHMENT

F More areola seen above baby’s top lip F More areola seen below bottom lip

F Baby’s mouth open wide F Baby’s mouth not open wide

F Lower lip turned outwards F Lips pointing forward or turned in

F Baby’s chin touches breast F Baby’s chin not touching breast

SUCKLING

F Slow, deep sucks with pauses F Rapid shallow sucks

F Cheeks round when suckling F Cheeks pulled in when suckling

F Baby releases breast when finished F Mother takes baby off the breast

Infant and Young Child Feeding Counselling: An Integrated Course. Participant’s Manual Fig. 4.1 How does the mother hold her baby?

a. Baby's body close, facing breast Face to face attention from mother

b. Baby's body away from mother, neck twisted No mother baby eye contact

Fig. 4.2 How does the mother hold her breast?

a. Resting her fingers on her chest wall so that her first finger forms a support at the base of the breast

b. Holding her breast too near the nipple

26 Session 4: Assessing a Breastfeed

Infant and Young Child Feeding Counselling: An Integrated Course. Participant’s Manual Fig. 4.3 How is the baby attached to the breast?

a. A baby well attached to his mother's breast b. A baby poorly attached to his mother's breast

Exercise 4.a. Using the B

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In this exercise, you practise recognizing the signs of good and poor attachment in some slides of babies breastfeeding. In some of the photographs you will also see signs of good and poor positioning.

With Slides 4/8-4/9, use your observations to practise filling in one of the

BREASTFEED OBSERVATION JOB AIDS on the following pages. There are two forms. Fill in one form for each slide.

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If you see a sign, make a 9 in the box next to the sign.

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If you do not see a sign, leave the box empty.

Infant and Young Child Feeding Counselling: An Integrated Course. Participant’s Manual

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LIDE

4/8

Mother's name _______________________________ Date ____________________ Baby's name _________________________________ Baby's age ______________

Signs that breastfeeding is going well: Signs of possible difficulty:

GENERAL

Mother: Mother:

F Mother looks healthy F Mother looks ill or depressed

F Mother relaxed and comfortable F Mother looks tense and uncomfortable

F Signs of bonding between mother and baby F No mother/baby eye contact

Baby: Baby:

F Baby looks healthy F Baby looks sleepy or ill

F Baby calm and relaxed F Baby is restless or crying

F Baby reaches or roots for breast if hungry F Baby does not reach or root

BREASTS

F Breasts look healthy F Breasts look red, swollen, or sore

F No pain or discomfort F Breast or nipple painful

F Breast well supported with fingers F Breast held with fingers on areola away from nipple

BABY’S POSITION

F Baby’s head and body in line F Baby’s neck and head twisted to feed

F Baby held close to mother’s body F Baby not held close

F Baby’s whole body supported F Baby supported by head and neck only

F Baby approaches breast, nose to nipple F Baby approaches breast, lower lip/chin

to nipple

BABY’S ATTACHMENT

F More areola seen above baby’s top lip F More areola seen below bottom lip

F Baby’s mouth open wide F Baby’s mouth not open wide

F Lower lip turned outwards F Lips pointing forward or turned in

F Baby’s chin touches breast F Baby’s chin not touching breast

SUCKLING

F Slow, deep sucks with pauses F Rapid shallow sucks

F Cheeks round when suckling F Cheeks pulled in when suckling

F Baby releases breast when finished F Mother takes baby off the breast

28 Session 4: Assessing a Breastfeed

Infant and Young Child Feeding Counselling: An Integrated Course. Participant’s Manual

B

REASTFEED

O

BSERVATION

J

OB

A

ID

S

LIDE

4/9

Mother's name _______________________________ Date ____________________ Baby's name _________________________________ Baby's age ______________

Signs that breastfeeding is going well: Signs of possible difficulty:

GENERAL

Mother: Mother:

F Mother looks healthy F Mother looks ill or depressed

F Mother relaxed and comfortable F Mother looks tense and uncomfortable

F Signs of bonding between mother and baby F No mother/baby eye contact

Baby: Baby:

F Baby looks healthy F Baby looks sleepy or ill

F Baby calm and relaxed F Baby is restless or crying

F Baby reaches or roots for breast if hungry F Baby does not reach or root

BREASTS

F Breasts look healthy F Breasts look red, swollen, or sore

F No pain or discomfort F Breast or nipple painful

F Breast well supported with fingers F Breast held with fingers on areola away from nipple

BABY’S POSITION

F Baby’s head and body in line F Baby’s neck and head twisted to feed

F Baby held close to mother’s body F Baby not held close

F Baby’s whole body supported F Baby supported by head and neck only

F Baby approaches breast, nose to nipple F Baby approaches breast, lower lip/chin

to nipple

BABY’S ATTACHMENT

F More areola seen above baby’s top lip F More areola seen below bottom lip

F Baby’s mouth open wide F Baby’s mouth not open wide

F Lower lip turned outwards F Lips pointing forward or turned in

F Baby’s chin touches breast F Baby’s chin not touching breast

SUCKLING

F Slow, deep sucks with pauses F Rapid shallow sucks

F Cheeks round when suckling F Cheeks pulled in when suckling

F Baby releases breast when finished F Mother takes baby off the breast

Infant and Young Child Feeding Counselling: An Integrated Course. Participant’s Manual

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