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Compassionate Care for Breastfeeding Mothers and Infants

Designed for Idaho State University. This workshop encourages compassion based care which facilitates breastfeeding and honors the biological partnership between mothers and their infants.
by

Catherine Davis

on 1 October 2013

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Transcript of Compassionate Care for Breastfeeding Mothers and Infants

Compassionate Care for Breastfeeding Mothers and Infants
Imagine that the world had created a new dream product to feed and immunize everyone born on Earth.
Imagine also that it was available everywhere, required no storage or delivery and helped mothers to plan their families and reduce the risk of cancer.
Then, imagine the world refused to use it.
 
Human milk is the preferred feeding for all infants, including premature and sick newborns, with rare exceptions.
1Year Recommended
AAP Policy Statement
World Health Organization
Created for Idaho State University
by Catherine Jayne Davis BS,
Lactation Education Specialist
2013
Today we will
learn how our own experiences
influence the delivery of health information

Building Your Own Philosophy
Honoring Mother/Infant Partnerships
Facilitating and Empathizing
Living as Baby-Friendly Practitioners
Honor & Educate
Obtain "Informed Consent", mothers make choices
Discuss risks of supplementation (there are many)
Provide infant feeding education prenatally
Pursue alternatives to supplementation with a bottle
Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development. Virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large.
2 Years
United Nations Children's Fund (UNICEF)
United States Surgeon General
One of the most highly effective preventive measures a mother can take to protect the health
of her infant and herself is to breastfeed.
Write Down Your Initial Reaction to Each Photo
Regulators (scheduled feedings, time and volume, concerned with efficiency, increased supplementation or full assist help) Most Nurses

Facilitators (believe in the mother/infant dyad, listen to concerns and help find solutions. Partial assist care) Most Midwives

Dis-empowering (give advice, do not listen to mothers concerns, RHETORIC)

Breastfeeding Antipathy (Aversion to breastfeeding, lack of knowledge or confidence in assisting, discomfort) Midwives, Doctors and Nurses
Breastfeeding Attitudes Among Counseling
Health Professionals
Ekstrom, A., Matthiesen, A-S, Widstrom, A-M. & Nissen, E. (2005) Breastfeeding attitudes among counseling health professionals Development of an instrument to describe breastfeeding attitudes. Scandinavian Journal of Public Health. 33: 353-359
Build Your Own Philosophy

" If you have no compassion for yourself then you are not capable of developing compassion for others.”
Dali Lama
Draw a simple sketch that represents your personal experiences with breastfeeding infants. Was it happy, frustrating, confusing, painful, or smooth sailing?
If you have never breastfed you can still help mothers, explore your feelings and comfort level by making a list of words you associate with breastfeeding moms and babies.
Think Critically
Picture #1 (Normalizing breastfeeding) Venezuelan mother nursing twins in public. How do you feel about nursing in public? How does our US culture and the subculture of Idaho influence your reactions?

Picture #2 What emotions or feelings does this photo bring up? What do you think the mothers promotional message was meant to be?

Picture #3 (Nursing toddlers/children) At what age do you feel it is necessary to wean a breastfeeding child? How does our culture influence your feeling? What benefits would there still be too continued nursing? Also what is the dis-empowering message contained in this ad?

Picture #4 (Pumping at Work) Mother pumping with manual pump and pumping halter. Many working moms stop breastfeeding when they return to work. What barriers might a working mom run into?

Picture #5 (Breast milk as food and medicine) This is an ad for an ice cream shop in London, Baby Gaga Ice Cream. They hire women to pump milk and make gourmet ice cream served to you by Baby Gaga waitresses. What potential does breast milk have for food? Think about populations other than infants. What medicinal or nutritional benefits might other age groups get from consuming breast milk?
A Qualitative measurement for healthcare professionals
Develop your skills as a Facilitator and you will play a positive role in a new mothers experience with her baby!
Compassionate Care
Requires
1) Species-specific (digest easily)
2) Optimal nutrition (secretory IGA, stem cells, human growth hormones, immunoglobins.)
3) Minimizes exposure to foreign proteins (always fresh, warm and alive.)
4) Immunization transference (dose response)
5) Lowers the risk of necrotizing enterocolitis cellular death of the digestive tract (preemies!)
6) Minimizes postpartum bleeding
7) Lowers the risk of respiratory infections
8) Decreases the severity and frequency of ear infection
9) Encourages skin to skin contact (colonization, respiratory and circulatory patterns)
10) Maternal bonding (stress relief, rise in prolactin)
11) Infant reflexology and socialization (attachment theories)
12) Expedites postpartum recovery and reduces risks of several types of cancer
13) Provides infant with pain relief in the form of oxytocin
14) Body temperature rises to incubate the baby and reduce stress
15) Reduces postpartum depression
17) Contains fatty acids (DHA), nucleotides, oligosaccharides, and taurine
to enhance neural and retinal development.
16) Decreases Infant Mortality worldwide
Breastfeeding Is an Evolutionary Mechanism that is Necessary for the Health of Mothers and Infants
Gaze at your baby now, and realize that she has been nourished completely from your body since her life began, and nature provided your body with the ability and wisdom for this miracle to continue. “Laura Keegan
Milk takes 3-5 days to increase volume (colostrum is milk)
The first 48-72 hours are protective (breast milk is medicine)
Teach self-expression to increase confidence
In a medical emergency;
Feed the baby
Protect the milk supply
Keep baby at the breast
Baby Friendly Practitioners
It is important to let moms know the following;
Elective inductions, epidurals, cesarean birth and narcotic pain management interfere significantly with the reflexes and maturity of infants, this makes breastfeeding an emotional and painstaking experience that can leave mothers feeling regretful and incompetent. This issue can be addressed during pregnancy by counseling mothers to make a goal to have a non medicated birth.
Facilitate positive outcomes by encouraging skin to skin contact, discouraging visitations and avoiding time oriented questions. The mother should be encouraged to feed her baby on cue and taught what a hunger cue looks like.
It is our ethical responsibility as health care workers to discuss the risks of artificial supplementation before providing it to the mother in any capacity.
Birth Matters
The first hour after delivery the infant is alert and needs skin to skin contact to raise basal body temperatures, set respiratory patterns and begin colonizing bacteria on the skin. All assessments should be postponed or done at the breast, including heel pricks.
Mothers that are given the chance to nurse unrestricted in a reclined or laid back position experience less nipple pain and greater milk transfer, as a result of an infants increased ability to latch.
Baby Friendly USA
1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
2. Train all health care staff in skills necessary to implement this policy.
3. Inform all pregnant women about the benefits and management of breastfeeding.
4. Help mothers initiate breastfeeding within one hour of birth.
5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from
their infants.
6. Give newborn infants no food or drink other than breast-milk, unless medically indicated.
7. Practice "rooming in"--allow mothers and infants to remain together 24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no pacifiers or artificial nipples to breastfeeding infants.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge
from the hospital or clinic.
World Health Organization and UNICEF
There is only 1 Baby Friendly Hospital in Idaho
Believe in the Birth and
Breastfeeding as a Biological Process.

"Referring to birth/breastfeeding as a medical process damages a mothers efficacy. She no longer believes her body is capable of birthing or breastfeeding her child. Indeed the most significant thing you can do to help a mother breastfeed is to restore her belief in her body as the "perfect" vessel for birthing and nurturing her child" (Molly Pessl BN, IBCLC, Lactation Conference 2011)
Watch what babies can and will do, if given the chance!
If complications arise there are many other ways to feed a baby without a bottle, it is up to the nurses to communicate this with physicians and colleagues.
Protect Supply
Homemade finger feeder
Spoon Feeding
5 mm french feeding tube for finger feeding
Cup Feeding
Monoject periodontal syringe at breast
Hand Express Colostrum
It is un-ethical to solicit the sale of formula in hospitals or medical practices. Encourage mothers to leave the
free gifts behind or they will use them!
http://www.who.int/nutrition/publications/code_english.pdf
World Health Organization Code for Ethical Marketing
Become Informed
Teach em' to Express Themselves
Colostrum is best collected through self-expression, use a syringe to collect the drops as mother massages, feed to baby. A pump will waste it!
Medical grade pump can be obtained from medicaid and/or WIC
for qualifying patients. Use if baby not latching for stimulation.
Learn how to self express here:
You will need;
Bachelors in a Health Field
90 CERPS (obtain online or conference)
1000 hours helping mothers
La Leche Leauge
Internship
WIC Peer Counselor
Become a Certified Lactation Counselor
Visit this site for more info on conference dates http://www.healthychildren.cc/CLC%202012S%20PDF.pdf
Become a Lactation Consultant
Take the International Board Certified Lactation Exam IBCLE

OR
EARN NURSING CREDITS
U.S. Department of Health and human Services (2011). The Surgeon Generals Call to Action to Support Breastfeeding.
http://www.surgeongeneral.gov/topics/breastfeeding/calltoactiontosupportbreastfeeding.pdf
Center for Disease Control and Prevention. (2011) Breastfeeding Report Card 2011, United States: Outcome Indicators.
http://www.cdc.gov/breastfeeding/data/reportcard2.htm
UNICEF. The baby friendly initiative. (2005). U.K. breastfeeding rates.
http://www.unicef.org.uk/BabyFriendly/About-Baby-Friendly/Breastfeeding-in-the-UK/UK-Breastfeeding-rates/
USDA, FSN. (2010) WIC Breastfeeding Peer Counseling Study
Final Implementation Report.
http://www.fns.usda.gov/ora/menu/published/wic/FILES/WICPeerCounseling.pdf
References
Google Doc link for more resources;
https://docs.google.com/a/nnu.edu/document/d/1vYhl0JEKymwjQWr439ni0AscFDn-mCSrNFsKquxy6CU/edit#heading=h.hxvnye9u8c56
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