2.4 An example
An example of good communication skills
Mother: | My child won't eat even though she is eight months old. She is only breastfeeding. |
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Health Worker: | It is wonderful that you are breastfeeding - that's still her best food. (approval) But you are right to offer her other food too. (agreement) |
Mother: | I give her porridge in her bottle but she spits it out and cries. |
Health Worker: | I see (acceptance, no criticism). What have you thought of doing? (exploring) |
Mother: | Well, I tried not breastfeeding her so much but she cried too much. |
Health Worker: | She really likes your breastmilk - she's a clever girl! (approval) How does she act when the other children are eating? (open question) |
Mother: | She cries and reaches for their food, but she is still too little for the foods they are eating. |
Health Worker: | So she is eager to eat with the other children (summarising). Have you tried preparing food for her specially? Or feeding her while the others are eating? (offering ideas) |
Mother: | Do you mean cooking her special meals? I am really very busy. |
Health Worker: | Of course you are! (accepting) Some mothers cook all the vegetables and then just take some out, remove the skins and mash them. Then they can spoon feed the baby while the others are eating whole vegetables. (offering ideas) |
Mother: | Well, I could try that. It doesn't sound like a lot of extra work. (mother makes decision) |
Health Worker: | You mentioned using a bottle? (exploring) |
Mother: | I know I shouldn't, but sugar water keeps her quiet when I'm cooking. |
Health Worker: | It's difficult to get everything done (accepting), but I agree that the bottle isn't the best solution. (agreement, no criticism) |
How would you feel about giving her a piece of soft chapati or fruit to try her teeth on while you are cooking? (offering ideas) | |
Mother: | Well, perhaps (mother making decision). But won't she choke on these things? I thought babies needed to drink. |
Health Worker: | You're right, they do need drinks (agreement) but just your breastmilk. That gives all the sugar and water they need (information). Now that she sits alone, she can start learning about your family food, too. |
Mother: | Should I go on giving her porridge? |
Health Worker: | Yes, that's very good food, especially with some mashed pumpkin or mashed banana added. (information). |
Bottles are not the best way to feed babies (correct by giving information, not criticism). | |
She might enjoy porridge more from a spoon or cup (offering ideas). | |
They are easier to keep clean than a bottle anyway (information). | |
So, how do you think you can best feed your daughter now? (checking) | |
Mother: | Well, let's see. I will go on breastfeeding and giving her porridge. I could add some fruit or pumpkin, and mashed beans and vegetables that the others are eating. Did you say I can give her some chapati? (shows understanding) |
Health Worker: | Yes, that's fine. |
Good counselling makes a mother more confident and readier to learn. Notice that the healthworker responded to the mother's concerns. She came back to correct the mistakes of the bottle and the sugar water but gave information in a gentle way that did not criticise the mother. She checked that the mother understood what to continue doing and what to change.
(Counselling scenario adapted from WHO Counselling Course, Helen Armstrong)
Assessment Quiz
When you are happy that you've understood all the information in this topic you will be ready to complete the Module 2 Assessment. To do this, go to the course opening page, scroll down to the Assessment section and choose Module 2.