2.2 Step/Point 3

Breastfeeding education during pregnancy

All mothers should receive sensitive counseling that will assist them to make an informed decision on the most appropriate infant feeding method for them. Informed decision-making is not possible when mothers have not received sufficient information on which to base their choice.

Information to be discussed

why breastfeeding is important and the risks associated with artificial feeding or supplements given before 6 months of age
non-pharmacological pain relief during labor, and the effect of drugs used in labour on both the newborn and the initiation of breastfeeding
the importance of early, uninterrupted skin-to-skin contact between mother and newborn until the first breastfeed, and why 24-hour rooming-in following this is important
why bottle teats (nipples) and dummies (pacifiers) are discouraged
basic breastfeeding management, including positioning and attachment, responding to feeding cues and frequency of feeding to ensure optimal milk production
indications that the infant is receiving sufficient breastmilk
the importance of 6 months of exclusive breastfeeding followed by continued breastfeeding with the addition of appropriate complementary foods
the availability of breastfeeding support groups and services in the community

There should be no group discussion or demonstration of artificial infant formula preparation or feeding.
The World Health Organization Code on the Marketing of Breastmilk Substitutes precludes the display of products covered by the Code and the promotion of those products.

Review your knowledge

When you completed the initial education required for Baby Friendly you will have studied each of these topics.
Look at them again now and make notes of the key points to discuss with mothers and their support people. If your knowledge needs refreshing re-read your original notes or speak with your Unit's educator.

It is important that you keep your knowledge up-to-date. Firstly the mothers in your care will benefit, but you may also be asked how you discuss any of those topics with mothers by the Baby Friendly assessor.



	Clinical Skills Competency: Communicating with pregnant women about breastfeeding Click on the link to download the Skills Competency. Even if this is not a requirement of you at this time it will provide good 'refresher' training, ensuring you continue to provide the very best care. Review the study materials and notes you made during your initial breastfeeding education.

Implementation



	How is this education scheduled for all parents in your Unit? How is it recorded that each mother received this education? Group sessions are acceptable, however all parents should also have the opportunity for private counseling and discussion if desired.

Activity



	Team up with some colleagues and locate all the parent information literature on breastfeeding that is distributed during pregnancy. Review it for accuracy, recency and that the content covers the material to be discussed. If changes are warranted, draft them and present them to the appropriate authority in your Health Unit. Who is the publisher or sponsor of the literature? Companies whose products infringe the WHO Code are not permitted to provide education directly to parents.



	'Gifts' for mothers Many hospitals give mothers a bag of promotional materials and samples when they book-in to have their baby. Randomly select one of these bags and review the contents. Read all the literature contained in it to ensure it conforms to evidence-based recommendations. Look through any parenting magazines provided too - do their articles and advertisements conform to the WHO Code on the Marketing of Breast-milk Substitutes? What are the samples? Giving food samples or redeemable vouchers for food for the baby is not appropriate. Is there a procedure in place for each 'batch' of new bags received to be reviewed? This is a worthwhile exercise.

Beware!



	Don't violate the WHO Code Look around your Unit. What can you see? Do you see breastfeeding supportive posters and literature? Look carefully: is there any artificial infant formula manufacturer-sponsored literature or 'give aways' visible, eg. cups, tape measures, pens, diaries, mobiles, cot cards, note paper, posters, etc?

Refer to the Policy



	Find the section that outlines the education to be provided for parents during pregnancy. Does it cover the issues relevant to this Step/Point? Only applicable if your health care facility provides antenatal services, such as a booking-in clinic, antenatal clinics, antenatal classes or antenatal inpatient care.

What should I remember?



	by what stage of pregnancy each mother should have received breastfeeding education the topics that must be covered with each mother, and how you will counsel her on these topics the literature given to mothers and/or displayed in the unit should all be evidence-based, comply with the WHO Code on the Marketing of Breastmilk Substitutes, and not be sponsored by an organization that infringes the WHO Code.