NATIONAL BREASTFEEDING POLICY
All mothers are encouraged to breastfeed their babies exclusively from birth to 6 months of age and to continue till the child is 2 years old.
Complementary food is recommended only when the baby reaches 6 months.
Birth 6 months 2 y/o
THE IMPORTANCE OF BREASTFEEDING FOR BABIES
• Perfect nutrition for baby
• Colostrum, the mother’s first milk, contains antibodies and is the baby’s first immunisation against bacteria and viruses.
• Lowers the risk of coughs, colds, ear infections, bronchitis, pneumonia, and meningitis
• Prevents colic and reduces the risk of gut infections and diarrhea
• Protects the baby from asthma, eczema, colds and food allergies
• Lowers the risk of the baby developing juvenile diabetes and heart disease
• Enhances IQ level
THE IMPORTANCE OF BREASTFEEDING FOR MOTHERS
weight Exclusively Breastfeeding contraction continue to breastfeed + introduce complementary foods
promotes bonding between mother and child reduces risk breast and ovarian cancer of loses to pre-pregnancy weight helps uterus and prevent uterine bleeding
THE IMPORTANCE OF SKIN-TO-SKIN
CONTACT IMMEDIATELY AFTER BIRTH
Immediately after birth, for at least one hour:
Immediately after birth, for at least one hour:
• Keep your baby warm and calm.
• Encourage bonding between you and your baby to facilitate breastfeeding initiation.
• Helps the baby learn that the mother’s breast is a safe place.
• Assist your baby in adjusting their metabolism and stabilising blood glucose levels.
• Enables colonisation of good bacteria from the mother’s body to the newborn.
• Allow the baby to have an earlier successful first breastfeed as well as more optimal suckling.
THE IMPORTANCE OF EARLY INITIATION OF BREASTFEEDING
Initiation breastfeeding as soon after birth within 1st hour of birth
To ensure the success of exclusive breastfeeding.
To ensure your baby quickly receives enough colostrum as newborns have a strong sucking instinct.
produced in first few days after birth
thick, sticky, and in colour
produced in small quantities suitable for your baby’s small stomach
COLOSTRUM
THE IMPORTANCE OF MOTHERS AND BABIES ROOMING-IN
WHY ROOMING IN?
Your baby cries less and sleeps more soundly.
After delivery, mother and baby stay in the same room day and night (24 HOURS)
You and your baby's sleep schedules are less likely to be disrupted when you are together.
It encourages bonding between you and your baby.
Feeding can follow your baby's cues, helping to sustain your milk supply.
You can monitor your baby at all times. Your baby has a lower risk of infection than being placed in a nursery.
Breastfeeding can be better supported, more consistent, and may help your baby gain weight more quickly.
THE IMPORTANCE OF BREASTFEEDING ON DEMAND OR BABY-LED FEEDING OR WHEN THE BABY SHOWS OF WANTING TO BREASTFEED (FEEDING CUES)
On Demand/ Baby-Led Feeding
• Guided by your baby’s needs and hunger cues.
• Whenever baby shows signs of hunger: feed on demand, not by the clock.
• Breastfeed as long as they want, allowing them to receive the hindmilk and release the breast on their own when they are full.
baby receives colostrum
cries
Signs of Hunger
Early cues - “I’m hungry”
• Stirring
mid cues -
• Mouth Opening
• Turning Head
• Seeking/Rooting
• Stretching
THE IMPORTANCE OF FREQUENT BREASTFEEDING TO ENSURE ADEQUATE BREAST MILK PRODUCTION
Breastfeed your baby frequently—on demand and whenever they show feeding cues, including during the night.
WAYS TO ENSURE ADEQUATE MILK PRODUCTION :
• Breastfeed as often as possible. If your breasts still feel full after feeding, express the remaining milk.
late cues“I’m really hungry” “Calm me, then feed me ”
• Increasing Physical Movement
• Hand to Mouth
• Crying
• Agitated Body Movement
• Turning Red
THE IMPORTANCE OF GOOD POSITIONING AND ATTACHMENT
• While feeding your baby on one breast, you can use a breast pump to express milk from the other side.
• Get enough rest, eat a balanced diet, and stay well-hydrated.
• Breastfeed directly on your non-working days.
• Express milk regularly at your workplace to maintain your milk supply.
• If you are working, breastfeed your baby before leaving in the morning and immediately after returning home in the evening.
1.Comfortable and relaxed
2.Sitting with her back well supported
3.Feet supported, if needed (e.g., with a footstool)
4.Supporting her breast, if needed, to help baby latch properly
Baby’s Position & Attachment
1.In line: Baby’s head, neck and back should be aligned.
2.Close: Baby is held close to the mother’s body.
3.Facing: Baby should be facing the mother’s breast.
4.Supported: Baby’s head, shoulder and buttock should be supported.
Good attachment: Poor attachment:
1. Baby’s mouth wide open.
2. More areola is visible above baby’s top lip than below the bottom lip.
1. Baby’s mouth is not wide open.
2. Baby’s lips point forward or turn inward.
3. Cheeks may be drawn in while sucking
3. Chin touching the breast.
4. Lips are curled out.
4. Baby’s chin does not touch the breast.
5. More of the areola is visible below the bottom lip
Notes: Signs of good suckling include baby’s cheeks are rounded and not drawn in during feeding, visible slow deep sucks, and gentle swallowing sounds like clicks or gulps.
Hand Expression
Handling Expressed Breast Milk
Aims of Expressing:
Maintain milk production
Relieve breast engorgement and blocked ducts
Soften the areola so the baby can latch properly
Guidelines:
1.Wash hands when handling expressed milk.
2.Use suitable containers:
- Glass/plastic containers with lids
- Clean/sterile condition (wash with soap and rinse with hot water
3. Store milk in amounts needed for one feeding or as per the baby's requirement.
Thawing Expressed Breast Milk
Do not heat breast milk in a microwave or directly on the stove
Thawed slowly by placing it overnight in the refrigerator's chill compartment. A bowl of hot water
Preparing of Breastfeeding When Returning to Work
Baby's feeding schedule before mother goes back to work
4. Label the storage container with the baby's name and date if multiple containers are stored.
5. Use previously expressed milk first.
Feeding Thawed Expressed Milk
CUP FEEDING SPOON FEEDING
if the amount is small
Thawed milk should be used within 24 hours and should not be REFROZEN.
Guide for working mothers:
• Train the mother or care giver to feed baby with expressed breast milk (EBM) 2 weeks before returning to work.
• After breastfeeding, any excess milk can be expressed and stored in a clean container.
(Write down the time and date and store in the freezer)
THE IMPORTANCE OF EXCLUSIVE BREASTFEEDING FOR FIRST 6 MONTHS, GIVING NO OTHER LIQUID OR FOOD
Exclusive Breastfeeding For First 6 Months:
• Exclusive breastfeeding from the birth till the age of 6 months of life.
• “Exclusive breastfeeding” is defined as giving only breast milk. No food or drink.
• Vitamin and supplement can be given if medically indicated and as advised by paediatrician.
Importance:
• Breast milk contains the ideal nutrition content and water needed to achieve optimal growth, development and health for the infants’ first 6 months of life.
• Reduces indigestion such as diarrhea or abdominal bloating.
• Reduces risks of respiratory infection.
• Breast milk contains antibodies that help your baby fight against viruses and bacteria.
THE IMPORTANCE OF CONTINUING BREASTFEEDING AFTER 6 MONTHS IN ADDITION TO GIVING COMPLEMENTARY FOOD
After 6 months:
• Your baby should be given complementary foods while breastfeeding should continue.
• Breast milk is crucial as it provides to ½ of your baby's energy needs at 12 months of age.
• Breastfeeding should be continued until your baby is 2 years old.
ADVICE ON STEPS OF EARLY INITIATION OF BREASTFEEDING
Practice skin-toskin contact Immediately breastfeed when the baby shows feeding cues. Practice rooming-in
Avoid the use of pacifiers and artificial nipples Learn proper techniques to position and latch the baby
reflex” “milk ejection reflex”
TECHNIQUES TO PROMOTE MILK FLOW OXYTOCIN
• Seeing, hearing, touching and thinking lovingly about baby
• Feeling pleased about her baby and confident
• Relaxing and getting comfortable for feeds
• Expressing little milk and gently stimulating the nipple
• Keeping the baby near
• Massage upper back Oxytocin Reflex
RISK OF GIVING WATER, FORMULA MILK AND REPLACEMENT MILK
1.Reduce breastfeeding frequency.
2.Reduce milk production.
3.Reduce the protective effect of breast milk.
4.Increase the risk of diarrhea and other infections.
5.Increase the risk of obesity.
6.Exposure to allergens that can cause eczema and asthma in babies.
IMPLEMENTATION OF MOTHER-FRIENDLY BIRTH AND CARE PRACTICES
THE IMPORTANCE OF HIV SCREENING TEST
Allow mothers to drink and eat light food during labour process (Low risk mothers).
Encouraging mothers to have companion of their choice for support during labour and birth.
Know your health status through an HIV test at a nearby health clinic or hospital near your residence. So that, you can discuss regarding your treatment plan and feeding option for your baby.
If you are confirmed HIV positive :
Mothers are encouraged to move and walk about before labour unless medically indicated.
Labour mothers are encouraged to use non-drug method of pain relief.
Invasive procedures to expedite labour such as episiotomy, caesarean section or assisted instrumental delivery will not be used unless you experience complications.
Please attend counseling sessions at nearby government health clinic or hospital.
HIV AND INFANT FEEDING
FindoutthefollowinginformationrelatedtoHIVandBABYFEEDING:
• Not all babies born to HIV-positive mothers will get HIV.
• Breastfeeding is NOT ALLOWED for all babies born to HIV positive mothers in this country to reduce the risk of infection.
• Approximately 20% of babies born to HIV positive mothers get HIV infection through breastfeeding.
• Mixed feeding (both breast milk and formula milk) should be avoided because it increases the risk of HIV infection, diarrhea and other infections.
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3
Wear a face mask all the time, especially when breastfeeding. Practice respiratory hygiene if there are symptoms.
• Cover the nose and mouth with a tissue during coughing or sneezing.
• Dispose of tissue in a closed container.
• Wash hand immediately afterwards.
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4
Practice hand hygiene before and after contact with the baby, including during breastfeeding and after coughing or sneezing.
Routine cleaning and disinfect surface touched by the symptomatic mother.
5
Reduce physical contact with baby during rooming in. Handling the baby for breastfeeding only.
6
Physical distancing with infants while not breastfeeding.
8 Avoid air conditioned room.
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Ensure good room ventilation.
WHERE TO GET HELP
Usefulinternetsourcesonbreastfeeding
Ifyouencounteranybreastfeedingproblemswhilebreastfeeding,please donotbeshytogethelp.Ifyouwanttobreastfeedsuccessfully,please seekadvicefromtheprofessional.
Herearesomecontactsthatyoucanreach:
KangarooClub
(BreastfeedingSupportgroupofPenangAdventistHospital) PenangAdventistHospital,465BurmaRoad10350Penang.
24hourshelpline
(+604)2227328
(+604)2227709 Mon-Thurs8am-5pmFri&Sun8am-1pm
FacebookPage& Sat&selectedpublicholidays:Closed lactation@pah.com.my(Attnto:LactationEducator) www.pah.com.my KangarooClubBreastfeedingSupportGroup
