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Session 4 Power Point - PowerPoint PPT Presentation


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Welcome Back! Crossword Puzzle (Review of Session 3) Review answers as a large group See “Crossword Puzzle Key” (Handout #5) Preview of Session 4 Silently read the topics for Session 4 What are you most interested in learning about? Helping Mothers with Special Challenges

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Presentation Transcript
welcome back
Welcome Back!
  • Crossword Puzzle (Review of Session 3)
    • Review answers as a large group
    • See “Crossword Puzzle Key” (Handout #5)
  • Preview of Session 4
    • Silently read the topics for Session 4
    • What are you most interested in learning about?
breastfeeding challenges
Breastfeeding Challenges
  • Twins
  • Premature baby
  • Premature twins
  • Sick baby
  • Baby with other medical problems
  • Sick mother / diabetes
how to help
How to Help
  • Listen – let her talk about her feelings
  • Refer to a lactation specialist if they…
    • Have trouble breastfeeding
    • Are told to stop breastfeeding
  • Ask health care provider ways to treat problem
  • Your support can make a difference!
discussion twins
Discussion: Twins
  • Did any of you breastfeed twins or

know a mother who has breastfed

twins?

twins
Twins
  • Most women make PLENTY of milk for twins
  • Nature made it possible to feed 2 babies
  • Breastfeeding can be easier and take less

time than preparing bottles and formula for

two babies

suggestions
Suggestions
  • Start by feeding one baby at a time
  • Comfortable - try feeding babies same time
  • Baby with strongest suck start on different

breast each time

    • Milk removed from both breasts
    • Reduces engorgement
    • Helps maintain good milk supply
more suggestions
More Suggestions
  • Let babies sleep in same crib
  • Get help shopping, cooking, cleaning, etc.
  • Keep snacks nearby
  • Rest when possible
  • Join a twin or multiple support group
discussion twins10
Discussion: Twins
  • What positions do you think would be

helpful for a mother breastfeeding two

babies at the same time?

  • Compare your list to page 96
activity twins
Activity: Twins
  • Activity
    • Find a partner
    • Practice teaching breastfeeding babies

at same time

    • Use dolls/stuffed animals
    • Take turns being mother and peer

counselor

discussion premature babies
Discussion: Premature Babies
  • Has anyone had or known someone who

has had a premature baby?

  • What was it like for the mother?
  • What helped her?
  • What would have been helpful?
premature babies
Premature Babies
  • 37 weeks or earlier
  • May be tiny and weak or healthy
  • Some cannot breastfeed in beginning
  • May need to pump until baby can breastfeed
  • Mother of premature baby makes special milk that meets baby’s needs
doctors recommend breastmilk
Doctors Recommend Breastmilk
  • Often prescribe breastmilk - premature babies
    • Some add extra calories, vitamins and minerals
    • Premature babies fed breastmilk:
      • Higher IQ - helps brain develop
      • Sick less often
      • Protects against necrotizing enterocolitis
how to help15
How to Help
  • Let the mother know:
    • Giving breastmilk – something only she can do
    • Breastfeeding gets easier as baby grows
    • Focus on breastfeeding/pumping - caring for baby
  • Help her get a breast pump from WIC
  • Instructions - pumping/storing/labeling breastmilk
  • Provide extra help and support
  • Be a good listener!
discussion sick baby
Discussion: Sick Baby
  • Who has known a breastfeeding mother

whose baby was sick or in the hospital?

  • How did breastfeeding go?
  • What happened?
  • What could you have done to help?
babies who are sick
Babies Who are Sick
  • Most get better faster with breastmilk
  • Breastfeed to prevent dehydration
  • Breastfeed more for comfort
  • Some only want to breastfeed when sick
  • Some too weak to breastfeed or do not want to
    • Talk about pumping to keep up milk supply
    • REFER her to baby’s health care

provider or a lactation specialist

babies in the hospital
Babies in the Hospital
  • Encourage mother spend time with baby
  • Breastfeed soon after any test or surgery
  • Talk with health care provider
  • If the baby can’t breastfeed…
    • Pump as often as she would breastfeed
    • Help get pump from WIC
mothers with diabetes
Mothers with Diabetes
  • Hard time controlling sugar in blood
  • Eat right, exercise and take medications
  • Can get heart disease, kidney disease or

become blind

mothers with diabetes20
Mothers with Diabetes
  • CAN breastfeed
  • Breastfeeding:
    • Improves the mother’s health
    • May reduce how much medication needed
    • May protect baby from getting diabetes later
  • Most medications are OK with breastfeeding
  • Suggest she talk to health care provider

BEFORE baby is born

discussion
Discussion
  • Divide into small groups - answer these:
    • If you were sick (colds, flu, etc.) while you

were breastfeeding, what did you do?

    • What did others tell you to do?
    • How could you help a mother who is sick keep

breastfeeding?

    • Share with the group
mothers with minor illnesses
Mothers with Minor Illnesses
  • Most of the time - can continue breastfeeding
  • Colds and flu do not pass through breastmilk
  • By the time mother knows - baby already exposed
  • Mothers give antibodies to their babies
    • May keep the baby from getting sick
    • Baby will get better faster
  • Everyone should wash their hands

before touching baby!

mothers in the hospital
Mothersin the Hospital
  • Talk to her about:
    • Can baby stay with her in the hospital?
    • Hospital let someone bring baby to breastfeed?
    • Will hospital let her use their electric pump?
    • If she can’t pump on her own, can someone help?
    • Where can she store milk in the hospital?
    • Can she pump & store breastmilk before

going to hospital?

mothers who are sick
Mothers Who are Sick
  • Mother told not to breastfeed due to illness or

treatment, talk to her about…

    • Pump & throw away breastmilk - keep up supply
    • Has she talked to a lactation specialist? Different

medication that will work with breastfeeding.

    • Get breastmilk from the human milk bank
activity
Activity
  • What questions do you have about helping a mother who is sick or in the hospital continue to breastfeed?
tuberculosis tb
Tuberculosis (TB)
  • Lung disease treated with medication
  • Close contact with person with active TB
  • A mother with active TB can breastfeed after:
    • Taking medication for 2 weeks, and
    • Health care provider tells her it’s OK
  • Questions? REFER her to health care provider or a lactation specialist
hepatitis
Hepatitis
  • Liver infection
    • Hepatitis A
      • CAN breastfeed - protects the baby
    • Hepatitis B
      • Babies now get vaccines
      • CAN breastfeed
    • Hepatitis C
      • CAN breastfeed - if doesn’t have HIV
sexually transmitted infections sti
Sexually Transmitted Infections (STI)
  • Most mothers can breastfeed
  • Most medications are safe
  • Herpes or syphilis - can breastfeed

(unless has open sores on her breasts)

  • Can pump on that side until healed
    • Any part of pump kit touches sore - throw out milk
  • Refer to lactation specialist or health care provider - if open sore on breast
should not breastfeed
Should NOT Breastfeed
  • HIV - (Formula is a safe alternative)
  • Human T-Cell Leukemia Virus
  • Chemotherapy
activity30
Activity
  • Divide into groups of 3
  • Complete item G on page 102
    • Make sure each person is the “counselor”, “mother” and “observer”
    • After each role-play, discuss questions on page 103 within your group of 3
  • Share how your “counseling” went with the large group
helping with grief
Helping with Grief
  • Difficult challenge
  • Mothers experience…
    • Extreme sadness
    • Some will not want to talk
    • Others want to talk / need a shoulder to cry on
    • Some will be angry / depressed
    • Others will be in denial
    • Some need more time to adjust
  • No right or wrong way to grieve
how to help33
How to Help
  • Be a good listener & understanding
  • Let the mother talk about her feelings
  • Remember her grief is her own
  • Listening & being supportive - BEST way to help
  • When appropriate, recommend a support group
  • Let lactation specialist know if mother

needs help with breastfeeding/weaning

activity grieving mother
Activity: Grieving Mother
  • In small groups…
    • Make a list of reasons a pregnant woman or someone who has recently given birth may be experiencing grief. (Compare to list on page 106)
    • Discuss how your family & friends helped you cope with a loss…
      • How did they make the situation a little easier?
      • What would you avoid saying?
  • Share with the large group
expressing milk36
Expressing Milk
  • Helps mother to start making milk
  • Helps keep her milk supply up
  • Mothers express breastmilk when:
    • Babies cannot breastfeed
    • They are away from their babies
ways to express milk
Ways to Express Milk
    • Hand expression
    • Manual pumps
    • Battery operated pumps
    • Semi-automatic pumps
    • Personal use electric pumps
    • Hospital grade electric pumps
  • Lactation specialist can help choose best pump (for situation)
discussion38
Discussion
  • In small groups, share your experience

with expressing milk

    • How did you express milk?
    • What was your reason for expressing milk?
    • How did it work out?
expressing milk by hand
Expressing Milk By Hand
  • Easy way for some mothers to express milk
  • Some like this method better than using a pump
  • Facilitator will demonstrate one method of hand

expression (using a breast model)

  • See steps on page 108
  • Optional activity – practice hand expression using a water balloon
manual pumps
Manual Pumps
  • Not expensive
  • Used by mothers who will not be pumping very often
  • 3 types of manual pumps:
    • Cylinder pumps

(e.g. Medela manual pump)

    • Trigger pumps
    • Rubber bulb pumps

(bicycle horn)

battery operated pumps
Battery Operated Pumps
    • Suction controlled
    • Mothers who only pump a few times per week
    • Batteries need to be changed often
    • Used pumps may not work well
  • Mothers should NEVER share a manual orbattery operated pump with other mothers!
electric pumps
Electric Pumps
  • For mothers who need to express milk many times during the day
  • Pump both breasts at same time
  • 3 types of pumps
    • Semiautomatic
    • Personal Use
    • Hospital Grade
putting together pump kit
Putting Together Pump Kit
  • Watch facilitator put together a pump kit & connect it to an electric pump
  • Divide into groups
    • Practice putting pump kit together
helpful tips for pumping
Helpful Tips for Pumping
  • Let mother know…
    • Normal for one breast to give more milk
    • Normal for milk to change color
    • Continue pumping after 1st Milk Ejection Reflex
      • Milk flow will slow or stop
      • Another MER will occur - more milk will flow
activity47
Activity
  • Find and review Handout #6

“Collecting and Storing Breastmilk When

You’re Away”

    • How would handout help a mother returning

to work/school?

  • Share in the large group
  • What questions do you have about handling, storing and using breastmilk?
weaning49
Weaning
  • Baby fed anything other than breastmilk
  • Most of us think of weaning - stop breastfeeding
  • In the U.S. – often begins in the hospital
  • Once mothers start giving formula - breastfeed

less & stop sooner

weaning50
Weaning
  • Around world most mothers breastfeed - 3 yrs. old
  • In the U.S. – most mothers wean by 4 months
  • If mother decides to wean before 1st birthday

Give formula - NOT cow’s milk!

  • Some babies wean themselves
weaning51
Weaning
  • Wean slowly
  • If stop suddenly…
    • Baby loses favorite way to be comforted
    • Mother’s breasts may become engorged
  • Can be an emotional time for mother
    • Some feel sad
    • Others feel satisfied - ready to stop
weaning52
Weaning
  • Examine your own beliefs about weaning so you can help each mother decide what is best for herself, her baby and her family
activity53
Activity
  • Find a partner and share:
    • How old was your baby when you or your baby

started the weaning process?

    • What were the reasons for weaning your baby?
    • How did your baby react to breastfeeding less often or being weaned?
    • How did you feel about weaning?
cultural awareness
Cultural Awareness
  • Take a closer look at different ethnic groups

and see how we are alike and different

  • Information is not meant to “stereotype”
  • Meant to help you be able to help many

mothers breastfeed

activity cultural awareness
Activity: Cultural Awareness
  • Which ethnic group do you identify with most
  • Find others that share your ethnicity - form group
    • Make a list of answers to 5 questions on pg. 113 (use flip chart)
  • Share list with the larger group
closing activity
Closing Activity
  • Sunshine Wheels
    • Complete this activity (item A on page 114)
  • Revisit our “Learning Tree”
    • What topics were covered today that you wanted to learn more about?
homework
Homework
  • Practice the 3-Step Strategy
      • Ask questions
      • Affirm feelings
      • Educate (when appropriate)
    • More you practice - Easier it will become!
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