
Protecting Babies: Breastfeeding and Sleeping. Learning Objectives. By the end of this presentation, participants will be able to:
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By the end of this presentation, participants will be able to:
1. State recommendations for breastfeeding initiation and duration rates of the American Academy of Pediatrics (AAP), the World Health Organization (WHO), and the breastfeeding goals of Healthy People 2010.
2. Provide anticipatory guidance on:
- importance of breastfeeding
- needs of babies
- benefits of breastfeeding exclusively for first six months
3.Discuss the risks and benefits of parent-infant bed
sharing.
4. Discuss the AAP safe sleeping recommendations for breastfeeding mothers.
5.Provide information on continuum of safe sleeping environments.
“…exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first six months of life… Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.”
(AAP, 2005)
“…exclusive breastfeeding for six months is the optimal way of feeding infants. Thereafter infants should receive complementary foods with continued breastfeeding up to two years of age or beyond.”
(WHO, 2007)
(Modified from Labbok M, Krasovec K: Toward consistency in Breastfeeding definitions. Stud Fam Plan 21:226, 1990. Cited in Lawrence, 2005)
(DHHS, Office of Disease Prevention and Health Promotion, 2005)
(CDC, National Immunization Survey, 2005)
(Statewide WIC Crystal Reports data, WIC Moms)
(Forste R. et. al, Pediatrics, 2001. Cited by M. Biancuzzo, 2003)
For rural Ghana:
(Edmond K et al (2006) Delayed Breastfeeding Initiation Increases
Risk of Neonatal Mortality. Pediatrics, 117:380-386)
“In low resource areas…Improved breastfeeding alone could save the lives of more than 3,500 children every day, more than any other preventive intervention.”
(Innocenti Declaration, 2005. Cited in “Invest in Breastfeeding”, 2007. LLLI, WABA, WHO)
(Adapted from AAP. “Infant Nutrition During a Disaster,” 2007)
Are about:
(National Breastfeeding Awareness Campaign Draft of Original Risk Statements from studies from developed countries. Cited by Walker, NABA, 2004.)
Are about:
(National Breastfeeding Awareness Campaign Draft of Original Risk Statements from studies from developed countries. Cited by Walker, NABA, 2004.)
(adapted from Breastfeeding and the Use of Human Milk, AAP 2005)
(Adapted from United States Breastfeeding Committee, 2002)
(“WHO Code”).
UNICEF/WHO.
(Biancuzzo, 2003)
(CHD Guidebook, TAG: Maternal 9.)
(ILCA, Core Curriculum…, 2007)
(ILCA, Core Curriculum, 2007)
(Division of Child Health and Development. Evidence for the ten steps to successful breastfeeding. Geneva: WHO. 1998- Cited in Core Curriculum, 2007.)
(Klaus, M. The Amazing Newborn, 1998. Cited in ILCA “Background Information” WBW 2007.)
(Walker, “Artificial Baby Milks” Core Curriculum, 2007)
(Simmer, 2003; Wright et al., 2006- cited in Mannel, Martens, Walker. ILCA, 2007)
(Christensson et al., 1995, cited by McKenna, 2007)
(Christensson et al., 1995, cited by McKenna, 2007)
(McKenna, 2007)
(Step 4 - Baby Friendly Hospital Initiative’s (BFHI), “Ten Steps to Successful Breastfeeding.”)
(ILCA.“Background Information, Breastfeeding: The 1st Hour-Welcome Baby Softly, WBW, 2007.)
(Uvnas, 1998)
(Charpak, 2001. cited by ILCA, WBW, 2007)
Step 9 – Baby Friendly Hospital Initiative’s (BFHI), “Ten Steps to Successful Breastfeeding states
(
“All breastfeeding newborn infants should be seen by a pediatrician or other knowledgeable and experienced health care professional at 3-5 days of age…and a second…visit at 2-3 weeks of age….”
(AAP Policy Statement, Section on Breastfeeding, 2005)
(Clinical Guidelines for the Establishment of Exclusive Breastfeeding, ILCA, 2005)
(Clinical Guidelines for the Estab. Excl Breastfeeding, ILCA, 2005)
(Loving Support© Through Peer Counseling, 2005)
“What have you heard about breastfeeding?” Does not lock her into a choice.
(“It hurts!!-I don’t want to do it.”)
(Loving Support©Through Peer Counseling Curriculum, 2005)
“I don’t blame you, Latoya. Many women are worried about pain. No one wants to do something that hurts.”
(May feel heard and open to new ideas.)
(Loving Support©Through Peer Counseling Curriculum, 2005)
“How would you feel about breastfeeding if it didn’t hurt?” (Latoya: “I’d try it.”)
“Breastfeeding isn’t supposed to hurt. When your baby takes enough of your breast far into her mouth, your nipple isn’t pinched and you are comfortable.”
(Loving Support© Through Peer Counseling Curriculum, 2005)
LLL, 24- hour toll- free hotline: 1-877-452-5324
There is disagreement among health care professionals about the benefits and risks of parent-infant bed sharing.
SIDS
Suffocation
Falling out of bed
Benefits:
Increased breastfeeding
Enhanced closeness
Increased awareness and response to infant needs
More infant arousals and less deep sleep for infant
Benefits and Risks of Bed Sharing“When all known adverse bedsharing risks are avoided, breastfeeding and bedsharing infants are under represented in SIDS and SUID populations.”
(McKenna, 2007)
Source: Ruys J Acta Paediatrica 2007
Carpenter R Paediatr Child Health 2006
(McKenna, 2007)
(McKenna, 2007)
(Survey conducted by Palm Beach County Health Department)
In 2005 the task force came out with new recommendations for reducing the risk of SIDS in the general population.
They recommended that infants not bed share during sleep.
Many groups came out in opposition to this specific recommendation.
(Policy Statement, 2005)
A separate, but proximate sleeping environment: room share. Use cribs that meet current safety standards.
Provide Education During Postpartum Hospital Stay
(McKenna, 2007)
(Academy of Breastfeeding Medicine, 2005b)
(Academy of Breastfeeding Medicine, 2005b)
“Mother and infants should sleep in proximity to each other to facilitate breastfeeding.”
(McKenna, 2007)
(Academy of Breastfeeding Medicine, 2005b; Sears, 2005; McKenna, 2007)
all pediatric scientists agree that co-sleeping in the form of room sharing should be supported not only because it facilitates breastfeeding but because a mother sleeping proximate to her infant reduces the infant’s chances of SIDS.”
Source: McKenna J Sleeping With Your Baby, 2007
“The baby at the breast represents the common language of mothering. Babies have basic needs that do not change, regardless of when or where they are born. And the beautiful natural act of nursing your little one has this same timeless quality. It is a link to other mothers and sign, even, of womanly power. The ability of a mother’s body to nurture her child is a source of strength to her. And through breastfeeding’s gentling effect, an island of peace is secured. It is a small miracle, belonging rightfully to mothers, babies, and families the world over.”
(LLLI, The Womanly Art of Breastfeeding, 2004, cited in“Invest in Breastfeeding”, 2007. LLLI, WHO, WABA)