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BREASTFEEDING MODULE (SCORPIO)
Aim: To understand breastfeeding anatomy and lactation physiology and how this relates
to effective breastfeeding.
Teaching method:
- Interactive station that uses tell-show-do-feedback to ensure participation of participants
c. Identify ovaries
- Progesterone
- Estrogen
II. HORMONAL CONTROL OF MILK PRODUCTION
B. PROLACTIN
- blood levels increase during pregnancy, stimulating the growth and development of
breast tissue in preparation for milk production
- triggers the cells of the alveoli to secret milk
- hormone that makes the alveoli produce milk
- under the influence of prolactin, breasts start to make large quantities of milk
- usually takes 30-40 hours after birth before large volume of milk is produced
- colostrum present when baby is born
- infant attaches & stimulates nerve endings in areola, sends signal to hypothalamus to
reduce prolactin inhibiting factor, hence prolactin release
- suckling of baby at the breast increases and stimulates milk production by the alveoli
(“supply and demand” feedback mechanism)
- night time feedings are important because more prolactin is produced at night
- prolactin induces relaxation in mothers & promotes sleep
C. OXYTOCIN
- causes muscle cells around the alveoli to contract & makes milk flow down the ducts
(MILK EJECTION REFLEX/OXYTOCIN REFLEX/LET DOWN REFLEX)
- suckling of baby on mother’s breast stimulates the “let down reflex”
- oxytocin also induces a state of calm and reduces stress
- Participants are handed out metacards & categorize which of the factors PROMOTE or
INHIBIT milk production
- Facilitator provides reinforcement or correction to participants
Do: 10 minutes
- The participants will be asked to explain how milk gets from the breast to the baby, mention
the promoting and inhibiting factors for breast milk production
Feedback: 10 minutes
RESOURCES:
1. Facilitator
2. Anatomical and physiological model of breastfeeding (infant, breast and brain picture)
3. Labels for anatomy and hormones
4. Picture of hormone levels in pregnancy and lactation
5. Picture of mother and baby with prompts for the ‘let-down’ down reflex, and
6. Labels for promoting and inhibiting factors
STATION NO. 2: ESTABLISHING EARLY AND EFFECTIVE BREASTFEEDING
Aim: That all participants are able to facilitate and support early and effective
breastfeeding for mothers and newborns
Teaching method: Interactive session incorporating the concepts of tell, show, do, feedback
- Facilitator emphasizes the different phases a newborn goes through before the first successful
breastfeeding as follows:
1. Birth cry - intense crying immediately after birth
2. Relaxation - no activity of head, arms or body
3. Awakening - small thrusts of head up & down, side to side
4. Active - moves head & limbs without moving body, rooting
5. Crawling - pushing which moves body
6. Resting - rests with some activity, such as sucking on hands
7. Familiarization - infant has reached areola/nipple with mouth
8. Sucking - infant starts to suckle
9. Sleeping - infants has closed its eyes - moves head & limbs without moving body, rooting
• Without knowledge of these steps, health care personnel may interrupt these innate
behaviour contributing to delay in first successful breastfeeding
- Participants will be asked to identify signs of good attachment and positioning through the
use of metacards
- Facilitator uses breast model and hand to demonstrate the signs of good attachment as
follows:
- (1) mouth wide open
- (2) lower lip turned outwards with a furrow below it
- (3) chin touching or almost touching the breast
- (4) more of the areola visible above the baby’s top lip than below the lower lip
- Facilitator uses baby doll to demonstrate good positioning as follows:
- (1) baby’s body should be straight, not bent or twisted
- (2) the baby should face the breast
- (3) baby’s body should be close to the mother
- (4) entire body, not just the head and neck should be supported
- Participants will be asked to identify incorrect signs of attachment & positioning via pictures
V. Breastfeeding Positions
- Facilitator uses a breast model, baby doll and asks for a volunteer to demonstrate the actual
breastfeeding positions. Facilitator also emphasises the C-hold.
Tell-Show: (5mins)
- Facilitator demonstrates the different feeding cues using pictures
- Increase alertness, movements of arms and legs
- Mouthing
- Licking
- Tonguing
- Hand to mouth
Tell-Show: (3 mins)
- Facilitator mentions that stable LBW infants can do direct breastfeeding
- Pictures of breastfeeding LBW infants are shown
RESOURCES:
1. Facilitator
2. Slides
3. Videos
4. Breast model
5. Baby doll
6. Metacards for attachment & positioning