Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
Place an Identification Label on the Baby
Place the identification tag /label on the wrist and ankle (as recommended by the Ministry of
Health). If a ready-made disposable identification is not available, prepare one locally using
sticking plaster and gauze strips. Note, at a minimum, the names of the mother and, if available,
the father, and the date and time of birth.
Early, Exclusive Breastfeeding
• Inform the mother about the importance of colostrum and encourage her to initiate
breastfeeding early within one hour of birth, without giving the baby any other milks, fluids,
or foods.
• Tell the mother to breastfeed the baby frequently and on demand, day and night (about 8-10
times in 24 hours).
• Advise the mother not to use pacifiers.
• Assist the mother to breastfeed the baby within the first hour after the birth/before
transferring out of the delivery room. Help the mother to find as comfortable a position as
feasible. Some of the steps noted below may need to be modified depending on the type of
table available in the delivery room. Make sure that:
o The baby’s whole body is fully supported and held close at the level of the breast and
turned toward the mother.
o The mother, if possible, holds the breast with thumb on top and other fingers at the
bottom without touching the nipple.
o When the baby opens his/her mouth widely, the nipple and most of the surrounding
areola are introduced into the mouth.
o The baby’s nose is not blocked by the breast tissue.
o The mother does not feel pain in the nipple when the baby sucks. If she does, show her
how to release the nipple from the baby’s mouth (by gently depressing the baby’s chin)
and reintroduce the nipple after the pain subsides.
o That attachment at the nipple is appropriate (see Figure 5.7 below).
o Unrestricted time is allowed for the feeding.
Signs of a proper attachment:
• The baby’s chin is touching or nearly
touching the breast.
• The mouth is wide open.
• The lower lip is everted (turned outward).
• Most of the areola is inside the mouth,
especially the part below so that the areola
is visible more above the mouth than
below.
• The sucking is slow and deep and
swallowing is audible.
Figure 5.7. Signs of proper attachment at the breast. (WHO, 2003)
Integrated maternal and newborn care
Basic skills course
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