Training of Roma Health Mediators in Reproductive Health

If a mother has large and low breasts, support may help her milk to flow, because it
makes it easier for the baby to take the part of the breast with the tubes into his mouth.
• Explain how she should touch her baby's lips with her nipple, so that he opens his
mouth.
• Explain that she should wait until her baby's mouth is open wide before moving
him to her breast. His mouth needs to be open wide to take a large mouthful of
breast. It is important to use the baby's reflexes, so that he opens his mouth wide
to take the breast himself. You cannot force a baby to suckle.
• Explain or show her how to move her baby to her breast quickly when he is
opening his mouth wide:
o Bring your baby to your breast. Do not move yourself to your baby.
o Aim your baby's lower lip below your nipple, so that his chin will touch your
breast.
• Notice how the mother responds. (The participant playing the “mother” should
say, "Oh, that feels better!", and look happier.)
Explain to participants:
o If you improve a baby's poor suckling position, a mother sometimes
spontaneously says that it feels better.
• You may need to work with the mother again, until breastfeeding is going well. If
she is having difficulty in one position, try to help her to find a different position
that is more comfortable for her (for example, in one of the positions described
below).
2. Demonstrate other ways for a mother who is sitting
You can do this demonstration more briefly than the previous one. It is not necessary to
repeat every step in detail.
Follow these steps:
• Help the “mother” to hold her baby in the underarm position.
• Ensure that the “mother” remembers and practices the above four key points. She
may need to support the baby with pillows at her side.
Explain to participants:
o The baby's head rests in the mother's hand, but she does not push it to the
breast.
o The underarm position is useful:
• If she is having difficulty attaching her baby across the front;
• To treat a blocked duct;
• If a mother prefers it.
• Show the ‘mother’ how to hold her baby with the arm opposite to the breast.
• Ensure that she remembers and practices the above four key points. If she needs
to support her breast, she can use the hand on the same side as the breast.
Explain to participants:
o The mother's forearm supports the baby's body.
o Her hand supports the baby's head, at the level of his ears or lower. She does
not push at the back of the baby's head.
o This way of holding a baby is useful:
- for very small babies;
144
RFHI/JSI Romania Training of RHMs in Reproductive Health Session 9: Breastfeeding