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Training of Roma Health Mediators in Reproductive Health

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- for sick or disabled babies.<br />

3. Demonstrate how to help a mother who is ly<strong>in</strong>g down<br />

Ask the participant who is help<strong>in</strong>g you to demonstrate breastfeed<strong>in</strong>g ly<strong>in</strong>g down.<br />

[Note: She should lie down propped on one elbow, with the doll far from her body,<br />

loosely held on the bed]<br />

Follow these steps:<br />

• Help the “mother” to lie down <strong>in</strong> a comfortable, relaxed position.<br />

Expla<strong>in</strong> to participants:<br />

o To be relaxed, the mother needs to lie down on her side <strong>in</strong> a position <strong>in</strong> which<br />

she can sleep.<br />

o Be<strong>in</strong>g propped on one elbow is not relax<strong>in</strong>g for most mothers.<br />

o If she has pillows, a pillow under her head and another under her breast may<br />

help.<br />

• Show her how to hold her baby.<br />

• Ensure that the “mother” remembers and practices the above four key po<strong>in</strong>ts.<br />

She can support her baby with her lower arm. She can support her breast if<br />

necessary with her upper arm. If she does not support her breast, she can hold her<br />

baby with her upper arm.<br />

Expla<strong>in</strong> to participants:<br />

o A common reason for difficulty attach<strong>in</strong>g when ly<strong>in</strong>g down is that the baby is<br />

too high, and he has to bend his neck forward <strong>in</strong> order to reach the nipple.<br />

o Breastfeed<strong>in</strong>g ly<strong>in</strong>g down is useful:<br />

• when a mother wants to sleep, so that she can breastfeed without gett<strong>in</strong>g<br />

up;<br />

• soon after a Caesarian section, when ly<strong>in</strong>g on her back or side may help<br />

her to breastfeed her baby more comfortably.<br />

4. Demonstrate some common mistakes<br />

[Note: You can give these demonstrations quickly, hold<strong>in</strong>g a doll and a model breast<br />

yourself]<br />

Expla<strong>in</strong> that there are some ways a mother holds her baby, which make it difficult for<br />

him to attach to her breast and suckle effectively.<br />

Give the demonstration (follow these steps):<br />

• Use a doll to show these ways <strong>of</strong> hold<strong>in</strong>g a baby:<br />

o too high (for example, sitt<strong>in</strong>g with your knees very high);<br />

o too low (for example, with the baby unsupported, so you have to lean<br />

forward);<br />

o too far to the side (for example, putt<strong>in</strong>g a small baby too far out <strong>in</strong> the `crook'<br />

<strong>of</strong> the arm, <strong>in</strong>stead <strong>of</strong> on the forearm. This can happen if the mother holds her<br />

baby's bottom <strong>in</strong> the hand on the same side as the breast he is feed<strong>in</strong>g from).<br />

Expla<strong>in</strong> to participants:<br />

o If a mother holds her baby <strong>in</strong> these ways, his mouth will not be opposite her<br />

nipple.<br />

o It will be difficult for him to take the breast <strong>in</strong>to his mouth.<br />

• On your own clothed body, or on a model, show these ways <strong>of</strong> hold<strong>in</strong>g a breast:<br />

145<br />

RFHI/JSI <strong>Roma</strong>nia <strong>Tra<strong>in</strong><strong>in</strong>g</strong> <strong>of</strong> RHMs <strong>in</strong> <strong>Reproductive</strong> <strong>Health</strong> Session 9: Breastfeed<strong>in</strong>g

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