Training of Roma Health Mediators in Reproductive Health

o holding the breast with fingers and thumb close to the areola;
o pinching up the nipple or areola between your thumb and fingers, and trying
to push the nipple into a baby's mouth;
o holding the breast in the `scissor' or `cigarette' hold (index finger above and
middle finger below the nipple).
Explain to participants:
o Holding the breast in these ways makes it difficult for a baby to attach and
suckle effectively.
o The `scissor hold' can block milk flow.
• Demonstrate holding the breast back from the baby's nose with a finger.
Explain to participants:
o This is not necessary, and can pull the nipple out of the baby's mouth.
o A baby can breathe quite well without the breast being held back.
Explain that there are also common mistakes that health workers make when they help
mothers.
Give the demonstration:
• Ask the participant to help you again. She should hold a doll in the same way as
for the first demonstration. She should also hold a model breast in place as if the
doll is trying to suckle.
• Take hold of the model breast in one hand and the doll in the other and push them
together.
Explain to participants:
o When we try to put the baby to the breast, instead of helping the mother to put
him on herself, she does not learn how to position her baby herself and she
does not gain confidence.
• Hold the doll at the back of his head, and demonstrate trying to push him onto the
breast.
Explain to participants:
o If you put pressure on the back of a baby's head, he may react by pushing his
head back. Our natural reaction is then to push the baby onto the breast more
strongly. This will likely cause the baby to fight back, and may cause him to
refuse to breastfeed.
Ask participants if they have any questions, and try to answer them.
Attachment to the breast
Explain that the baby needs to open his mouth wide and take more than just the nipple
into his mouth. He actually needs to take much of the areola into his mouth, and to
suck the milk by compressing the areola with his tongue.
If the baby takes only the nipple into his mouth, his tongue will not compress the tubes,
milk will not flow well, and the mother’s nipple is likely to become sore and damaged.
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RFHI/JSI Romania Training of RHMs in Reproductive Health Session 9: Breastfeeding