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Breastfeeding Module Oregon WIC Training Breastfeeding Module Staff Training 57-6614-engl (12/2004) Leave this page blank. Oregon WIC Training Breastfeeding Module Original Publish Date: 1990 Revised: December 2004 Debi VanderMey Barr, MS, RD A generous thank you to Dixie Whetsell, the staff at the Oregon Department of Human Services and the staff at the local WIC agencies who helped in the completion and review of this module. Oregon WIC Training Breastfeeding Module December 2004 Oregon WIC Training Breastfeeding Module Table of Contents 1 Table of Contents Starting the Module S-1 Introduction ......................................................................1 S-2 Instruction Levels..............................................................1 S-3 Steps for Completing the Module ....................................1 S-4 Self-Evaluation ..................................................................1 S-5 Questions about Past Breastfeeding Experience..............1 S-6 Items Needed ....................................................................1 Chapter 1—Why “Breast is Best” 1-1 Breast is Best ................................................1 Why Choose Breastfeeding? .........................................................2 Social and Economic Benefits for Breastfeeding .........................4 1-2 Who Recommends Breastfeeding? ..................1 What Do Other Organizations Recommend?..............................2 WIC's Role in Breastfeeding Support...........................................2 What is Your Role? .......................................................................3 Providing a Positive Clinic Environment .....................................4 Breastfeeding Positive Messages...................................................4 1-3 Who Should NOT Breastfeed ..........................1 When is Breastfeeding NOT Recommended? .............................2 Needs Evaluation before Breastfeeding Begins ............................3 1-4 What Services are Available to Breastfeeding Women .........................................................1 Breastfeeding Services at Your WIC Clinic ..................................2 Breastfeeding Services in Your Community.................................2 Review Activity with Training Supervisor..................1 December 2004 2 Table of Contents Chapter 2—Deciding to Breastfeed 2-1 Planning for Breastfeeding Success .................1 Developing a Support System ......................................................2 How to Plan for Breastfeeding Success at Birth ..........................4 2-2 Preparing for Breastfeeding during Pregnancy.....................................................1 How the Breast Changes during Pregnancy .................................2 How to Care for Breasts during Pregnancy .................................3 How the Baby is Preparing for Breastfeeding ..............................3 2-3 The 3-Step Counseling Strategy ......................1 The 3-Step Counseling Strategy.....................................................2 What are the Most Common Concerns about Breastfeeding? ....6 Review Activity - Self-Evaluation .............................1 Chapter 3 - Breastfeeding Basics 3-1 Breastfeeding Positions and Latching On .........1 Breastfeeding Positions .................................................................2 Putting Baby to the Breast (Latching On) ....................................4 3-2 How Often to Breastfeed ...............................1 Feeding Cues .................................................................................2 How Often to Breastfeed ..............................................................2 3-3 How the Breasts Make Milk .............................1 Breast Anatomy.............................................................................2 Breastfeeding Hormones ..............................................................3 The Letdown Reflex......................................................................4 3-4 How to Make Enough Milk ...............................1 How to Make Enough Milk ..........................................................2 Mothers Concerns about Milk Supply..........................................4 Review Activity with Training Supervisor..................1 Oregon WIC Training Breastfeeding Module Table of Contents 3 Chapter 4—Nutrition while Breastfeeding 4-1 Nutrition for Breastfeeding Mothers ................1 What Should a Breastfeeding Mother Eat? ..................................2 Are There Foods Breastfeeding Mothers Should Avoid?............3 What About Weight Loss? ............................................................4 How Much Fluid Should a Breastfeeding Mother Drink? ...........5 Do Breastfeeding Mothers Need More Calcium?........................5 Do Breastfeeding Mothers Need More Vitamins? ......................6 Do Breastfeeding Mothers Need More Iron? ..............................7 Can a Vegetarian Mother Safely Breastfeed?................................7 4-2 Eating Well While Caring for a New Baby .........1 Tips for Quick and Healthy Eating ..............................................2 How Much “Junk Food” Is Too Much? .......................................2 4-3 Substances to Avoid or Limit While Breastfeeding................................................1 Caffeine ..........................................................................................2 Herbal Teas ...................................................................................3 Alcohol ..........................................................................................3 Tobacco .........................................................................................4 Drugs of Abuse ............................................................................4 Medications ...................................................................................5 Oral Contraceptives and Other Hormonal Contraceptives ........5 Review Activity—Observation..................................1 Chapter 5—Managing Breastfeeding Problems 5-1 The First Two Weeks—No Problems v. Red Flags .............................................................1 Breastfeeding with No Problems .................................................2 Red Flags (or Possible Causes of Concern) in the First 2 Weeks.............................................................................................3 5-2 Inadequate Milk Supply ..................................1 Assessing Inadequate Milk Supply ................................................2 Common Causes for Inadequate Milk Intake and Management Strategies .......................................................................................3 Addressing Concerns when Milk Intake is Adequate...................5 Supplemental Formula................................................................11 December 2004 4 Table of Contents 5-3 Engorgement ................................................1 What is Engorgement? ..................................................................2 Causes of Engorgement ...............................................................2 Treatment for Engorgement .........................................................4 5-4 Sore Nipples ..................................................1 Symptoms of Sore Nipples ..........................................................2 Assessment of Sore Nipples.........................................................2 Treatment of Sore Nipples ...........................................................3 What is Thrush?.............................................................................3 5-5 Mastitis, Plugged Ducts and Breast Abscess .....1 Plugged Ducts...............................................................................2 Mastitis ..........................................................................................2 Breast Abscess...............................................................................3 5-6 Sleepy Baby ..................................................1 Sleepy Baby ...................................................................................2 5-7 Fussy Baby ....................................................1 Normal Fussiness..........................................................................2 Colic ..............................................................................................4 5-8 Overactive Letdown and Leaking Breasts ........1 Overactive Letdown .....................................................................2 Leaking Breasts .............................................................................3 5-9 Jaundice .......................................................1 Causes of Jaundice ........................................................................2 Symptoms of Jaundice ..................................................................2 Treatment of Jaundice ...................................................................2 5-10 Breastfeeding a Preterm Infant ......................1 Definition of Preterm Infant ........................................................2 Feeding the Preterm Infant ...........................................................2 “Red Flags” for Preterm Infants ..................................................3 Breastfeeding and Human Milk Fortifier .....................................3 Review Activity with Training Supervisor..................1 Oregon WIC Training Breastfeeding Module Table of Contents 5 Chapter 6—Other Issues about
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