Posted by: Admin | July 19, 2011

My Thoughts on Breastfeeding Training for Health Care Workers

Note: In this post I talk about health care workers, which includes myself as a Lactation Consultant, and I will refer to what I believe health care workers should abide by in their practice. If I seem to be critical and overly demanding of health care workers, take note that I ask the same from myself. When you read this post, remember that you are entitled to the best quality of care from all health care workers you seek help from and that the elements mentioned in the following paragraphs form part of most health care workers’ code of ethics.

The post also refers to “evidence-based information,” which means that the information given to mothers should be proven to give the best results by solid research.

Step 2 of the Baby-Friendly Initiative (BFI) is all about the health care workers’ breastfeeding knowledge and the importance of the transmission of this knowledge to the mothers. We must consider the 4 Ws to clearly understand how essential breastfeeding training is.

WHO should receive breastfeeding training?

All health care workers that see pregnant women, mothers and babies should receive breastfeeding training. Such Health care workers include doctors, nurses, pharmacists, CHRs, nutritionists, Occupational Therapists, Physiotherapists, Community Workers, etc.

WHY should health care workers receive breastfeeding training?

Because breastfeeding is the first stepping stone towards a healthier future generation and because health care workers need to be convinced of this to encourage, support and protect breastfeeding.

WHAT kind of breastfeeding training should the health care workers get?

Breastfeeding training for health care workers should cover the benefits of breastfeeding as well as the consequences of not breastfeeding. The training should inform them about most breastfeeding techniques and evidence-based breastfeeding management and provide them with a deep understanding of how the breast works. In its Step 2, the BFI asks that all health care workers get the training required according to the degree of direct care they give to pregnant women and mothers. For example, an Awash (Children) nurse should receive at least 18 hours of theory and many hours of clinical training. A nutritionist seeing pregnant women, but never doing any postpartum visits, would need fewer hours of training.

Health care workers also need counseling training and should give the mothers only evidence-based information. It is inappropriate to use personal experience or beliefs in a professional setting. This is difficult for health care workers. Most of us have had some experience with breastfeeding, and we carry our experiences with us at all times. When seeing a mother live through a similar difficulty we might think it will be helpful to tell her how we resolved the problem and suggest she do the same.  This is not right as it might have worked only by chance, and might even be proven to be harmful.

WHEN should the information received during the trainings be transmitted to mothers?

Have you ever received information you asked for two weeks after you needed it? Was it still useful to you? Or had you passed on to something else? It is important to get good information, but the information has to be timely – if you want to know whether you can breastfeeding while taking penicillin antibiotics and the health care worker calls you back one week after your request, what do you think will have happened? Either 1) you stopped breastfeeding so you can take the medication without worrying about harming your child, or 2) you decided to not take the medication to avoid weaning your baby and may have put your own well-being in danger by doing so (by the way, penicillin is an antibiotic that is considered compatible with breastfeeding). Another example is that a woman needs to know why it is important to breastfeed at the very beginning of pregnancy. Research shows that women decide if they will breastfeed very early on, even before they get pregnant. It is inappropriate to elaborate on the benefits of breastfeeding when the mother has been bottle-feeding her child for the last two months and has no interest in breastfeeding. It is not only important for health care workers to receive training but they also need to pass on their knowledge at the time it is needed.

And last but not least, knowledge needs to be given in a way that makes it well received!

HOW to transmit the knowledge to the mothers?

When health care workers receive training, they get a lot of information thrown at them in a very short time. They need to take all of it in, and then transform it into advice and actions that will be helpful for the mothers. The art of transmitting knowledge to mothers is not easily acquired. It takes an extra little something, a lot of humility and a huge amount of patience!

As the mother asking for help and support, what do you think is the “extra little something” health care professionals should have to give you the help and information you need about breastfeeding?

Thursday’s Post:

Dear LC: As a breastfeeding mother, what should I expect to receive in terms of help and support from the health care workers of my community?

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