Best Practice:Counseling in Breast Feeding and Complementary Feeding

Dr. Merina ShresthaSecretary

Nepal Breast Feeding Promotion Forum(NEBPROF)

Tribhuvan University Teaching Hospital

• General Hospital – Total beds: 650

• Maternity: Tertiary care

• Pediatric • 56 beds• PICU: 4• NICU: 6• Neonatal Ward: 6• General/ Sub-speciality OPDs

Infant Young Child Feeding Strategies

• Training for under graduate and post graduate students

• Lactation Management Clinic

• Well Baby Clinic

• Birthing Centre and Maternity ward

IYCF Training

Master Trainer Faculties, Nursing

In-charges

Training of Middle LevelDoctors, Residents, Nursing StaffsField workers

Lactation ManagementClinic• Started in August 1st , 2012• Nursing staffs supported by faculties• Twice a week• Group sessions( 6-8) for mothers, fathers,

grandparents• Individual sessions• Counseling about breast feeding and

complimentary feeding• IEC material, dummies and live demonstrations

Challenges in the clinic

• Resource• Space• Timing• Issues: engorged breast, nipple sore, working

mothers, support form the family

Postnatal Care

• Total deliveries: 350-400/months

• Initiation of Breast Feeding– As early as possible within 1 hour– No pre-lacteal feed– Teats and bottles not allowed– For preterm: expressed breast milk

Birthing Centre

• 18 beds ( NVD and LSCS)• Every morning 1 hour class that includes IEC, discussions by nursing students and nursing

staffs• Individuals counseling

• Maternity beds: 30 • Post cesarean section: 4• Neonatal ward : 6• NICU: 6• Intermediate neonatal ward: 6

Challenges

• Visitor Control• Refresher Training• Cesarean section• Provision of formula from the hospital itself

when required • Human resource

Thank you