[...]... implementing the others Winikoff et al (1986) observed institutional constraints on breastfeeding in a hospital in the USA Breastfeeding mothers and infants were often separated for long periods and the infants were given formula despite written policies to the contrary There was confusion about which drugs, when given to the mother, might be contraindicated with breastfeeding and about the identification of breastfeeding. .. women to decide to breastfeed and to carry out their decision For this it may be necessary to use additional strategies, for example including the woman’s partner, mother, close friends or peers in antenatal education programmes 3.4 Evidence for the benefits of antenatal education Antenatal education for mothers can increase breastfeeding if it builds their confidence and skills Classes seem to be... Africa (The Interagency Group on Breastfeeding Monitoring, 1997; Taylor, 1998) Mothers who recalled receiving company-associated negative information (i.e information understood by a woman to promote bottle-feeding and/or to discourage breastfeeding) were found to be significantly more likely to bottle-feed their infants than mothers who did not receive such information The mean age of infants at the time... STEP 3 3.1 “Inform all pregnant women about the benefits and management of breastfeeding. ” If the hospital has an affiliated antenatal clinic or antenatal ward breastfeeding counseling [should be] given to most pregnant women using those services The antenatal discussion should cover the importance of exclusive breastfeeding for the first 4-6 months, the benefits of breastfeeding, and basic breastfeeding. .. breastfeeding is the norm, women may not need to be motivated to choose to breastfeed – they expect to do so The main benefit of antenatal preparation is likely to be to help them to breastfeed optimally and to avoid difficulties It has been shown repeatedly in developed countries that one third to one half of women decide how they will feed their babies before they are pregnant (Hally et al, 1984; Neifert... 1990, but the changes were only partial The obstetrics department did not participate, and gift packs containing formula continued to be distributed The authors state that the greatest limitation of the intervention was that it was not a priority for the administrative staff, although they were generally supportive of the efforts of the task force For this reason, nurses were never required to attend in-service... how to assure enough milk, and positioning and attachment (The Global Criteria for the WHO/UNICEF Baby Friendly Hospital Initiative, 1992) 3.2 Introduction Common sense suggests that it must be important to talk to all pregnant women about infant feeding, to prepare them for this aspect of motherhood They should be given all the education that they need to make a fully informed decision However, there... that there is no important difference between breastfeeding and bottlefeeding; a reluctance to allocate staff time to breastfeeding support; and a failure to recognize the impact of inconsistent or inaccurate information Health workers may undermine mother’s confidence, for example by implying criticism, or doubt about a mother’s milk supply For in-service training to be successful it must be mandatory,... excluded 4 The Ten Steps to Successful Breastfeeding Every facility providing maternity services and care for newborn infants should: 1 Have a written breastfeeding policy that is routinely communicated to all health care staff 2 Train all health care staff in skills necessary to implement this policy 3 Inform all pregnant women about the benefits and management of breastfeeding 4 Help mothers initiate breastfeeding. .. more gestation should confirm that the benefits of breastfeeding have been discussed with them [including] at least two of the following benefits: Nutritional, protective, bonding, health benefits to the mother and that they have received no group education on the use of infant formula They should be able to describe at least two of the following breastfeeding management topics: importance of rooming-in, . 1 EVIDENCE FOR THE TEN STEPS TO SUCCESSFUL BREASTFEEDING INTRODUCTION The Ten Steps to Successful Breastfeeding are the foundation of the WHO/UNICEF. (BFHI). They summarize the maternity practices necessary to support breastfeeding. The purpose of this document is to review the evidence for the efficacy