BHFI RATIONALE 10 TO 1

Rationale: While the time in the facility providing maternity and newborn services should
provide a mother with basic breastfeeding skills, it Is very possible her milk supply has not
been fully established until after discharge. Breastfeeding support is especially critical in the
succeeding days and weeks after discharge, to identify and address early breastfeeding
challenges that occur

Rationale: Proper guidance and counselling of mothers and other family members enables
them to make informed decisions on the use or avoidance ofpacifiers and/or feeding bottles
and teats until the successful establishment of breastfeeding.

Rationale: Breastfeeding involves recognizing and responding to the infant’s display of

hunger and feeding cues and readiness to feed, as part of a nurturing relationship between
the mother and infant.

Responsive feeding (also called on-demand or babyled feeding) puts no restrictions on the
frequency or length of the infant’s feeds, and mothers are advised to breastfeed whenever
the infant is hungry or as often as the infant wants.

Scheduled feeding, which prescribes a predetermined, and usually time restricted,

frequency and schedule of feeds is not recommended.

Rationale: Rooming-in is necessary to enable mothers

to practise responsive feeding, as mothers cannot

learn to recognize and respond to their infants’ cues

for feeding if they are separated from them.

This, along with the close presence of the mother to her infant, will facilitate the
establishment of breastfeeding.

Rationale: Giving newborns any foods or fluids other than breast milk in the first few days
after birth interferes with the establishment of breast-milk production. Newborns’ stomachs
are very small and easily filled. Newborns who are fed other foods or

fluids will suckle less vigorously at the breast and thus inefficiently stimulate milk
production, creating a cycle of insufficient milk and supplementation that leads to
breastfeeding failure.

Rationale: While breastfeeding is a natural human behaviour, most mothers need practical
help in learning how to breastfeed. Early

adjustments to position and attachment can prevent breastfeeding problems at a later time.

Rationale:

Immediate and uninterrupted skinto- skin contact facilitates the newborn’s natural rooting
reflex that helps to imprint the behaviour of looking for the breast and suckling at the
breast.

Additionally, immediate skin-to-skin contact helps populate the newborn’s microbiome and
prevents hypothermia.

Early suckling at the breast will trigger the production of breast milk and accelerate

lactogenesis.
Rationale:

All pregnant women must have basic information about breastfeeding, in order to make
informed decisions. Pregnancy is a key time to inform women about the importance of
breastfeeding, support their decision making and pave the way for their understanding of
the maternity care practices that facilitate its success.

Rationale: Timely and appropriate care for

breastfeeding mothers can only be accomplished if

staff have the knowledge, competence and skills to

carry it out. Training of health staff enables them to

develop effective skills, give consistent messages, and

implement policy standards.

Rationale: Facilities providing maternity and newborn

services need to integrate recording and monitoring

of the clinical practices related to breastfeeding into

their quality-improvement/monitoring systems .

Rationale: Policy drives practice.

. Written policies are the vehicle for ensuring patients receive consistent, evidence-based
care, and are an essential tool for staff accountability. Policies help to sustain practices over
time and communicate a standard set of expectations for all health workers.

Rationale:

.Compliance with the Code is important for facilities

providing maternity and newborn services, since

the promotion of breast-milk substitutes is one of

the largest undermining factors for breastfeeding