New Tools for Implementing Lactation Counselling Programs

New Tools for Implementing Lactation Counselling Programs

New Tools for Implementing Lactation Counselling Programs

Information about New Tools for Implementing Lactation Counselling Programs

Newborn News


“Skilled breastfeeding counselling meant that breastfeeding could remain a choice for me and my baby.” 

“Having skilled breastfeeding counselling completely changed my mental state. It was transformative.”

“Without it, I probably would have just given up and never breastfed ever again.”

These are direct quotes from parents, shared in a new video released during the webinar Building Better Breastfeeding Counselling Programmes: New tools for implementation.

As a lactation professional, you know the importance of skilled lactation care to families.

However, you also know that access to care is far from guaranteed. In some countries, there are no or very few International Board Certified Lactation Consultants® (IBCLCs®) available. In other areas, IBCLCs may be practicing, but existing policies do not support a full range of options for families.

How can we as IBCLCs support the creation of more and better skilled breastfeeding counselling programs? IBCLCs are critical to ensuring improved options, by advocating for high-quality care, training others, and helping to implement programs where IBCLCs are a critical part of the warm chain of support. 

The recent webinar from the Global Breastfeeding Collective (GBC), including ILCA, WHO and UNICEF was created to update you on new tools and resources to increase access to high quality breastfeeding counselling programs. Recordings of the event are available in five languages (Arabic, English, French, Russian, and Spanish).

Implementation Guidance on Counselling Women to Improve Breastfeeding Practices

In 2018, WHO released its ground-breaking guideline, “Counselling of Women to Improve Breastfeeding Practices.”

The 2018 guideline represented a paradigm shift in thinking about breastfeeding counselling, explains Laurence M. Grummer-Strawn, MPA, MA, PhD the unit head of the Food and Nutrition Actions in Health Systems unit at WHO. 

Key recommendations of the 2018 guideline include counselling for all pregnant women and mothers of young children during both the antenatal and postnatal period; at least six contacts, ideally face-to-face; and offering counselling that anticipates and addresses key challenges.

Now, there is new guidance available on how to carry out these important guidelines.

In chapter format, the document describes the stages of breastfeeding counselling program implementation and includes case studies from around the globe.

From gathering initial data to providing services to designing, implementing, and monitoring a skilled breastfeeding counselling training program—as well as evaluating, advocating, and sustaining it—this document provides a wealth of applicable advice. 

Find the document in the Global Breastfeeding Collective’s Breastfeeding Advocacy Toolkit here.

Infant and Young Child Feeding Counselling: Training Course

Now available: the second edition of a curriculum that “aims to address the practices that address childhood malnutrition as well as those that lead to the accumulation of excessive weight,” according to Dr. Ma del Carmen Casanovas Vargas, MPH.

Tied to the WHO Child Nutrition Standards, this curriculum covers breastfeeding, advanced breastfeeding, complementary feeling, growth assessment, and HIV and infant feeding.

With modules for each area and eight clinical practice sessions, it combines lecture with hands-on learning, with the goal of giving health care workers basic counselling skills so they can help mothers and caregivers more effectively.

The curriculum also includes materials for course directors, course trainers, and participants, such as manuals, handouts, and counselling cards with guides for use.

The curriculum is designed for lay counselors, community health workers, primary healthcare nurses and physicians, pediatricians, nutritionists, and many other professionals.

No prior knowledge of infant feeding is assumed, and guidance is given for adapting it to your own setting.

“We hope that [this course] will be useful for different countries and different regions, considering the wide type of uses we are expecting for it,” Cassanova notes.

Find the document in the Global Breastfeeding Collective’s Breastfeeding Advocacy Toolkit here.

Operational Guidance: Breastfeeding Counselling in Emergencies

The newly released document “Breastfeeding Counselling in Emergencies: Operational Guidance” offers pragmatic guidance on how to apply the 2018 WHO Counselling of Women to Improve Breastfeeding Guideline specifically in emergency settings.

“When systems are disrupted, breastfeeding continues to offer nutrition and hydration, comfort and connection, and protects babies from infectious disease … yet just when it’s needed the most, good breastfeeding practices are often eroded and undermined by misinformation, formula donations, and other Code violations,” notes Isabelle Modigell, Lead Researcher of the Operational Guidance.

Parents need “urgent reassurance and skilled support so they can continue to nurture and nourish … their babies under difficult circumstances,” Modigell continues.

Skilled breastfeeding counselling can make a critical difference during emergencies, but real-world guidance is needed to operationalize effective support.

“When there are hundreds affected, how to reach them all?” Modigell says. “How do we provide six sessions of counselling, when they are constantly changing locations to escape violence? Do we continue to provide face-to-face care, even during an infectious disease outbreak?”

The IFE Core Group conducted a desk review of 80 papers and case studies and conducted interviews with key informants around the world.

“We explored the successes, challenges, gaps, required resources, compromises, and adaptations for implementing counselling interventions in emergency settings, guided by an expert peer review group,” Modigell says.

The end result is Implementation Guidance: Breastfeeding Counselling in Emergencies.

The document “elaborates on several recommendations,” providing “challenges, solutions, adaptations, and compromises.”  

For example, Modigell says, one of the WHO guidelines recommends that all pregnant parents and parents of children under two receive skilled BF counselling.

But this is not always possible in an emergency, when needs tend to rise and systems are overwhelmed.

“So a compromise is to prioritize particular groups, through rapid triage and screening,” Modigell explains.

The new guidance contains specific suggestions on who to prioritize—sick and malnourished infants, for example.

“Despite the perceived difficulty … experiences have shown that it is possible to establish or reestablish breastfeeding counselling services and even to improve breastfeeding practices, even in the midst of a crisis,” Modigell shared. “This guidance will tell you how to do it!”

Find the document in the Global Breastfeeding Collective’s Breastfeeding Advocacy Toolkit here.

Advocacy Brief: The Role of Midwives and Nurses in Protecting, Promoting, and Supporting Breastfeeding

Nurses and midwives are “key health providers who care for women and children before and during pregnancy and birth, and throughout early childhood.”

A new advocacy brief by the Global Breastfeeding Collective highlights the role of nurses and midwives in protecting, promoting, and supporting breastfeeding.

To produce the document, authors first conducted a survey to gather the experiences of nurses, neonatal nurses, and midwives in the area of breastfeeding.

“Why is this important?” asks Carole Kenner, PhD, RN, FAAN, FNAP, ANEF, the Chief Executive Officer, Council of International Neonatal Nurses, Inc., who worked on the document.

Kenner’s answer: Nurses and midwives must be empowered to provide skilled breastfeeding support because we know that when breastfeeding mothers and infants are not supported, there is an increase in mortality rates and childhood infections, cognitive development is compromised, and rates of lifelong illnesses increase in both mothers and children.

“All midwives and nurses, including neonatal nurses, must endorse the importance of breastfeeding and be competent in providing support as well as protect mothers and newborns from barriers to breastfeeding,” Kenner adds.

This new tool provides a key opportunity to advocate for this reality.

“We’re asking all of you to join us in this call of action,” says Theresa Shaver, USAID, GHSI-III contractor.

“Please invest in midwives. We need to fully integrate critical competencies, funds to develop a comprehensive specialized training for midwives, nurses, and neonatal nurses, and to fully integrate quality and respectful maternal and newborn care. We need to establish and enforce legislation to protect breastfeeding.”

“And most importantly, we need time,” she continues, urging professionals to advocate in their settings for the allocation of “adequate staffing levels so there is time to dedicate to breastfeeding and supporting women and their babies.”

This is an ideal tool if you are in a position to “strengthen the leadership role of midwives and nurses at a national, local, and facility level,” she concludes.

Find the document in the Global Breastfeeding Collective’s Breastfeeding Advocacy Toolkit here.

Case Studies Compendium

See the development of skilled breastfeeding counselling programs in action with the newly released Case Studies Compendium.  

“Last year, the Global Breastfeeding Collective released an advocacy brief on skilled breastfeeding counselling, which outlined seven key actions stakeholders, donors, and governments can take to improve access to skilled breastfeeding counselling,” explains Lesley Oot, MPH, an Associate Director of Alive & Thrive.

“In support of the call to action, the GBC worked with authors around the world to document case studies of how individual countries, programs and initiatives have successfully answered this call to action, with practical guidance and lessons learned that others can use to duplicate their successes,” she continues.

The result is a compendium of eight case studies.

Geographically diverse, these case studies represent a robust set of examples that are applicable around the globe.

To conclude the webinar, four of the case study authors share their stories about supporting skilled breastfeeding counselling with videos and interactive sessions.

Watch the webinar to learn from and be inspired by stories from eight countries (four in each webinar), highlighting work with government agencies, peer support groups, university midwifery training programs, and hospitals in implementing BFHI. 

Coming soon! When available, you will be able to find the document in the Global Breastfeeding Collective’s Breastfeeding Advocacy Toolkit here.

Breaking Story – New Tools for Implementing Lactation Counselling Programs

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