Prenatal education has been a key part of the 10 Steps to Successful Breastfeeding since the beginning - and for good reason. Intention to breastfeed is usually set during pregnancy and is highly correlated with breastfeeding initiation.
The content of prenatal education on breastfeeding has to fit into all of the other clinical and teaching tasks that make up prenatal care - and that list grows ever longer each year. How do we squeeze all the things that we need parents to know about breastfeeding? And how do we get it to stick among all the other information that new parents receive?
Within the new BFHI competencies, the focus in Step 3 is on counseling skills, both in assessing individual learning needs and teaching information and skills necessary for a good start. Counseling is different from teaching or providing clinical care - it is a skill set entirely its own.
In August 2021, the WHO released the implementation guidance (https://www.globalbreastfeedingcollective.org/reports/implementation-guidance-counselling-improve-breastfeeding-practices) based on the 2018 breastfeeding counseling guidance (https://www.who.int/publications/i/item/9789241550468). The implementation guidelines provide practical guidance for those designing and implementing programs to ensure that counselling is provided:
The Implementation Guidance covers the entire period from pre-natal to 24 months, with a few recommendations specific to the prenatal period. While the guidance suggests a single breastfeeding-related contact in the prenatal period as a minimum, multiple brief contacts will be more effective and feasible for many settings.
Michelle Pensa Branco MPH IBCLC
Colaizy, T. T., Saftlas, A. F., & Morriss, F. H., Jr (2012). Maternal intention to breast-feed and breast-feeding outcomes in term and preterm infants: Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2003. Public health nutrition, 15(4), 702–710. https://doi.org/10.1017/S1368980011002229
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