Session 5

1. Session 5

2. Session 5 Session 5

3. Session 5

4. Activity Looking Toward The Future As you look towards the future, think about the best part of being a Peer Counselor. Draw a picture or write down 3 words that best describe your feelings. Share with the group Session 5

5. Review and Preview • Hand expression sharing • Review Session 4 topics • 3-Step Counseling Sharing • Preview of Session 5 What questions do you have? Session 5

6. Challenges to Breastfeeding Session 5

7. Challenges to Breastfeeding • What do you think are the challenges and barriers to breastfeeding? • List identified challenges and/or barriers

8. Discussion • How did you prepare for your hospital stay? • What do you wish you had done differently? • How could a peer counselor have helped you? Session 5

9. Hospital Practices • Hard to get breastfeeding off to a good start if: • Mother doesn’t get to breastfeed within 1st hour • Mother and baby are separated • Baby given formula, sugar water, or pacifier • Free formula is given • Advice not based on latest information Session 5

10. Discussion A positive breastfeeding experience in the hospital makes it easier to continue breastfeeding! • How can you help a pregnant mother prepare for her hospital stay? • Compare your list to the one in your handbook • See birth plan in Appendix Session 5

11. Lack of Confidence Mothers may: • Worry they won’t be able to breastfeed • Feel unsure they can make enough milk • Have family members that weren’t able to breastfeed Session 5

12. Lack of Support Family/friends comments - Not supportive • Mother may doubt her ability to breastfeed • Mother may stop breastfeeding Session 5

13. Discussion • What comments did you hear from family & friends? • Did you have family members or friends who made negative comments about breastfeeding? • How did you handle these situations? • What could you say to a mother whose family & friends are not supportive? Session 5

14. Body Changes • Worries about body not looking the same • What would you say to a mother who says: • “My breasts will be too large” • “My breasts will sag” • “I want to diet to lose weight quickly” Session 5

15. ACTIVITY Counseling Mothers Experiencing Challenges Part 1 • Divide into groups of threes • Practice role-playing using the Best Start 3 - Step Counseling Strategy • Use worksheet entitled “Observer’s Checklist found in handbook Session 5

16. Scenario 1 Wants formula “I don’t think I’m making enough milk.” Baby cries and wakes up at night Scenario 3 Pregnant mother Not sure she wants to breastfeed “I want to go on a diet after I have the baby. I’ve gained a lot of weight…” ACTIVITY Counseling Mothers • Scenario 2 • Wants formula • “You are starving that baby! He’s still hungry. Give him a bottle of formula.” Session 5

17. Not Eating Right? Let mothers know: • She can make “good” milk even if not eating “right” everyday • Breastmilk from moms who eat “junk food” is far better than formula • She does not have to drink milk to make milk • Eat the way she ate during pregnancy • Eating poorly – tired/sick more often Session 5

18. Worried About Not Eating Right • Mothers can eat all types of foods without baby getting an upset stomach • If mother thinks that baby is fussy/colicky after she eats a certain food… • Suggest that she stop eating it for a week • See if it makes a difference Session 5

19. Foods Thought to Cause Baby to Fussy Common foods that may upset baby’s tummy: • cabbage, broccoli, • cauliflower, • brussels sprouts • chocolate • garlic • milk • spicy foods • drinks with caffeine Session 5

20. Beverages Drink to thirst • Drinking more will not increase milk supply • Whenever breastfeeding, have something to drink • Limit caffeine • Caffeine passes to breastmilk and may cause baby to be fussy and/or not sleep well Session 5

21. Embarrassment • Some mothers are embarrassed about breastfeeding in public • If a mother is worried… • Affirm her feelings • Show her to breastfeed without showing breasts • California Law - Mothers can breastfeed in public anywhere babies are allowed to be! Session 5

22. Suggestions for Breastfeeding In Public What suggestions could you give a mother worried about breastfeeding in public? • Share answers in a larger group • Compare to list in your handbook Session 5

23. Returning to Work or School If mother is worried about breastfeeding successfully… • Affirm her feelings: • There are ways to continue breastfeeding • Special closeness -“makes up” for time spent away • Allows for more time with her baby when home Session 5

24. More suggestions… • Mother should talk to employer before baby is born about: • Breastfed baby sick less often - miss less school/work • Her right to have (CA Law): • Adequate break-time to pump • A private place to pump (other than a bathroom) Session 5

25. Busy Lifestyles Mother worried breastfeeding will “tie her down”… • Affirm her feelings • Quicker & easier - less supplies than bottle feeding • Mothers need rest (rest when baby naps) • “Stressed” - may have trouble producing milk • Focus on her & baby for 1st few weeks • Someone to help with housework Session 5

26. Busy Lifestyles (cont’d) More suggestions: • Get breastfeeding going well, then gradually add other activities • Pump for times when away • Breastfeed most of the time, give breastmilk in the bottle if necessary • Give breastfeeding a try! It works great with a lot of busy mothers’ schedules! Session 5

27. Activity Counseling Mothers Experiencing Challenges Part 2 • Divide into groups of threes • Practice role-playing using the Best Start 3 - Step Counseling Strategy • Use worksheet entitled “Observer’s Checklist” found in handbook Session 5

28. Scenario 1 6 week old baby “I have to go back to work. But I don’t have a job yet.” Doesn’t know about the law or pumping at work Scenario 3 Pregnant mother Doesn’t think she can breastfeed All she can afford is inexpensive foods Doesn’t have money to spend on expensive “breastfeeding” foods ACTIVITY Counseling Mothers • Scenario 2 • Pregnant mother • Doesn’t want to expose her breasts in public • Too busy • Formula would be easier Session 5 28

29. Referring to a Lactation Specialist or Health Care Provider Session 5

30. Role of a Peer Counselor • Listen to mother’s concerns • Affirm feelings • Provide basic breastfeeding education • Do not give medical advice • Refer to a lactation specialist or health care provider when necessary Session 5

31. Activity To Refer or Not To Refer, That is the Question • In your table groups • Listen to the statements and decide as a group whether or not you would refer to a lactation specialist • Hold up your “refer” or “not to refer” card • Compare with lists in your handbook “Reasons for Referral” Session 5

32. Documentation & Confidentiality Session 5

33. Documentation Documentation is very important! • Improves communication • Saves time • Prepares for next counseling session • Keeps track of work done Session 5

34. Confidentiality WIC clients share personal info when enrolled DO NOT: • Share info with partner and/or friends • Leave out forms that participant fills out • “Gossip” about mothers Session 5

35. Confidentiality • Your agency will have you sign a “Confidentiality Agreement” • Sharing personal info about a mother you are helping with non-WIC staff is illegal and could cause you to lose your job! Session 5

36. ActivityConfidentiality: Yes or No? In your table groups: • Listen while your facilitator reads four scenarios • When the table group has determined their answer, all STAND UP • Your facilitator will ask you to call out your answers Session 5

37. Telephone Manners Session 5

38. Role Play: Telephone Manners Watch facilitators role play two telephone calls • What did the “counselor” do well? • What could the “counselor” have done differently? Review “Telephone Counseling Suggestions for Peer Counselors" found in your handbook Session 5

39. Review in your handbook – “Suggestions for Topics to Cover” Activity Topics to Cover When Talking to Mothers Session 5 39

40. Activity Topics to Cover When Talking to Mothers Circle one topic in each section as instructed: • 1st section: Prenatal • What topic was the most important in your personal experience? • 2nd section: 1st Weeks • Which topic would be the most uncomfortable to talk about? • 3rd section: Next Follow-Up • What topic are you excited to talk to mothers about? Session 5

41. ActivityTopics to Cover WhenTalking to Mothers • Discuss what you circled in your table groups Session 5

42. Topics to Cover When Talking to Mothers Optional Activity • Listen as your facilitators demonstrate a phone call regarding one of the topics in the Follow-Up section • What questions do you have about topics to be covered when talking to a mother? Session 5

43. ActivityPracticing Counseling Divide into groups of threes Practice role-playing using the Best Start 3 - Step Counseling Strategy Use worksheet entitled “Observer’s Checklist” found in handbook Session 5 43

44. Discussion What other questions do you have? Session 5

45. Activity Closing Tree Chart What topics were covered Move Post-it Notes Session 5 45

46. Final Bits and Pieces • Steps for applying to become a peer counselor… • Please fill out the evaluation form in your handbook Thank you! Session 5

47. Closing Activity & Celebration Session 5

48. Activity Standing in a big circle… • What have you gained from this training? • How has this training changed (or will change) your life? • Share your thoughts Session 5

49. Congratulations! Session 5