new training guide to help babies with special needs to breastfeed: maits
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Introduction to the MAITS guideon infant feeding difficulties
Himali de Silva & Maya Asir
MAITS: Multi Agency International Training and Support
The remit of MAITS:To provide training and resources for people supporting individuals with disabilities and/or mental health challenges in low-resource settingsThe main ways in which MAITS provides support: - Funding experienced professionals around the globe to
provide face-to-face training in their own country or abroad
- Developing materials and resources that can be used on the ground, such as MAITS Guides
Why Guide on working with vulnerable infants
• Due to changes to neurology and anatomy caused by prematurity, birth trauma and congenital anomalies, infants with ‘additional needs’ require more support to establish and maintain breastfeeding.
• Practical support should be available to all mothers to establish and maintain successful breastfeeding.
• The Guide fills a gap in the existing training available for people working in low resources settings, e.g. WHO Breastfeeding, Essential Newborn Care.
• Existing training focuses on some vulnerable populations, but no specific reference is given to the diverse groups of children falling under the ‘ill’ category.
• Some of the generic advice in existing programmes may not be effective, and can sometimes be harmful for specific populations e.g. infants with birth asphyxia.
MAITS Guide - How is it different?
• The Guide is also beneficial for infants <6 months admitted with malnutrition without a known cause.
“In addition to causative factors such as low birth weight, persistent diarrhoea and chronic underlying
diseases or disability, the development of severe acute malnutrition in infants under 6 months of age
commonly reflects suboptimal feeding practices, especially breastfeeding practices”
http://www.who.int/elena/titles/sam_infants/en
• MAITS Guide focuses on ‘how’ and not ‘why’.
Aim of the Guide
The guide is aimed at improving the knowledge and skills of healthcare professionals to support breastfeeding and nutrition in vulnerable infants.
Scope of the Guide
• Train the trainer model• Includes guidelines for specific populations: preterm,
hypertonic and hypotonic infants and cleft lip/palate• Focuses on areas of difficulty specific to vulnerable
infants, e.g. readiness for feeding, muscle tone, changes to suck patterns, swallow safety and after-feeding care
• Includes practical sessions and video footage• Encourages health workers to problem-solve
intervention strategies based on assessment findings
Sample page and video
Sample page from special populations
Who the Guide is for
This guide is designed to be delivered to healthcare professionals who:• have knowledge about infant feeding • have preferably completed training through a
breastfeeding programme (e.g. WHO, UNICEF) • are currently supporting vulnerable infants to breastfeed
in Neonatal Units / Special Care Units
Anyone delivering the guide needs to be specifically trained to do so
How the Guide is organised
The training programme has two compulsory components:
• classroom-based teaching• practical sessions
Classroom-based teaching
There are 4 modules which need to be delivered in the correct sequence. Each module will take 45 minutes–1½ hours (allowing for translation time).
Module 1: Lactation (optional module):-importance of breastmilk -breastmilk production
Module 2: Understanding infants with feeding difficulties:-types of feeding difficulties-assessment and breastfeeding checklist
Classroom-based teaching
Module 3: Intervention:-breastfeeding positions-intervention strategies
Module 4: Special populations:-premature infants-infants with high muscle tone-infants with low muscle tone-cleft lip/palate
Practical sessionsPractical sessions are delivered throughout the training, in facilities that care for newborn infants who need specialist support
Practical session 1: Observation onlyPractical session 2: Carry out breastfeeding checklist and assess infants feedingPractical session 3: Observe interventional strategiesPractical session 4: Apply interventional strategiesPractical session 5: Consolidation of skills
Sample timetableDay 1 9am-12pm: module 1 (optional) + module 212pm-1pm: practical 1 1pm-2pm:lunch break2pm-3pm:module 3 3pm-4pm:practical 2 Day 2 9pm-10pm: practical 3 10pm-12pm: module 4 12pm-1pm: practical 4 1pm-3pm:lunch break3pm-4pm:practical 5
Timeline and Next Steps• Draft version of Guide written, based on trials in Malawi
and Uganda• Draft completed with feedback from specialists• Guide to be trialed in Sri Lanka in November 2016• Guide to be finalised by February 2017• Infant outcome data to be collected pre and post training
in Sri Lanka• Aim to integrate into existing breastfeeding and essential
newborn care training• Scope to form a platform for generating research and
evidence-base
Contact details
• MAITS: www.maits.org.uk Mel Adams, MAITS director of operations: [email protected]• Himali de Silva: [email protected]• Maya Asir: [email protected]