What should be included in a monthly meeting agenda for new mothers or pregnant women seeking breastfeeding support?

Monthly Breastfeeding Support Meeting Agenda

Monthly breastfeeding support meetings should be structured around evidence-based education combined with behavioral skills training and ongoing peer/professional support, with sessions lasting 30-90 minutes and incorporating both prenatal and postnatal components. 1

Core Educational Content

Health Benefits Discussion

• Cover maternal benefits: Reduced risk of breast cancer, ovarian cancer, diabetes, hypertension, and heart disease, plus more rapid return of uterine tone 1, 2
• Cover infant benefits: Reduced rates of otitis media (OR 0.39-0.61), respiratory infections, gastrointestinal infections (adjusted OR 0.60), atopic eczema (adjusted OR 0.54), asthma, type 2 diabetes, obesity, and SIDS 1, 3
• Emphasize exclusivity: The protective effect increases with exclusive breastfeeding, and any breastfeeding is more protective than none 3

Technical Skills Training

• Positioning and latch-on techniques: Practical, hands-on demonstration and practice, not just didactic instruction 1
• Basic physiology: How milk production works, supply and demand principles, and what to expect in the first days and weeks 1, 4
• Recognizing infant feeding cues: How to identify when babies are ready to breastfeed and support cue-based feeding 5
• Equipment discussion: When and how to use breast pumps, especially for mothers returning to work 1

Behavioral Problem-Solving Components

Overcoming Common Barriers

• Situational barriers: Address specific challenges like returning to work, public breastfeeding concerns, and managing night feedings 1
• Problem-solving counseling: Use directive health education combined with behaviorally-oriented skills training, not just information provision 1
• Anticipatory guidance: Identify medical, anatomical, and other risk factors for breastfeeding challenges and provide targeted support 4

Social Support Strategies

• Partner and family involvement: Include family members when appropriate to bolster home support for breastfeeding 1, 4
• Peer support integration: Facilitate connections between experienced breastfeeding mothers and new mothers, though peer counseling alone has modest effects 1, 6
• Provider support coordination: Ensure participants know how to access lactation consultants, nurses, or peer counselors for scheduled and unscheduled support 1

Hospital and Early Postpartum Practices

Immediate Postpartum Period

• Skin-to-skin contact: Emphasize immediate SSC after birth for at least 1 hour, regardless of delivery method, to enhance breastfeeding readiness and success 5
• First breastfeeding timing: Discuss breastfeeding within 30 minutes of birth to reduce postpartum hemorrhage and establish early feeding patterns 5
• Rooming-in benefits: Explain 24-hour rooming-in to support cue-based feeding, decrease hyperbilirubinemia, and increase breastfeeding continuation up to 6 months 5

Hospital Policies to Avoid

• Commercial discharge packs: Warn that formula samples, bottles, and nipples are associated with reduced exclusive breastfeeding at 1 month and any breastfeeding at 4 months 1
• Unnecessary supplementation: Discuss risks of formula supplementation without medical indication 4
• Delayed procedures: Explain that routine procedures can be safely delayed for 1-4 hours to allow uninterrupted SSC and first breastfeeding 5

Ongoing Support Structure

Follow-Up Components

• Scheduled contacts: Arrange pre-planned appointments or telephone calls with lactation consultants or trained nurses for ongoing support 1
• Problem-oriented access: Provide clear pathways for unscheduled visits or calls when challenges arise 1
• Duration of support: Continue support through at least 6 months postpartum, as combined education and support increases breastfeeding duration at 4-6 months (13% increase) 1

Medication and Contraindication Review

• Few true contraindications: HIV infection in developed countries and current alcohol/drug dependence are primary contraindications 1
• Medication compatibility: Most medications and vaccinations are safe during breastfeeding; direct participants to resources like LactMed 3, 2
• Avoid unnecessary cessation: Emphasize that most maternal medications or minor illnesses do not require stopping breastfeeding 3

Nutritional Supplementation

Infant Supplementation

• Vitamin D: All breastfed infants need 400 IU daily starting in the first few days of life 3
• Iron considerations: Discuss iron supplementation (1 mg/kg/day) if complementary foods are delayed or inadequate after 6 months 7
• Complementary foods: Around 6 months, introduce iron-rich foods like finely ground meats, iron-fortified cereals, fruits, and vegetables 7

Meeting Format Considerations

Session Structure

• Group or individual format: Both are effective; choose based on participant preference and resource availability 1
• Session duration: Plan for 30-90 minutes per session 1
• Frequency: Monthly meetings with 1-8 total sessions showing effectiveness, though more frequent early contact may be beneficial 1

Facilitator Qualifications

• Trained professionals: Most effective programs use nurses with advanced training as lactation consultants or midwives 1
• Lactation consultant involvement: Interventions using lactation consultants increase breastfeeding initiation (OR 1.35) and any breastfeeding up to 1 month (OR 1.49) 6

Critical Pitfalls to Avoid

• Written materials alone are ineffective: Do not rely solely on handouts; they must be combined with face-to-face education and support 1
• Brief advice insufficient: Primary care provider advice during routine visits alone has not been proven effective without structured programs 1
• Education without support: While education alone increases initiation and early continuation (23% and 39% respectively), ongoing support is needed for duration beyond 3 months 1