WHO breastfeeding recommendations in 1950. Current WHO breastfeeding recommendations

The World Health Organization (WHO) recommends a number of rules for successful breastfeeding. These are the rules most lactation consultants, including myself, follow when counseling women and when feeding their own children.

Breast milk is the best food for a baby in his first 6 months of life, and there are no substitutes for it. Every woman should know this and accept it as an axiom if she wants to provide her baby with health and the best conditions for the development of his body. Actually, the recommendations explain this very clearly.

Early breastfeeding- within the first hour after birth!
Avoiding bottle feeding of a newborn or in some other way before the mother puts him to the breast. This is necessary so that the child does not develop a mindset for any other feeding than breastfeeding.
Joint maintenance of mother and child in the maternity hospital in one ward.
Correct position of the baby at the breast allows the mother to avoid many problems and complications with the breast. If the mother was not taught this in the maternity hospital, she should invite a lactation consultant and learn this specifically.
Feeding on demand. It is necessary to put the baby to the breast for any reason, to give him the opportunity to suckle when he wants and as much as he wants. This is important not only for satiating the child, but also for his psycho-emotional comfort. To feel comfortable, the baby can be attached to the breast up to 4 times per hour.
The duration of feeding is regulated by the child: do not take your baby off the breast before he releases the nipple on his own!
Night feedings the child ensures stable lactation and protects the woman from the next pregnancy for up to 6 months - in 96% of cases. In addition, it is night feedings that are the most complete and nutritious.
No additional soldering and the introduction of any foreign liquids or products. If the baby is thirsty, he should be put to the breast more often.
Full pacifier refusal, pacifiers and bottle feeding. If it is necessary to introduce complementary foods, it should be given only from a cup, spoon or pipette.
Transferring the baby to the second breast only when he will suck the first breast. If the mother rushes to offer the baby the second breast, he will not receive additional “late milk” rich in fats. As a result, the baby may experience digestive problems: lactose intolerance, foamy stools. Prolonged sucking on one breast will ensure proper bowel function.
Avoiding nipple washing before and after feeding. Frequent breast washing leads to the removal of the protective layer of fat from the areola and nipple, which leads to the formation of cracks. Breasts should be washed no more than once a day during a hygienic shower. If a woman showers less often, then in this case there is no need for additional breast washing.
Refusal of control weighings child, carried out more than once a week. This procedure does not provide objective information about the nutritional status of the infant. It only irritates the mother, leads to a decrease in lactation and the unreasonable introduction of supplementary feeding.
Elimination of additional milk expression. With properly organized breastfeeding, milk is produced exactly as much as the baby needs, so there is no need to pump after each feeding. Pumping is necessary in case of forced separation of mother and child, mother going to work, etc.
Only breastfeeding up to 6 months— the child does not need additional nutrition and complementary feeding. According to some studies, a child can be exclusively breastfed for up to 1 year without harming his health.
Support for mothers who breastfed children up to 1-2 years of age. Communicating with women who have had positive experiences with breastfeeding helps a new mother gain confidence in her abilities and receive practical advice to help establish breastfeeding. Therefore, new mothers are advised to contact maternal breastfeeding support groups as early as possible.
Child care and technology training breastfeeding are necessary for a modern mother so that she can raise him up to 1 year without unnecessary hassle and comfort for herself and her baby. Lactation consultants will help you arrange care for your newborn and teach your mother breastfeeding techniques. The sooner a mother learns motherhood, the fewer disappointments and unpleasant moments she and her baby will endure.
Breastfeeding until the child is 1.5-2 years old. Breastfeeding for up to one year is not a physiological period for cessation of lactation, so both mother and child suffer during weaning.

You can also download some .

Global Strategy on Infant and Young Child Feeding

The Global Strategy was jointly developed by WHO and UNICEF and aims to ensure that, through optimal feeding practices, the nutritional status, growth and development, and therefore the health of infants and young children are achieved.

The information is intended to help specialists in the CIS countries update current feeding recommendations.

Feeding infants. Guide for Mothers

The brochure is aimed primarily at new mothers and answers questions people often ask about breastfeeding in emergency situations. It will help organize breastfeeding without endangering the baby and return breast milk.

Breastfeeding is the natural and best way to feed a newborn baby. In recent years, thousands of studies have been conducted on the effects of breast milk on infant development. In accordance with these studies, the World Health Organization has developed some rules for breastfeeding.

Breastfeeding consultant

According to WHO recommendations, breastfeeding consultants are now available in all maternity hospitals and children's clinics. At first glance, the work of these people is not visible, but it is the consultants who help young mothers properly organize breastfeeding.

For many years, mothers were forced to cope with all the complexities of breastfeeding themselves. Today, every woman has a professional assistant who can prevent many of the difficulties of natural nutrition and lactation.

Experts say that according to WHO breastfeeding recommendations, a child should be exclusively breastfed for at least 6 months after birth. Further, breastfeeding should be combined with complementary feeding. The total period of breastfeeding should be on average 2 years.

Modern consultants are guided in their work by the latest WHO recommendations on breastfeeding infants.

Differences between the new standards

Previous application. Unlike in past years, today the baby is put to the breast in the first minutes after birth. Early attachment ensures that the child develops a preference for natural feeding.
Breastfeed your baby exclusively for the first six months of life. The absence of complementary feeding and supplementation in the first months of a child’s life ensures complete, balanced nutrition for the baby and is a natural contraception for the mother.
The joint stay of the newborn and mother in the maternity hospital. Until a few years ago, a newborn was brought to the mother only for feeding. This was a great psychological stress for the baby. Today, mother and child are together from the moment of birth, unless there are contraindications from the pediatrician.
Feeding on demand. Previously, it was believed that the optimal feeding regimen was feeding by the hour. This schedule was practiced in the Soviet Union solely so that young women could go to work earlier. However, recent studies have shown that the best schedule for a baby is breastfeeding on demand.
Long-term feeding. Today, experts say that it is necessary to allow the baby to nurse for as long as he needs. Of course, many mothers complain about the baby constantly hanging on their chest, but this is the only way the child can feel mother’s love, care and develop correctly.
Feeding at night. Studies have shown that night feedings are the most valuable for the baby and mother. At night, the child receives the maximum nutrients, and the mother receives the maximum concentration of the hormone that prevents reconception.
Ban on bottles and pacifiers. The use of bottles and pacifiers creates incorrect breastfeeding technique in the baby. Violation of sucking technique leads to the cessation of natural contraception in a woman’s body and leads to the development of breast diseases.
Compliance with the breast change regimen. Later, milk, which is located deep in the mammary glands, is of great value to the child. Only if the breast is completely sucked out will the baby receive all the most valuable components of human milk. Therefore, the second breast should be offered to the baby only after the first one has been completely emptied.
Prohibition on frequent nipple washing. Previously, women were advised to wash their breasts before each feeding. Nowadays it is already known that this should never be done. A special protective layer is formed on the areola of the breast, which is rich in bacteria beneficial to the intestinal microflora. It is thanks to these bacteria that a child develops a healthy intestinal microflora. This layer also protects the mother from the appearance of cracks on the nipples.
Prohibition on frequent weighing of the baby. Today, pediatricians say that frequent weighings do not provide a complete picture of a child’s development. The optimal weighing schedule is once a week in the first month, then once a month.
Prohibition on expressing milk. According to the results of ongoing research, the mammary glands, with proper feeding, produce only the amount of milk necessary for the baby. Pumping leads to the production of excess milk, which provokes repeated pumping and disruption of the milk production schedule.
Long feeding. According to WHO recommendations, continuous feeding of a child up to 2 years of age is the most optimal period of natural feeding. With this schedule, weaning occurs naturally. This does not bring discomfort to either the mother or the child.

Popular positions for comfortable feeding of newborns

According to research results, adequate breastfeeding significantly reduces the percentage of infant mortality from diseases such as diarrhea and pneumonia. Breastfeeding also protects the baby from viral diseases and promotes a speedy recovery of the baby in case of illness. In addition, children who receive breast milk develop much faster.

Experts also note that full breastfeeding, in compliance with all the rules of natural feeding, has a positive effect on women’s health.

Training of qualified consultants

WHO, in collaboration with UNICEF, has developed special training courses, the purpose of which is to train medical personnel in the basics of proper breastfeeding. The training of qualified breastfeeding consultants is a priority for the World Health Organization. Today, lactation consultants should work in clinics and maternity wards. Specialists are called upon to teach young mothers all the rules of proper feeding.

What WHO recommendations on breastfeeding should every expectant and established mother know? What is the advice of the World Health Organization? How are they justified and supported? Ten principles for successful breastfeeding in recommendations adopted by the international community.

In 2003, at the international conference of the World Health Organization in Geneva, the Global Strategy for Infant and Young Child Feeding was adopted. The document is intended to systematize and organize the knowledge of the international community about the value of breastfeeding. And to convey to medical personnel in all countries of the world the need to maintain it through training and informing mothers.

Ideal nutrition - saving lives

In 2000, WHO and UNICEF specialists began a large-scale study to find out how breast milk actually affects children in the first year of life. The results of the study were stunning.

Depriving children of the first six months of life from breastfeeding greatly increases the risk of mortality as a result of dangerous diseases. About 70% of children in the first year of life living in developing, socially disadvantaged countries of the world, suffering from diarrhea, measles, malaria, and respiratory tract infections, received artificial food.
Breast milk is a complete source of nutrition and reduces mortality among malnourished children. Studies have confirmed that until a child reaches six months of age, it covers 100% of the necessary nutrients. Up to twelve months it serves as a supplier of 75% of valuable substances, and up to twenty-four months it supplies the child’s body with almost a third of the necessary substances.
Breast milk protects against obesity. Excess weight is a global problem for humanity. The prerequisites for it are created by artificial feeding of newborns. The risk of future obesity for such children increases 11 times.
Breast milk develops intelligence. Naturally fed children exhibit higher intellectual abilities than artificially fed children.

The main message given by the World Health Organization in the Strategy is the promotion of breastfeeding in order to reduce child mortality among children from birth to five years. This problem is especially acute in socially disadvantaged regions of the planet. But even in developed countries its relevance is high. After all, breastfeeding is the basis of a healthy human life.

The strategy includes ten points that provide practical guidance for medical staff in maternity hospitals and women in labor. Let's take a closer look at WHO advice on breastfeeding.

The basic postulates of the Strategy are based on the principles of widely informing mothers about the benefits of natural feeding.

Supporting breastfeeding rules and regularly bringing them to the attention of medical personnel and mothers

A feature of medical institutions that adhere to the principles of the Strategy in their daily activities is their focus on creating favorable conditions for women in order to stimulate lactation in the first days after the birth of a child. It will be much easier for young mothers to establish natural feeding in such conditions. Health centers that use the WHO Strategy are considered Baby Friendly Hospitals.

Training of medical personnel in breastfeeding techniques

Past medical education programs paid minimal attention to breastfeeding issues. Over seven years of training for maternity ward doctors, literally several hours were devoted to this topic. It is not surprising that “old-school” doctors do not know the basics of natural feeding and cannot give professional advice to mothers.

In Russia, the issue of advanced training for doctors has not been resolved. Additional funds are needed for retraining and courses. Ideally, every employee of a Baby-Friendly Hospital, from the doctor to the nurse, should provide the woman after childbirth with all the information she needs about breastfeeding.

Informing pregnant women about the benefits of breastfeeding

A pregnant woman makes a decision about how exactly the baby will be fed long before giving birth. Various factors can influence this decision. For example, an expectant mother is often prompted to decide to feed formula by “horror stories” from older relatives about the constant crying of a hungry child or mastitis due to stagnation of milk.

Medical personnel should not only inform the young mother about the advantages of natural feeding. But also teach the technique of breastfeeding, which ensures full feeding without problems and discomfort.

Helping mothers in labor start breastfeeding early

The baby's first breastfeeding should occur within thirty minutes of birth. These WHO recommendations on breastfeeding are difficult to overestimate.

Nature has designed the activation of the sucking reflex in a baby during the first hour after birth. If the baby does not receive the breast now, he will probably fall asleep later to rest from the difficult work done. And he sleeps for at least six hours.

At this time, the woman will not receive stimulation of the mammary glands, which is a signal to the body: it’s time! The beginning of breast milk production and its quantity directly depend on the time of the first contact of the woman with the baby. The longer the first latch is delayed, the less milk the mother will receive and the longer she will have to wait for it - not two or three days, but seven to nine...

The first attachment provides the baby with the first and most valuable food for him - colostrum. And even though there is very little of it, literally drops, it has a colossal effect on the newborn’s body:

populates the food tract with friendly microflora;
provides immune, anti-infective protection;
saturates with vitamin A, which facilitates the course of infectious diseases;
cleanses the intestines of meconium containing bilirubin.

The first application, which took place within half an hour after birth, forms the body's immune defense against environmental hazards. The duration of suckling on each breast for a newborn should be 20 minutes.

Helping mothers conserve breast milk if they are temporarily separated from their babies

Some women are unable to start breastfeeding immediately after giving birth. However, waiting for doctors to allow breastfeeding is disastrous! Lack of breast stimulation leads to delayed lactation: milk comes later and in a much smaller volume than the baby needs.

Babies separated from their mothers are given formula before they are even breastfed. This leads to sad consequences. Once near the mother, the baby stubbornly refuses to take the breast, demanding to be fed from a familiar bottle. The minimum amount of milk in the mother’s breast is an additional factor in the baby’s dissatisfaction. After all, milk needs to be “extracted”, sucked out with effort, and the mixture flows on its own.

When mother and child are separated, breastfeeding recommendations suggest an alternative to feeding - pumping. They should be regular, every two to three hours for 10-15 minutes on each breast. Hand expression after childbirth is uncomfortable and painful. It is better to use a clinical or individual breast pump with a two-phase operating mode.

The amount of milk released is not indicative; do not pay attention to how much came out during pumping. A woman’s task is not to express as much as possible, but to give a signal to the body that it is time to produce milk in full.

Its success and duration largely depend on whether the start of breastfeeding is correct. However, after being discharged from the maternity hospital, the young mother is faced with many questions. WHO breastfeeding recommendations help answer some of these questions.

Lack of food and food other than breast milk

Unless otherwise indicated by individual medical conditions, WHO does not recommend giving children any other food or water until they are six months old.

In the first days of life, the child receives colostrum, rich in nutritional value. The small amount that is produced is enough to satisfy all his needs. There is no need to supplement your baby with anything! Moreover, this is fraught with negative consequences.

Too much water overloads the kidneys. Supplemental feeding with formula creates an unjustified load on the child’s immature kidneys, which have not yet adapted to living conditions in the environment. Adding water works similarly. The baby does not need additional water during the first days of life. He is born with a supply sufficient until the arrival of the mother's first full milk. Colostrum contains very little water, so it is ideal for the baby’s body.
The mixture disrupts the intestinal microflora. Usually on the second day after birth, the baby begins to actively suckle at the breast. Inexperienced mothers immediately come to the conclusion that he is hungry and urgently needs to be “fed” with formula. In fact, this is how the baby encourages the mother’s body to begin producing primary milk, which comes with colostrum. Neither the baby nor your body needs any help, everything will happen by itself! If you give the baby formula at this moment, the microflora of his intestines will change. Dysbacteriosis will develop, which is the main cause of intestinal colic and crying in infants up to three months of age. It will be possible to normalize the child’s condition, even if you adhere to exclusive breastfeeding, no earlier than in two to four weeks.

Of course, there are situations in which supplementary feeding is necessary. But only a doctor should give recommendations for its administration. Spontaneous decisions of the mother to feed her with formula “one time” are dangerous for the baby.

24/7 shared stay

In practice, it has been confirmed that babies who are constantly in the same room with their mothers are calmer, do not scream or cry. Women who have had time to get to know their children are more confident in their abilities. And even if it is their first baby, upon returning home the mother will not face the problem “I don’t know what to do with him.”

In addition, only staying together after childbirth provides the opportunity for the normal development of lactation.

Feeding on demand

Lactation consultants advise looking at your baby, not the clock. Your baby knows better when he's hungry than you or the hospital staff. On-demand breastfeeding provides several benefits.

The baby is always full, is gaining weight well.
The child is calm because he has no reason to worry or be upset. His mother is always nearby, and the breast, which has taken on the “role” of the umbilical cord during intrauterine development, will warm him up, help him sleep and cope with fear.
There is more milk. The amount of milk in women who feed “on demand” is twice as much as in women who adhere to the regime. This conclusion was made by doctors at Moscow perinatal centers based on an analysis of the condition of women in labor upon discharge home.
The quality of the milk is better. Feeding “on demand” enriches milk with valuable substances. It has been established that the level of proteins and fats in it is 1.6-1.8 times higher than in the product for “regular” feeding.
Prevention of lactostasis. The risk of milk stagnation in mothers who breastfeed “on demand” is three times lower.

The practice of feeding at the child's request should also be followed at home. Gradually, the baby will develop an individual feeding regimen that will be convenient for the mother.

Refusal of products and devices that imitate breasts

The use of pacifiers is possible in artificial babies, who should be offered an alternative to the mother's breast to satisfy the sucking reflex. For infants, this alternative is unacceptable, as it changes the sucking technique and becomes a reason for choosing between the nipple or the breast.

Feeding up to two years

WHO breastfeeding advice includes recommendations to breastfeed until age 2. At this age, mother’s milk plays a primary role in the formation of the baby’s brain, the formation of his nervous system, and the final development of the gastrointestinal tract to fully digest and assimilate “adult” food.

WHO recommends supporting breastfeeding after 2 years in developing countries with insufficient levels of medicine, hygiene, and a simple lack of quality products. It is better to continue feeding mother's milk than dangerous food that can lead to life-threatening diseases, say WHO and UNICEF experts.

It is necessary to maintain breastfeeding after 1 year, according to WHO recommendations. The complementary foods that a child receives are not intended to displace or replace mother's milk. He must introduce the baby to new tastes, unusual textures of foods, and teach him to chew. But the child should still receive the most important substances for the development of his body from his mother’s breast.

Following the recommendations of the World Health Organization will allow every mother to gain confidence in her own abilities. After all, the health of her baby depends on her, and not on doctors, baby food manufacturers or experienced grandmothers. It is based on “white gold” - breast milk produced by the mother’s body in the ideal quantity and composition for her baby.

Almost every young mother faces a variety of problems when breastfeeding. In order to avoid unforeseen situations during lactation, it is worth following WHO recommendations on breastfeeding, clearly outlined by month. With their help, every young mother will be able to establish this important process for every woman and fully enjoy motherhood.

In 2003, at the international meeting of the World Health Organization, a declaration on infant nutrition was approved. Thanks to the adoption of this document, an increasing number of young mothers prefer feeding with their own milk, and this serious topic is being popularized at the level of medical institutions.

In the course of research by WHO and UNICEF specialists, it was found that breast milk has a huge impact on the physical and mental development of children under one year old, namely:

Breast milk is a complete source of nutrition for a newborn. So, according to the existing table, babies under the age of six months receive 100% of the nutrients they need from mother’s milk, from 6 to 12 months - 75%, and after a year - 25%.
In the complete absence of breastfeeding, the risk of mortality among newborns increases to 70%. This applies to formula-fed children from poor countries where infectious diseases predominate.
Breast milk affects mental development. Breastfed babies show higher developmental rates than bottle-fed babies.
Breast milk is a reliable protection against obesity. According to statistics, children who are bottle-fed subsequently suffer from excess body weight 11 times more often than babies raised on breast milk.

The main motive of the WHO and UNICEF declaration is to promote the principles of breastfeeding among young mothers. This guardianship program makes it possible to reduce the increase in mortality among children aged 1 to 5 years in countries with unfavorable economic situations.

WHO feeding principles involve receiving mother's milk directly from the breast. If you bottle-feed your baby with breast milk or formula, he will not receive the benefit (although the norms for weight gain according to the monthly table can be met) that the baby receives by listening to the mother’s heartbeat, feeling her affection and warmth. This aspect is very important because it affects the emotional contact between mother and child. A practical guide to feeding children consists of 10 principles. They should help nursing mothers and medical facility staff properly organize the breastfeeding process month by month. It is worth familiarizing yourself with these principles of breastfeeding in more detail.

Supporting breastfeeding principles

According to WHO recommendations, every medical institution is obliged to create comfortable conditions for young mothers to improve the lactation process in the first days of the birth of a child. This will help the nursing mother adapt faster and get rid of all worries about breastfeeding.

Education of medical personnel

Unfortunately, not all medical institutions can provide qualified care to young mothers. For many years, the issue of breastfeeding was not given much attention. Women lacked certain knowledge, which is why many refused to breastfeed. Today the situation is gradually changing.

Each woman decides for herself how to feed her newborn baby. This important issue is decided long before the birth of the child, and this decision is usually influenced by scary stories heard somewhere about breastfeeding, about possible congestion in the chest, poor health and a constantly crying and hungry child. To prevent a negative attitude towards the natural process of feeding, medical personnel are obliged to advise expectant mothers during pregnancy, as well as immediately after the birth of the baby.

First aid for breastfeeding for women in labor

According to WHO recommendations, the first attachment of a newborn to the breast should occur no less than 30 minutes after birth. During this period, the woman’s process of producing breast milk is activated, and the baby, tired during the birth process, will be able to refresh himself and fall asleep. If you do not put the baby to the breast in time, he will fall asleep and the young mother will not produce milk.

At first, the young mother only stands out. Many people underestimate its role for the baby. However, even these small drops can be of great benefit to the child, because colostrum:

Strengthens the immune system, protects the child’s body from infections.
Helps clear the intestines of meconium, thereby reducing the amount of bilirubin.
Fills the food tract with beneficial microflora.
Enriches the child's body with vitamin A.

Preservation of breast milk in case of temporary separation of mother and child
There are times when a newborn and his mother need to be temporarily separated for health reasons. In this case, staff in many medical institutions try to feed the baby with an artificial formula. The child quickly gets used to the fact that he does not have to strain, because mother’s milk needs to be “extracted”, and it flows freely from the bottle on its own. In most cases, the baby stops demanding the breast. In such a situation, a young mother should express milk regularly and not panic if the amount is very small. The main thing is that the breasts will receive a signal about feeding, and gradually the lactation process will improve.

If while staying in the maternity hospital, a young mother can still get the necessary advice from the medical staff, then after discharge, at home, many women are tormented by questions to which it is not always possible to get answers. In this case, it is recommended to breastfeed based on the principles and recommendations of WHO:

In the first days, the newborn will have enough colostrum. Since not everyone can establish successful breastfeeding right away, do not despair, the baby will be completely satisfied with a small, but no less valuable amount of colostrum.
Remember that water overloads a newborn's kidneys. There is no need to give your baby more food; colostrum will be enough for him.
Do not feed your baby formula. This often leads to disturbances in the intestinal microflora.
24-hour stay of the baby with the mother. Staying together with the child will give confidence to both of them - the baby will be calm and protected, and the young mother will be able to quickly adapt to new conditions.

!!! New WHO Guidelines to set global standards for providing health care to healthy pregnant women and reducing unnecessary medical interventions have been signed

« We want women to give birth in a safe environment, with trained birth attendants in well-equipped health facilities. However, the increasing medicalization of normal childbirth undermines women's own ability to bear children and negatively impacts their birth experience." said Dr Princess Nothemba Simelela, WHO Assistant Director-General for Families, Women, Children and Adolescents.

Also note:

Each woman can choose whatever type of birthing service she prefers (any position possible: standing, kneeling, squatting, in a clinic or at home, in water or dry).
Informal antenatal, birth and postnatal care systems (where they already exist) need to operate alongside the formal system. Cooperation with them should be supported in every possible way in the interests of mother and child. Such relationships, established in the absence of superiority of one system over another, can be highly effective.
Information about the methods practiced in the hospital (maternity hospital) chosen by the woman and its statistics should be known to the population served by these hospitals (rate of cesarean sections, mortality rate per 1000 births, incidence of staphylococcus, streptococcus in newborns, etc.).
The psychological well-being of the new mother should be ensured not only through free access to relatives of her choice during childbirth, but also through free visitation after childbirth.
A healthy newborn should remain with the mother. When their health condition allows it. No process of monitoring the health of a newborn justifies separating him from his mother! Joint communication between mother and child should not be prevented, the duration of which should be determined by the mother’s wishes. Mother and baby should be encouraged to be in the same room.
Breastfeeding should begin no later than 30 minutes after birth (that is, while still in the delivery room).
Caesarean section is used on average in no more than 10% of cases.
Electronic monitoring of the fetus during labor does not always have an adequate effect on the birth process. Computer-assisted fetal monitoring should be performed in carefully selected cases and in induced (induced) labor.
There are no indications for shaving pubic hair or taking an enema before childbirth.
It is necessary that women can walk during contractions. Every woman should be free to decide what position to take during childbirth.
Provoking contractions should be practiced no more than 10% of the time.
During childbirth, the use of painkillers and anesthetics without appropriate medical indications should be avoided.
Attention must be paid to the emotional, psychological and social aspects of childbirth care:

a) the choice of place of birth and the specific candidacy of the obstetrician delivering the child are important (for paid births);

b) it is necessary to maintain physical integrity and for the mother and child to occupy a separate room;

c) it is necessary to consider the birth of a child as a purely personal family event;

d) it is important to provide warmth, proper living conditions and nutrition in the 1st month after the birth of a child only with breast milk: artificial feeding is permissible only in 10% of cases;

e) follow-up medical care after the birth of the child is necessary;

f) paid leave should also be provided to fathers so that they have the opportunity to communicate with the child and provide assistance to the mother;

g) in any country or region, customs associated with the birth of a child should be respected and supported if they do not pose a threat to his health. The placenta and umbilical cord are the property of the child;

h) care provided at home to all mothers and children should be equivalent to that provided to healthy women and children in hospital;

i) all parents and newborns have the right to direct communication from the moment of birth. Joint communication between mother and child should not be prevented, the duration of which should be determined by the desire of the mother;

j) Women can keep a medical record or a copy of it at home; it must contain information about the course of pregnancy and childbirth. The confidential nature of the information contained in these documents must be respected;

k) all women and newborns should have their immune status tested by laboratory methods in accordance with the recommendations adopted in their countries, regardless of whether they are at home or in hospital.

The time of discharge from the hospital should be determined depending on the condition of the mother and child, the wishes of the parents and support at home. In particular, the policy of discharge from the hospital should not be determined only by the criteria of the child’s body weight, but should be focused on the earliest possible discharge.
Parents have the right to early active participation in their child's care. Government health authorities should strive to include maternal and child health in the curricula of universities, medical schools and public health courses. Conduct outreach and educational work to prepare young people - parents and health workers - for the responsibilities associated with giving birth and caring for children, through lectures, thematic programs on television and radio, as well as publications in newspapers and other media.

Caring for Normal Childbirth: A Practical Guide (Technical Working Group Report)

2.4 Place of birth

“...Where a trained birth attendant can correctly assess risk, advice on location of birth based on that assessment is not always followed. Many factors deter women from accessing higher-level health care facilities. Among them:

cost of childbirth in hospital,
unusual [medical] practices,
unsatisfactory staff attitude,
restrictions placed on the possibility of family members being present during childbirth, and often the need to obtain permission from another family member (usually a man) to go to a medical facility...

Often, high- and very high-risk women do not feel sick or show symptoms of ill health, and therefore give birth at home, with the help of family members, neighbors or traditional birth attendants...However, a properly managed home birth requires some basic preparation...transportation vehicles to the health facility must be available when necessary. In practice, this means that community support and funds are needed to provide emergency transport in areas where transport is problematic. Some developed countries have established special maternity centers in and outside hospitals, where low-risk women can give birth in a home-like environment while receiving basic care usually provided by midwives. Most of these centers do not use electronic fetal monitoring or induction of labor and use minimal pain medications. Detailed report on care in maternity centers in USA describes care in alternative birthing centers in and outside of hospitals...

Research into the care provided by midwives in hospitals in the UK, Australia and Sweden showed that the satisfaction women receive from such care significantly exceeds the satisfaction from standard care. In general, the number of artificial interventions was lower, especially the use of obstetric analgesia, induction and induction of labor. Birth outcome data did not differ significantly from those observed when births were attended by consultants, although in some cases mortality during birth was slightly higher with the obstetric model of care... In a number of developed countries, dissatisfaction with hospital care has prompted small groups of women and their caregivers to turn to the practice of home birth in an alternative setting, often in greater or lesser conflict with the official health care system. Statistics on these home births are scarce. One Australian study collected data indicating that selection for low-risk pregnancies was only moderately successful. In planned home births, hospital transfers and obstetric interventions were low. Death rates during childbirth and infant mortality were also relatively low, but no data were provided on preventable factors...

Netherlands are a developed country with a formal home birth system. The proportion of home births varies greatly by region, and varies even among large cities. A study of mortality during childbirth found no correlation between the rate of hospital attendance for childbirth and the rate of death during childbirth in the respective regions... A study carried out in the province of Gelderland compared the outcome of home and hospital births. The results indicate that for first-time women with low-risk pregnancies, home birth was as safe as hospital birth. For multiparous women with low-risk pregnancies, home birth outcomes were significantly better than hospital birth outcomes... There is no reason to believe that this system of care for pregnant women would be improved by increasing the degree of medicalization of birth...

So where should a woman give birth? It is safe to say that a woman should give birth in a place where she feels safe, in the closest environment to her, where appropriate care will be feasible and safe... For women with a low-risk pregnancy, this could be a home, a small maternity hospital or a maternity center in the city, or perhaps a maternity ward in a general hospital. However, it should be a place where her needs and safety are the focus and as close to her home and culture as possible. If birth occurs at home or in a small peripheral birth center, ensuring access to a staffed health center in case of emergency should be part of antenatal preparations.”

For Belarus, these documents are only advisory in nature and have not been supported at the legislative level. But the experience and recommendations of WHO on conditions during childbirth for women would be more than appropriate to use to improve the conditions of obstetric care.

In Russia, for example, the State Duma supported the provisions of the WHO back in May 1998. And maternity hospitals that have the status of “Baby-Friendly Hospital” strive to support many of the provisions of the Recommendations on the technology of obstetric care.

The Ministry of Health of Belarus and some maternity hospitals supported only the WHO/Unicef Baby-Friendly Hospital Initiative. The “Baby Friendly Hospital” status confirms that the maternity hospital places emphasis on breastfeeding infants, and all conditions have been created for this. It is assumed that medical staff in such maternity hospitals promote and teach young mothers breastfeeding skills, and comfortable conditions for feeding are created in all departments, including the emergency room.

Feeding on demand. It is necessary to put the baby to the breast for any reason, to give him the opportunity to suckle when he wants and as much as he wants. This is important not only for satiating the child, but also for his psycho-emotional comfort. To feel comfortable, the baby can be attached to the breast up to 4 times per hour.

The duration of feeding is regulated by the child: Do not take your baby off the breast before he releases the nipple on his own!

Night feedings of the baby ensure stable lactation and will protect a woman from the next pregnancy for up to 6 months - in 96% of cases. In addition, it is night feedings that are the most complete and nutritious.

No additional soldering or introduction of any foreign liquids and products. If the baby is thirsty, he should be put to the breast more often.

Complete refusal of pacifiers, pacifiers and bottle feeding. If it is necessary to introduce complementary foods, it should be given only from a cup, spoon or pipette.

Transferring the baby to the second breast only when he has suckled the first breast. If the mother rushes to offer the baby the second breast, he will not receive additional “late milk” rich in fats. As a result, the baby may experience digestive problems: lactose intolerance, foamy stools. Prolonged sucking on one breast will ensure proper bowel function.

Avoid washing nipples before and after feeding. Frequent breast washing leads to the removal of the protective layer of fat from the areola and nipple, which leads to the formation of cracks. Breasts should be washed no more than once a day during a hygienic shower. If a woman showers less often, then in this case there is no need for additional breast washing.

Refusal from control weighings of the child, carried out more than once a week. This procedure does not provide objective information about the nutritional status of the infant. It only irritates the mother, leads to a decrease in lactation and the unreasonable introduction of supplementary feeding.

Elimination of additional milk expression. With properly organized breastfeeding, milk is produced exactly as much as the baby needs, so there is no need to pump after each feeding. Pumping is necessary in case of forced separation of mother and child, mother going to work, etc.

Only breastfeeding up to 6 months— the child does not need additional nutrition and complementary feeding. According to some studies, a child can be exclusively breastfed for up to 1 year without harming his health.

Support for mothers who breastfed children up to 1-2 years of age. Communicating with women who have had positive experiences with breastfeeding helps a new mother gain confidence in her abilities and receive practical advice to help establish breastfeeding. Therefore, new mothers are advised to contact maternal breastfeeding support groups as early as possible.

Training in baby care and breastfeeding techniques are necessary for a modern mother so that she can raise him up to 1 year without unnecessary hassle and comfort for herself and her baby. Lactation consultants will help you arrange care for your newborn and teach your mother breastfeeding techniques. The sooner a mother learns motherhood, the fewer disappointments and unpleasant moments she and her baby will endure.

Breastfeeding until the child is 1.5-2 years old. Breastfeeding for up to one year is not a physiological period for cessation of lactation, so both mother and child suffer during weaning.