Feeding the non-breastfed infant 0 up to 6 months

Notes for community health workers to share when counselling on infant formula:

• When a mother or family expresses interest in using infant formula instead of breastfeeding or in addition to breastfeeding, discuss the reasons why and explore all options.
• If a mother is having problems breastfeeding, explore whether the issue is related to positioning or attachment, and provide support using the appropriate counselling cards.
• If a mother has to be separated from her baby (e.g., because of employment outside the home), explore the idea of expressing and leaving milk for someone else to feed the baby while she is away. See Counselling Card 10 on how to hand express breastmilk and cup feed.
• If a mother explains that she is not producing breastmilk, for whatever reason, explore the possibility of re-lactation (i.e., the process of re-establishing breastmilk production). See Counsellor’s Book Part 2: Technical Notes Section 7.5: Re-lactation and Drip Drop Method.
• In the case of re-lactation, or if there is another difficult problem, refer the mother to the health facility or to a trained lactation consultant for counselling.
• If the mother is not breastfeeding, or if the baby’s mother is not available, explore the option of having another mother breastfeed the baby.
• For mothers and caregivers who use infant formula, support them to feed the child in a way that reduces risks by explaining the importance of the steps mentioned in this Counselling Card, including cleaning hands and utensils, reading the instructions, measuring the formula powder, measuring the water, mixing carefully and feeding the baby.
• It is important to maintain the mother’s central role in feeding her baby. This helps with bonding.
  • Never over-dilute or under-dilute infant formula, which can cause dehydration and other serious problems for the baby.
  • Use a cup instead of a bottle to feed the baby. 
  • See Counselling Card 10 on how to hand express breastmilk and cup feed.
  • See Counselling Card 37 for more information on the conditions needed to feed the non-breastfed infant.
  • Refer the mother or family to the health facility if the baby gets sick with diarrhoea or other illnesses or if there is difficulty obtaining sufficient infant formula.