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  3. Red Flags for Baby and Mother
Course Content
Why Breastfeeding Matters (10 minutes)
Health and developmental benefits for infants Maternal benefits (physical and mental) Economic and community-level advantages Common myths and culturally specific misconceptions
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Health & Developmental Benefits for Infants from Breastfeeding
Maternal Benefits of Breastfeeding (Physical and Mental)
Economic and Community-Level Advantages of Breastfeeding
Common Myths and Culturally Specific Misconceptions about Breastfeeding
Newborn Feeding Cues & Anatomy (20 minutes)
Early vs. late hunger cues and what they mean Normal newborn feeding patterns and stomach capacity Brief breast anatomy (lobes, ducts, nipple, areola) in plain language Signs of effective feeding (swallowing, contentment, diaper output)
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Early vs. Late Hunger Cues in Infants
Normal Newborn Feeding Patterns and Stomach Capacity
Breast Anatomy (in Plain Language)
Signs of Effective Feeding in Breastfed Babies
Positions & Achieving a Good Latch (40 minutes)
Position options: cradle, cross-cradle, football/clutch, side-lying Stepwise approach to help baby latch (prepare — attach — assess) Signs of a good vs. poor latch (comfort, nipple shape, audible swallowing) Small-person adaptations (premature, small mouth, tongue-tie considerations) Safe positioning for mothers with C-section recovery
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Position Options for Breastfeeding
Stepwise Approach to Help Baby Latch
Signs of a Good vs. Poor Latch
Small-Person Adaptations in Breastfeeding
Safe Positioning for Mothers with C-Section Recovery
Protecting & Building Milk Supply (25 minutes)
Establishing supply in the first days and weeks (frequency, skin-to-skin) Night feeds and cluster feeding explained Lifestyle and medical factors that reduce supply (e.g., certain medications, stress) Relactation and increasing milk supply safely Nutrition and hydration myths vs. evidence
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Establishing Milk Supply in the First Days and Weeks
Night Feeds and Cluster Feeding
Lifestyle and Medical Factors That Reduce Supply
Relactation and Increasing Milk Supply Safely
Nutrition and Hydration Myths vs. Evidence in Breastfeeding
Expressing & Storing Breastmilk (20 minutes)
Hand-expression steps and common mistakes Choosing and using pumps (manual vs. electric) — practical tips Safe collection, labeling, storage, thawing and warming guidelines (low-resource options included) Cleaning and hygiene for bottles and storage containers Feeding expressed milk to infant (cup, spoon, paladai, bottle considerations)
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Hand-Expression Steps and Common Mistakes
Choosing and Using Breast Pumps (Manual vs. Electric)
Safe Breast Milk Handling
Cleaning and Hygiene for Bottles and Storage Containers
Feeding Expressed Milk to Infants
Common Problems & Practical Solutions (25 minutes)
Causes of sore nipples and immediate relief techniques Managing engorgement and preventing blocked ducts Recognising mastitis vs. normal engorgement and when antibiotics may be needed Low weight gain: assessment steps and feeding plan adjustments Non-judgmental approach to supplementation and safe short-term options
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Causes of Sore Nipples and Immediate Relief
Managing Engorgement and Preventing Blocked Ducts
Recognising Mastitis vs. Normal Engorgement
Low Weight Gain — Assessment and Feeding Plan Adjustments
Non-Judgmental Approach to Supplementation
Returning to Work or School; Feeding Outside the Home (15 minutes)
Creating an express-and-feed routine (timing, containers, transport) Practical storage and transport tips for different commute types Rights and workplace basics (general guidance; encourage local legal verification) Communicating with caregivers and preparing safe feeder notes Emotional coping and practical fallback plans
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Creating an Express-and-Feed Routine
Practical Storage & Transport Tips for Expressed Breast Milk by Commute Type
Rights and Workplace Basics for Breastfeeding Mothers
Communicating with Caregivers and Preparing Safe Feeder Notes
Emotional Coping and Practical Fallback Plans
Special Situations (20 minutes)
Feeding preterm or low-birthweight infants: kangaroo care, cup or tube feeding basics Managing twins/multiples: tandem feeding tips and time-saving routines Mothers on medication or with infectious illness: how to check drug safety and local guidelines (HIV, TB, etc.) Using donor milk or milk banks (where available) — safety basics
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Feeding Preterm or Low-Birthweight Infants
Managing Twins/Multiples — Tandem Feeding Tips and Time-Saving Routines
Mothers on Medication or with Infectious Illness — Drug Safety & Guidelines
Using Donor Milk or Milk Banks — Safety Basics
When to Seek Help & Building a Support Network (15 minutes)
Red flags for baby and mother (e.g., poor weight gain, fever, severe pain) Where to seek help: clinic, CHW, lactation consultant, emergency care Building a support network: partners, family, peer counsellors, community groups Using telephone/text supports, community groups, and referral pathways
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Red Flags for Baby and Mother
Where to Seek Help for Breastfeeding Challenges
Building a Support Network for Breastfeeding Mothers
Using Telephone/Text Supports, Community Groups, and Referral Pathways
Wrap-up, Resources & Final Assessment (15 minutes)
Key takeaways and common pitfalls to avoid Next steps: seeking local support, advanced training options How to use course materials beyond the course (groups, sharing, peer support) Final 20-question multiple-choice quiz (80% pass mark)
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Key Takeaways and Common Pitfalls to Avoid
Next Steps — Seeking Local Support & Advanced Training Options
How to Use Course Materials Beyond the Course
Final 20-question multiple-choice quiz (80% pass mark)
How to Breastfeed — Self-Paced, Evidence-Based Course for African Moms

1. Introduction

While most breastfeeding challenges are minor and manageable, some signs indicate serious problems that require urgent medical attention. Recognizing red flags early can save lives.

2. Red Flags for the Baby

Feeding & Growth Concerns

  • Poor weight gain: Baby not regaining birth weight by 2 weeks, or very slow growth thereafter.

  • Persistent refusal to feed or inability to latch.

  • Signs of dehydration: Very few wet diapers (<6 per day after 5 days old), sunken fontanelle, dry mouth.

Behavior & Appearance

  • Lethargy: Baby unusually sleepy, difficult to wake for feeds.

  • Excessive irritability or inconsolable crying.

  • Yellowing (jaundice) spreading to legs after first week or worsening.

Illness Signs

  • Fever (≥38°C / 100.4°F) in a newborn (medical emergency).

  • Breathing difficulty (fast breathing, grunting, chest retractions).

  • Bluish lips/skin (possible oxygen shortage).

  • Persistent vomiting (not just small spits).

3. Red Flags for the Mother

Breast & Feeding Issues

  • Severe, persistent nipple or breast pain not improving with latch correction.

  • Signs of infection: Red, hot, swollen breast area with fever (possible mastitis/abscess).

  • Cracked, bleeding nipples that do not heal.

  • Sudden decrease in milk supply with illness or other concerning symptoms.

General Health Concerns

  • High fever, chills, or flu-like symptoms that worsen.

  • Heavy vaginal bleeding beyond normal postpartum recovery.

  • Severe headaches, vision changes, or swelling (possible postpartum hypertension/preeclampsia).

  • Severe sadness, hopelessness, or thoughts of self-harm (postpartum depression emergency).

4. What To Do if Red Flags Appear

  • Seek medical care immediately — do not wait.

  • Bring baby to hospital/clinic for urgent evaluation if fever, breathing problems, or poor feeding are present.

  • Call a health worker for guidance on whether emergency care is needed.

  • Continue safe feeding (expressed breast milk, cup feeding) if baby is unable to latch while awaiting help.

End of Lecture Quiz

Q1. Which of the following is a red flag for a newborn?
A. 8–12 feeds per day
B. 6+ wet diapers daily
C. Fever above 38°C (100.4°F)
D. Regular burping after feeds

Answer: C. Fever above 38°C (100.4°F)
Rationale: Fever in a newborn always requires urgent medical evaluation.

Q2. What breast symptom in a mother requires urgent review?
A. Mild fullness before feeds
B. Tenderness that eases after feeding
C. Red, hot, swollen area with fever
D. Tingling sensation during letdown

Answer: C. Red, hot, swollen area with fever
Rationale: This suggests mastitis or abscess requiring treatment.

Q3. True or False: Persistent maternal sadness and hopelessness should be taken seriously as a medical concern.
Answer: True
Rationale: Postpartum depression can be life-threatening if untreated.

Curated Resources

Key Takeaways

  • Red flags in babies include poor weight gain, fever, breathing difficulty, dehydration, and lethargy.

  • Red flags in mothers include severe pain, fever with breast redness, excessive bleeding, or mental health crisis.

  • Early recognition and rapid medical attention prevent complications.

Call to Action

  • Mothers/Families: Trust your instincts — if baby or mother seems unwell, seek care immediately.

  • Health workers: Teach red flags during prenatal and postnatal visits.

  • Communities: Support mothers emotionally and practically so they seek help without delay.

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Ushauri Mama - Your MNCH Guide