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  3. Safe Breast Milk Handling
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

Introduction

Breast milk is a living fluid rich in nutrients and antibodies. Safe handling ensures milk remains fresh and free from contamination. Even in low-resource settings, simple, practical steps can help mothers store and use milk safely for their babies.

1. Collection Guidelines

  • Wash hands with soap and water before expressing.

  • Use clean containers:

    • Glass jars with tight lids, food-grade plastic containers, or clean cups.

    • If possible, avoid bottles with BPA.

  • Do not touch inside of containers or lids.

  • Express directly into container if possible to reduce contamination.

2. Labeling Guidelines

  • Always label container with:

    • Baby’s name (if in shared facility).

    • Date and time milk was expressed.

  • Use waterproof marker or tape.

  • Store oldest milk first (FIFO: First In, First Out).

3. Storage Guidelines

General Rules (WHO/CDC)

  • At room temperature (≤25°C/77°F): up to 4 hours.

  • Refrigerator (≤4°C/39°F): up to 4 days.

  • Freezer (-18°C/0°F or colder): 6 months best, 12 months acceptable.

Low-Resource Options

  • Cooler with ice packs: Keeps milk safe for 24 hours.

  • Clay pot cooler (“zeer pot”): Place container in a covered clay pot with wet sand between — evaporation keeps it cool.

  • Shaded area with wet cloth wrap: Provides some cooling effect if refrigeration unavailable (short-term only).

4. Thawing Guidelines

  • Best method: Move container from freezer to refrigerator (overnight).

  • Faster method: Place sealed container in bowl of lukewarm water.

  • Do NOT:

    • Use boiling water.

    • Microwave (destroys nutrients, causes hot spots).

5. Warming Guidelines

  • Warm by placing container in bowl of warm water for a few minutes.

  • Gently swirl (not shake) to mix separated fat.

  • Test milk temperature by placing a drop on the inside of the wrist (should feel lukewarm, not hot).

  • If baby is happy with cold milk — warming is not required.

6. Common Mistakes to Avoid

  • Refreezing thawed milk.

  • Mixing freshly expressed warm milk with frozen milk (cool it first).

  • Leaving milk out for long periods in hot climates.

  • Heating directly on stove or with microwave.

End of Lecture Quiz

Q1. What is the safest way to thaw frozen breast milk?
A. In boiling water
B. In the microwave
C. In the refrigerator or bowl of lukewarm water
D. On the windowsill in the sun

Answer: C. In the refrigerator or bowl of lukewarm water
Rationale: These methods preserve nutrients and avoid dangerous hot spots.

Q2. True or False: It is safe to refreeze breast milk once thawed.
Answer: False
Rationale: Refreezing increases risk of bacterial growth and nutrient loss.

Q3. Which low-resource option can safely keep milk cool?
A. Clay pot cooler (zeer pot)
B. Leaving it on a windowsill
C. Wrapping in dry cloth only
D. Heating it every few hours

Answer: A. Clay pot cooler (zeer pot)
Rationale: Evaporative cooling from wet sand helps preserve milk safely when refrigerators are unavailable.

Curated Online Resources

Key Takeaways

  • Safe milk handling prevents contamination and spoilage.

  • Always wash hands, use clean containers, and label clearly.

  • Storage depends on temperature — short at room temp, longer in fridge/freezer.

  • Low-resource solutions like cooler boxes or clay pots can extend storage life.

  • Thaw safely in fridge or lukewarm water, never refreeze.

Call to Action

  • Mothers: Learn simple storage methods that fit your home environment.

  • Health workers: Teach mothers both modern and low-resource safe storage options.

  • Communities: Support working and rural mothers with safe milk storage spaces and education.

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