Republic of the Philippines

Zamboanga Peninsula
Province of Zamboanga del Norte
MUNICIPAL GOVERNMENT OF BALIGUIAN
Poblacion, Baliguian, Zamboanga del Norte
Email address: [email protected]
Cellphone number: 09060596378/09157656576

OFFICE OF THE RURAL HEALTH UNIT

April 30, 2019

EMILIA P. MONICIMPO, MD, MPH, CSEE

Regional Director IV
Department of Health – Region IX
Upper Calarian, Zamboanga City

Thru: EVELYN CAPISTRANO, RND

MBFHI Coordinator/Nutrition Program

Doctor/Madame:

Salutations!

The Baliguian Rural Health Unit is committed to providing the best health solutions in
our area. We value the importance of breastfeeding and promote its practice especially in early
life. We support initiatives to strengthen its campaign like the MBFHI.

This is a letter of intent for the establishment of Baliguian RHU as a mother-friendly

health institution. This would enforce early breastfeeding practices since our facility provides
basic obstetrics and newborn care.

We have undergone the necessary trainings, updated our polices, passed our
resolutions on breastfeeding and had pre-assessment of the facility by provincial DOH
representatives (Ms. Daarol and Ms. Bataga) November of last year.

We are looking forward to be guided as an MBFHI as well as getting continued support

from you as health partners.

Attached herewith are: (1) BF updated policies; (2) BF resolutions; (3) Action Plans for
2017 and 2019 trainings; (4) Attendance sheet for 2017 20-hr BF training and orientation; (5)
course timetable and (6) photos of RHU.

Thank you and more power.

Sincerely,

(sgd)Fatima F. Kunting, MD, MPH

Municipal Health Officer
Baliguian Rural Health Unit
XVIII. BREASTFEEDING

This Birthing Facility should:

1. Have a written breastfeeding policy that is routinely communicated to all

health care staff.
2. Train all health care staff in skills necessary to implement this policy.
3. Inform all pregnant women about the benefits and management of
breastfeeding.
4. Help mothers initiate breastfeeding within a half-hour of birth.
5. Show mothers how to breastfeed and how to maintain lactation, even if
they should be separated from their infants.
6. Give newborn infants no food or drink other than breastmilk unless
medically indicated.
7. Practice rooming-in. Allow mothers and infants to remain together – 24
hours a day.
8. Encourage breastfeeding on demand.
9. Give no artificial teats or pacifiers (dummies or soothers) and feeding
bottles to breastfeeding infants.
10. Foster the establishment of breastfeeding support groups and refer
mothers to them on discharge from the hospital or clinic.

BREASTFEEDING POLICIES:

1. A Breastfeeding Committee shall be created with the Municipal Health

Officer as the Chairman and the LMT trained Nurse/Midwife as the Vice-
Chairman. The members of the committee shall have undergone
Lactation Management Training (Re echo) conducted by LMT trained staff
at the Regional Health Office. The Breastfeeding Committee should be
posted in the Breastfeeding Area or Corner.

2. The Breastfeeding Committee shall see to it that breastfeeding advocacy

is intensified by conducting breastfeeding counseling to all pregnant
women and mothers who delivered.

3. Every section/department of the Birthing facility should have a

Breastfeeding Policy posted conspicuously and made available to
everyone.

4. All areas/sections in the Birthing Facility should have IEC materials like
Breastfeeding Logo and Breastfeeding TSEK and other Breastfeeding
pictures and posters posted.
 5. A Breastfeeding Room/Corner or Lactation Room shall be established
equipped with reclining chair/bed, sink with water, soap and towel and
refrigerator. It should be located outside the Birthing Room Complex. A
Breastfeeding Logbook which contains the names of the breastfeeding
mothers who used the Lactation Room should be provided.

6. All breastfeeding mothers who received breastfeeding advocacy from the

health care provider should be registered in the Breastfeeding Logbook
with their signatures to include the date and time the advocacy was
done.

7. The facility and the staff are not allowed to promote milk substitutes in
any form such as promotional materials or commercial samples in any of
the health activities.

Breast Feeding Policies

(Mga Palisiya Sa Pag Pasusu)

Palisya:

1. Tanan nga ma admit sa ospital para manganak normal o operahan (cesarian

section) kinahanglan magpasusu.
2. Tanan nga mangalanak nga dili magpasusu dili i admit sa ospital.
3. Ang tanang bag o nahimugso nga bata kinahanglan ipasusu dayon sa inahan
aron mapahigayon ang pagdapat sa ilang mga lawas o panit “SKIN TO SKIN
CONTACT” sa inahan ug sa bata.
4. Ang pagbutang ug mga posters o hulagway labi na sa mga gatas de lata o infant
formula sa tibuok lugar sa ospital.
5. Ginadili ang pagdala ug pagpagamit ug beberon, tsupon gatas de lata sa sulod
sa ospital labi na ang pagbaligya niini sa Botika o parmasya.
6. Ang tanang bata nga nag idad 6 ka bulan paubos nga naadmit sa ward sa mga
bata o Pediatric ward kinahanglan ipasusu sa inahan.
7. Gina dili and pagdawat ug mga milk formula sample o mga prelacteal food gikan
sa mga ahente sa bisag unsa nga milk companies.
8. Ang tanang hospital staff ilabi na ang naga duty sa Station OB Ward, NICU,
Labor ug Delivery rooms kinahanglan motabang sa bag ong nanganak aron
mapahigayon ang eksakto nga posisyon sa pagpasusu u gang mga pama agisa
pagpagawas sa gatas sa inahan.
9. Ang tanang hospital staff gi tahasan sa pag konfiskar o pagkuha ug beberon,
tsupon, gatas de lata nga makit an sa sulod sa nahisgutan nga lugar.
10. Ang tanang hospital staff hi tahasan sa pagbansay bahin sa pagpasusu (
LACTATION MANAGEMENT ) aron mapadayon ang pag awhag ang ka
importansiya sa pagpasusu.

 PRE NATAL ROOM DURING ANTE NATAL CARE

1. All RHU Staff should promote BREASTFEEDING among women of

reproductive age, more especially the pregnant women.

2. All women of reproductive age, and most especially pregnant women,

should be informed about the BENEFITS and ADVANTAGES of
breastfeeding.
 3. During prenatal check-ups, the midwife should perform BREAST
EXAMINATION to all clients. Note for any mass, and refer immediately to
the doctor for further evaluation. Nipple and areola should be examined
for any cracks, /or skin infection, and the presence of milk during the last
trimester.

4. All RHU staff must HELP PREPARE expectant mothers PHYSICALLY and
PSYCHOLOGICALLY for Exclusive Breastfeeding. They should be taught
about avoidance of stress and good nutrition that help milk secretion,
aside from the number one factor which is constant sucking of the nipple
by the baby.

5. If the expectant mother has NO BREASTMILK during the last trimester of

pregnancy, especially on the 9th month, she should be encouraged to let
her husband SUCK her breasts frequently to produce milk, and to take
Malunggay capsule, 1 cap 3x a day , in preparation for the upcoming
baby.

6. All pregnant women including her family, should be ALARMED that NO

FEEDING BOTTLES, artificial TEATS, and MILK SUBSTITUTE are allowed in
the birthing facility, otherwise, they will be CONFISCATED.

7. NO BREASTFEEDING, NO ADMISSION policy may be imposed.

8. If a patient is a known HIV-positive mother, practice utmost

confidentiality. Confirm her birth plan and respect her choices. Encourage
exclusive breast-feeding up to 6 months. Adapt the HIV and infant
feeding recommendations based on the latest guidelines.

 LABOR ROOM DURING LABOR

1. At the early labor period, all mothers are advised to TAKE A BATH, change
clothes to a clean Malong, Patadyong, duster with opening in front, or
patients’ gown issued in the facility, if available.

2. The pregnant woman in labor may eat her meals as she desires, but she
should be informed that LIGHT MEALS are preferable, like fruits,
vegetables, lugaw/or arroz caldo, in small frequent intake, and she
should drink more fluids.

3. The pregnant woman in labor may have all the positions she desires in
which she is comfortable to, like standing, sitting, lying down, squatting,
etc., as long as it would not harm her or her baby.

4. The Midwife on duty should NOT LEAVE the pregnant woman in active
labor with one watcher in the Labor Room. She should monitor the
 progress of labor and the fetal heart beats frequently, especially if the
second stage of labor is almost to begin. She must be assured that she is
safe with health professionals to lessen her anxiety.

5. Advise pregnant women in labor to manipulate or massage their nipples

gently from time to time for it helps in the contraction of the uterus, thus
hasten cervical dilatation as well as the delivery of the baby.

 DELIVERY ROOM DURING DELIVERY OF THE BABY

1. Immediately following delivery, the baby should be placed at her

mothers’ abdomen. The cord is clamped after one minute, or when the
pulsation in the cord already disappeared and cut between 2 clamps. The
baby should be dried up immediately and placed at her mothers’ chest
for skin to skin contact. BREASTFEEDING may start at this time.

2. The Midwife assisting the delivery should wash the mothers’ nipples with
water before putting the nipple into the baby’s mouth (this can also be
done while the pregnant woman is in labor).
3. The Midwife on duty should remind the newly delivered mother about
the benefits and management of breastfeeding, as well as the
importance of COLOSTRUM.

4. After fixing the mother, the Midwife on duty should INSTRUCT and
DEMONSTRATE the correct technique and positions of Breastfeeding,
especially to the primi gravida.

5. The Midwife on Duty should also promote FAMILY PLANNING to the

newly delivered mother. She should inform the mother regarding the
benefits of spacing pregnancies, and the advantages and disadvantages
of each method of CONTRACEPTION, especially of the POSTPARTUM IUD,
DEPO INJECTION and LAM or exclusive breastfeeding for six months as
one of the natural family planning method.

 OB WARD DURING THE POST PARTUM PERIOD

1. ROOMING-IN AND EXCLUSIVE BREASTFEEDING are policies of Siocon

Rural Health Unit Birthing Facility, unless the Mother and/ or the Newly
delivered infant is very ill and breastfeeding is impossible. The baby can
still be fed with breast milk from her mother, or from other mother, by
NGT, cup feeding, or by dropper feeding.
2. Feeding bottles, artificial teats, and pacifiers are NOT ALLOWED inside
the facility, otherwise they should be confiscated.
3. The mother and the baby should take a bath every day. If possible, a
daily defecation is advised to the mother before bathing.
4. Washing the nipple with water only should be done before every
breastfeeding, no need to use soap or alcohol.
 5. In the WARD, the mother should wear a clean DUSTER or BLOUSE with
opening in front, for EASY Breastfeeding.
6. FEEDING PER DEMAND should be practice. Each mother should LEARN
the CUES when her baby demand feeding. The baby is REMOVED only
from the breast when she removes her mouth from the nipple. A healthy
Neonate can feed as many as 6 to 10 times in 24 hours.
7. The Midwife on duty and the rest of the staff should TEACH all mothers in
the ward the proper way to EXPRESS and STORE breast milk in the
Refrigerator.
8. All babies should be BURPED every after feeding, by holding her UPRIGHT
with her ABDOMEN gently PRESSED on the chest of the one burping her.
9. Lactating mothers should EAT nutritious food, more of fruits and
vegetables, and drink a lot of fluids/or water to produce enough milk for
her baby.

 UPON DISCHARGE WHEN MOTHER GOES HOME:

1. All mothers discharged from the birthing facility should be REFERRED to

the COMMUNITY BREASTFEEDING SUPPORT GROUP in their respective
Barangays.

2. The Community Breastfeeding Support Group (CBFSG) is composed by

the CHT Navigators, BHWs, BNS, Parents Leaders, Barangay Chairman,
Hilots and RHM in every Barangay.

3. The functions of the Breastfeeding Support Group are the following:

a. MONITOR the post partum mother if she practices exclusive

breastfeeding at home. Midwives report the exclusive breastfeeding
infants monthly.
b. COACH the post partum women on proper nutrition for both mother
and infant.
c. Monitor any Post Partum COMPLICATION during the first 42 days
after giving birth and refer immediately to Municipal Health Officer.
d. HELP post partum women in DELAYING pregnancy thru INFORMED
CHOICE / or permanently STOP getting pregnant.
e. Help post partum women in all their problems regarding
Breastfeeding.
f. Give ASSURANCE to all post partum women that everyone is CAPABLE
of producing milk for their baby, and everyone has the capability of
breastfeeding.