The banner of the training
Greetings from BPNI!
BPNI conducted training on IYCF counseling and lactation management in Delhi. The details of the training are as follows.
Dated: 22nd to 28th April 2019
Course Director: - Dr. Anita Gupta.
National Trainers: - Dr. Anita Gupta, Dr. Sangeeta Rani, Dr. Mukesh Yadav, Mr. Manish Kumar
Training Help Support – Dr Karmanya, Dr Kalyan & MTS ( Mr Jameel & Mr Manoj)
Training Coordinator: - Veena Rawat
Venue: - Conference Hall, Library Block, UCMS and GTB Hospital, Delhi.
Number of Participants: - IYCF Counselling & Lactation ManagementSpecialist Trained: - 26
Number of Trainers – 4 (In the ratio of 1 trainer: 6-8 Participant)
On the first day of the training, registration of the participants was done & training kit was distributed. Former Introduction of the participants & trainers was done. Dr. Anita Gupta discussed the local IYCF situation and practices. National Trainers (Resource Persons) of BPNI explained about the course objectives, training methodology, training kit and training tools to the Participants. They were explained about the difference between teaching and training & also principles and attributes of organizing such training.
Before the commencement of the sessions, participants were given a standard questionnaire as a Pre intervention test to assess the present knowledge levels of the subject. The questionnaire comprised of 27 multiple choice and few open ended questions.
The training was conducted by the national trainers & was of seven days duration . In the whole of the course there were 31 Theory, 7 counselling skills practice ,5 Clinical Practice and 2 Practical sessions. Participants had to practice counselling skills with new born baby & 6months to 2 years baby and mother pair in Post natal ward & Pediatric OPD of UCMS & GTB.
The training course was divided into different sessions, which were distributed amongst the four national trainers. The national trainers used the ‘Trainer’s Guide to impart the training. The training course has already been developed keeping in mind the principals of adult learning.
The different ways that were used to conduct the sessions in an interactive manner are explained below:
- Didactic Lectures using Power point presentations: Majority of the sessions like ‘What is the need for “Optimal Infant and Young Child Feeding’, ‘Production and Intake of breast milk’, Different kinds of ‘breast conditions’, Reasons for ‘baby’s refusal to breastfeed and crying’, Need and Importance of ‘Complementary Feeding and how one can fill the nutrient gaps’, ‘Breastfeeding in Special circumstances especially HIV’, ‘Growth Monitoring’ etc. All these sessions were conducted using the power point presentations. These sessions were conducted with an aim to widespread the immense knowledge about Infant and Young Child Feeding. This way the complete theoretical content of the subject was explained to the participants in a very interactive manner.
- Demonstration Sessions: Few sessions were planned in a more participatory manner for example the”counselling skills”. These sessions were taught to the participants using innovative demonstrations. These demonstrations made the topic easier to understand in an interesting way. Especially the skills based sessions like ‘Listening & Learning’, ‘Building Confidence and Giving Support’, how to ‘Position baby at the breast’, ‘Feeding techniques and strategies that a care giver should adopt while feeding a child”, etc. were taught using the demonstration technique.
- Enacting/Role-plays to convey important information and messages: To convey important information and messages, trainers enacted in form of role-plays in front of the participants. These methods are useful for practicing skills like counselling and for exploring how people react in specific situations. Objective of the role-play was to lead to an attitudinal change dealing with feeling and emotions. Role-plays have many advantages like: - The trainees get involved in problem-solving; active participation of trainees stimulates interest and helps in understanding and developing the behavior of self and others. The sessions which have the role-plays as their backbone are: how is it possible for a ‘working mother to breastfeed’, ‘Growth Monitoring: Take Action’, ‘institutionalizing skilled Infant and Young Child Feeding Counselling’ etc.
- Clinical Practice: Clinical practice sessions required working in the clinical settings so they were conducted in the Pediatric / Gynecology, ward and OPD of UCMS & GTB hospital. In order to conduct these sessions in a more supervisory manner, the participants were divided into four groups, thus comprising of 6-7 participants per group. One National Trainer of BPNI worked as a facilitator for every group. After returning back from each clinical practice session, a detailed discussion was conducted about how the practice went. Using a discussion checklist, the trainers and participants shared the experiences and difficulties faced at the wards/OPD. These discussion sessions are usually planned to understand the different experiences of each group. During these sessions, the participants were praised for what they did well thus encouraged do better in subsequent clinical sessions. These Clinical practice sessions were very useful as trainees got hands-on experience on the topic, which was thought and also discussed, in the previous theoretical sessions.
In these clinical practice sessions, participants got a chance to work with the mother-baby dyad in the ward at the bedside and also in OPD. This helped them to understand how they can use their skills and counsel a mother about the importance of breastfeeding & complementary feeding. The participants were also taught how they can practically help mothers to adopt the correct attachment and positioning of a baby, which lead to successful breastfeeding. The participants also learned & tried using all Communication skills to “assess and observe a breastfeed” and to “take the child’s feeding history” from the mother.Participants also recorded Dietary History of a child by using a 24 hour dietary recall form. Anthropometric Measurements like weight and length of the child was also taken in a real situation & plotted on the growth charts. With the help of all these filled growth charts, participants finally counseled the mothers on adequacy, quality; frequency & consistency of complementary feeding according to the child’s nutritional needs. Mothers were also motivated to breastfeed the child exclusively for the initial 6 months then starting complementary feeding at 6 months & continuing breastfeeding for 2 years & more. Most participants felt a little hesitant in the first clinical practice while talking to the mothers. By the end of the first practice and having done three clinical sessions they began to feel more confident.
- Practice Sessions: In these specially designed practice sessions, participants learnt how to prepare replacement feeds (one feed) and complementary foods (one meal) for the child.
- Preparing Replacement Feed: The activity was done in 3 groups. During this session, the participants were asked to prepare one replacement feed for the child. Each group was given different heating sources, gas stove, chulah, electric kettle for boiling the water. This session helped the participants to understand how difficult it is to prepare milk feed under different circumstances. They could identify that if a mother makes minor mistakes while preparing a feed for e.g.in maintaining hygiene (clean hands, clean utensils, clean water, and clean surface), dilution, measurement, etc this can lead to child sickness. The participants could also understand that a lot of time & money is required to formula feed a child, which is not feasible in long run. They could also realize the ease and economic benefit of breastfeeding compared to replacement feeds.
- Preparing Complementary Feed: The activity was also done in groups. During this session, the participants were asked to prepare one meal for the child. All the groups were given different age groups of a child (7 months, 15 months etc.) and asked to prepare one meal accordingly. Participants were provided with cooked ingredients from almost all food groups like rice, bread, dal, boiled vegetables (green & yellow), milk, curd, egg, butter etc using which they had to prepare the meal. This session helped the participants to understand the difficulties a mother faces while preparing food for the child. By this activity participants also understood the importance of specific quantity and consistency of food while feeding a child. Need to maintain hygiene during food preparation was also emphasized during the session.
These exercises provided them a first-hand experience of various logistic needs (ie- time consumption, hygiene requirement, etc) required in preparing complementary feeds.
At the end of the training, the Participants were also informed about how to use flipbook provided in the kit & its utility in the community. They were also informed on how to open a lactation Counseling & Management center. Total of 26 participants participated in the training from varied backgrounds like nutrition, health, and physiotherapy.
Participants weighing a child on weighing scale
Dr.Sangeeta taking the session
participants during an outdoor activity