NUH BFHI Steering Committee

March 2021

National University Hospital (NUH)

is a WHO-UNICEF certified
Baby Friendly Hospital
(since 2013)

Newborn 6 Month 2 year

3 Month 1 year

 
 
Information is correct at time of printing (March 2021) and subject to revision without prior notice.
 Copyright (2021). National University Hospital
 All Rights reserved. No part of this publication may be reproduced without permission in writing from the National University Hospital.
 NUH Breastfeeding Policy
1. NUH implements best practice standards in
obstetrics and newborn care, in accordance
with the Baby Friendly Hospital Initiative (BFHI)
“Ten Steps to Successful Breastfeeding”
to support mothers to exclusively breastfeed for
6 months and continue breastfeeding till 2 years
and longer
2. The first few hours and days of a newborn’s life
are a critical window for establishing lactation
and providing mothers with the support they
need to breastfeed successfully
3. Parents’ choice in feeding their newborns will
be respected and supported

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 10 Steps to Successful
Breastfeeding
1. NUH staff adheres to NUH Breastfeeding 5. We support mothers to maintain
policy. We comply with the International Code breastfeeding and manage common
of Marketing of Breast-milk Substitutes and difficulties
SIFECS1
6. We support exclusive breastfeeding from
2. Our staff are knowledgeable and skilled in birth, and supplement for medical reasons
supporting breastfeeding
7. We enable mothers and babies to room-in
3. Pregnant women and their families are together 24 hours a day
informed about the importance and
management of breastfeeding 8. We support mothers to recognise and
respond to their newborn’s cues for feeding
4. Mothers and babies will have immediate and
uninterrupted skin-to-skin contact, and 9. We counsel mothers on the use and risks of
breastfeeding initiated as soon as possible feeding bottles, teats and pacifiers
after birth
10. We coordinate post-discharge follow-up to
enable parents and infants to get timely
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Sale of Infant Foods Ethics Committee Singapore access to ongoing support and care

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 Benefits of Breastfeeding
Breastfeeding is a natural way Your breast milk helps your
to help you: baby:
• Contract your uterus and reduce • Grow and develop optimally
bleeding after delivery
• Be protected against infections of the
• Return to pre-pregnancy weight ears, lungs, bowels and urinary tract
• Keep bones strong • Decrease risk of allergies, asthma
• Reduce risk of breast and ovarian • Decrease risk of developing diabetes,
cancers obesity and ulcerative colitis
• Decrease risk of developing diabetes • Decrease risk for Sudden Infant
Death Syndrome (SIDS)
• Bond with baby
• Reduce household costs

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 Early Steps to
Successful Breastfeeding
Why Skin-to-skin? Rooming-in with baby
• Skin-to-skin helps to maintain baby’s temperature
and promote bonding
• Keeps baby interested in breastfeeding
• Keeps baby calm

Why Room-in?
• You will be able to better sense when baby is ready
to feed and breastfeed him on time
• Baby will be comforted easily and cry less
• You can spend more time getting to know your baby,
Early Skin-to-Skin and initiation of and practise breastfeeding
breastfeeding
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 Feeding Cues
Get ready to feed baby when he shows early cues

Early Cues – “I am interested in feeding.”

Stirring Mouth opening Turning head/ rooting

Mid Cues- “I am really interested in feeding

NOW!”

Licking Increasing movements Hand to mouth

Late Cues – “Calm me then feed me.”

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Crying Agitated movements Face turning red
 Breastfeeding Positions

QR code for video:

Breastfeeding positions
Cradle Side-lying

Cross-Cradle Football
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Effective Latching
“CALM”(DorisFok, 2005)

C: Chin and Cheek close to breast

A: Areola covered as much as
possible
L: Upper and lower lips flanged out
M: Mouth is wide open

QR code for video:

“Attaching Your Baby at Breast”

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 Baby’s urine and stools
Meconium
Day 1 -2
Seedy stools

Transitional Watery yellow

stools Day 3-4 stools

Urine with urates,

up to day 3

Clear urine
Heavy diapers 10
Breast Massage and
Hand Expression

QR code for video:

Breast massage &
expression
(from 3 min)

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 Supplementation
1. Unnecessary milk formula in the first few days after birth will interfere with
breast milk production and establishment of breastfeeding

2. Use of feeding bottles may affect baby’s feeding cues and suckling at the
breast. You may use these alternative methods.

Syringe Cup Spoon

3. Approach your baby’s doctor or nurse for advice, if you wish to use the
feeding bottle

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 Guidelines for storing
Expressed Breastmilk (EBM)
For Fresh EBM
Location Temperature Duration
Room Temperature 19°C – 26°C 4 hours
Insulated Cooler Bag with ice packs 4°C – 15°C 24 hours
Freezer compartment of a bar fridge -15°C 2 weeks
Refrigerator < 4°C 72 hours
Freezer -18°C 3 months – 6 months
Deep Freezer -20°C 6months – 1 year

For Thawed EBM

Location Temperature Duration
Room Temperature 15°C – 29°C 1-2 hours
Refrigerator 4°C 24 hours
Warmed 40°C 1-2 hours
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 For more information
A copy can be downloaded with this QR code.

Please refer to the ‘Health Brochures’ tab and

look for ‘Breastfeeding Flip Chart 2021’.

National University Hospital

5 Lower Kent Ridge Road, Singapore 119074
Tel: (65) 6779 5555 Fax: (65) 6779 5678
Website: www.nuh.com.sg
Company Registration Number. 198500843R
 

The information provided in this publication is meant purely for educational purposes and may not be used as a substitute for
medical diagnosis or treatment. You should seek the advice of your doctor or a qualified healthcare provider before starting any
treatment or if you have any questions related to your health, physical fitness or medical conditions.

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