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    <meta name="author" content="Denise Fisher" />
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    <title>Building confidence</title>
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      <h1 id="top">2.3 Building confidence</h1>
      <div>
    <p>In topic 3 you will learn of the importance of nurturing maternal self-efficacy and self-confidence for a mother to breastfeed her infant confidently. Your communication skills can help the mother to feel good about herself and confident in her role as a mother. Confidence can help a mother to carry out her decisions and to resist pressures from other people.</p>
    <p>To build confidence the mother must trust that you <span style="font-weight: bold;">accept her</span> and her decisions <span style="font-weight: bold;">without judgment</span>; that you notice and praise what she is <span style="font-weight: bold;">doing right</span> and you offer <span style="font-weight: bold;">additional information</span> in an <span style="font-weight: bold;">easily understood</span> manner that will allow her to make her own informed decisions.<br /></p>
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      <div class="section" id="Acceptance"><h2>Acceptance</h2>
    <div>
      <p>Acceptance of a person's actions or beliefs is the starting point of any relationship.<br /></p>
      <p>Accepting what a mother says helps her to trust you and encourages her to continue the conversation. Accepting what a mother says is not the same as agreeing that she is right. You can accept what she is saying and give correct information later. </p>
      <p class="listTitle">Which one of these statements demonstrates acceptance?</p>
      <dl>
        <dt>Mother: &ldquo;<q>I give my baby a bottle each night because he was waking up.</q>&rdquo;</dt>
        <dd>Health worker: &ldquo;<q>It's normal for babies to wake at night. That's not a reason to give a bottle.</q>&rdquo;</dd>
        <dd>Health worker: &ldquo;<q>A bottle just at night will stop him waking so often.</q>&rdquo;</dd>
        <dd>Health worker: &ldquo;<q>Getting up to settle a baby at night is very tiring.</q>&rdquo;</dd>
      </dl>
      <p>The first response disagreed with the mother. The second response agreed with the mother even though the information was incorrect. The third response demonstrates acceptance of her statement without either agreeing or disagreeing.</p>
    </div>
    <table class="callout"><thead><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_01.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background: repeat-x url(design/callout_02.png);"><img src="design/callout_02.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_03.png" width="10" height="10" alt="" /></td></tr></thead><tfoot><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_07.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background-image: url(design/callout_08.png);"><img src="design/callout_08.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_09.png" width="10" height="10" alt="" /></td></tr></tfoot><tbody><tr><td class="middleleft" style="background: repeat-y url(design/callout_04.png);"><img src="design/callout_04.png" width="10" height="80" alt="" /></td><td class="body"><h3>Acceptance statements quiz</h3>
      <div><br />Choose the response that demonstrates acceptance of the mother's statement. <br /><br /></div>
      <div></div><div class="activity" id="activity_y">
<script type="text/javascript">
/* <![CDATA[ */
var yqs = {settings : {type : 'mcq'}, questions : [
	new MCQ('Mother says, \"I give drinks of water if the day is hot.\"', [{text:'That isn\'t necessary! Breastmilk has enough water.',feedback:'This statement disagrees with the mother.',score:0},{text:'Drinking more water in hot weather is important for everyone.',feedback:'This statement agrees with the mistaken information the mother has made.',score:0},{text:'In hot weather we all want to drink more.',feedback:'Accepting. Correct information can be given later.',score:1}]),
	new MCQ('Mother says, \"My baby has diarrhoea, so I am not breastfeeding until it is gone.\"', [{text:'Yes, while he\'s sick he won\'t want to drink warm milk.',feedback:'Agreeing to incorrect statement.',score:0},{text:'You\'re worrying that your breastmilk will make the diarrhea worse.',feedback:'Accepting.',score:1},{text:'Breastmilk is the best food for your baby now.',feedback:'Disagreeing.',score:0}]),
	new MCQ('Mother says, \"The first milk is not good. I\'ll breastfeed when it is gone.\"', [{text:'You\'re concerned the first milk will harm your baby.',feedback:'Accepting.',score:1},{text:'The first milk is very important for your baby.',feedback:'Disagreeing with mother.',score:0},{text:'There\'s only a small amount of the first milk anyway, so he won\'t be missing out on much.',feedback:'Agreeing with an incorrect statement.',score:0}])
]};

/* ]]> */</script>
</div><script type="text/javascript">renderActivity('y');</script>
    </td><td class="middleright" style="background: repeat-y url(design/callout_06.png);"><img src="design/callout_06.png" width="10" height="80" alt="" /></td></tr></tbody></table>
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      <div class="section" id="Avoiding_judgmental_words"><h2>Avoiding judgmental words</h2>
    <div>
      <p>Words that may sound like you are judging include: right, wrong, well, bad, good, enough, properly, adequate, problem, still. <br />Words like this can make a woman feel that she has a standard to reach or that her baby is not behaving normally. Examples: "Is your baby latching properly?", "Does he have enough wet and dirty nappies/diapers?". <br /></p>
      <p>The mother may hide how things are going if she feels she is being judged. In addition, the mother and the health worker may have different ideas about what "properly" or "enough" means. It is more helpful to ask open questions such as "How do you feel he is going with latching now?", "Could you describe his wet and dirty nappies/diapers to me?"</p>
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    <table class="callout"><thead><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_01.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background: repeat-x url(design/callout_02.png);"><img src="design/callout_02.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_03.png" width="10" height="10" alt="" /></td></tr></thead><tfoot><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_07.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background-image: url(design/callout_08.png);"><img src="design/callout_08.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_09.png" width="10" height="10" alt="" /></td></tr></tfoot><tbody><tr><td class="middleleft" style="background: repeat-y url(design/callout_04.png);"><img src="design/callout_04.png" width="10" height="80" alt="" /></td><td class="body"><h3>Practice avoiding judging words</h3>
      <div></div><div class="activity" id="activity_z">
<script type="text/javascript">
/* <![CDATA[ */
var zqs = {settings : {type : 'response'}, questions : [
	{ c : '<p>Rewrite each of the sentences below, avoiding words that appear to judge the mother.</p><ol><li>Is your baby feeding well?</li><li>You\'ve just had baby weighed. Has he put on plenty of weight this month?<br/></li><li>Is he still being a naughty baby and waking at night?</li></ol>', r : '<p>The following are suggestions. Look carefully at what you have written. Did you use any words that would make a mother feel you had an expectation of what she should be doing or saying?<br/></p><ol><li>How is breastfeeding going for you and baby?</li><li>You\'ve just had baby weighed. Are you happy with his progress?<br/></li><li>How are things at night with sleeping and breastfeeding?</li></ol>' }
]};

/* ]]> */</script>
</div><script type="text/javascript">renderActivity('z');</script>
    </td><td class="middleright" style="background: repeat-y url(design/callout_06.png);"><img src="design/callout_06.png" width="10" height="80" alt="" /></td></tr></tbody></table>
  </div>
      <div class="section" id="Acknowledge_what_is_right"><h2>Acknowledge what is right</h2>
    <div>
      <p>Notice and praise what the mother and baby are achieving. An example might be to comment that it is good to see she responds to early feeding cues, or that her baby opens his mouth really well just before latching.</p>
    </div>
  </div>
      <div class="section" id="Use_language_that_is_easily_understood"><h2>Use language that is easily understood</h2>
    <div>
      <p>Regardless of the mother's educational level, using simple language and avoiding medical terms or jargon provides greater clarity and better understanding.</p>
    </div>
    <table class="callout"><thead><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_01.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background: repeat-x url(design/callout_02.png);"><img src="design/callout_02.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_03.png" width="10" height="10" alt="" /></td></tr></thead><tfoot><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_07.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background-image: url(design/callout_08.png);"><img src="design/callout_08.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_09.png" width="10" height="10" alt="" /></td></tr></tfoot><tbody><tr><td class="middleleft" style="background: repeat-y url(design/callout_04.png);"><img src="design/callout_04.png" width="10" height="80" alt="" /></td><td class="body"><h3>Using simple language</h3>
      <div></div><div class="activity" id="activity_a">
<script type="text/javascript">
/* <![CDATA[ */
var aqs = {settings : {type : 'response'}, questions : [
	{ c : '<p>Rewrite the following statements using language that would be more easily understood.</p><ol><li>The milk will flow when baby has stimulated hormones in your breast that will cause the milk ejection reflex.<br/></li><li>Exclusive breastfeeding for 6 months provides all the nutrients your baby needs.</li><li>The immunoglobulins in breastmilk provide your baby with protection from viral and bacterial infections.</li></ol>', r : '<p>The following are examples of how you could have rephrased the statements.</p><ol><li>You can tell the milk is flowing when the baby\'s suck slows and you can hear him swallowing.</li><li>Breastmilk provides everything your baby needs to grow strong and healthy for the first 6 months.</li><li>Your milk has disease-fighting components in it to keep your baby healthy.<br/></li></ol>' }
]};

/* ]]> */</script>
</div><script type="text/javascript">renderActivity('a');</script>
    </td><td class="middleright" style="background: repeat-y url(design/callout_06.png);"><img src="design/callout_06.png" width="10" height="80" alt="" /></td></tr></tbody></table>
  </div>
      <div class="section" id="Provide_relevant_information"><h2>Provide relevant information</h2>
    <div>
      <p>Additional ideas and options can be added to the ones the mother has already tried or knows about. Limit your suggestions to only a few that would be relevant to her. Don't overwhelm her with information. Use phrases such as: &ldquo;<q>How would you feel about...?</q>&rdquo; or &ldquo;<q>Some recent research shows that... Could this apply in your situation?</q>&rdquo;</p>
      <p>Your aim is to ensure the mother has enough information to make an informed decision. The mother solves her own problem.<br /></p>
      <p>If you've applied the communication skills discussed so far you may find that the mother has already found her own solution. Sometimes just a good listener who can accurately reflect her feelings and provides a well-organized summary is sufficient for her to see her situation in a new light.</p>
    </div>
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              <img src="design/callout_08.png" width="59" height="10" alt="" />
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              <img src="design/books.png" class="icon" alt="" />
              <h3>Workbook Activity 2.3</h3>
              <p>Complete Activity 2.3 in your workbook.</p>
            </td>
            <td class="middleright" style="background: repeat-y url(design/callout_06.png);">
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      <div class="section" id="What_should_I_remember_"><h2>What should I remember?</h2>
    <table class="callout"><thead><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_01.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background: repeat-x url(design/callout_02.png);"><img src="design/callout_02.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_03.png" width="10" height="10" alt="" /></td></tr></thead><tfoot><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_07.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background-image: url(design/callout_08.png);"><img src="design/callout_08.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_09.png" width="10" height="10" alt="" /></td></tr></tfoot><tbody><tr><td class="middleleft" style="background: repeat-y url(design/callout_04.png);"><img src="design/callout_04.png" width="10" height="80" alt="" /></td><td class="body"><img src="design/remember.png" class="icon" alt="" /><h3></h3>
      <div>
        <ul>
          <li>WHAT you say and HOW you say it affects a mother's self-confidence<br /></li>
          <li>how to phrase sentences to reflect acceptance without judgment</li>
          <li>praise is important</li>
          <li>how to provide additional information in a manner that is easily understood and leads to informed decision-making<br /></li>
        </ul>
      </div>
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      <h1>Breastfeeding Essentials</h1>
      <ol>
        <li>1.0 <a href="topic_1-0.html">Why Breastfeeding is Important</a><ol><li>1.1 <a href="topic_1-1.html">Biochemistry</a></li><li>1.2 <a href="topic_1-2.html">Immunology</a></li><li>1.3 <a href="topic_1-3.html">Relative risks</a></li></ol></li>
        <li>2.0 <a href="topic_2-0.html">Communication Skills</a><ol><li>2.1 <a href="topic_2-1.html">Non-verbal</a></li><li>2.2 <a href="topic_2-2.html">Listening skills</a></li><li class="current">2.3 <img src="design/bullet_arrow_right.png" alt="*" title="You are here" /><a href="topic_2-3.html">Building confidence</a></li><li>2.4 <a href="topic_2-4.html">An example</a></li></ol></li>
        <li>3.0 <a href="topic_3-0.html">Pregnancy Care</a><ol><li>3.1 <a href="topic_3-1.html">The feeding decision</a></li><li>3.2 <a href="topic_3-2.html">The barriers</a></li><li>3.3 <a href="topic_3-3.html">Physical preparation</a></li></ol></li>
        <li>4.0 <a href="topic_4-0.html">The Birth Experience</a><ol><li>4.1 <a href="topic_4-1.html">The first hours</a></li><li>4.2 <a href="topic_4-2.html">Labor interventions</a></li><li>4.3 <a href="topic_4-3.html">Postnatal interventions</a></li></ol></li>
        <li>5.0 <a href="topic_5-0.html">Breastfeeding the Baby</a><ol><li>5.1 <a href="topic_5-1.html">Positioning Principles</a></li><li>5.2 <a href="topic_5-2.html">Breastmilk transfer</a></li><li>5.3 <a href="topic_5-3.html">Assessing breastfeeding</a></li></ol></li>
        <li>6.0 <a href="topic_6-0.html">A time to learn</a><ol><li>6.1 <a href="topic_6-1.html">Practical skills</a></li><li>6.2 <a href="topic_6-2.html">Breastfeeding messages</a></li><li>6.3 <a href="topic_6-3.html">Normal growth</a></li><li>6.4 <a href="topic_6-4.html">Sleep</a></li><li>6.5 <a href="topic_6-5.html">Psychological support</a></li><li>6.6 <a href="topic_6-6.html">Discharge planning</a></li></ol></li>
        <li>7.0 <a href="topic_7-0.html">Infant Challenges</a><ol><li>7.1 <a href="topic_7-1.html">Late preterm infant; Non-latching</a></li><li>7.2 <a href="topic_7-2.html">Hypoglycemia; Jaundice</a></li><li>7.3 <a href="topic_7-3.html">Supplementation</a></li><li>7.4 <a href="topic_7-4.html">Crying baby</a></li><li>7.5 <a href="topic_7-5.html">Inadequate weight gain</a><ol><li>7.5.1 <a href="topic_7-5-1.html">Feeding-line device at the breast</a></li><li>7.5.2 <a href="topic_7-5-2.html">Cup feeding</a></li><li>7.5.3 <a href="topic_7-5-3.html">Finger Feeding</a></li><li>7.5.4 <a href="topic_7-5-4.html">Bottle feeding</a></li></ol></li></ol></li>
        <li>8.0 <a href="topic_8-0.html">Maternal Challenges</a><ol><li>8.1 <a href="topic_8-1.html">Engorgement</a></li><li>8.2 <a href="topic_8-2.html">Nipple Pain</a></li><li>8.3 <a href="topic_8-3.html">Breast Problems</a></li><li>8.4 <a href="topic_8-4.html">Insufficient breastmilk</a></li><li>8.5 <a href="topic_8-5.html">Medical, Surgical Issues</a></li></ol></li>
        <li>9.0 <a href="topic_9-0.html">Promotion, Protection and Support</a><ol><li>9.1 <a href="topic_9-1.html">The International Code of Marketing of Breastmilk Substitutes</a></li><li>9.2 <a href="topic_9-2.html">The Baby Friendly Initiative</a></li><li>9.3 <a href="topic_9-3.html">Young Child Feeding</a></li><li>9.4 <a href="topic_9-4.html">Local initiatives</a></li><li>9.5 <a href="topic_9-5.html">Infant feeding in emergencies</a></li></ol></li>
        <li>10.0 <a href="topic_10-0.html">Closing session</a><hr /></li>
        <li class="appendix"> <a href="references.html">List of references</a></li>
        <li class="appendix"> <a href="contents.html">Course contents</a></li>
        <li class="appendix"> <a href="full.html">Print version</a></li>
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