Welcome to Baby Behaviors In-Service

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Welcome to Baby Behaviors In-Service
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Facilitation Objectives

• Your role as Helping HANDs is to facilitate the
  discussion.
• The purpose of this in-service is to reinforce
  offering baby behavior and nutrition education
  messages and usage of the new WHO grids
• Encourage a positive and open environment

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What we have already achieved

• Regional training objectives
• Identify a Need for a Baby Behavior Message using
  ABCDE/GTHM and Observations
• Provide an appropriate Baby Behavior Message
  based on the identified need (Client Lead)
• State how Baby Behaviors are apart of healthy
  weight

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Today

• We will discuss obstacles and successes
  discovered since the regional training
• What new resources will be coming October 1st
• How to they will play into Nutrition Education

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Why? What CA discovered?

• California WIC was the first to implement Baby
  Behaviors. They found that Baby Behavior
  messages
• Increased exclusive breastfeeding rates
• Decreased formula use
• Decreased overfeeding

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Why WIC teaches Baby Behavior
Being a new parent is stressful!
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What to Expect

• Refresher Training for
• Offering discussions about healthy growth on the
  new growth grids
• Offering the message based on Baby Behavior Cues,
  Crying and Sleep
• Promoting positive infant feeding relationships
• NEW Posters to display and books to give!!!

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Warm up

• Share a recent experience using Baby Behavior
  with participants, family, or friends.
• Or any new AH-HA moments.

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Check In

• How is it going?
• Have you had to adjust your counseling style?
• Have you found it easier or more difficult with
  particular situations?
• Explain a time you were able affirm and
  incorporate a baby behavior message to a parent.

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In Order to Offer The Message

• Keep in Mind

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Baby Behaviors are Solution

• Traffic
• If mom doesnt see a solution
• Offering the message is the solution

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Example Mom is frustrated and confused about her
babys crying.

• Finding their Exit

• Stuck in Traffic

• Seeking solutions with the help of her family,
  doctor, or WIC about her babys behavior

• Tell herself it is okay or that she must
  overfeed to keep her baby from crying

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Two Ways of Coping with Stress

• Exit or Detour
• If parents believe a solution is possible - they
  will try to find ways to fix the problem.

• Traffic Jam
• If parents dont believe a solution is possible -
  they wont try to solve the problem. Instead,
  they will try to calm themselves down.

Discussion Share an experience when you were
stuck in traffic and someone helped you find your
exit. Or when you helped someone find their exit.
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Identifying the Traffic

• Discussing Growth Grids

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Growth Grids Can Be a Clue

• Key messages to offer parents on how baby may be
  tracking
• Ask parents how they feel baby is growing?

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What the Grids Might Be Saying

• What the Risk Code Cut-offs Are.
• What is high 98th percentile RISK 115
• What is low 2nd percentile RISK 103.1
• 2nd percentile 5th percentile RISK 103.2
• Remember
• The percentile isnt the focus.
• Gives the impression that a higher number is
  better
• The CHILDS GROWTH TRACK IS WHAT MATTERS.
• Growing steady Growing well!

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Facilitator Note

• Ask staff what has been working for them.
• If staff are reluctant or uncomfortable
  discussing the growth grids with clients take
  this time to Role Play or incorporate another
  activity.

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But How Do We Talk about Growth Grids?

• Go to phrases
• This graph shows how baby is growing. Babies
  come in all shapes and sizes and this is where
  your baby is tracking. How do you feel your baby
  is growing?
• We like to see babies growing steady on their
  own track. It looks like hes been growing on a
  healthy track! How do you feel about his growth?
• This graph represents typical growth for babies,
  your baby is tracking in this range. How do you
  feel about your babys growth?

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Offering The Message
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Facilitator Note

• Recommendation of utilizing an activity or
  additional discussions for offering the message.
• In Summarizing/Reflecting a recommended activity
  could be batting practice
• One person offers a statement and another
  reflects back

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Facilitator Note

• Batting Practice Activity
• The pitcher says I am going to start solids,
  because my baby is always hungry.
• The batter reflects
• It sounds like your babys appetite has
  increased.
• OR
• It sounds like you are worried your baby is not
  getting enough

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Summarizing/Reflecting

• When you reflect or summarize back to what a
  client has just shared you are able to check-in
  with them to make sure you are understanding what
  they are saying.
• By reflecting or summarizing you are better able
  offer the right message that meets the needs of
  the client.

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Asking For Permission

• Asking permission to share messages communicates
  puts the client in control and respect for the
  client.
• Is it okay with you
• May I
• Would you be interested in
• Would that be ok

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Affirmations

• Be Genuine
• Great to build rapport
• Encourage and acknowledges strengths

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Staff Resource

• How has this resource been received?
• Are staff more confident with baby behaviors and
  infant feeding during their sessions?

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Additional Resources, Coming this Fall
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Using Handouts

• Handouts are most effective when they match
  verbal discussion
• After you discussion
• Step 1 Ask the client for permission/interest in
  handout
• Step 2 Highlight the section youve covered
• Step 3 Describe the rest of the handout/use for
  at home

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Facilitator Note

• For the See in in Action
• This is the time for you to decide which method
  or presentation will work best for your clinic.
• See it in Action by
• Access the LMS Revisit specific modules/videos
• Final Activity in the LMS course Module 9 is the
  decision tree for a counseling session
• Role Play
• New waiting room video

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Facilitator LMS Reference List

• -LMS Modules
• 1. Introduction of Baby Behaviors
• 2. Just Being Themselves
• 3. Baby Cues and Crying
• 4. Sleepy Time
• 5. Physical Activity
• 6. Infant Feeding Misinformation
• 7. Support for Caregivers
• 8. Caregiver Infant Interactions
• 9. WIC Essential Roles

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See it in Action!
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Offering the Message

• Directions
• Read the following scenario. Using the wheel,
  decide how you will affirm the parent and what
  Baby Behavior do you see.
• All of the babies in these scenarios are
  healthy.

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Scenario 1

• Bradley looks proudly at his 2-month-old son,
  Jonathan during their WIC appointment. He talks
  about his sons interest in solid foods. He has
  been giving him tastes of table food because he
  can tell by the way the baby looks at food that
  he wants to eat more than just breast milk.

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Offering the Message

• Directions
• Read the next scenario. Using the wheel, decide
  how you will affirm the parent and determine what
  Baby Behavior message you could offer.
• All of the babies in these scenarios are
  healthy.

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Scenario 2

• During her WIC appointment, mom tells you that
  4-year-old Daniel just loves to play with
  3-week-old Amber. You watch as Daniel puts his
  face very near baby Ambers face and then she
  yawns, opens and closes her eyes, and tries to
  turn away. Daniel then begins to sing a loud
  song, you watch as Amber stiffens her hands and
  points her fingers. The mother smiles and says,
  Daniel just loves playing with Amber but
  sometimes she gets so fussy and I dont know why.

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Offering the Message

• Directions
• Read the scenario. Using the wheel, decide how
  you will affirm the parent and determine what
  Baby Behavior message you could offer. Also
  which section of the booklet could you refer to
  and highlight for the parent?
• All of the babies in these scenarios are
  healthy.

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Scenario 3

• Dad is bottle-feeding 3-month old Roberto as he
  sits in your counseling office. You weighed
  Roberto today and see that he has jumped up to
  the 85th. As you watch the feed, Roberto stops
  sucking, kicks his feet, starts to fuss, and
  tries to turn his head away. The father jiggles
  the bottle until the baby starts sucking again.
  The dad asks, How do I get Roberto to finish his
  bottle?

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Facilitator Note

• The next two scenarios are for fine tuning the
  practice of affirmations, offering the message,
  and highlighting the resource. If your clinic
  staff are in need of additional practice, they
  are scenario resources to use per your
  discretion. If you feel staff are hitting the
  mark save these scenarios for a future in-service.

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Scenario 4

• Sara and 3 week old Carlos are in for their
  certification. When you ask her to pick a color
  that best represents how she feels when
  breastfeeding Carlos is, she chooses yellow. You
  ask her to tell you more about that color and
  Sara tells you she is thinking of weaning Carlos,
  because he is never satisfied after
  breastfeeding. You notice that Carlos is trending
  at a healthy weight. She tells you that Carlos
  will start to fuss and move around just a few
  minutes after each feeding. Sara is sure she
  doesnt have enough milk, even though Carlos is
  growing well.

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Scenario 5

• Susan comes to WIC for her certification and to
  ask if she can get some help with breastfeeding.
  She tells you she is not sure when shes supposed
  to feed her 7-day-old baby Mike, and she is
  feeling overwhelmed. You notice the baby is
  moving around in the car seat, his eyes are open
  and he is rooting. After taking Susan and baby
  Mike back for their certification, you see that
  Mike is in the 10th.

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Promoting Positive Interactions
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Staff Roles in Baby Behavior

• Clerks or at the Front Desk
• Are there any moments in the front of the clinic,
  that affirmations could be utilized?
• The front desk is the perfect point to begin an
  appointment on a positive note and prepare the
  client to be greeted by their counselor.

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Staff Roles in Baby Behavior

• Counselors AKA Baby Behavior Gurus
• -You have the understanding and resources to help
  parents and caregivers understand what their baby
  may be communicating.
• -You are the cheerleaders to give parents kudos
  and support. You offer parents confidence in
  knowing they are doing best for baby.
• -You are parents resource for infant feeding
  questions and concerns.

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Promoting Positive Interactions for Parents in
the Clinic

• We want to Support and Affirm Parents to
• Look at what their baby is doing
• Recognize what their baby is trying to tell them
• Respond by doing the right thing at the right
  time to meet babys needs
• What have been some phrases/actions each role can
  do in the clinic you could use to promote this
  interaction?
• What can be done at the front desk?

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Wrap Up

• Think about what we learned today. Discuss with
  a partner one new thing you will try during an
  assessment.

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Questions?
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Evaluations