 So, this is part 2, I am going to continue with you know 45 points of counseling non-PDF. Now comes the latching, ok. So, let us see what happens in latching, latching the baby's attachment to significant portion of lower part of the area is called latching, ok. The mother should lightly brush her nipple against baby's upper lip, so the baby opens his mouth widely. So, many times what happens now, I have seen in the field that a lot of mothers tend to open baby's mouth by putting finger in the mouth, and they will try to do something to open the mouth. They do not have patience, so this is not recommended at all, you do not want to put finger in the mouth and open baby's, baby will clench further, so what you need to do is to you ask the mother to kind of brush the nipple against the nipple. So, here in this position what is happening, baby's upper lip is basically brushed against the nipple, ok, and then as soon as baby opens the mouth, you know, you tell the mother to be ready, ok. So, here what is happening again, I will show you on, I will demonstrate to you, ok. Here baby is ready now to feed, ok, baby's mother is holding the breast properly, ok, and what she is doing, she is basically brushing the upper lip of the baby on the nipple, it takes sometime maybe 3 minutes, 4 minutes to baby to open the mouth, tell her that she has to wait good at least 3 to 5 minutes, you know, for baby to open the mouth, and how much mouth opening should be there, which I have mentioned over here, should be between 120 to 160 degree, minimum 120 degree, ok, so if she does not wait, and if she immediately poach the baby, there will be only nipple latch, ok, so tell her to wait till and the way I explain to mother, I tell her that, ok, if I make a big sandwich for you, how are you going to open your mouth? And she, most of the time she opens, she shows like, it should be this big, ok, so that's how I tell her that, ok, you wait till baby opens a big mouth, because there is a big, you know, breast which is ready to go in baby's mouth, so she has to, baby has to open the big mouth, right, so this is how I explain, so that is important, another thing which is very important, you tell mother to be ready, because if she is ready, she will be immediately able to push that breast in baby's mouth, ok, and then, because it takes just fraction of a second for baby to keep that mouth open, and within that couple of fraction, if she doesn't push that baby into the breast, you know, baby will immediately close the mouth, ok, so tell her to be ready, and it's like, it's like that she need to have a very good reflex, as soon as the baby opens the mouth, just push the baby in the breast, ok, that's important, you must practice all this thing, you know, in the world, or wherever you are, so that, you know, you know, like, how, what it takes to have a good attachment, ok, so you practice first, and then basically teach mother's, ok, so here, your 26th point is, when the baby opens his mouth between 120 to 160 degree wide, the mother should put the lower part of the area of her breast inside the baby's mouth, ok, this can take around 2 to 3 minutes, but it is important to wait until the baby opens his mouth widely, in a hurry, if the mother tries to put the area into baby's mouth, which is not widely open yet, the baby will only attach to nipple, and will not get enough milk while breastfeeding, ok, and one more thing you want to tell her, that try it for just about 8 to 10 minutes, and if she's baby's not opening the mouth, that means baby's not hungry, you put the baby down, ok, baby's not hungry, or there's some other issues, but you don't want to force feed the baby, ok, the baby's not opening the mouth for say 8 to 10 minutes, just let baby sleep, ok, so that's, this is important, ok, now another point which is important, the baby's upper lip should be a little above mother's nipple, ok, so this, this one, this upper lip should be just above the nipple, ok, the lower lip should be at the edge of the areola, so let's focus what's going on, baby's upper lip should be little above mother's nipple, baby's lower lip should be at the border of the areola, if the mother's areola is small, then the baby's lower lip will be beyond the border of the areola, this is correct and deep attachment of baby's breast, so this means that, you know, if the areola is big, then the upper lip should be just above the nipple, ok, so the upper lip will be just over here, ok, and the lower lip will be at the border of the areola and the breast, but if areola is say very small, ok, so in that case basically baby will have a full areola in the mouth, but the lower, lower lip will be on the breast, ok, so you make sure there is a asymmetrical latch, this is called asymmetrical latch, ok, so here what is happening, your upper areola is visible, lower, lower areola goes into baby's mouth, ok, so this is important, ok, the baby's lower lip should be curled in an outward direction, this is part of your WHO criteria, ok, you want to make sure that both lips, especially lower lip is curled outside, not inside, because when baby's, you know, the lips are curled inside, baby will not be able to suck, ok, baby's lip and chin should be completely embedded into mother's breast, so this is one more important point which I feel very, very strongly about, ok, because what is happening that, you know, when we are only focusing on the chin going into the breast and not lips, many times, you know, baby's don't have deep attachment, ok, so just in how I had explained to you that we need to do press, compress, release for expression of milk, you know, like press, compress, release, so similarly I want you to understand what this is press, so if baby is basically kind of brought very close to the mother and baby's, you know, head is pressed in the breast, ok, so that, that pressing will kind of, will ensure that baby is latching on to the deeper part of the collecting duct and will be able to kind of suck out a lot of milk, ok, so this, this is, this is very important that you make sure that you tell the mother once, you know, once a latching is done, you tell the mother to take the baby and push it into the breast, so that the breast is kind of pressed a little bit inside, ok, so that the lips are not visible and the chin is not visible, both lips and chin should not be visible, ok, if the lips are visible that means it's still very far, we will not get a good amount of milk transfer and if you want really good ketchup growth that pressing of lips into the breast is very, very important, ok, alright, so now you have latched the baby, ok, now what we want to do, we want to teach mothers how to see if the latching is good or not, ok, so that objective examination is very, very important because what happens many times when we teach mothers latched good or not, they, they don't look at the latch, without looking at the latch how would you know whether latch is good or not, so that objective examination is very important, I don't like some objective examination, just by looking at it you won't know whether there is a good amount of big mouth, there's good amount, you know, where is the lower lip, all these points that you need to check when you are checking the latch, ok, so the way you check the latch is basically what we're going to do is suppose mother is, you know, holding the baby, ok, and you teach mother how to check the latch, ok, and here baby is deeply attached, ok, but she has to check it whether baby is deeply attached or not, what she's going to do, she's going to basically put her fingers, ok, on the breast where the lower lip is there and she's going to press it because right now baby is so close to mother that she will not be able to see how the mouth is, where the lower lips are, so she has to press and press where the lower lip is there, ok, and then she's going to check, so over here she's going to push it over here and going to check, you know, attachment points, so what are the attachment points that she's going to see that I'll come, but let me go through this point. To check if baby is deeply attached to mother's breast, the mother should lightly press her breast upward near the baby's lower lip, then she must check whether the lower part of the relapse entirely inside baby's mouth or not, and whether baby's lower lip is curled in the outward direction or not, ok, so this is important. She must also check whether the baby's mouth is open at least 120 degrees wide or not, it is essential to check these three points, the mother must be taught to check them, ok, so one point that you want to, so there are a few points of latching that I want you to check, ok, first thing is the opening of the mouth, so when you're checking the latch you will make sure that baby's has at least 120 degree opening of mouth, ok, second point is all about lips, so first your mouth, ok, how big is the mouth, then about lips, so lips may there are two three points, one point is that the lower lip should be at the border of areola or at the breast, ok, if the areola is small. Another point about lip is that the upper lip should be just about the nipple, ok, not, it should not cover the whole upper areola, because during upper areola, this is again the concept is same, like when we eat food, we always put food at the lower jaw, we don't put food on the upper jaw, right, because with lower jaw we're going to chew, we're going to chew it, right, so we want to put the lower areola more towards the lower lip, not, you know, we don't want the upper areola going to the upper part of the lip, ok, upper part of the mouth, ok, so this is important, so it's the third point is that where is the upper lip, ok, upper lip should be on the upper lip of nipple, third point is that where should be the, how the lower lip should be called outside, so you want to just make sure that the lips are called outside and not inside, ok, and another point about basically chin and upper lip, both the lips and upper, both lips and chin is embedded into baby's mother's breast, so that is very, very important that, you know, it should be completely embedded, like for example here, if baby is coming like this, if suppose if baby has very good attachment, see here you will not be able to see the lips and the chin, ok, so baby has really good deep attachment, but deep attachment will occur only if there is a big mouth, so that big mouth opening is very, very important while you're checking the latch, ok, and the last point is basically there should be asymmetrical latch, so while you're checking you have to make sure that you're seeing the upper areola more and then lower areola, you don't see lower areola because obviously it's in the mouth, ok, so that, that one point that you want to check, so this are latching points that you want to examine, ok, once the mother confirms deep attachment, so here now what is happening is basically here mother has already checked the latch, ok, and baby has a deep attachment, ok, now what she's going to do, she's going to bring this hand, you know, behind baby's back, ok, for the support, but many times what happens, when she brings his hand back, many times she removes his hand, now if this happens, if she removes his hand, remember that baby does not have neck control for first two months, so she doesn't have neck control in first two months, baby will be able, baby will what will happen, baby will fall backward, ok, so if baby will fall backward or baby's neck fall backward then basically there'll be deep latching, ok, or the latch will become very superficial, so you want to make sure that, you know, you tell mother to keep this control of neck very, keep the control strong, she should in fact push that head in the breast, ok, will not, baby should not be falling off, and second hand she can bring it behind baby's kind of back, ok, now sometime what happens, sometime mother has very heavy breast, ok, so you want to make sure that you have a full support of the breast, so you bring that hand, ok, elbow below the breast and give the support a little bit, so you tell her to lift up the breast a little bit, because many times what happens, the breast is so heavy that baby, poor baby cannot hold the whole breast just by mouth, ok, so she will have to give support to her breast, so I do recommend pretty much in all the mothers that when she brings the hand, tell her to support her, you know, that breast with the elbow joint and lift it up a little bit, ok, so that really helps the deep attachment for the baby, so here again I'm going to go back again, once the mother confirms deep attachment of the baby to the lower part of the arula of a breast, she can release her breast from her hand and place that hand around baby's back for support, but she should not move the hand with which she's holding baby's head, if a mother has a very big or heavy breast and she releases from her hand after deep attachment, then the arula can slide out of baby's mouth, in such cases after releasing the breast from her hand, the mother can use her elbow to support her breast, so here what I'm saying is this is the elbow, so she is basically supporting her breast in that elbow joint, ok, sometime what happens that breast is so big that even this doesn't help here and basically breast tend to come out from mother's baby's mouth, ok, so in those scenarios I tell mother to keep holding the breast in a U-shape hold, but to make sure that she put some pillows under the elbow joint, so that she can basically breast feed well, and this is, you have to do this only while baby's small, when baby's little bit big, then baby will have big mouth, baby will have everything, but first couple of, I would say first couple of months she'll have to support the baby a lot, ok, and specially in low birth with babies or premature babies, you know, because babies are small, so you want to kind of give full support, you know, so that there is a good deep attachment, ok, here point number 33 is the mother should breast feed from one breast completely before offering the other breast to the baby, ok, now this part is very important because we know that the front for milk which is in front part of the breast, that milk is more watery and has protein, while the back part of that breast has lot more fat and it is very, you know, it has lipid rich, good fat, ok, so it is high in calories as well, also it has fat which has more of DHA EPA which is omega-3 fats which are very very important for brain development, ok, so we want to make sure that mother understand the importance of emptying of one breast, the way we tell them is that, you know, we want to tell mother not to judge whether breast is completed or not or breast is finished one side or not, you want to basically have equal, you know, you want to teach them objective examination not just subjective, ok, so the objective examination is very very important to kind of assess whether breast is completely emptied or not, ok, to check whether she has fed the baby from one breast completely, the mother should express milk from that breast with her hand, if the thin watery milk comes out of the breast or if there is a good flow of thick milk on expression, it means that the baby has not completely breast fed from that breast, the mother should continue breastfeeding from the same breast, so here, you know, obviously here we want to teach mother how to do milk expression, I have shown earlier also, but it's basically PCR, remember PCR, you know, breast compressed release, so you're pressing the breast against the chest, ok, backward against the chest, ok, then you're compressing and then you're releasing, you're pressing it against the chest wall, press, compress, release, so that press, compress, release and you want to make sure that your fingers are only two fingers away, not too far, because if it's too far, you know, you will not be able to express milk, if it's too close, it will only basically press on nipple and then breast milk will not come, ok, so you want to make sure that, you know, we don't have, you know, just a nipple pressing, ok, and you want to now, and she has to see it, objectively she has to see it, what is the kind of milk that she's, you know, when she's removing, what kind of milk is coming, ok, and this she should do if the baby, say, de-latches or if baby has gone to sleep, you know, so when she's trying to see whether she needs to feed the baby on the same side, on the other side, she needs to kind of make, you know, she has to press, compress, release and manually express and see, you know, what kind of milk is still remaining in the breast, ok, so here the mother should feed the baby, you know, completely, mother should breast, feed the baby from each breast completely, this includes the thin watery milk rich in protein that comes first and the thick milk rich in fat that comes later, both for milk and hand milk are necessary for the baby's growth, the baby should be offered the other breast only after breastfeeding from one breast is complete, ok, if the baby is still hungry, it will breastfeed from the second breast too, so this is important, like when to breastfeed, you know, on the other side, ok, so if suppose the milk is flowing and it's watery, it's translucent, obviously the milk is still, the fine milk is still there, if she's pressing and the milk is very thick and it's coming with a lot of force, you tell the mother to feed the baby still on the same side, ok, but if now, you know, she's pressing it and only few drops are coming, thick drops are coming, that means that milk is now over on that side, she can then breastfeed on the other side, ok, so this is the opposite examination, I very very strongly believe that, you know, once mother understand, like how, like how the empty breast should look like or feel like, you know, then, you know, she will ensure that the whole breast is completely empty before she goes on the other side, most of the time what happens in the field, when say baby delaches or when baby sleeps on the breast, she feels, she tries to compare the weight of one breast to another side, ok, and when you compare it, you know, although she may have lot more hind milk present, because she's comparing it on the other side with the full breast, obviously, your, your, this breast is much lighter than the other one, right, and then she will inadvertently, inadvertently put the baby on the other side before she completely emptied the side of the breast, ok, so that's why I put in this objective examination. The mother must make the baby burp before offering the second breast, to do so the mother should make the baby sit on her lap comfortably, then the mother should cup the baby's jaw with the hand, so this cupping is very important, so the fingers will come on the jaw, over your jaw angle, not on the neck, ok, because in the neck you have this carotid artery, carotid vein, so you don't want to press on the neck, it is basically on the bone, ok, slightly bend baby's back and slightly bend baby's torso forward, the baby will burp within two to three minutes, the baby will also open its eyes, ok, so two things happen as I explained earlier, you, once you put the baby in a sitting position, you know, you want to make sure that you're holding the jaw of the baby and not the neck, ok, and you're basically putting the baby forward a little bit and the other hand would be just on the back of the back, you know, not, you don't need to pat the baby, you don't need to do anything, it's just you put the baby, your hand on baby's back, ok, and two things will happen, one thing that baby will immediately burp within a minute, promise, it's very very, you know, powerful, and second thing what will happen is baby will, if baby's hungry they will open the mouth, mouth, actually they'll open the eyes, so you know, baby will open the eyes and then they'll look around, ok, so you want to kind of, this is a, you don't want to put the baby this way, because what happens, you know, baby goes to sleep, mother goes to sleep, everybody goes to sleep and baby will feel only one side, ok, and that too in half, so I don't recommend doing this, you know, put the baby in a sitting position, wake up the baby, if baby goes to sleep, immediately you, you know, try to wake up the baby, but if baby's not waking up, you delage the baby, put the baby in a sitting position, examine your breast, whether you have finished your hind milk or not, and then make recession fast, don't keep sitting with baby lashed to the breast without baby actively sucking, ok, because that will take a lot of time out of mother's schedule, ok, and that will also kind of, what will happen, and baby will feel only the four milk, baby will pass urine, but baby will not gain weight, ok, so that quickly, you know, making decisions and putting baby to sleep, you know, once baby is fed well, that will help both mother and the baby, ok, now the 37 point is, if the baby falls asleep, breastfeeding, the mother should caress its back or tickle feet, the mother can also make the baby sit in a position of the burping, ok, so this is a very powerful way of again waking up the baby to put the baby in a burping position, in a sitting position, ok, if the baby is attached only to nipple or if the baby goes to sleep while breastfeeding, then the mother can put her clean little finger in baby's mouth to remove her breast from baby's mouth, so here a lot of time what happens is baby goes to sleep on the breast, sometimes they, she see that, you know, latching is not good, so she will have to kind of put her finger in baby's jaw, kind of release a suction, ok, and then remove the baby, ok, because if you don't do that, what will happen, if you just pull the baby when baby is attached, then the mother will get nipple sore and you don't want that, so make sure that, you know, she puts, she releases the suction and kind of open baby's mouth and it becomes much easier to delage the baby, ok, this will open baby's clenched mouth and the baby can easily take her Rella out of baby's mouth, now if baby's nose is pressed tightly into mother's breast, then the mother can gently extend baby's neck in the outward direction, so the baby's chin is pressed further into mother's breast and the baby's forehead is pulled away from mother's breast, ok, so this is very important, here what is happening is basically suppose for some reason, ok, if mother, if baby's nose is pressed into mother's breast, what you want to do, you want suppose here, you know, here is the breast and if the nose is getting pressed, what you want to do, you want to tell mother to just extend the neck a little bit like this, ok, so when she does that, of course you want to see that baby has a good attachment, so if there is no good attachment, she has to remove baby delage and latch again, but if the mouth is big, if the attachment is good, but the nose is getting pressed, tell her to basically, you know, just extend the neck a little bit like this, ok, so that way what happens is the nose is coming out like this and the lips and the chin is going more further into baby's breast, ok, mother's breast I mean, ok, ok, if the, here so this I mentioned that how you can just extend the neck, don't bring the baby out completely, don't bring the baby out like this, ok, you just kind of extend the neck, ok, so then, so the nose comes out, ok, 40th point is if the baby is breastfeeding correctly, then baby's cheeks will appear round and full, there will be no dimple in its cheeks, the baby won't make fast swallowing sound, when swallowing milk the baby's jaw will slowly and distinctly drop down, so here this part is very very important, you want to examine baby's cheeks when baby is sucking, ok, it should be round and full, there should not be any dimple, if there are dimples then it is in a wrong latch, ok, so let's see what happens when there are dimples, if, if dimple appears in baby's cheeks while breastfeeding then it means that the baby is feeding only from the nipple, there is more of upper part of arula than the lower part of the arula in the baby's mouth or baby's lips and chins are not completely embedded into mother's breast, so this is important, the three things that you need to look for, ok, now this is diagnostic step, so if there are any dimple that you see in baby's cheeks, three things will happen, one thing that basically either there is only nipple in the mouth, just nipple latch, so nipple latch will create dimpling, ok, second thing is that baby will have, that the, you know, baby will be very far from the breast, so even the latch may be good, but if both the lips are visible, you know, chin is visible, that means baby will have, baby will have, you know, it's like, you know, when we have a straw, we always have a straw very, kind of very close, our mouth is very close to the straw, right, so when you're sucking, you know, you have a very good sloping, right, but if the straw is very far, then you will have to basically work very hard and you will see the dimple in your cheeks too, so similarly, you know, basically baby's sucking, right, from the breast, so if baby's very far, that so much so that the lips are visible, chin is visible, that means baby's not attached deeply and that baby will have, you know, and in that case, what I do, if the mouth is big, then I just press the baby's head into mother's breast, ok, but if the mouth is small, that means baby's attaching only to nipple, in that case I will remove, delage the baby and attach the baby again, ok, and the third point is if the upper area lies in the mouth, so what happens many times when the baby is brought with too much lateral to the nose being too lateral to nipple, ok, in that case what is happening is basically more of a upper area going into the mouth, so when you examine the latch and if there is more of upper area, that means baby will have again dimple, ok, so those are the three diagnostic things, so if there is a dimple, you want to do diagnostic and figure out where the problem is and then come up with a solution, ok, alright, then second, next point is your every 24 hours the mother must breastfeed 10 to 12 times out of which she must feed at least 3 to 4 times at night and this is mainly for first 2-3 months, ok, they will need 10 to 12 times, so after 3 months or so they will feed, you know, 8 times and then by 5 months they go to, you know, just 6 times in 24 hours, ok, but first 2 months you want to make sure that baby feeds at least 10 to 12 times, if baby's not waking up, you wake up the baby, ok, and also monitor weight gain, weight gain should be at least in first 5 to 6 weeks, I recommend 40 grams, ok, but minimum should be 30, ok, because if it is lower than 30 baby will falter, ok, the baby must be exclusively breastfeed, breastfed for 6 months, after 6 months continue breastfeeding along with the complementary feeding until 2 years of age, ok, so this is important, baby grow very fast at 2 weeks, 6 weeks and 3 months of age, during this days the baby needs more milk, that's why the mother must breastfeed more frequently and each session should be longer duration, the mother must learn the correct technique of breastfeeding, so you know what happens during this time, right, 2 weeks, 6 weeks and 3 months, baby's feeding a lot, ok, and feeding a lot, why, because they're growing, this is a growing phase, ok, so if you want to tell the mother beforehand, because if you don't tell her that baby's hungry because baby's growing, what she'll feel that, oh, I'm not getting enough milk now, I need to give pre-lact, oh, I need to give, you know, outside milk, I want to top feed, right, so she will immediately switch to formulas, ok, so you, if you tell her beforehand that, you know, this is a time that baby is growing, just make sure that you give her, give baby frequent breast milk or you increase the duration, ok, so then she'll, she is well informed and she will not start formula, ok, alright, and the last point is basically I've shown that how to express breast milk, you want to show this technique, press, compress, release, exactly where to keep the fingers as I've shown, ok, it can be C shape, U shape, doesn't matter, basically it's all quadrant, ok, but the finger should be only 2 fingers away, not 3 fingers, ok, and this is the final position of the mother and the baby, do not leave that cross-caddle hole, so do not leave this hand which is there, ok, which is there on the back of the head, ok, and the other hand should be just at the back and one more thing you want to make sure that you can definitely put pillow once baby has a good attachment, pillow is fine, mother can then take any position, once the neck control comes, then what you can do is the after neck control, you can, you know, use any technique, it does not matter, cradle hole anything, but what generally mothers do in our project is they try to latch the baby in a cross-caddle hole when babies are older, but then they become comfortable and they come into cradle hole, ok, but latching is much more easy in a cross-caddle holder, there is no doubt about it, it's just a mechanical engineering, I would say, of breastfeeding, you know, so, ok, so I'm going to end my 45 points over here and I hope you understand what I'm talking about, so now I'm going to discuss breastfeeding assessment form which we have improvised or we have taken it from the BHO breastfeeding observation form, but we have improvised as per our experience, you know, so in this form what you need to do is basically once you teach the mother, ok, in first 24 hours after birth, you're teaching her proper techniques of breastfeeding, ok, and you're teaching her 45 points, but after day, after day zero, so on day one, after 24 hours, you want to see whether mother understood what you have told her, right, so here what we do is basically we fill out this assessment form when mother comes to us, so when we go to mother, you know, after 24 hours, and then we basically, it's a checklist, ok, so in this checklist what we basically what we want is we want mother's name, we want baby's name, baby's date of birth, date of first assessment, like when you're starting, you know, to assess the breastfeeding and then baby's birth weight, ok, so here this left side is all the favorable behavior, ok, favorable behavior means whatever you told mother, she's doing that correctly, and on the right side, these are all unfavorable behavior, ok, so that means that mother probably didn't understand or she did not remember or she still needs to work on her skill, skill and also content, just not skill, ok, so here what we recommend that here this particular, so we have drawn columns, ok, and we want at least, I would say, you know, five, you know, checks, at least, ok, so here suppose you have checked, suppose baby's born yesterday, so you will write, you know, baby's date of birth, which is yesterday, and today day, today's day one, so today you will write the date, today's date, you will, here you will write day of like one, ok, which is 24 hours, and here then you will start looking, you will start observing, so you will see, when you do rounds on mothers, ok, if she's not breastfeeding, you will ask her these questions, ok, when do you breastfeed the baby, and if she's saying that, ok, she knows early hunger cues, you know, when baby's kind of little bit squirming, opening the mouth, if that time she's breastfeeding the baby, that means it is favorable behavior, and you will tick mark over here under day one, ok. Now, if you realize that mother is waiting for baby to cry, and only then she breastfeed, that means it's unfavorable behavior, so here again you will write down today's date, day one, day of life one, and then you will click on this one, means this one is, means that mother does not know that she has to breastfeed when baby is showing early hunger cues, ok, so this is how you fill out the whole form, we have put in all the important points of, you know, breastfeeding, you have to observe, and if there are a few points, you may have to ask her directly, ok. So, for example, when you're observing, suppose you miss that mother washed her hands, ok, so you will ask her, did you wash your hands, and she says yes, if she says yes, then you will be ticking mark over here, but if she says no, she hasn't washed her hands with soap and water, then you will be ticking mark where, over here, ok, so this is important. The mother drinks one glass of water before breastfeeding, so here you will put in that, you know, here you will say, ok, mother drinks one glass of water, and here you say, mother does not drink water before breastfeeding, so this way we have the whole form, we have put it, you know, for you so that you don't need to remember a lot of these points, ok, and you know, this way you will not miss any point, if there are any points which are unfavorable, then you can only focus on those points, ok, you don't have to keep repeating same thing over and over again if mother understood. So, this I recommend for all the babies, ok, in a hospital I recommend, of course, you know, we have a project right now going in Nashik, and over there, you know, we are coming up with a protocol where every shift, these babies will be observed, mothers will be observed by staff nurse in every shift, and then, you know, they will fill out this breastfeeding assessment form, but if you are in a private practice, what I recommend is to definitely, you know, teach her during ANC time, and then you can visit her once in the hospital, ok, and fill out this assessment form to understand whether she's learning it or not properly, and also then you will have to follow LAP protocol, so in LAP protocol, you know, you will basically see at what date or what day of life that you need to fill out this breastfeeding assessment form. So, here you can, again, mother's preparation, I've gone already a lot in detail in my 45 points, so I'm not going to go in each point, but it's basically, this left side is all your favorable, and this all unfavorable, ok, so it goes in the horizontal line, so for example, baby's position, baby's head, back, hips and legs are fully supported by mother's left hand, here baby's full body is not supported by the mother, only the, you know, head of the baby is supported, only the shoulders are supported, ok, baby's ear, shoulder joint and your hip joint are in the same line, here it's not in the same line, baby's body is twisted, neck is twisted, so again you will observe it when mother is breastfeeding, and you will check mark if it's positive, you do it over here, if it is, like if it's unfavorable, you check it over here, ok, so this is how you will go through each and every aspect of breastfeeding, so contouring of breast I've put, attaching, latching the, latching the baby to the lower LRD please, we have put it, important counseling points, so this all the important counseling points, so this all the, you know, important aspect of breastfeeding form that you need to work on, and you know physically make sure that mothers, by end of it mother should have all the positive favorable points, if you get all the points on this side that means you have, mother has mastered the breastfeeding technique, and then obviously comes your, you know, your weight monitoring, because weight monitoring very important as I told you in first five weeks babies gain almost 40 to 50 grams a day, ok, so if she's gaining less than 35, 30 then I would be, my antenna would be up and again do this breastfeeding assessment form every two days, ok, don't wait for one week because by the time you know baby will learn long latching, mother's supply will decrease and then baby will have a problem, ok, so do it every two days till you kind of, till mother master this technique, ok, so this is where I'm going to end it, and I hope you use it, we're going to put the link of this, you know, breastfeeding assessment form, LAP card, learning action protocol, and as well as your PDF for 45 points, stun paan chart, nutrition chart, which you'll be seeing in my next session, and you know, I will again come back and talk to you in my live sessions, ok, thank you so much.