• 1.Common challenges and contexts include returning to work or school; the specific needs of mothers who are obese, adolescent girls, primiparous (first-time mothers) or carrying multiple pregnancies (when the mother is pregnant with two or more babies); mothers with mental health difficulties; mothers of infants with special needs, e.g. low birth weight or disability; mothers who delivers by caesarean section; breastfeeding in public spaces; and breastfeeding in humanitarian emergencies.

Anticipatory breastfeeding counselling

• 2.To some extent, all breastfeeding counselling is anticipatory. The goal of the counselling contact is to support mothers in achieving their individualized goals for breastfeeding, whether they are considering initiating breastfeeding, or they are already breastfeeding and are facing particular challenges for continuation of breastfeeding. Anticipatory counselling therefore refers to evaluating and assessing potential and existing challenges that may impact the mothers’ breastfeeding goals. The anticipatory nature of breastfeeding counselling helps to reduce potential risks, problems or complications, for optimal breastfeeding.
• 3.In difficult or complicated circumstances, positive feedback and emotional support are especially needed to support the mothers’ confidence and self-efficacy in breastfeeding.

• 4.Using the principles of person-centred and quality-focused care, each Member State may need to identify which circumstances will require additional training and skills-building, based on their assessment of the primary challenges to optimal breastfeeding in their contexts.
• 5.Advice and information for women who do not intend to breastfeed needs to be considered as a potential component of anticipatory counselling for pregnant women.
• 6.During emergencies, appropriate and timely support to infant and young child feeding saves lives; protects child nutrition, health and development; and benefits mothers. Breastfeeding counselling is a vital intervention in emergency response and needs to be protected. Emergency preparedness is critical to a timely, efficient and appropriate response.
• 7.Emergency preparedness includes training of personnel likely to be involved in providing support to mothers in an emergency, and building the capacity of those delivering services during a response. As a minimum, staff in contact with mothers and children aged under 2 years are trained to be sensitive to psychosocial issues, on nutrition screening and on referral pathways to more specialist support.
• 8.More specialist capacity to counsel mothers with heightened needs, such as stressed or traumatized mothers, malnourished infants and mothers, low-birth-weight infants, and infants with disability and feeding difficulties, may be needed.