Self-Assessment Questions (SAQs) for Study Session 4

Now that you have completed the study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers on your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the notes on the Self-Assessment Questions at the end of the Module.

SAQ 4.1 (tests Learning Outcomes 4.1 and 4.2)

Why is it so important for you to be able to advise mothers about how to feed babies and very young children?


If babies and young children can be fed well there is a real opportunity to break the cycle of malnutrition. However, at the moment, many babies are not exclusively breastfed and many infants are given complementary food too early or too late. These problems are due to lack of knowledge on the mother’s part. Therefore, it is important they receive more information and advice, and as a Health Extension Practitioner you are in a good position to be able to do this.

SAQ 4.2 (tests Learning Outcomes 4.3 and 4.5)

Whilst giving education to mothers about breastfeeding, they may ask you why they need to breastfeed their babies when they can give them cow’s milk or formula and go to work. What would you tell them to try to convince them?


When giving education to mothers about breastfeeding, you could tell them that breastmilk is an irreplaceable gift of the mother to the baby because it protects the baby from different infectious diseases. In addition, the fat in breastmilk has been found to be very important for the development of the brain. Breastfed children show better intelligence compared to bottle or formula fed ones.

Breastfeeding also has other advantages. It has contraceptive and uterine-contracting effects that help the mother to space pregnancies and prevent postpartum haemorrhage, respectively. And it is also readily and freely available, and saves household expenditures for feeding the baby.

So the working mother should express her breastmilk and get the baby fed by the caregivers when she is at the work.

SAQ 4.3 (tests Learning Outcome 4.3)

A mother who is expecting her first baby soon is very keen to breastfeed and asks for your advice. What is the key advice you should give her now so she is prepared for the first few weeks?


When advising a mother who is expecting her first baby you need to tell her to start breastfeeding within an hour of birth; to breastfeed frequently; to give the baby only breastmilk for the first six months; and to eat more than usual herself. You might also want to tell her now about how to position the baby. And you should also tell her that if she has any difficulties she should ask you how to overcome these.

SAQ 4.4 (Tests Learning Outcome 4.4)

What advice should you give to an HIV-positive mother who is unable to buy replacement foods?


If you are advising an HIV-positive mother who cannot afford to buy replacement foods, you should tell her that:

  • She should practice exclusive breastfeeding for six months and then introduce appropriate complementary foods
  • If she experiences breast difficulties such as mastitis, cracked nipples or breast abscess, she should breastfeed with the unaffected breast and express and discard milk from the affected breast
  • She should seek immediate care for a baby with thrush or oral lesions
  • If she experiences AIDS-related conditions (prolonged fever, severe cough or diarrhoea, or pneumonia) she should visit a health centre immediately
  • She should use condoms to protect herself from exposure to infected semen.

SAQ 4.5 (tests Learning Outcome 4.6)

A mother tells you that breastfeeding is hurting her. What kinds of pain might she be referring to? Would you advise her to stop breastfeeding until the pain goes? Give reasons for your answer.


If a mother tells you that breastfeeding hurts, the reasons might be engorgement, sore or cracked nipples, or plugged breast ducts and mastitis. You should advise her to continue breastfeeding, giving her information about the appropriate solutions to relieve the problem.

SAQ 4.6 (Tests Learning Outcome 4.7)

Suppose you want to educate a mother about optimal complementary feeding. What are the key messages you will give her?


Key messages about optimal complementary feeding include the following:

  • At six months, the mother or caregiver should introduce soft, appropriate foods and continue breastfeeding on demand
  • She should give a range of different foods
  • She should increase complementary food if the child becomes sick
  • The mother has to increase the amount of food the baby eats as the baby grows older, increasing food thickness (density) and variety
  • She should practice good hygiene and safe food preparation
  • She should interact with the child during feeding (active/responsive feeding).

Summary of Study Session 4