Infant and young child feeding
counselling: an integrated course
2nd edition
Module 1
Introduction to infant
and
young child feeding and
growth assessment
WHO/HEP/NFS/21.16
© World Health Organization 2021. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence.
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Session 1: Introduction to infant and
young child feeding – objectives
After completing this session, participants will be
able to:
• list evidence-based interventions targeting
infants and young children
• describe global initiatives or strategies
promoting nutrition interventions targeting the
first 1000 days of life
• state the current recommendations for feeding
children from 0 up to 24 months of age
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The window of opportunity: conception to 2
years
Source: Victora CG, de Onis M, Hallal PC, Blössner M, Shrimpton R. Worldwide timing of growth faltering: revisiting implications
for interventions. Pediatrics. 2010;125(3):e473–80. doi:10.1542/peds.2009-1519.
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Nutrition interventions targeted at
young infants (0 up to 6 months)
• Early initiation of breastfeeding
• Exclusive breastfeeding
• Counselling and support for appropriate feeding
of
low-birth-weight infants
• Infant feeding in the context of human
immunodeficiency virus (HIV)
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Exclusive breastfeeding
• Breastfeeding provides ideal food for the
healthy growth and development of infants
• Infants should be exclusively breastfed for the
first
6 months of life
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Actions to protect, promote and support
breastfeeding
• Global strategy for infant and young child feeding
(2002)
• International code of marketing of breast-milk
substitutes and subsequent relevant World
Health Assembly (WHA) resolutions (the Code)
• Baby-friendly Hospital Initiative
• The International Labour Organization (ILO)
Maternity Protection Convention No. 183
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Nutrition interventions targeted at
infants and young children (6 up to 24
months)
• Continued breastfeeding
• Nutritionally adequate and safe
complementary feeding
• Use of multiple micronutrient powders (MNPs)
for home fortification of foods consumed by
infants and young children
• Other…
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Complementary foods
• After 6 months, all babies require
complementary foods, while breastfeeding
continues up to 2 years of age or beyond
• Complementary feeding should be:
- Timely: introduced in a timely fashion – at
6 months
- Adequate: age-appropriate from 6 up to 24
months,
in terms of:
o Frequency
o Amount
o Thickness/texture
o Variety
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Global targets – Comprehensive
implementation plan on maternal, infant
and young child nutrition
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Session 2: Introduction to the WHO child
growth standards – objectives
After completing this session, participants will be
able to:
• describe the significance of the WHO child
growth standards
• list the benefits of the WHO child growth
standards
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Development of the WHO child growth
standards
• Based on a sample of children from six countries
- Brazil, Ghana, India, Norway, Oman,
United States of America (USA)
• WHO Multicentre Growth Reference Study (MGRS)
• How children should grow – selection criteria
based on recommended behaviours (e.g.
breastfeeding, providing standard paediatric care
and not smoking)
• Term babies followed from birth to 2 years of age,
with frequent observations in the first weeks of life
• Another group of children, aged 18 to 71 months,
measured once
• Data from the two samples combined to create the
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The WHO Multicentre Growth Reference
Study (MGRS)
• The WHO child growth standards differ from
many existing single-country references, which
merely describe the size of children assumed
to be healthy
• By including children from many countries,
with recommendations for feeding and care,
the MGRS resulted in prescriptive standards
for normal growth
• The standards show what growth can be
achieved with recommended feeding and
health care
• They can be used anywhere in the world
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Benefits of the new growth standards
• Establish the breastfed infant as the model for
normal growth and development
• They should lead to strengthening of public
support for breastfeeding
• They will help better identify stunted and
overweight/obese children
• New standards (such as for body mass index
[BMI]) are useful for measuring the increasing
worldwide epidemic of obesity
• Charts that show patterns of expected growth
rate over time enable health-care providers to
identify children at risk of undernutrition or
overweight
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Gross motor milestones
• Sitting without support
• Standing with assistance
• Hands-and-knees crawling
• Walking with assistance
• Standing alone
• Walking alone
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Session 3: Local infant and young child
feeding situation – objectives
After completing this session, participants will
be able to:
• describe the infant and young child feeding
trends in the country
• list the common infant and young child
feeding practices in the country
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Session 4: Local nutrition situation –
objectives
After completing this session, participants will be
able to:
• describe the nutrition trends in the country
• list the common nutritional problems in the
country
