INFANT AND YOUNG CHILD FEEDING ppt
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The document outlines the Global Strategy for Infant and Young Child Feeding (IYCF) developed by WHO and UNICEF, emphasizing the critical role of optimal feeding practices in reducing malnutrition-related child mortality and promoting growth and development in infants and young children. It details key recommendations for breastfeeding, complementary feeding, and health care interventions, highlighting the importance of early initiation and exclusive breastfeeding in the first six months. Additionally, it emphasizes the necessity for public health policies to support IYCF practices, and addresses specific circumstances affecting breastfeeding, including maternal illness and the impact of COVID-19.
![Introduction
• Optimal Infant and Young Child Feeding (IYCF) is presented in the WHO/UNICEF Global Strategy for Infant and Young Child Feeding (2003)
(Resources Annex 1-1) as follows:
As a global public health recommendation, infants should be exclusively breastfed for the first six months
of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional
needs, infants should receive safe and nutritionally adequate complementary foods while breastfeeding
continues for up to two years of age or beyond. Exclusive breastfeeding from birth is possible except for a
few rare medical conditions as specified by WHO and UNICEF [2], and virtually every mother can breastfeed.
In addition, a growing body of recent evidence underscores the important global recommendation that breastfeeding be initiated within the first hour of
birth.
• IYCF actions are often implemented as part of the priority child survival and development programs ofUNICEF and WHO, as well as the plans of many nations.
The scientific rationale for this decision is clear, with several decades of scientific documentation on this topic including the several Lancet Series on Child
Survival 2003 [3], Nutrition 2008 [4], Newborn Health 2005 [5], Childhood Development 2007 [6] reconfirming the essential role of infant and young child
feeding as major factor in child survival, growth and development.](https://image.slidesharecdn.com/iycffinalppt03-210310171018/85/INFANT-AND-YOUNG-CHILD-FEEDING-ppt-3-320.jpg)
![IYCF and child growth
• Optimal IYCF is essential for child growth. The period during pregnancy and a child‘s first two years of life are considered a
“critical window of opportunity” for prevention of growth faltering. Recent anthropometric data from low-income countries
confirms that the levels of undernutrition increase markedly from 3 to 18-24 months of age
IYCF and child development
• The period from birth to about 36 months is a critical period in early childhood development for stimulating positive cognitive
development, particularly in settings where ill health and undernutrition are common [59]. Furthermore, a recent Lancet series
on Child Development [60] recognized tackling stunting and iron deficiency as two of the four most effective early childhood
development interventions, along with addressing iodine deficiency and cognitive stimulation. Thus, by reducing stunting and
iron deficiency, optimal infant and young child feeding can have a significant effect on child development.](https://image.slidesharecdn.com/iycffinalppt03-210310171018/85/INFANT-AND-YOUNG-CHILD-FEEDING-ppt-13-320.jpg)
![Long-term benefits of optimal IYCF for the
child
• Optimal IYCF ensures a child is protected from both under- and over-nutrition
and their consequences later in life. An analysis of several studies has shown
that breastfeeding may have a protective effect on the prevalence of obesity and
is a cost-effective obesity intervention [62], [63]. In addition to protecting against
obesity, breastfed infants have a lowered risk of several chronic conditions later in
life compared to artificially-fed infants, including asthma, diabetes [64], heart
disease [65], [66] and cardiac risk factors such as hypertension [67] and high
cholesterol levels [68], as well as cancers such as childhood leukaemia [69] and
breast cancer later in life [70].](https://image.slidesharecdn.com/iycffinalppt03-210310171018/85/INFANT-AND-YOUNG-CHILD-FEEDING-ppt-14-320.jpg)
INFANT AND YOUNG CHILD FEEDING ppt
- 1. INFANT AND YOUNG CHILD FEEDING Presented by: PROF.NIYATI DAS VICE-PRINCIPAL&HOD, CHILD HEALTH NURSING,
- 2. INTRODUCTION: THE GLOBAL STRATEGY FOR INFANT AND YOUNG CHILD FEEDING(IYCF) • Developed by WHO and UNICEF to revitalize world attention on the impact that feeding practices have on infants and young children. • Malnutrition has been responsible, directly or indirectly, for over 50% of the 10.9 million deaths annually among children <5 years. • Over two-thirds of these deaths occur in the first year of life
- 3. Introduction • Optimal Infant and Young Child Feeding (IYCF) is presented in the WHO/UNICEF Global Strategy for Infant and Young Child Feeding (2003) (Resources Annex 1-1) as follows: As a global public health recommendation, infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional needs, infants should receive safe and nutritionally adequate complementary foods while breastfeeding continues for up to two years of age or beyond. Exclusive breastfeeding from birth is possible except for a few rare medical conditions as specified by WHO and UNICEF [2], and virtually every mother can breastfeed. In addition, a growing body of recent evidence underscores the important global recommendation that breastfeeding be initiated within the first hour of birth. • IYCF actions are often implemented as part of the priority child survival and development programs ofUNICEF and WHO, as well as the plans of many nations. The scientific rationale for this decision is clear, with several decades of scientific documentation on this topic including the several Lancet Series on Child Survival 2003 [3], Nutrition 2008 [4], Newborn Health 2005 [5], Childhood Development 2007 [6] reconfirming the essential role of infant and young child feeding as major factor in child survival, growth and development.
- 4. Infant and Young Child Feeding (IYCF) is a set of well- known and common recommendations for appropriate feeding of new-born and children under two years of age. WHAT IS IYCF ? I-INFANT-(0-12month) Y-YOUNG- (Up to 2 years of age) C-Child F-Feeding
- 5. Overall Goal of IYCF • To provide the framework for ensuring the survival of, and enhancing the nutrition, health, growth and development of infants and young children, as well as strengthening the care and support services to their parents and caretakers to help them achieve optimal IYCF.
- 6. SPECIFIC OBJECTIVES-1 • 1. To improve availability and accessibility of appropriate and correct information on IYCF for the population. Indicators: - Number of communal health stations with communication and counseling corners on IYCF. - Number of local health workers being trained on IYCF knowledge and counseling skills. - Number of IEC materials on IYCF published and disseminated.
- 7. Specific objective-2 2. To improve awareness and to change behavior/practice on IYCF for mothers and other caregivers. • Indicators: - Number of mothers being trained on IYCF knowledge and skills. - Percentage of infants being breastfed within one hour after birth. - Percentage of children being exclusively breastfed in the first 6 months of life. - Percentage of children being given proper complementary feeding (initiation, quantity and quality of complementary food).
- 8. Specific objective-3 • 3. To create an enabling environment and policies, which support proper IYCF practice. • Indicators: - Number of establishments, workshops, factories achieving the criteria of "Baby Friendly Initiative". - The establishment of a system of legal documents and supportive policies to reinforce proper IYCF, meeting the need of a legislative corridor for IYCF. - Number of hospitals achieving the criteria of BFHI. - Number of communes (or CHS) achieving the criteria of “Baby Friendly Initiative”. Establishment of a supervising and monitoring network on IYCF from the central to the local level
- 9. OPTIMAL IYCF PRACTICES 1. Early initiation of breastfeeding; immediately after birth, preferably withinone hour. 2. Exclusive breastfeeding for the first six months of life i. e 180 days 3. Timely introduction of complementary foods (solid, semisolid or soft foods) after the age of six months i. e 180 days. 4. Continued breastfeeding for 2 years or beyond
- 11. IYCF TECHNICAL GUIDELINES 1. Breastfeeding 2. Complementary feeding 3. HIV and Infant feeding 4. Special situations
- 12. IYCF and its role in Child Survival, Growth and Development • IYCF and child survival Of all proven preventive health and nutrition interventions, IYCF has the single greatest potential impact on child survival. Therefore, reduction of child mortality can be reached only when nutrition in early childhood and IYCF specifically are highly prioritized in national policies and strategies.
- 13. IYCF and child growth • Optimal IYCF is essential for child growth. The period during pregnancy and a child‘s first two years of life are considered a “critical window of opportunity” for prevention of growth faltering. Recent anthropometric data from low-income countries confirms that the levels of undernutrition increase markedly from 3 to 18-24 months of age IYCF and child development • The period from birth to about 36 months is a critical period in early childhood development for stimulating positive cognitive development, particularly in settings where ill health and undernutrition are common [59]. Furthermore, a recent Lancet series on Child Development [60] recognized tackling stunting and iron deficiency as two of the four most effective early childhood development interventions, along with addressing iodine deficiency and cognitive stimulation. Thus, by reducing stunting and iron deficiency, optimal infant and young child feeding can have a significant effect on child development.
- 14. Long-term benefits of optimal IYCF for the child • Optimal IYCF ensures a child is protected from both under- and over-nutrition and their consequences later in life. An analysis of several studies has shown that breastfeeding may have a protective effect on the prevalence of obesity and is a cost-effective obesity intervention [62], [63]. In addition to protecting against obesity, breastfed infants have a lowered risk of several chronic conditions later in life compared to artificially-fed infants, including asthma, diabetes [64], heart disease [65], [66] and cardiac risk factors such as hypertension [67] and high cholesterol levels [68], as well as cancers such as childhood leukaemia [69] and breast cancer later in life [70].
- 15. BREAST FEEDING • Should be promoted to mothers and other caregivers as the gold standard feeding option for babies • Antenatal Counselling to be done : – Individual – Groups • Tobe initiated as early as possible afterbirth
- 16. • Operative birth : Mother may need motivation and support (for initiating breast feeding within 1 hour) • Skin to skin contact should be encouraged : –“Bedding in Mother and Baby pair” –“Breast Crawl” Mother should communicate, look into the eyes, touch and caress the baby while feeding. The new born should be kept warm by promoting Kangaroo Mother Care and promoting local practices to keep the room warm.
- 17. • Colostrum MUST NOT be discarded • NO PRELACTEAL fluids should be given • Baby should be fed “ON CUES” – Early Feeding Cues: • Sucking movements and sucking sounds • Hand to mouth movements • Rapid eye movements • Soft cooing or sighing sounds • Lip smacking • Restlessness
- 18. • Exclusive breastfeeding should be practiced from birth till six months • After 6 months : Complementary food Breast Feeding for a minimum of 2 years and beyond • Even during 2nd year of life : Breast Feeding frequency should be 4-6 times in 24 hrs. (Including night feeds)
- 19. COMPLEMENTARY FEEDING •Appropriately thick complementary foods to be prepared from locally available foods •TO BE INTRODUCED at 6 completed months •Breast Feeding should be continued •AVOID the term “WEANING”
- 21. • HEALTHVISITS : Harms of artificial feeding and bottle feeding to be explained • Inadvertent advertising of infant milk substitutes in health facilities to be avoided • Artificial Feeding…..Only when medically initiated • Efforts to provide appropriate facilities : For mothers to breastfeed babies easily at Public Places • Adoption of WHO Growth Charts :For growth monitoring
- 23. HIV AND INFANT FEEDING • Best time for counselling ?? ANTENATAL PERIOD • EXCLUSIVE BREAST FEEDING is better than EXCLUSIVE REPLACEMENT FEEDING . • Prevention of parent to child transmission interventions should begin in early pregnancy. • EBF is the recommended infant feeding choice ,irrespective of the fact that mother is on ART early or infant is provided with anti – retroviral prophylaxis for 6 weeks
- 24. ADVANTAGES of exclusive replacement feeding • No risk of HIV transmission • ERF milk can be given by anyone (Mother Not required) DISADVANTAGES of exclusive replacement feeding • Animal milk is not a complete food for baby . • Formula milk may be complete but it is expensive . • Baby has more risk of infections • Careful and hygienic preparation is needed • Mothers who are HIV infected and insist on not breastfeeding and opt for exclusive replacement feeding should be explained they are so at their own risk and this is contrary to the WHO / NACO’s guidelines.
- 25. SPECIAL SITUATIONS • Feeding During Sickness of Babies?? –IMPORTANT –Prevents sickness and prevents undernutrition • Infant Feeding in Maternal Illness?? –Treatment of primary condition (Breast abcess / postpartum psychosis) must be treated 1st –Chronic infections (TB/Leprosy/Hypothyroidism) need treatment of primary condition and do not warrant
- 26. • CONTRAINDICATIONS OF BREASTFEEDING ??? – Ant thyroid drugs – Immunosuppressant – Antineoplastic agents – Atropine – Amphetamines – Reserpine – Psychotropic drugs – Antibiotics – Antihistamines – Digoxin – Diuretics – Prednisone – Propranolol
- 27. SOME SPECIFIC CONDITIONS OF INFANTS… • Very Low Birth Weight, Sick, Or Depressed Babies : –ALTERNATIVE METHODS can be used depending on Neurodevelopmental status –Includes : expressed breast milk through intra-gastric tubes • GERD : Tobe treated CONSERVATIVELY through – –Thickening of complementary foods –Frequent small feeds –Upright positioning for 30 minutes after feeds
- 28. • During EMERGENCIES ??? –Priority health and nutrition support for pregnant and lactating mothers –Donated or subsidized supplies of breast milk substitutes should be avoided –Donation of bottles and teats should be refused and their use to be actively avoided
- 29. FEEDING IN PRETERM/ LOW BIRTH WEIGHT INFANTS • All LBW / VLBW infants : Breast Feeding • Should be fed with EXPRESSED breast milk via katori / spoon if unable to suckle or cant be fed orally • LBW infants : EBF for 6 months • VLBW babies : 10 ml/kg of enteral fluids (preferably Breast Milk) + IV Fluids (Remaining) • LBW infants who cant be breast fed with their own mother’s milk?? DONOR HUMAN MILK
- 30. TRENDS IN IYCF INDICATORS - INDIA
- 32. PROTECTIO N • IMS Act • Amendment act 2003 PROMOTIO N • Providing accurate info and skilled counselling to women family and community members SUPPOR T • For sustained appropriate feeding through maternity protection
- 36. HEALTH FACILITIE S During and after Institutional Deliveries Outpatient services and consultations for pregnant women, mothers and children: Inpatient services for children PROMOTION OF IYCF IN A HEALTH FACILITY
- 41. 2. Activities for reaching out to mothers/ caregivers during home visits and community level activities: a. One to one counselling during home visits by the ANM and ASHA is the best way to reach out to mothers and caregivers in the community. b. Group counselling sessions, at fixed day and time, should be organizedat VHND. c. Display of Appropriate IEC material – Specific points for discussion on feeding, examination/observation and key messages to be delivered at each of the 6 visits (or 7 in case of home delivery) should be clearly specified to ASHAs and ANMs during the training on IYCF. – Mothers of children identified as moderately or severely underweight or with weight plotting in yellow & orange zone of the growth chart (Mother and Child Protection Card)
- 42. KEY INTERVENTIONS DURING COMMUNITY AND HOME BASED CARE 1. MCH contact opportunities during home visits- • Community contacts include: a. Postnatal Home visits b. Home visits for mobilizing families forVHND c. Growth monitoring and health promotion sessions at AWC d. Mothers’ Group Meetings /Self Help Groups’ Meetings
- 46. TEN STEPS FOR SUCCESSFUL BREASTFEEDING 1. Have a written Breastfeeding policy that is routinely communicated to all health care staff. 2. Train all health care staff in skills necessary to implement this policy. 3. Inform all pregnant women about the benefits and management of breastfeeding. 4. Help mothers initiate breastfeeding within a one-hour of birth. 5. Show mothers how to breastfeed, and how to maintain lactation
- 47. 6. Give newborn infants no food or drink other than breast milk, unless medically indicated. 7. Practice rooming-in -- allow mothers and infants to remain together -- 24 hours a day. 8. Encourage breastfeeding on demand. 9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants. 10.Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital. Cont…
- 48. IYCF IN THE CONTEXT OF COVID-19 Recommended IYCF practices Early initiation of breastfeeding within 1 hour Exclusively breastfeeding for the first 6 months. Timely introduction (at 6 months) and age- appropriate, adequate, safe complementary feeding from 6 months till 24 months of age Continued breastfeeding for up to 2 years of age or beyond. Necessary hygiene precautions Mothers should always wash hands with soap and water at critical times, including before and after contact with the infant. Routinely clean the surfaces around the home that the mother has been in contact with, using soap and water. Use a face mask or mouth/nose covering when feeding or caring for infant. Locally available/adaptive face mask can be used as an alternative. Mother with her infant should maintain physical distancing from other people (at least 1 m) and avoid touching eyes, nose and mouth.
- 49. Protection, promotion and support of infant and young child feeding AT HOME during COVID -19 To continue recommended feeding practices with necessary hygiene precautions during feeding: Intensify support to families on what, when and how to feed infant and young children at home Intensify promotion of safe hygiene behaviours. Make simple, practical and context-specific information available using all available communication channels(digital, broadcast and social media) to the families on healthy feeding options for young children in the context of lockdowns and financial barriers