Presentation on theme: "Dr Yasmeen Memon Associate Professor Paediatric Unit 1 LUMHS"— Presentation transcript:
1 Dr Yasmeen Memon Associate Professor Paediatric Unit 1 LUMHS IYCFDr Yasmeen MemonAssociate ProfessorPaediatric Unit 1LUMHS
2 What do these letters stand for? IYCF= Infant (0—11 months)= Young ( up to 2 years)= Child= Feeding
3 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
4 Major Causes of Death Among Children under five in developing countries, 2008 Deaths associatedWith malnutrition54%Source: The World Health Report 2008, WHO, Geneva.
5 Global situation (save the children-2012 report) 7.6 million children U5 yr die /year2.6 million (35%) ---- malnutrition---1/3rd (10%) of these deaths are due to micronutrient deficiencies170 million (27% of all children globally )--- stunted ( low Ht/age), million of total in Asia100 million --- under weight (Low wt/age)---19% of child death60 million ---wasted (low wt/ht)20 million/yr ---LBW (<2.5 kg)
6 The State of the World’s Children 2014 More than 150 million children in developing countries are malnourished.According to more recent estimates, IUGR, stunting and severe wasting are responsible for one third of under-5 mortality.
8 Malnutrition in Pakistan (NNS 2011) In Pakistan, the nutritional status of children under five years of age is extremely poor Child Malnutrition rates in Pakistan is significantly high.Types of Malnutrition PDHSStunting(low Ht/age) 43.7% ( Sind %) % (57% in sind )Under weight ( low wt/age) %( Sind 39.8%) %Wasting (low wt/Ht) %(Sind 17.5%) % (17.5% in sind )Micronutrient deficiency----Anemia % ( Sind 73%)Vitamin A deficiency % (Sind 53%)Vitamin D deficiency % (Sind 43%)Zinc deficiency % (Sind 39.2%)
10 Trend of IYCF in Pakistan (preliminary results) DHSDHS(preliminary results)Exclusive breastfeeding37.1%37.7%Predominant breastfeeding18.2%17.1%Bottle feeding32.1%41.0%Complementary feedingRecommended CF practices33.6%56.6%15%
11 IYCF Component Nutrition of pregnant & Lactating women's Breast feedingComplementary feedingCounselling & Key messages.
12 Appropriate diet during pregnancy & lactation During Lactation3 meals each day plus two extra small meals or snacks in between meals to sustain energy and better take care of childPeas, lentils , beans, oil, green vegetables or fruit and meatNever stay thirsty; use of juice, soups etc. should be increasedDuring PregnancyWomen does not need more food during pregnancy3 meals each day plus one extra small meal or snack in between meals
13 Advantages of breast feeding Breast milk• Breastfeeding immediately after birth helps: - Reduce bleeding after delivery - Quicken the expulsion of placentaHelps emotional bonding and developmentHelps delay a new pregnancy• Exclusive breastfeeding – contraception (98% effective)Protects mothers’ health • Reduces risks of breast and ovarian cancer.Benefits of Breastfeeding for the community ---Better brain development - leads to intelligence and better jobs• Healthy children become healthy adults that can work hardPerfect nutrientsEasily digested; efficiently usedProtects against infectionIt is free! Costs less than artificial feedingBreastfed children get sick less often
14 TEN STEPS TO SUCCESSFUL BREASTFEEDING The Baby-Friendly WayTEN STEPS TO SUCCESSFUL BREASTFEEDINGEvery facility providing maternity services and care for newborn infants should: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 an half hour of birth.5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.6. Give newborn infants no food or drink other than breast milk unless medically indicated.7. Practise 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 or clinic.14
17 28/2Key Message 1Breastfeeding for two years or longer helps a child to develop and grow strong and healthy
18 Good and poor attachment 3/8Good and poor attachmentWhat differences do you see?12
19 Good position & Attachment Baby head & body in lineBaby held close to mothers bodyBaby whole body supportedBaby approaches breast nose to nipple.More areola visible above baby’s mouth than belowBaby’s mouth wide openLower lip turned outwardsChin close to breast
21 Energy required by age and the amount supplied from breast milk 28/4Energy required by age and the amount supplied from breast milkEnergy (kcal/day)10008000-2 m3-5 mAge (months)Energy GapEnergy from breast milk6-8 m9-11 m12-23 m600400200
22 Complementary foodComplementary feeding means giving other foods in addition to breast milk. These other foods are called complementary foodsComplementary foods should be introduced from 6 months of age, when breast milk alone no longer meets infant’s nutrient needs.According to age of the child food needs to have the right amount, texture, variety, and should be given in the right frequency and cleanly prepared.FATVAH ---frequency, amount, texture, variety, active feeding, hygiene
24 Breast milk in second year of life 2/11Breast milk in second year of life100%Gap75%Percentage of daily needs50%Provided by 550 ml breast milk25%0%EnergyProteinIronVitamin ANutrient
25 Key Message 228/5Starting other foods in addition to breast milk at 6 completed months helps a child to grow well
26 29/5Key Message 3Foods that are thick enough to stay in the spoon give more energy to the childJust rightToo thin
27 Gap for iron Absorbed iron needed and amount provided 30/2Gap for ironAbsorbed iron needed and amount provided220.127.116.11Iron gapIron from birth storesIron from breast milk0-2 m3-6 m6-8 m9-11 m12-23 mAge (months)Absorbed iron (mg/day)
28 Animal-source foods are especially good for children, to help them grow strong and lively 30/3Key Message 4yoghurtpoultryfishmeatcheeseeggsliver
29 30/4Key Message 5Peas, beans, lentils, nuts and seeds are also good for childrenlentilsbeanspeasnutsseedsGroundnut paste
30 Vitamin A needed and amount provided 30/5Gap for vitamin AVitamin A needed and amount provided400Vitamin A gapVitamin A from birth storesVitamin A from breast milk0-2 m3-6 m6-8 m9-11 m12-23 mAge (months)Vitamin A (µg RE/day)300200100
31 30/6Key Message 6Dark-green leaves and yellow-coloured fruits and vegetables help a child to have healthy eyes and fewer infectionspumpkinspinachpapayamangocarrotyellow sweet potato
32 Gaps to be filled by complementary foods for a 12-23 months old child 31/2Gaps to be filled by complementary foods for a months old child
33 Three meals 31/3 Nutrients from meals Mid-day meal Gap Morning meal Evening mealBreast milk
34 Three meals and two snacks 31/5SnacksMid-day mealGapMorning mealNutrients from mealsEvening mealBreast milk
35 Key Message 7 A growing child 6 – 8 months needs 2 – 3 meals a day 31/6A growing child 6 – 8 months needs 2 – 3 meals a dayA growing child 9 – 24 months needs three to four meals a dayPlus additional 1 – 2 snacks if the child is hungry:Give a variety of foods
43 3 step counselingHelp you to counsel with mothers for infant & young child feedingStep Assess ; Ask , Listen & observe--- Assess age appropriate feeding practices & health of child & motherStep Analyze ; identify difficulties & prioritize the difficulties if more then than 1 difficulty, praise motherStep Act ; discuss , suggest small amount of relevant information, give option regarding feeding difficulty & help mother to select one option .Additional Support --- Refer to health facility, IYCF support group in community, Health workerThank the mother ,Set next meeting for F/up
44 Benefit of IYCF teaching/training Improvement in feeding practices↓Prevention of malnutrition & its consequences↓ U5 mortality → Achieve MDG 4Healthy children → Healthy adultwork hardimprove GDPNational benefitBenefit to community Helpful for onward counseling and support to mothers to carry out recommended feeding practices for their infants and young children from birth up to 24 months of age at any opportunity.