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New lecture on iycf
The document discusses infant and young child feeding (IYCF). It defines IYCF as referring to infants from 0-11 months and young children up to 2 years. Poor feeding practices are responsible for over 50% of deaths in children under 5 globally. The document outlines the key recommendations of the WHO/UNICEF Global Strategy for IYCF, including exclusive breastfeeding for 6 months, introducing complementary foods at 6 months, and continuing breastfeeding for up to 2 years or beyond. It also discusses gaps in nutrient requirements that complementary foods need to address and provides counseling guidelines to promote appropriate IYCF practices.
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Presentation by Dr. Yasmeen Memon on Infant and Young Child Feeding (IYCF).
Explanation of IYCF: Infant (0-11 months), Young (up to 2 years), Child, Feeding.
IYCF Strategy by WHO and UNICEF. Malnutrition causes >50% of 10.9 million annual deaths in children under 5.
Data on major child death causes (2008): 54% deaths linked to malnutrition among under-5s.
2012 report shows 7.6 million under-5 deaths/year; 35% from malnutrition, affecting stunting and wasting.
2014 findings: 150 million malnourished children in developing countries; one-third of under-5 mortality.
Brief mention of nutritional importance across life stages.
High malnutrition rates in Pakistan (NNS 2011): Stunting 43.7%, underweight 31.5%, wasting 15.1%.
IYCF trends (2006-2013): slight changes in breastfeeding practices, increase in bottle feeding.
Key components of IYCF: nutrition for pregnant & lactating women, breastfeeding, and counseling.
Nutritional recommendations for pregnant and lactating women: 3 meals plus snacks.
Advantages of breastfeeding: nutrition, infection protection, emotional bonding, cost benefits.
Ten steps for successful breastfeeding in maternity facilities promoting breastfeeding.
Importance of breastfeeding during the first 6 months.
Encourages engagement with questions regarding breastfeeding.
Key message: Breastfeeding for two years or more supports child growth and health.
Illustration and importance of good attachment while breastfeeding.
Graph detailing energy requirements by age and how breast milk fulfills these needs.
Definition and importance of complementary foods introduced at 6 months.
Food groups for child nutrition: calories, proteins, vitamins, and minerals essential for growth.
Chart showing nutritional gaps filled by breast milk during the second year of life.
Key messages on introducing solid foods, meal frequency and dietary diversity needed for growth.
Counseling tips for mothers about hygiene and responsive feeding practices.
Three-step counseling approach for IYCF: assess, analyze, act to improve feeding practices.
Benefits of IYCF training: reducing malnutrition, improving child health, contributing to GDP.
Final thoughts and gratitude towards the audience for engagement.
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- 1. IYCF Dr Yasmeen Memon AssociateProfessor Paediatric Unit 1 LUMHS
- 2. • I • Y •C • F = Infant (0—11 months) = Young ( up to 2 years) = Child = Feeding What do these letters stand for?
- 3. The Global Strategyfor 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 ofDeath Among Children under five in developing countries, 2008 18% 15% 10% 5%4% 23% 25% Acute Respiratory Infections Diarrhoea Malaria Measles HIV/AIDS Perinatal Other Deaths associated With malnutrition 54% Source: The World Health Report 2008, WHO, Geneva.
- 5. Global situation (savethe children-2012 report) • 7.6 million children U5 yr die /year • 2.6 million (35%) ---- malnutrition---1/3rd (10%) of these deaths are due to micronutrient deficiencies • 170 million (27% of all children globally )--- stunted ( low Ht/age), 100 million of total in Asia • 100 million --- under weight (Low wt/age)---19% of child death • 60 million ---wasted (low wt/ht) • 20 million/yr ---LBW (<2.5 kg)
- 6. The State ofthe 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.
- 7. Nutrition and lifecourse
- 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 PDHS 2012-13 • Stunting(low Ht/age) 43.7% ( Sind -49.8%) 45% (57% in sind ) • Under weight ( low wt/age)-- 31.5%( Sind 39.8%) 30% • Wasting (low wt/Ht) - 15.1%(Sind 17.5%) 11% (17.5% in sind ) • Micronutrient deficiency---- • Anemia --- 61.9% ( Sind 73%) • Vitamin A deficiency --- 54% (Sind 53%) • Vitamin D deficiency --- 40% (Sind 43%) • Zinc deficiency --- 37% (Sind 39.2%)
- 10. Trend of IYCFin Pakistan DHS 2006-07 DHS 2012-13 (preliminary results) Exclusive breastfeeding 37.1% 37.7% Predominant breastfeeding 18.2% 17.1% Bottle feeding 32.1% 41.0% Complementary feeding Recommended CF practices 33.6% 56.6% 15%
- 11. IYCF Component • Nutritionof pregnant & Lactating women's • Breast feeding • Complementary feeding • Counselling & Key messages • .
- 12. Appropriate diet duringpregnancy & lactation • During Pregnancy • Women does not need more food during pregnancy • 3 meals each day plus one extra small meal or snack in between meals • During Lactation • 3 meals each day plus two extra small meals or snacks in between meals to sustain energy and better take care of child • Peas, lentils , beans, oil, green vegetables or fruit and meat • Never stay thirsty; use of juice, soups etc. should be increased
- 13. Advantages of breastfeeding Breast milk • Perfect nutrients • Easily digested; efficiently used • Protects against infection • It is free! Costs less than artificial feeding • Breastfed children get sick less often Breast feeding • • Breastfeeding immediately after birth helps: - Reduce bleeding after delivery - Quicken the expulsion of placenta • Helps emotional bonding and development • Helps 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 hard
- 14. 1. Have awritten 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. The Baby-Friendly Way TEN STEPS TO SUCCESSFUL BREASTFEEDING 14 Every facility providing maternity services and care for newborn infants should:
- 15. During first 6months = + + + =
- 16.
- 17. Key Message 1 •Breastfeeding for two years or longer helps a child to develop and grow strong and healthy 28/2
- 18. Good and poorattachment • What differences do you see? 1 2 3/8
- 19. Good position &Attachment More areola visible above baby’s mouth than below Baby’s mouth wide open Lower lip turned outwards Chin close to breast • Baby head & body in line • Baby held close to mothers body • Baby whole body supported • Baby approaches breast nose to nipple.
- 20.
- 21. Energy required byage and the amount supplied from breast milk Energy(kcal/day) 1000 800 0-2 m 3-5 m Age (months) Energy Gap Energy from breast milk 6-8 m 9-11 m 12-23 m 600 400 200 0 28/4
- 22. Complementary food • Complementaryfeeding means giving other foods in addition to breast milk. These other foods are called complementary foods • Complementary 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
- 23. Nutrition- food Groups Calories: fat honey sugar Mineralsand vitamins: green leaves fruit vegetables Protein: Meat, fish beans Nuts Egg Staple foods: wheat corn rice
- 24. Breast milk insecond year of life Percentageofdailyneeds 100% 75% 50% 25% 0% Energy Protein Iron Vitamin A Nutrient Gap Provided by 550 ml breast milk 2/11
- 25. Key Message 2 •Starting other foods in addition to breast milk at 6 completed months helps a child to grow well 28/5
- 26. Key Message 3 •Foods that are thick enough to stay in the spoon give more energy to the child Just right Too thin 29/5
- 27. Gap for iron Absorbediron needed and amount provided 1.2 0.8 0.4 0 Iron gap Iron from birth stores Iron from breast milk 0-2 m 3-6 m 6-8 m 9-11 m 12-23 m Age (months) Absorbediron (mg/day) 30/2
- 28. Key Message 4 •Animal-sourcefoods are especially good for children, to help them grow strong and lively 30/3 yoghurt poultry fish meat cheese eggs liver
- 29. Key Message 5 30/4 •Peas,beans, lentils, nuts and seeds are also good for children lentils beans peas nuts seeds Groundnut paste
- 30. Gap for vitaminA Vitamin A needed and amount provided 30/5 400 Vitamin A gap Vitamin A from birth stores Vitamin A from breast milk 0-2 m 3-6 m 6-8 m 9-11 m 12-23 m Age (months) VitaminA(µgRE/day) 300 200 100 0
- 31. Key Message 6 30/6 •Dark-greenleaves and yellow-coloured fruits and vegetables help a child to have healthy eyes and fewer infections pumpkin spinachpapaya mango carrot yellow sweet potato
- 32. Gaps to befilled by complementary foods for a 12-23 months old child 31/2 Percentage of daily needs 0 25 50 75 100 Energy Protein Iron Vitamin A % Gap Provided by 550 ml breast milk
- 33. Three meals Nutrients frommeals Gap Evening meal Mid-day meal Morning meal Breast milk 31/3 Percentage of daily needs 0 50 100 150 200 250 Energy Protein Iron Vitamin A % Gap Evening meal Mid-day meal Morning meal Breast milk
- 34. Three meals andtwo snacks Nutrients from meals Gap Evening meal Mid-day meal Morning meal Breast milk Snacks 31/5 Percentage of daily meals with iron rich food and snacks added 0 50 100 150 200 250 Energy Protein Iron Vit A % Gap Snacks Evening meal Mid-day meal Morning meal Breast milk
- 35. Key Message 7 •A growing child 6 – 8 months needs 2 – 3 meals a day • A growing child 9 – 24 months needs three to four meals a day • Plus additional 1 – 2 snacks if the child is hungry: • Give a variety of foods 31/6
- 36. Key Message 8 •A growing child needs increasing amounts of food 31/9
- 37. Key Message 9 •A young child needs to learn to eat: encourage and give help … with lots of patience 34/3
- 38. Key Message 10 •Encourage children to drink and eat during illness and provide extra food after illness to help them recover quickly 37/3
- 39. From 6 upto 9 months ( FATVAH) : Recommended complementary feeding practices Breas t feeding + Staple (porridge, other local e xa mples Legu mes vegetables / Fruits Anima l foods Thick porridge Mas hed /pureed fa mily food 2— 3 table s poons Tastes upto 1/2cup (250ml) 2 –3 time6 –8 month VarietyTe xture thicknes s/ cons is tency Amount of food an average child will us ually eat at each s erving in addition to breas t milk frequencyAge x
- 40. From 9 upto 12 months ( FATVAH) x
- 41. From 12 upto 24 months ( FATVAH) x
- 42. : Recommended complementaryfeeding practices Feed your baby using a clean cup & spoon ,never a bottle as this is difficult to c lean & may cause your baby to get diarrhea. Wash your hands with soap & water before preparing food,before eating & before feed ing young children Hygiene Be patient & act ively encourage your baby to eatResponsive feeding use iodized salt in preparing food
- 43. 3 step counseling •Help you to counsel with mothers for infant & young child feeding • Step 1 ---- Assess ; Ask , Listen & observe--- Assess age appropriate feeding practices & health of child & mother • Step 2 ---- Analyze ; identify difficulties & prioritize the difficulties if more then than 1 difficulty, praise mother • Step 3 ---- 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 worker • Thank the mother ,Set next meeting for F/up
- 44. • Improvement infeeding practices • ↓ • Prevention of malnutrition & its consequences • ↓ • ↓ U5 mortality → Achieve MDG 4 • ↓ Healthy children → Healthy adult work hard ↓ improve GDP ↓ National benefit • Benefit 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. Benefit of IYCF teaching/training
- 46.