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Role of Breastfeeding & Complementary Feeding in controlling Child Anemia <br />Dr. Anchita Patil<br />USAID/India<br />IA...
IAPSM <br />2010<br />NFHS-3 reports are worrying …<br />Anemia rates in children 6-35 months<br />India: 78.9%<br />Jhark...
IAPSM <br />2010<br />The story starts with the mother’s nutritional status<br />	Low iron reserves in mother <br />	Reduc...
IAPSM <br />2010<br />Till                          of age …<br />Iron Stores from mother<br />(delayed cord clamping)<br ...
IAPSM <br />2010<br />How does BF work against child anemia?<br />Low iron content, <br />but high bioavailability (50%)<b...
IAPSM <br />2010<br />Beyond six months …<br />Infant needs increase<br />6 -12 months, Recommended Daily Allowance for Fe...
IAPSM <br />2010<br />How does CF work for child anemia (Complementary Feeding)<br />Adds-on to low quantity / better bio-...
IAPSM <br />2010<br />Complementary Feeding<br />Balanced energy - dense diet<br />Foods with heme iron<br />Avoid tea / c...
IAPSM <br />2010<br />Breastfeeding Myths<br />If it’s so simple, why aren’t women doing it?<br />Myth 1:<br />Breastfeedi...
IAPSM <br />2010<br />Not enough milk<br />PERCEIVED PROBLEM<br />Breasts don't seem full<br />Baby cries soon after feedi...
IAPSM <br />2010<br />Artificial feeding<br />PERCEIVED PROBLEM<br />Bottle feeding is easier<br />Formula IMS as good as ...
IAPSM <br />2010<br />Breastfeeding is            consuming<br />PERCEIVED PROBLEM<br />A breast-feeding mother is home-bo...
IAPSM <br />2010<br />Breastfeeding myths<br />If education is the answer, why are breastfeeding rates lower in the “educa...
IAPSM <br />2010<br />Working women<br />PROBLEM<br />Women need to join work often as soon as a few weeks after delivery<...
IAPSM <br />2010<br />Family and community support<br />POTENTIAL SOLUTION<br />Health care providers need intense trainin...
IAPSM <br />2010<br />Complementary Feeding Myths<br />	Reality: Complementary feeding / responsive feeding is an art and ...
IAPSM <br />2010<br />Complementary Feeding myths<br />	Myth 2:<br />	Complementary feeding is meant to replace breast mil...
IAPSM <br />2010<br />Complementary feeding myths<br />Reality<br />Babies may start off life with low iron stores<br />Ch...
IAPSM <br />2010<br />Iron Deficiency Anemia in children - a complex issue<br />Maternal nutritional status, determines bi...
IAPSM <br />2010<br />Breast-milk is magic.<br />Understand it.<br />
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Dr Anchita

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  1. 1. Role of Breastfeeding & Complementary Feeding in controlling Child Anemia <br />Dr. Anchita Patil<br />USAID/India<br />IAPSM Conference, 2010-11<br />In absentia presented by:<br />Dr. A. K. Gupta<br />State Coordinator UP <br />USAID Micronutrient Project<br />
  2. 2. IAPSM <br />2010<br />NFHS-3 reports are worrying …<br />Anemia rates in children 6-35 months<br />India: 78.9%<br />Jharkhand: 78.2%<br />UP: 85.0%<br />Kerala: 56.1%<br />
  3. 3. IAPSM <br />2010<br />The story starts with the mother’s nutritional status<br /> Low iron reserves in mother <br /> Reduced iron transferred to fetus <br /> New Born starts life without adequate iron stores.<br /> Overall malnutrition in mother (usually linked with IDA)<br /> LBW baby<br />
  4. 4. IAPSM <br />2010<br />Till of age …<br />Iron Stores from mother<br />(delayed cord clamping)<br />Exclusive breastfeeding for six months<br />Enough to maintain the iron stores for the baby<br />6 months<br />
  5. 5. IAPSM <br />2010<br />How does BF work against child anemia?<br />Low iron content, <br />but high bioavailability (50%)<br />Vitamin A in Breast Milk helps in iron transport and metabolism.<br />Reduced infections, especially diarrhea prevents losses / impaired absorption.<br />Animal milk consumption  gut lesions  blood losses<br />
  6. 6. IAPSM <br />2010<br />Beyond six months …<br />Infant needs increase<br />6 -12 months, Recommended Daily Allowance for Fe: 11mg/day <br />( 0.8 mg of Absorbed Fe)<br />Breast-milk not enough<br />Complementary Feeding initiated<br />+ Iron Supplementation<br />
  7. 7. IAPSM <br />2010<br />How does CF work for child anemia (Complementary Feeding)<br />Adds-on to low quantity / better bio-availability Fe in Mother’s milk.<br />Improve overall nutrition<br />Increased availability of absorption facilitators.<br />
  8. 8. IAPSM <br />2010<br />Complementary Feeding<br />Balanced energy - dense diet<br />Foods with heme iron<br />Avoid tea / coffee (absorption inhibitors)<br />Fortified foods<br />Continue breast feeding<br />
  9. 9. IAPSM <br />2010<br />Breastfeeding Myths<br />If it’s so simple, why aren’t women doing it?<br />Myth 1:<br />Breastfeeding is simple<br />Reality: Breastfeeding is natural, not easy!!<br />
  10. 10. IAPSM <br />2010<br />Not enough milk<br />PERCEIVED PROBLEM<br />Breasts don't seem full<br />Baby cries soon after feeding<br />EXPLANATION<br />Genuine lactation failure – an extremely rare event<br />Babies have variable hunger cycles<br />Attachment / position<br />Baby cry has other causes<br />Reassure: weight gain, urine frequency.<br />More sucking produces more milk.<br />wah!!!!<br />
  11. 11. IAPSM <br />2010<br />Artificial feeding<br />PERCEIVED PROBLEM<br />Bottle feeding is easier<br />Formula IMS as good as breast-milk<br />EXPLANATION<br />Bottle-feeding has huge issues related to increased infections and nipple confusion<br />The “processes” related to bottle feeding (cleaning regime, preparing formula) is more difficult.<br />Formula milk has no antibodies, enzymes etc. and does not vary with feed duration, age of baby, season etc.<br />
  12. 12. IAPSM <br />2010<br />Breastfeeding is consuming<br />PERCEIVED PROBLEM<br />A breast-feeding mother is home-bound.<br />Babies should be bottle-fed at night to avoid disturbing the mother<br />EXPLANATION<br />A breastfeeding mother is free, as she is her baby’s food!!<br />Night feeds increase baby’s satiety levels and therefore sound sleep at night<br />Most babies develop their own rhythm soon and will sleep for longer periods in the night.<br />
  13. 13. IAPSM <br />2010<br />Breastfeeding myths<br />If education is the answer, why are breastfeeding rates lower in the “educated” women?<br />Myth 2: <br /> Informing women about the benefits of breastfeeding will ensure appropriate behavior change<br /> Reality: A “supportive environment” is essential to ensure “compliance” to IYCF guidelines.<br />
  14. 14. IAPSM <br />2010<br />Working women<br />PROBLEM<br />Women need to join work often as soon as a few weeks after delivery<br />Pumping does not maintain milk supply as well as suckling does<br />POTENTIAL SOLUTION<br />Maternity break for at least 6 months (investing in the future)<br />Improved work-place policies<br />Research for viable options …..<br />
  15. 15. IAPSM <br />2010<br />Family and community support<br />POTENTIAL SOLUTION<br />Health care providers need intense training<br />Stronger implementation of IMS Act<br />Counseling of family along with mother <br />Breastfeeding should be a social norm<br />PROBLEM<br />Absence of comfort has a negative psychological effect on mother with detrimental impact on milk production and flow<br />Health care providers promote formula<br />
  16. 16. IAPSM <br />2010<br />Complementary Feeding Myths<br /> Reality: Complementary feeding / responsive feeding is an art and science both. It can be and needs to be taught to the caregivers.<br /> Myth 1:<br /> Complementary feeding is learnt by trial and error<br />
  17. 17. IAPSM <br />2010<br />Complementary Feeding myths<br /> Myth 2:<br /> Complementary feeding is meant to replace breast milk as amount of breast-milk reduces after six months <br />Reality:<br />Complementary feeding is not “weaning-off” the breast, but adding on to breast-milk<br />Breast milk production does not reduce after 6 months; baby’s requirements overshoot the supply.<br />
  18. 18. IAPSM <br />2010<br />Complementary feeding myths<br />Reality<br />Babies may start off life with low iron stores<br />Child’s requirement (per kg weight) is much more than adults.<br />More difficult if foods have less bioavailability iron therefore more food bulk needed.<br />Supplementation is almost always necessary.<br /> Myth 3:<br /> If complementary feeding is given in adequate amounts, it has enough iron to meet the child’s needs<br />
  19. 19. IAPSM <br />2010<br />Iron Deficiency Anemia in children - a complex issue<br />Maternal nutritional status, determines birth weight and iron stores<br />Period of exclusive breastfeeding<br />Age of Complementary feeding (increased iron requirement vs. risk of infections) <br />Dietary diversity in complementary food<br />
  20. 20. IAPSM <br />2010<br />Breast-milk is magic.<br />Understand it.<br />
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