Infant and young child feeding who 2009
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Infant and young child feeding who 2009

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The first two years of life: a critical window of opportunity ensuring children’s appropriate growth and development through optimal feeding

The first two years of life: a critical window of opportunity ensuring children’s appropriate growth and development through optimal feeding

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  • 1. Ezy Barnita
  • 2. Introduction Nutrition Poor Adequate InappropriateMorbidity & mortality ↑ Directly or indirectly Obesity Ensure growth, health and development ~ 2006: ⅓ of 9,5 potential million deaths in children <5 yo,
  • 3. …introduction The first two years of life: a critical window of opportunity ensuring children’s appropriate growth and development through optimal feeding Optimal breastfeeding prevent 13% of deaths in children <5 years of age, appropriate complementary feeding practices  an additional 6% reduction in underfive mortality
  • 4. Malnutrition during the 1 st 2 yrs of life Short stature (stunting) Impaired intellectual performance (adult) Implication of national development Reduced capacity for physical work Affected reproductive capacity in ♀(LBW)
  • 5. Global strategy for infant and young child feeding (2002) 1Exclusive breastfeeding for 6 months (180 days) 2 Complementary feeding starting from the age of 6 months with continued breastfeeding up to 2 years of age or beyond.
  • 6. Definition Exclusive breastfeeding Infant receives only breast milk or expressed breast milk, and no other liquids or solids, not even water, with the exception of oral rehydration solution, drops or syrups consisting of vitamins, minerals supplements or medicines Complementary feeding process starting when breast milk is no longer sufficient to meet the nutritional requirements of infants, and therefore other foods and liquids are needed, along with breast milk.
  • 7. Evidence for recommended BF (1) No breastfeeding Mortality 6-10 times higher at 1st month of life Diarrhea and pneumonia are more common and more severe even with adequate hygiene, as well as other acute infections (otitis media, Haemophilus influenzae meningitis, UTI) ↑ risk diseases with an immunological basis, (asthma and other atopic conditions, type 1 diabetes, celiac disease, ulcerative colitis and Crohn disease
  • 8. Evidence for recommended BF(2) Greater risk of childhood leukaemia Obesity in later childhood and adolescence is less common among breastfed children  dose response effect ↑risks to cardiovascular health (hypertension, cholesterol level, atheros- clerosis in later adulthood) A meta-analysis of 20 studies: cognitive function on average 3.2 points higher among children who were breastfed
  • 9. Exclusive and partial BF Diarrhea : 8,6 times higher Mortality: 4,2 times higher
  • 10. Exclusive and no BF Diarrhea : 25 times higher Mortality: 14,2 times higher
  • 11. Complementary feeding
  • 12. After 6 month old: It becomes increasingly difficult for breastfed infants to meet their nutrient needs from human milk alone inadequate nutritional quality Most infants are developmentally ready for other foods given too early or too late at about 6 months in too small amounts or not frequently enough premature cessation low frequency of breastfeeding In many countries, the period of complementary Feeding (6–23 months) peak incidence of growth faltering, micronutrient deficiencies and infectious illnesses
  • 13. Ten guiding principles forcomplementary feeding of thebreastfed child
  • 14. 1. Introduce complementary foods at 6 months of age (180 days) while continuing to breastfeed. Six months old doubled his or her birth’s weight and more active exclusive BF is no longer sufficient to meet baby’s energy and nutrient needs Digestive system is mature enough to digest the starch, protein and fat in a non-milk diet. Tongue thrust and rooting reflexes begin to disappear infants can receive and hold semi-solid food in their mouths
  • 15. 2. Continue frequent on-demand breastfeeding until 2 years of age or beyond higher quality nutrients protective factors reduces the risk of acute and chronic diseases
  • 16. 3. Responsive feeding Feed infants directly & assist older children feeding themselves. Feed slowly,patiently, and encourage children to eat, but do not force them If children refuse experiment with different food combinations, tastes, textures and methods of encouragement. Minimize distractions during meals Feeding times are periods of learning &love
  • 17. 4. Practise good hygiene and proper food handling
  • 18. 5. Start with small amounts of food, increase the quantity as the child gets older Breastfeeding 0.7kcal/ml Amount of energy 0.6-1kcal/ml Complementary feeding Dilute food ~0.3kcal/ml Complementary foods should have a greater energy density than breast milk, that is, at least 0.8 kcal per gram
  • 19. Practical guidance of complementary food
  • 20. 6. Increase food consistency and variety gradually The most suitable consistency for an infant’s or young child’s food depends on age and neuromuscular development 6 months pureed, mashed or semi-solid foods 8 months finger foods 12 months family food delayed beyond 10 months of age may ↑ the risk of feeding difficulties
  • 21. 7. Frequency of complementary food How much energy the child needs to cover the energy gap The amount that a child can eat at one meal stomach capacity (~30ml/kg) The energy density of the food offered at least 0.8kcal/g (>BF) or need greater volume need to be divided into more meals
  • 22. 8. Feed a variety of nutrient-rich foods to ensure that all nutrient needs are met
  • 23. such as: Vegetarian (plant-based) complementary foods do not by Animal themselves provide enough iron source and zinc to meet child’s needs Dairy Pulses Fruit Fats & and veg oil There are no controlled studies that show that restrictive diets have an allergy-preventing effect
  • 24. 9. Fortified complementary foods or vitamin-mineral supplements as needed In settings where little or no animal-source foods are available to many families, iron- fortified complementary foods or foods fortified at the point of consumption with a multinutrient powder or lipid-based nutrient supplement may be necessary
  • 25. 10. Increase fluid intake during illness During illness the need of fluid often ↑ child’s appetite for desire to breastfeed food often decreases increases breast milk may become the main source of both fluid and nutrients give more frequent, smaller meals
  • 26. Take home message Breastfeeding is the bestAfter 6 months yo start complementary feeding due to energy gap along with maturity of digestive tract and feeding skills development
  • 27. Thank you