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Nutrition And The 0 6 Months Infants (Final)
1. Dr. K P Kushwaha Prof & Head, BRD Medical College, Gorakhpur Nutrition and the 0-6 Months Infants
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7. Trends in Nutritional Status Percent of children age under 3 years (Low-height-for-age) (Low-weight-for-height) (Low-weight-for- age) Slide Source: NHFS-2 & 3
9. How Many Children Receive Services from an AWC? ICDS (??? 0 – 6 yrs ) Percent of age-eligible children in areas with an AWC Slide How many 0-6 ms are being looked after? Source: NHFS-3
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12. Lancet 2004;363:1571-8 Singhal A, Cole TJ, Lucas A Breastmilk and Lipoprotein profile in adolescents born preterm: Followup of a prospective randomised study (n=926) Slide Evidence class I
20. Community Benefits New parents miss Less work Fewer healthcare Visits & lower Treatment costs Breast milk is a Natural and Renewable resource Slide Evidence class III
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22. Breastfeeding decreases the prevalence of obesity in childhood at age five and six years, Germany Adapted from: von Kries R, Koletzko B, Sauerwald T et al. Breast feeding and obesity: cross sectional study. BMJ, 1999, 319:147-150. Slide
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24. Potential Child Mortality Reduction from Preventive Interventions Jones et al. How many deaths can we prevent this year? Lancet 2003 Slide Preventive Intervention Number (thousands) Deaths prevented as proportion of all child deaths Breastfeeding 1301 13% Insecticide - treated materials 691 7% Complementary feeding 587 6% Zinc 459 5% H influenzae vaccine 403 4% Antiseptic delivery 411 4% Water, sanitation, hygiene 326 3%
29. What is the infant mortality risk from not breastfeeding? WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet. 2000 Feb 5;355(9202):451-5. Pooled Odds Ratios Lowest tercile of mat. education Ghana Slide
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31. Mother of Twin Slide Mother of twins - mother in law told her she didn’t have enough for two, UNICEF 1992, Mushtaq Khan
33. How do we are compare Cow with calf Mother Breastfeeding Slide
34. Why Mothers do not succeed? Slide Evidence class I-III NO? No Correct information Lack of Early Assistance Embarrassed Hospital practice Work or school Fear Tied down ‘ modern’ way Marketing of formula No role Models No confidence No support
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37. Which photograph will increase TRP ? ( Even Media is afraid of Promoting Breastfeeding ) Which photograph will create controversy ? Malnourished baby & mother A beautiful women breastfeeding Slide
50. Effective Communication Explore Feelings Information, Options, Suggestions Respect Identify & Praise right things Accept what she ‘ thinks’ or feels Listen carefully Ask open ended questions Provide Practical Help Slide Evidence class I-II
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Editor's Notes
Source: Table 4.10
The United Nations Millennium Declaration, was adopted on 8 September 2000 by all 189 Member States of the United Nations (147 of them represented directly by their head of State or Government). This Declaration embodies a large number of specific commitments aimed at improving the lot of humanity in the new century. The Declaration is divided into eight sections as listed in the slide. Sections 3 and 4 are highlighted since these are the only sections within the Declaration from which the Millennium Development goals have grown.
A vast scientific literature exists demonstrating the health, psychosocial, and economic benefits associated with breastfeeding & different BF patterns. A 2000 meta-analysis of over 500 infant deaths in environments where diarrhea and respiratory infections are the major causes of infant mortality ( Brazil, Pakistan, the Philippines – …data from the Gambia, Ghana and Senegal after 11 mo because virtually all babies were BF in first year ) found that non-breastfed babies were significantly more likely to die of infectious diseases than breastfed infants (WHO, 2000). The benefits of breastfeeding were greatest in the first two months of life (OR 5.8) and declined with age (up to the first year, at which time it did not continue to show continued declines - hovered around 2 (12-15 mo 1.6, 16-19 mo 2.1, 12-23 mo 1.7) . The Risk of death from not BF in settings with HIV may be higher than these WHO, 2000 overall figures because: - differential risks in WHO 2000 by education of mother at 6-11 mo: OR = 5.1, lowest tercile (least education, authors’ rec for HIV) (vs 2.0 medium tercile or 1.1 highest tercile) r ather than pooled OR of 1.8 (6-8 mo) or 1.4 (9-11) - Non – BF infants 12-24 mo of age in Ghana had 7.9 times higher risk of death than BF infants. Two more studies since this meta-analysis have also confirmed higher rates associated with not-BF - Bahl et al* found the ROR was 10.5 from 6 wk to 6 mo in Ghana, India and Peru - Rutstein**(DHS) estimated ROR was about 3 ( 2.7) for 6-12 months *Bahl R, et al. Infant feeding patterns and risks of death and hospitalization in the first half of infancy: multicentre cohort study. Bull World Health Organ. 2005 Jun;83(6):418-26. **Rutstein SO Effects of preceding birth intervals on neonatal, infant and under-five years mortality and nutritional status in developing countries: evidence from the DHS. Int J Gynaecol Obstet. 2005 Apr, 89 Suppl 1:S7-24.
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