2. INTRODUCTION:
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
3. Introduction
• Optimal Infant and Young Child Feeding (IYCF) is presented in the WHO/UNICEF Global Strategy for Infant and Young Child Feeding (2003)
(Resources Annex 1-1) as follows:
As a global public health recommendation, infants should be exclusively breastfed for the first six months
of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional
needs, infants should receive safe and nutritionally adequate complementary foods while breastfeeding
continues for up to two years of age or beyond. Exclusive breastfeeding from birth is possible except for a
few rare medical conditions as specified by WHO and UNICEF [2], and virtually every mother can breastfeed.
In addition, a growing body of recent evidence underscores the important global recommendation that breastfeeding be initiated within the first hour of
birth.
• IYCF actions are often implemented as part of the priority child survival and development programs ofUNICEF and WHO, as well as the plans of many nations.
The scientific rationale for this decision is clear, with several decades of scientific documentation on this topic including the several Lancet Series on Child
Survival 2003 [3], Nutrition 2008 [4], Newborn Health 2005 [5], Childhood Development 2007 [6] reconfirming the essential role of infant and young child
feeding as major factor in child survival, growth and development.
4. Infant and Young Child Feeding (IYCF) is
a set of well- known and common
recommendations for appropriate feeding
of new-born and children under two years
of age.
WHAT IS IYCF ?
I-INFANT-(0-12month)
Y-YOUNG- (Up to 2 years of age)
C-Child
F-Feeding
5. Overall Goal of IYCF
• To provide the framework for ensuring the survival of, and
enhancing the nutrition, health, growth and development of infants
and young children, as well as strengthening the care and support
services to their parents and caretakers to help them achieve
optimal IYCF.
6. SPECIFIC OBJECTIVES-1
• 1. To improve availability and accessibility of appropriate and
correct information on IYCF for the population.
Indicators:
- Number of communal health stations with communication and
counseling corners on IYCF.
- Number of local health workers being trained on IYCF knowledge and
counseling skills.
- Number of IEC materials on IYCF published and disseminated.
7. Specific objective-2
2. To improve awareness and to change behavior/practice on IYCF for
mothers and other caregivers.
• Indicators:
- Number of mothers being trained on IYCF knowledge and skills.
- Percentage of infants being breastfed within one hour after birth.
- Percentage of children being exclusively breastfed in the first 6
months of life.
- Percentage of children being given proper complementary feeding
(initiation, quantity and quality of complementary food).
8. Specific objective-3
• 3. To create an enabling environment and policies, which support proper
IYCF practice.
• Indicators:
- Number of establishments, workshops, factories achieving the criteria of
"Baby Friendly Initiative".
- The establishment of a system of legal documents and supportive policies
to reinforce proper IYCF, meeting the need of a legislative corridor for
IYCF.
- Number of hospitals achieving the criteria of BFHI.
- Number of communes (or CHS) achieving the criteria of “Baby Friendly
Initiative”. Establishment of a supervising and monitoring network on IYCF
from the central to the local level
9. OPTIMAL IYCF PRACTICES
1. Early initiation of breastfeeding; immediately after birth,
preferably withinone hour.
2. Exclusive breastfeeding for the first six months of life i. e
180 days
3. Timely introduction of complementary foods (solid,
semisolid or soft foods) after the age of six months i. e
180 days.
4. Continued breastfeeding for 2 years or beyond
10.
11. IYCF TECHNICAL GUIDELINES
1. Breastfeeding
2. Complementary feeding
3. HIV and Infant feeding
4. Special situations
12. IYCF and its role in Child Survival, Growth and
Development
• IYCF and child survival Of all proven preventive health and nutrition
interventions, IYCF has the single greatest potential impact on child
survival. Therefore, reduction of child mortality can be reached only
when nutrition in early childhood and IYCF specifically are highly
prioritized in national policies and strategies.
13. IYCF and child growth
• Optimal IYCF is essential for child growth. The period during pregnancy and a child‘s first two years of life are considered a
“critical window of opportunity” for prevention of growth faltering. Recent anthropometric data from low-income countries
confirms that the levels of undernutrition increase markedly from 3 to 18-24 months of age
IYCF and child development
• The period from birth to about 36 months is a critical period in early childhood development for stimulating positive cognitive
development, particularly in settings where ill health and undernutrition are common [59]. Furthermore, a recent Lancet series
on Child Development [60] recognized tackling stunting and iron deficiency as two of the four most effective early childhood
development interventions, along with addressing iodine deficiency and cognitive stimulation. Thus, by reducing stunting and
iron deficiency, optimal infant and young child feeding can have a significant effect on child development.
14. Long-term benefits of optimal IYCF for the
child
• Optimal IYCF ensures a child is protected from both under- and over-nutrition
and their consequences later in life. An analysis of several studies has shown
that breastfeeding may have a protective effect on the prevalence of obesity and
is a cost-effective obesity intervention [62], [63]. In addition to protecting against
obesity, breastfed infants have a lowered risk of several chronic conditions later in
life compared to artificially-fed infants, including asthma, diabetes [64], heart
disease [65], [66] and cardiac risk factors such as hypertension [67] and high
cholesterol levels [68], as well as cancers such as childhood leukaemia [69] and
breast cancer later in life [70].
15. BREAST FEEDING
• Should be promoted to mothers and other
caregivers as the gold standard feeding option for
babies
• Antenatal Counselling to be done :
– Individual
– Groups
• Tobe initiated as early as possible afterbirth
16. • Operative birth : Mother may need motivation and
support (for initiating breast feeding within 1 hour)
• Skin to skin contact should be encouraged :
–“Bedding in Mother and Baby pair”
–“Breast Crawl”
Mother should communicate, look into the eyes, touch and
caress the baby while feeding.
The new born should be kept warm by promoting Kangaroo
Mother Care and promoting local practices to keep the room
warm.
17. • Colostrum MUST NOT be discarded
• NO PRELACTEAL fluids should be given
• Baby should be fed “ON CUES”
– Early Feeding Cues:
• Sucking movements and sucking sounds
• Hand to mouth movements
• Rapid eye movements
• Soft cooing or sighing sounds
• Lip smacking
• Restlessness
18. • Exclusive breastfeeding should be practiced from birth till
six months
• After 6 months : Complementary food
Breast Feeding for a minimum of 2 years
and beyond
• Even during 2nd year of life : Breast Feeding
frequency should be
4-6 times in 24 hrs. (Including
night feeds)
19. COMPLEMENTARY FEEDING
•Appropriately thick complementary foods
to be prepared from locally available
foods
•TO BE INTRODUCED at 6 completed
months
•Breast Feeding should be continued
•AVOID the term “WEANING”
20.
21. • HEALTHVISITS : Harms of artificial feeding and bottle
feeding to be explained
• Inadvertent advertising of infant milk substitutes in
health facilities to be avoided
• Artificial Feeding…..Only when medically initiated
• Efforts to provide appropriate facilities : For mothers to
breastfeed babies easily at Public Places
• Adoption of WHO Growth Charts :For growth monitoring
22.
23. HIV AND INFANT FEEDING
• Best time for counselling ?? ANTENATAL PERIOD
• EXCLUSIVE BREAST FEEDING is better than
EXCLUSIVE REPLACEMENT FEEDING .
• Prevention of parent to child transmission interventions
should begin in early pregnancy.
• EBF is the recommended infant feeding choice ,irrespective of
the fact that mother is on ART early or infant is provided with
anti – retroviral prophylaxis for 6 weeks
24. ADVANTAGES of exclusive replacement feeding
• No risk of HIV transmission
• ERF milk can be given by anyone (Mother Not required)
DISADVANTAGES of exclusive replacement feeding
• Animal milk is not a complete food for baby .
• Formula milk may be complete but it is expensive .
• Baby has more risk of infections
• Careful and hygienic preparation is needed
• Mothers who are HIV infected and insist on not breastfeeding and opt for exclusive
replacement feeding should be explained they are so at their own risk and this is contrary to
the WHO / NACO’s guidelines.
25. SPECIAL SITUATIONS
• Feeding During Sickness of Babies??
–IMPORTANT
–Prevents sickness and prevents undernutrition
• Infant Feeding in Maternal Illness??
–Treatment of primary condition (Breast abcess /
postpartum psychosis) must be treated 1st
–Chronic infections
(TB/Leprosy/Hypothyroidism) need treatment
of primary condition and do not warrant
27. SOME SPECIFIC CONDITIONS OF INFANTS…
• Very Low Birth Weight, Sick, Or Depressed Babies :
–ALTERNATIVE METHODS can be used depending on
Neurodevelopmental status
–Includes : expressed breast milk through intra-gastric
tubes
• GERD : Tobe treated CONSERVATIVELY through –
–Thickening of complementary foods
–Frequent small feeds
–Upright positioning for 30 minutes after feeds
28. • During EMERGENCIES ???
–Priority health and nutrition support for pregnant
and lactating mothers
–Donated or subsidized supplies of breast milk
substitutes should be avoided
–Donation of bottles and teats should be
refused and their use to be actively avoided
29. FEEDING IN PRETERM/
LOW BIRTH WEIGHT INFANTS
• All LBW / VLBW infants : Breast Feeding
• Should be fed with EXPRESSED breast milk via
katori / spoon if unable to suckle or cant be fed
orally
• LBW infants : EBF for 6 months
• VLBW babies : 10 ml/kg of enteral fluids
(preferably Breast Milk) + IV Fluids
(Remaining)
• LBW infants who cant be breast fed with their
own mother’s milk?? DONOR HUMAN MILK
32. PROTECTIO
N
• IMS
Act
• Amendment act
2003
PROMOTIO
N
• Providing accurate info and skilled counselling to
women family and community members
SUPPOR
T
• For sustained appropriate feeding through
maternity protection
41. 2. Activities for reaching out to mothers/ caregivers during home
visits and community level activities:
a. One to one counselling during home visits by the ANM and
ASHA is the best way to reach out to mothers and
caregivers in the community.
b. Group counselling sessions, at fixed day and time, should
be organizedat VHND.
c. Display of Appropriate IEC material
– Specific points for discussion on feeding,
examination/observation and key messages to be delivered
at each of the 6 visits (or 7 in case of home delivery) should
be clearly specified to ASHAs and ANMs during the training
on IYCF.
– Mothers of children identified as moderately or severely
underweight or with weight plotting in yellow & orange zone
of the growth chart (Mother and Child Protection Card)
42. KEY INTERVENTIONS DURING
COMMUNITY AND HOME BASED CARE
1. MCH contact opportunities during home visits-
• Community contacts include:
a. Postnatal Home visits
b. Home visits for mobilizing families forVHND
c. Growth monitoring and health promotion sessions at AWC
d. Mothers’ Group Meetings /Self Help Groups’ Meetings
43.
44.
45.
46. TEN STEPS FOR SUCCESSFUL
BREASTFEEDING
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 a one-hour of birth.
5. Show mothers how to breastfeed, and how to maintain lactation
47. 6. Give newborn infants no food or drink other than
breast milk, unless medically indicated.
7. Practice 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.
Cont…
48. IYCF IN THE CONTEXT OF COVID-19
Recommended IYCF practices
Early initiation of breastfeeding within 1 hour
Exclusively breastfeeding for the first 6 months.
Timely introduction (at 6 months) and age-
appropriate, adequate, safe complementary
feeding from 6 months till 24 months of age
Continued breastfeeding for up to 2 years of age or
beyond.
Necessary hygiene precautions
Mothers should always wash hands with soap and
water at critical times, including before and after
contact with the infant.
Routinely clean the surfaces around the home that
the mother has been in contact with, using soap and
water.
Use a face mask or mouth/nose covering when
feeding or caring for infant. Locally
available/adaptive face mask can be used as an
alternative.
Mother with her infant should maintain physical
distancing from other people (at least 1 m) and avoid
touching eyes, nose and mouth.
49. Protection,
promotion and
support of infant
and young child
feeding AT HOME
during COVID -19
To continue recommended feeding practices with
necessary hygiene precautions during feeding:
Intensify support to families on what, when
and how to feed infant and young children at
home
Intensify promotion of safe hygiene behaviours.
Make simple, practical and context-specific
information available using all available
communication channels(digital, broadcast and
social media) to the families on healthy feeding
options for young children in the context of
lockdowns and financial barriers
