infant feeding breastfeeding of newborns

1. Infant and Young Child
Feeding
Ms Mumtaz Khalid Ismail
Consultant Nutritionist
NRHM

2. Why Is Infant And Young Child Feeding
So Important?
► They are at the most vulnerable age
► Poor Intake of food is common during first two years
(Quantity And Quality)
► Poor feeding practices result in malnutrition, contribute to impaired
cognitive and social development, poor school performance
► Cause of malnutrition which is responsible directly or indirectly for 60%
death among under five.

3. Correct Norms for Infant and
Young Child Feeding
► Initiation of breastfeeding immediately after birth, preferably
within one hour.
► Exclusive breastfeeding for the first six months
► Receives only breast milk and nothing else, no other milk. Food, drink
or water.
► Appropriate and adequate complementary feeding from six
months of age while continuing breastfeeding.
► Continued breastfeeding up to the age of two years.

4. Infant and Young Child Feeding
practices
Indicator DLHS-3
(2007-08)
DLHS-2
(2002-04)
1.Children under 3 years breastfed within
one hour of birth
65.3 72.7
2. Children age 0-5 months exclusively
breastfed
69.1 N A
3. Children age 6-35 months exclusively
breastfed for at least 6 months?
22.3 22.0
4. Children age 6-9 months receiving
solid/semi-solid food and breast milk
84.6 N A
* Source: District Level Household Surveys

5. Nutritional Status of Children
Indicator NFHS-3
(2005-06)
NFHS-2
(1998-99)
1. Children under 3 years who are stunted
(%)
21.1 21.9
2. Children under 3 years who are
wasted (%)
16.1 11.1
3. Children under 3 years who are
underweight (%)
28.8 26.9
* Source: National Family Health Survey (NFHS-3)

6. The Tenth Plan -nutrition goals by
2007.
1. Intensify nutrition &health education to improve IYCF & caring
practices to:
• Bring down the prevalence of under-weight children <3yrs
from the current level of 47% to 40%;
• Reduce prevalence of severe Under nutrition in children in the 0-6
years age group by 50 per cent
2. Enhance early initiation of BF (colostrum feeding) from the current
level of 15.8 % to 50 %
3. Enhance the exclusive BF rate for the first six months from the current
rate of 55.2 % (for 0-3 months) to 80 %
4. Enhance the complementary feeding rate at six months from the
current level of 33.5 per cent to 75 per cent.

7. The objectives of the national
guidelines on IYCF
► To advocate IYCN and its improvement through optimal feeding
practices
► To disseminate widely the correct norms of BF & complementary
feeding from policy making level to the public at large in different
parts of the country in regional languages
► To help plan efforts for raising awareness and increasing commitment
of the concerned sectors of the govt, NGOs and professional groups for
achieving optimal feeding practices for infants and young children
► To achieve the national goals for IYCF practices set by the planning
commission for the 10th five year plan so as to achieve reduction in
malnutrition levels in children.

8. 0 – 6 months
► Energy 110 to 140 kcal / kg
► Protein requirement is about 2 gm/kg
► Calcium 500mg/day
► Best food for the neonate is mother’s milk

9. Infant And Young Child Feeding
Practices
► Breastfeeding is the best way to satisfy the nutritional and psychological needs
of the baby.
► Mother’s milk is designed for easy digestion and assimilation.
► Protein in mother’s milk is in a more soluble form which is easily digested and
absorbed by the baby.
► Fat and calcium in human milk which are also easily absorbable.
► The amount of vitamins such as thiamine, vitamin A and vitamin C found in
mother’s milk depends on the diet of the mother.

10. Advantages of breastfeeding
► The best natural food for babies.
► Is always clean.
► Protects the baby from diseases.
► Makes the child more intelligent.
► Available 24 hours a day & requires no special
preparation.
► Nature’s gift to the infant and does not need to be
purchased.
► Makes a special relationship between mother and baby.
► Helps parents to space their children.
► Helps a mother to shed extra weight gained during
pregnancy.

11. Summary of differences between
milks
Human milk Animal milks Infant formula
Protein
correct amount, easy
to digest
too much, difficult to
digest
partly corrected
Fat
enough essential fatty
acids, lipase to digest
lacks essential fatty
acids, no lipase
no lipase
Water enough extra needed may need extra
Anti-infective
properties
present absent absent

12. RDA 6 to 12 months
► Energy 98 kcal/kg
► Protein 1.65 gm/kg
► Calcium 500mg/kg
► Vitamin A 1550mcg/d
► Vitamin B1 50mcg/kg, B2 65mcg/kg
► Vitamin C 25mg/d

13. Importance of Complementary Feeding
► To meet the growing needs of the growing baby.
► An infant weighing around 3kg at birth doubles its weight by six
months and by one year the weight triples and the body length
increases to one and a half times than at birth.
► Most of the growth in the nervous system and brain is complete in the
first two years of life.

14. COMPLEMENTARY FEEDING
► Complementary feeding at six months
► First food for the baby- Porridge can be made with
suji, broken wheat, ground rice, ragi, millet etc
► Traditional foods for infants – mixed food like
khichidi,dalia, suji kheer, upma, idli, dokhla.
► Modified family food-rice or wheat preparation
couldbe mixed with pulse and/or vegetable
► Mashed potato, carrots, cauliflower, pumpkin,
spinach
► Weekly 3 – 4 cooked eggs
► 9 -10 months fish, chicken, and meat

15. Ensuring safety of
complementary foods
► Hands should be washed with soap and water
► Utensils used should be scrubbed, washed well,
dried and kept covered.
► Cooking kills most germs.
► After cooking, handle the food as little as possible
and keep it in a covered container
► Cooked foods should not be kept for >2 hours.
► The hands of both mother and child should be
washed before feeding the child.

16. 1 to 6 years
► Fuzzy eating starts at this time
► Need 5 to 6 meals per day
► Require high protein, high calorie, high calcium, iron rich diet
► No restriction on fat but avoid fried food

17. RDA 1to 3 and 4 to 6 years
► Energy 1240kcal/d, 1690 kcal/d
► Protein 22gm/d, 30gm/d
► Fat 25gm/d
► Calcium 400mg/d
► Iron 12mg/d, 18mg/d

18. Energy density of foods can be
increased by
► By adding a teaspoonful of oil or ghee in every
feed.
► By adding sugar or jaggery to the child’s food.
► By giving malted foods. Malting reduces viscosity
of the foods and hence child can eat more at a
time. Malting is germinating whole grain cereal or
pulse, drying it after germination and grinding.
► By feeding thick mixtures.

19. FEEDING IN DIFFICULT
CIRCUMSTANCES
►Malnourished infants
►Preterm or Low Birth Weight Infants
►Feeding During Emergencies
►Feeding in Maternal HIV – if AFASS AF,
exclusive BF or exclusive artificial feeding

20. Feeding during and after illness
► Malnourishment increases incidence & severity of
infection
► Sick child needs more nourishment
► children with measles, diarrhoea and RTI must eat
plenty of vitamin A rich foods
► After the illness, a nutritious diet with sufficient
► Energy, protein and other nutrients enable him to
catch up growth &replacement of nutrient stores.

21. Take-home Messages
► Malnutrition is a serious and prevalent problem
► Malnutrition Increases Morbidity And Mortality and
decreases Educational Achievement and lifetime earnings
► Inadequate Infant And Young Child Feeding is the major
cause of Malnutrition
► Inadequate IYCF is not primarily due to lack of food
(Quantity), But because of poor practices at the household
level
► Lack of Information about how feeding young children is a
major reason for poor Breastfeeding and complementary
feeding of Infants and young children

22. ►Thank You