About breastfeeding

1. .
WHO & UNICEF
Guidelines On IYCF &
Breastfeeding & Their
Practical Application
Group 4; HND 6th (M)

2. Presented By:
• Sadia Mumtaz (L)
• Areeba Khan
• Emaan Nasir
• Ariba Rasool
• Abeera Arshad
• Fasi-hun-nisa
• Masooma Ahsan
• Hamna Ahsan
• Wishma Yasir
• Haider Ali
Presented To:
• Mam Reema Arshad

3. Introduction: Importance Of Following WHO &
UNICEF Recommendations
• Dedicated to the well-being and health of
women, children, and adolescents worldwide
• Provide guidance and support on feeding
guidelines, including IYCF and Breastfeeding
practices
• Ensure that babies receive the best possible
nutrition and protection during early stages
of life

4. Importance of Optimal Feeding
Practices for Infants and Young
Practices for
Children
1 Early Development
Proper nutrition in the early years is crucial for
physical and cognitive development.
2 Immune System
Optimal feeding practices strengthen the
the immune system, reducing the risk of
illnesses.
3 Mental Growth
Nutrition impacts mental growth, influencing
influencing learning abilities and emotional
emotional well-being.
4 Long-term Health
Healthy feeding habits in childhood set the
the stage for lifelong well-being and disease
disease prevention.

5. WHO & UNICEF’s recommended feeding
practices for infants 0-6 months
• Early Initiation Of Breastfeeding: Initiation of breastfeeding within 1st hour of life
• Exclusive Breastfeeding: Encourage breastfeeding for the first 6 months of life
• Breastfeeding On Demand: As often as the baby wants, day and night
• No Use Of Bottles Or Pacifiers: Helps establish strong connection between mother and
baby

6. WHO & UNICEF’s recommended
feeding practices for infants &
young children (6-23 months)
• Continued Breastfeeding Up to 2 Years
• Introduction Of Solid, Semisolid or Soft Foods at 6 Months
• Appropriate Food Diversity
• Appropriate Frequency Of Meals
• Safe Preparation Of Foods
• Feeding Infants In Response To Their Cues

7. Key Recommendations For
Breastfeeding
Early initiation of breastfeeding within 1 hour of birth
Strong bonding forms, milk productionmore , essential nutrients
provision
Exclusive breastfeeding for 6months
Encourageexclusivebreastfeedingforthe first6 monthsoflifewithoutany
otherfoodordrink,notevenwater.
Introduction of nutritionally-adequate and safe complementary
(solid) foods at 6 months together with continued breastfeeding
up to 2 years of age or beyond
1
2
3

8. Benefits Of Exclusive Breastfeeding
• Breast milk meets all of baby’s nutritional needs
• Immune system development
• Protects babies againstshort and long-term illnesses
• Breast-fed babies have a lower risk of
Asthma Obesity GastrointestinalInfections
Type 1 diabetes SIDS Ear Infections
• More rapid maternal weight loss after birth
• Delayed return to menstrual process
• Breastfeeding reduces mother’s risk of breast and ovarian cancer, type 2
diabetes and hypertension
• Helps uterus contract
• Saves time and money
• Reduce Depression

9. Guidelines For Proper Positioning And Attachment
`
Signs of a good latch
• A comfortable experience with no
pain.
• More areola is visible above baby’s
mouth than below.
• Baby’s mouth is wide open.
• Lower lip is turned out.
• Chin is touching your breast.
Signs of good positioning
• Baby’s head and body are in line.
• Baby is held close to your body.
• Baby’s whole body supported with your
arm along their back, particularly
newborns and young babies.
• Your baby approaches breast nose to
nipple.

10. Common Breastfeeding Positions
helps provide an
enjoyable feedingand
bonding experience
useful when first learning
to breastfeedand is a
great option for small
babies
helps to prevent plugged
ducts by positioning your
baby to empty the
bottom ducts
If you and your baby are
more comfortablelying
down, this is a great
position to try.
If your baby has
difficulty latching or is
restlessand crying, this
is a calming position to
try

11. Avoidance Of Feeding Bottles and
Artificial Nipples
• The UNICEF/World Health OrganizationBFHI recommends avoidingthe use of pacifiers or bottle feeding to establish
successful breastfeeding
• Cup feeding has been suggested as a safe alternativeto bottle feeding in breastfed infantswho require supplemental
feedings to prevent “nippleconfusion” or future problems with breastfeeding.
1. Interference with breastfeeding
2. Increased risk of respiratory tract infections.
3. Higher risk of diarrhea and other GIT infections
4. Association with ear infections
5. Impact on oral development
6. Delay in language development
7. Increased risk of dental caries
8. Nutritional imbalance:

12. Complementary Feeding Guidelines For Infants And Young
Children
After 6 months, breastfed babies need more than just
breast milk for nutrients. Introducing solid foods at this
time is important, even in areas with poor sanitation,
as delaying it doesn't prevent exposure to germs.
However, during this transition, there's a risk of
undernutrition if complementary foods aren't
introduced or managed properly, especially if
breastfeeding stops too soon or happens infrequently.

13. • Introduction: WHO recommends introducingcomplementaryfoods at 6
months alongsidebreast milk.
• Feeding Frequency:
Begin with 2–3 times a day between 6–8 months.
Increase to 3–4 times daily between 9–11 months.
Offer 1–2 additionalnutritioussnacks per day for ages 12–24 months.
• Food Consistency:
Start with pureed, mashed, and semi-solid foods at 6 months.
Progress to "finger foods" by 8 months.
• Family Foods:
By 12 months, childrencan generally eat the same foods as the rest of
the family.
• Nutrient-Dense Foods:
Emphasize nutrient-dense foods like meat, poultry, fish, eggs, and dairy
products.
• ChokingHazards:
Avoidfoods that may cause choking, such as whole grapes or raw
carrots.
• Beverage Guidelines:
Do not give low-nutrientdrinks like tea, coffee, or sugary soft drinks
Limit juice intake to prevent displacement of more nutrient-rich foods.

14. The Guiding principles for complementary feeding of the breastfed child set standards for developing locally appropriate feeding
recommendations. They provide guidance on desired feeding behaviour as well as on the amount, consistency, frequency, energy
density and nutrient content of foods.
GUIDING PRINCIPLE 1. Practice exclusive breastfeeding from birth to 6 months of age and introduce complementary foods at 6
months of age (180 days) while continuing to breastfeed
GUIDING PRINCIPLE 2. Continue frequent on-demand breastfeeding until 2 years of age or beyond
GUIDING PRINCIPLE 3. Practice responsive feeding applying the principles of psychosocial care
GUIDING PRINCIPLE 4 Practice good hygiene and proper food handling
GUIDING PRINCIPLE 5. Start at 6 months of age with small amounts of food and increase the quantity as the child gets older, while
maintaining frequent breastfeeding
GUIDING PRINCIPLE 6. Gradually increase food consistency and variety as the infant grows older, adapting to the infant's
requirements and abilities
GUIDING PRINCIPLE 7. Increase the number of times that the child is fed complementary foods as the child gets older
GUIDING PRINCIPLE 8. Feed a variety of nutrient-rich foods to ensure that all nutrient needs are met
GUIDING PRINCIPLE 9. Use fortified complementary foods or vitamin-mineral supplements for the infant as needed
GUIDING PRINCIPLE10 Increase fluid intake during illness, including more frequent breastfeeding, and encourage the child to eat
soft, favorite foods. After illness, give food more often than usual and encourage the child to eat more
Guiding Principle 1
Guiding Principle 3
Guiding Principle 4
Guiding Principle 5
Guiding Principle 6
Guiding Principle 7
Guiding Principle 8
Guiding Principle 9
Guiding Principle 10
Guiding Principle 2

15. Addressing Some Common Misconceptions
“Misconceptions Related To Breast Feeding”
1: Pre-lacteal feeds are good
The most importantprelacteal feeds are honey and herbal preparationbut are absolutelywrong as they elevatedrisks of
hospitalization ,diarrhoea and lower respiratory tract infection.
2: Colostrumis not enough and not good
Its amount is small (30-100 mL/day) but sufficient for the first few days. It containshigh content of protein, vitaminA, leukocytes,
lactoferrin, and lysozyme. It helps to clear gut meconium and bilirubinfrom the gut and prevent jaundice.
3: Small breasts give insufficientamount of milk
The size of the breast depends on the amountof fat not the milk-producingalveoli.It is possible for mothers with smaller breasts
to have a good supply of milk by understandingthe needs and demand of their infants.
4: Breastmilk is dilute and not nourishing
Mature breast milk consists of foremilk and hind milk. Foremilkis bluish-grayand watery, which provides plenty of water, protein,
and lactose, whereas hind milk is whiter than foremilk and provides extra fat to achieve satiety.
5: Any expressedbreastmilkis immediately spoiled
The expressed breast milk should be kept in clean tightly covered container.The storage is either at room temperature,up to 4h, or
in the refrigerator, up to 96h.
6: Mother must eat special foodto increase breast milk
A breastfeeding mother should eat a balanceddiet, but there is absolutelyno need to unnecessarily limit her diet. Manysocieties
have traditional foodsand herbs for postpartum women to increase the mother's strength and enhance lactation

16. 7: stop breastfeeding if infant has diarrhea or mother is ill
Breastfeeding is the ideal feeding for a sick infant, as there are many factors that protect his GI system and fight off illness.
8: Mother cannot breastfeedfor 24h if she gets vaccine
There is absolutelyzero risk to the infantor may get benefit from the vaccine. However, if infant has an immune deficiency then
mother shouldn't receive any vaccinationsthat containalive attenuated virusi.e. polio,measles
9: if an infant has lactose intolerance,he/she needs to be weaned onto soy or lactose-free formula
Even with strong family history, lactose intolerancerarely developsbefore the age of 4 years. However, secondary lactose, a
temporary conditionfollowing diarrhea, can occur in infancy. Breast milk has healingproperties that will assist an infant's GIT to
recover faster and should be encouraged.
10: Mothers who don't have enough to eat can't breastfeed
Malnourishedmothers are able to breastfeed their babies, but they need extra food and water to improve the qualityof their
milk and be stronger. Feed the mother and let her feed her baby.
11: Once breastfeeding has stopped it cannot be resumed
Women who have breastfed and stopped can restart breastfeeding if they are helped, it usuallytakes a week or more to start
again. Thisis calledre-lactation
12: Stress makes milk dry up
Mothers who are stressed might reduce the number of times they feed their baby, so it's importantto help them relax and
provide them with places where they can breastfeed comfortably.

17. “Misconception related to complementary feeding”
1) Children should eat less when they are sick. Children needs to be strong
when they are sick and for that, they need to eat more. Give sick child food to
eat more frequently.
2) Most mothers avoided dhal (pulses) because it was considered difficult to
digest and produce gas in the child's stomach
3) There was a belief in mothers that undiluted milk is harmful as a weaning
food
4) Jaggery, papaya, eggs, mangoes Chicken, mutton, fish, beet root, brinjal
etc. were considered 'hot' for the child
5) Banana, curd/butter milk, fruits like guava, lemon juice and other citrus
fruits were considered to be 'cold' for the child
6) Only liquid foods like dal water, rice water good
7) Vegetables choke in food pipe

18. Cultural & Social Barriers To
Breastfeeding In Pakistan
1. Cultural beliefs:Some communities consider breastfeeding to be a private and
taboo subject. There might be myths or misconceptions about the benefits of
breastfeeding versus formula feeding.
2. Social norms: Prioritize modesty and discourage breastfeeding in public, leading
mothers to feel uncomfortable or ashamed to breastfeed outside the home.
3. Family dynamics: Family members, particularly elders, may influence
breastfeeding decisions. Pressure to conform to family traditions or advice from
older generations could impact a mother’s choice to breastfeed exclusively.

19. 4. Workplace challenges: Women often face difficulties in balancing breastfeeding with work
responsibilities. Lack of supportive policies, such as adequate maternity leave or on-site childcare facilities,
may hinder a mother’s ability to continue breastfeeding after returning to work.
5. Marketing of formulamilk:Aggressive marketing strategies by formula milk companies can undermine
breastfeeding practices by promoting formula as a convenient and superior alternative to breastfeeding. This
can create a perception that formula feeding is more modern or sophisticated.
6. Healthcare practices: Healthcare providers’ knowledge and attitudes towards breastfeeding can influence
mothers’ decisions. Lack of proper support and guidance from healthcare professionals may lead to early
introduction of formula feeding or inappropriate feeding practices.

20. Lack of knowledge and
misconceptions about
breastfeeding
1. Belief that formulamilk is superior: Leads to opt for formula feeding instead of
breastfeeding.
2. Concerns about milk supply: Some mothers may worry about not producing enough milk to
meet their baby’sneeds, leading them to supplement with formula
3. Perceived inconvenience of breastfeeding:Some mothers may view breastfeeding as
inconvenientdue to concerns about breastfeeding in public or the belief that formula
feeding is more flexible.
4. Fear of pain or discomfort: Some women may avoidbreastfeeding due to fear of pain or
discomfort associated with breastfeeding, particularlyduring the initialdays
5. Misinformation aboutthe benefits of breastfeeding: Lack of awareness about the
numerous benefitsof breastfeeding for both the mother and the baby can contribute to
misconceptions about its importance.

21. Limited Access to Skilled Breastfeeding Support
and Counseling
• Access to skilled breastfeeding support and counseling is often limited in Pakistan, particularly in rural
areas.
• The shortage of healthcare professionals trained in lactation management and breastfeeding support
creates significant barriers for mothers and families seeking guidance and assistance.
• Many mothers struggle to establish and maintain exclusive breastfeeding, leading to adverse health
outcomes for both infants and mothers.
• This lack of comprehensive support contributes to high infant and child mortality rates, malnutrition, and
other preventable health issues.
• Effectiveinterventionsto improve access to skilled breastfeeding supportand counselingare essential
to address these challengesand ensure the well-being of mothers andinfantsacross Pakistan.

22. Impact of Formula Milk Marketing on
Breastfeeding Practices
Marketing Strategies Misleading Information
Formula milk companies often employ aggressive
marketing strategies targeting new mothers,
emphasizing convenience and the supposed
benefits of formula feeding. The use of celebrities
and endorsements creates a false image of
superiority, influencing maternal decisions
regarding breastfeeding.
Advertisements andpromotionalmaterials
often providemisleading informationabout
formula milk, downplayingtherisks and
promotingunrealisticbenefits. This can leadto
a lack of awareness aboutthe health risks
associatedwith formula feeding and can
negativelyimpactexclusivebreastfeeding
practices.

23. Government Policies and Initiatives to
promote Breastfeeding in Pakistan
• Enabling Breastfeeding: Making a difference for working
parents
• Maternity and Paternity leave act
• Sindh Protection and Promotion of Breastfeeding and Young
child nutrition act
• Collaboration of Nutrition International with SUN

24. Challenges in implementing and monitoring the Breast
Feeding policies in Pakistan
• Low awareness and cultural practices of pre lacteal feed
• Undernutrition of mother which leads to insufficient milk production
• Mother's occupation as fieldworkers
• Less birth spacing
• Less awareness about the correct technique of Breastfeeding
• Maternal and child ailments
• Abnormal breasts
• Influence of in-laws to start top-up feeds

25. Recommendations for improving IYCF and
breastfeeding practices in Pakistan
Community Awareness Programs
Implement community-based
education and awareness programs to
educate families and communities
about the importance of exclusive
breastfeeding for the first 6 months of
an infant's life. Empower local
healthcare workers and community
leaders to advocate for proper infant
and young child feeding (IYCF)
practices.
Workplace Breastfeeding Support
Encourage businesses and workplaces to
establish supportive environments for
breastfeeding mothers, providing
designated lactation rooms, flexible
break times, and support for expressing
and storing breast milk. Workplace
policies should prioritize the well-being
of both working mothers and their
infants.
Quality Antenatal and Postnatal Care
Strengthen antenatal and postnatal
care services to ensure that pregnant
and new mothers receive evidence-
based information on breastfeeding
and IYCF early in their pregnancy. This
should include counseling on proper
breastfeeding techniques and
addressing any potential challenges or
complications
Regulation of Formula Milk
Marketing
Enforce strict regulations on the
marketing of formula milk to prevent
misleading or aggressive marketing
tactics that undermine breastfeeding.
This includes monitoring advertising,
labeling, and promotional activities to
ensure that they align with
international standards and ethical
practices.

26. Conclusion
The WHO and UNICEF guidelines emphasize the critical importance
of optimal feeding practices during the first 2 years of a child’s life.
It highlights the benefits of exclusive breastfeeding for the first 6
months, followed by introduction of nutritious complementary
foods. These guidelines provide essential strategies for promoting,
supporting, and monitoring infant and young child feeding
practices at the community level.