THIS PRESENTATION VIVIDLY DESCRIBES ALL THE NATIONAL PROGRAMMES OF INDIA SUPPORTING BREAST FEEDING PRACTICES IN INDIA

1. PROGRAMMES AND POLICIES
FOR PROMOTION OF BREAST
FEEDING IN INDIA
Dr Sugandha Jauhari
JR-2
Upgraded department of Community
medicine and public health

4. PROGRAMMES AND POLICIES PROMOTING
BREAST FEEDING
1) GLOBAL STRATEGY ON INFANT AND YOUNG CHILD FEEDING(IYCF)
2) BREAST FRIENDLY HOSPITAL INITIATIVE(BFHI)
3) INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS(IMNCI)
4) HOME BASED NEWBORN CARE(HBNC)
5) MOTHER’S ABSOLUTE AFFECTION PROGRAMME(MAA)
6) INFANT MILK SUBSTITUTES(IMS)ACT
7) MATERNITY BENEFIT ACT

5. 1.GLOBAL STRATEGY ON INFANT AND YOUNG CHILD
FEEDING (IYCF)
 To improve – through optimal feeding – the nutritional status, growth and
development, thus the survival of infants and young children
 Ensure that the health and other relevant sectors protect, promote and support
exclusive breastfeeding for six months and continued breastfeeding up to two years of
age or beyond, while providing women access to the support they require
 Promote timely, adequate, safe, and appropriate complementary feeding with
continued breastfeeding
 Provide guidance on feeding infants and young children in exceptionally difficult
circumstances

7. RECOMMENDATIONS ON IYCF(AS PER NHM)
 Early initiation of breastfeeding; immediately after birth, preferably within one hour.
 Exclusive breastfeeding for the first six months of life i. e 180 days (no other foods or
fluids, not even water; but allows infant to receive ORS, drops, syrups of vitamins,
minerals and medicines when required).
 Timely introduction of complementary foods (solid, semisolid or soft foods) after the
age of six months i. e 180 days.
 Continued breastfeeding for 2 years or beyond.
 Age appropriate complementary feeding for children 6-23 months, while continuing
breastfeeding.
 Active feeding for Children during and after illness.

8. INTERVENTIONS FOR PROMOTING IYCF PRACTICES IN
HEALTH SYSTEMS
 Actions to promote infant and young child feeding are grouped at three levels:
(1) at health facilities
(2) during community outreach activities and
(3) during community and home based care
.

9. HEALTH FACILTY PRIMARY ROLE KEY PRACTICES
ANTENATAL
CLINIC
Medical officer, staff
nurse, ASHA, Nutrition
or ICTC counsellor
• Counselling for early initiation, exclusive breast feeding and
Importance of colostrum during third trimester
• Specific counselling if mother is HIV positive
POST NATAL
CLINIC
Doctors, staff nurse,
TBA/NSSK trained
service provider/s
conducting delivery,
Nutrition Counsellor
• Ensure initiation of breastfeeding within one hour
• avoiding pre lacteal feeds
• promoting colostrum feeding, establishment of exclusive BF
• Management of breast conditions
• Direct observation by the health service provider for technique
and attachment while breast feeding the infant for first time
OUTPATIENT
SERVICES/
CONSULTATIONS
IMMUNISATION
CLINICS
Medical officer, staff
nurse, ANM(if available)
Nutrition or ICTC
counsellor
• Ensure exclusive breastfeeding message and complementary
feeding messages are reinforced
• Group counselling on IYCF and nutrition during pregnancy and
lactation
INPATIENT
SERVICES
Medical officer, staff
nurse, counsellor
• Monitoring of lactation and breast conditions
• Implementation of IMS Act
SPECIAL NEW
BORN CARE
UNITS
Medical officer, staff
nurse, counsellor
• Counselling on breastfeeding/breast milk feeding of low birth
weight and preterm babies
• helping mother for cup feeding the baby

10. COMMUNITY LEVEL
 At Routine Immunisation sessions (RI sessions), held at AWC, SUBCENTRE, PHC’s -
Group counselling on age appropriate IYCF practices and maternal and child nutrition.
 Dada- Dadi/Nana- Nani Sammelan:
In addition to using the platform of VHND, Monthly group counselling sessions can be
held at each village by ASHA where she does interpersonal communication regarding
Infant Young Child Feeding to secondary care givers who are major influencers in child
feeding at home such as grandparents (dada- dadi- paternal grandparents; nana-nani
maternal grandparents), father or relatives.

11. 2.BABY FRIENDLY HOSPITAL INITIATIVE(BFHI)
 The Baby-friendly Hospital Initiative(BFHI),also known as Baby Friendly Initiative (BFI)
was launched by WHO and UNICEF in 1991, following the Innocenti Declaration of
1990.
 The initiative is a global effort for improving the role of maternity services to enable
mothers to breastfeed babies for the best start in life.
 It provide maternity services for protecting, promoting and supporting
breastfeeding, in accordance with the International Code of Marketing of Breastmilk
Substitutes.

12. Step 1. Have a written
breastfeeding policy that is routinely communicated
to all health care staff

13. Step 2.Train all health-care staff in skills
necessary to implement this policy

14. Step 3. Inform all pregnant women about
the benefits of breastfeeding

15. Step 4. Help mothers initiate breastfeeding within
half-hour of birth.
New interpretation of Step 4 in the revised BFHI Global Criteria
(2006):
“Place babies in skin-to-skin contact
with their mothers immediately
following birth for at least an hour
and encourage mothers to recognize
when their babies are ready to
breastfeed, offering help if needed.”

16. Step 5. Show mothers how to breastfeed and how to
maintain lactation, even if they should be separated
from their infants

17. Step 6. Give newborn infants no food or drink other
than breast milk unless medically indicated
There are rare exceptions during
which the infant may require other
fluids or food in addition to, or in
place of, breast milk. The feeding
programme of these babies should
be determined by qualified health
professionals on an individual basis

18. Step 7. Practice rooming-in — allow mothers and
infants to remain together —
24 hours a day.
Rooming-in
A hospital arrangement
where a mother/baby pair
stay in the same room day
and night, allowing unlimited
contact between mother and
infant

19. Step 8.Encourage breastfeeding on demand
Breast feeding on
demand:
Breast feeding whenever the
baby or mother wants, with no
restrictions on the length or
frequency of feeds.

20. Step 9. Give no artificial teats or pacifiers (also called
dummies and soothers) to breastfeeding infants
ALTERNATIVES
TO ARTIFICIAL
TEATS
cup
spoon
dropper
Syringe

21. Step 10. Foster the establishment of breastfeeding
support groups and refer mothers to them on
discharge from the hospital or clinic.

22. FURTHER STRENGTHENING OF BFHI
 Monitoring and reassessing already designated facilities
 Expanding the Initiative to include clinics, health centre, and paediatric hospitals
 Provide support for feeding infants and young children in exceptionally difficult
circumstances:-
 To adapt the BFHI by taking account of HIV/AIDS
 By ensuring that those responsible for emergency preparedness are well trained to
support appropriate feeding practices consistent with the Initiative’s universal principles

23. 3.INTEGRATED MANAGEMENT OF NEONATAL AND
CHILDHOOD ILLNESS(IMNCI)
 IMNCI is an evidence based syndromic approach under NRHM.
 As per IMNCI, Physicians, health and nutrition workers are trained in management of sick
newborns and children.
 F-IMNCI is the integration of facility based care package with the IMNCI, to empower the health
personnel with the skill to manage new born and childhood illness at the community level as well
as health facility level.
 One of the component of IMNCI is Home visits for young infants by health worker in order to
Promote & support exclusive breastfeeding

24. 4.HOME BASED NEWBORN CARE (HBNC)
 The main purpose of HBNC is to improve neonatal survival by training ASHAs on
identified aspects of newborn care.
 Together with the Janani Suraksha Yojana(JSY) and the Janani Shishu Suraksha
Karyakaram (JSSK), the HBNC ensures that mother and newborn have access to
services in order to ensure positive health outcomes.
UNDER HBNC,ASHA SHOULD PERFORM THE FOLLOWING ACTIVITIES FOCUSSING
ON BREASTFEEDING:-
 Supporting exclusive breastfeeding through teaching the mother proper positioning
and attachment for initiating and maintaining breastfeeding
 Diagnosing and counselling in cases of problems with breastfeeding
 Health Promotion and counselling mothers and families on key messages on
newborn care which includes discouraging unhealthy practices such as early bottle
feeding

26. 5.MOTHER’S ABSOLUTE AFFECTION
PROGRAMME(MAA)

27. .
 India’s National Nutrition Policy and the National Plan of Action on
Nutrition clearly articulates the role of health sector in promoting
breastfeeding through training of health workers.
 Similarly, the National Guidelines on Infant and Young Child Feeding
2006 and the Infant Milk Substitutes: Feeding Bottles, and Infant Foods
(Regulation of Production, Supply and Distribution) Act 1992, and
Amendment Act 2003 also state the role of health care system in
ensuring Optimal Infant and Young Child Feeding Practices.

28. 6.IMPLEMENTATION OF THE IMS ACT
(Infant Milk Substitutes, Feeding Bottles and
Foods Act,1992)
 Provides regulation against commercial influence of baby food industry on people
with a view to protect and promote breastfeeding.
 Health care providers must not allow the health systems to be used for promotion
of any baby foods or companies manufacturing such foods.
 The Act also prohibits any kind of direct or indirect benefit to the manufacturers of
baby food companies.

29. 7.MATERNITY BENEFIT ACT,1961
 Provides maternity leave for twelve weeks
 Two breastfeeding breaks, until the child attains the age of fifteen months
 Paid maternity leaves on average daily wage for a period of eighty four days
 In 2008, the central government adopted the recommendations of the Sixth Pay
Commission and gave a generous allowance of 180 days of maternity leave on full pay
and paid Child Care Leave for a period of 2 years
 States like Tamil Nadu, Andhra Pradesh, Karnataka is following this