The document discusses guidelines for infant and young child feeding from the WHO and UNICEF. It recommends exclusive breastfeeding for the first six months, and continued breastfeeding along with complementary foods from six months to two years or beyond. Complementary foods should be provided in a timely, adequate, safe and proper manner. Special considerations are given for feeding in difficult circumstances and malnourished or low-birth-weight children.
Global Strategy for Infant and Young Child Feeding
1. The Global Strategy for Infant and
Young Child Feeding
• 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 10.6 million deaths
annually among children <5 years
• Over two-thirds of these deaths occur in the first
year of life
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2. Exclusive breastfeeding
• Breastfeeding provides ideal food for the healthy
growth and development of infants
• Infants should be exclusively breastfed for the first
six months of life
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3. Complementary feeds
• After six months all babies require complementary
foods while breastfeeding continues for up to two
years of age or beyond
• Complementary feeds should be:
• timely
• adequate
• safe
• properly fed
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4. Feeding in exceptionally difficult
circumstances
• Emergency situations
• Malnourished children
• Low-birth-weight babies
• Infants of HIV-infected mothers
• Orphans
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5. Why breastfeeding is important
After completing this session participants will
be able to:
• state the advantages of exclusive breastfeeding
• list the disadvantages of artificial feeding
• describe the main differences between breast milk
and artificial milk
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6. Advantages of breastfeeding
Breastfeeding
• Helps bonding
and development
• Helps delay a new
pregnancy
• Protects mothers’
health
Costs less than artificial feeding
Breast milk
• Perfect nutrients
• Easily digested;
efficiently used
• Protects against
infection
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7. Nutrients in human and animal milks
Fat
Protein
Lactose
Human Cow Goat
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8. Differences in the quality of proteins in
different milks
Cow’s milk
Human milk
Whey protein
Curds
Easy to digest Difficult to digest
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9. Protection against infection
1. Mother infected 2. White cells in
mother’s body
make antibodies
to protect
mother
4. Antibodies to
mother’s
infection secreted
in milk to protect
baby
3. Some white cells
go to breast and
make antibodies
there
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11. Colostrum
Property Importance
• Antibody rich - protects against allergy & infection
• Many white cells - protects against infection
• Purgative - clears meconium
- helps to prevent jaundice
• Growth factors - helps intestine to mature
- prevents allergy, intolerance
• Rich in Vitamin A - reduces severity of infection
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12. Risk of diarrhoea by feeding method
Philippines, infants aged 0-2 months
1
3.2
13.3
17.3
0
2
4
6
8
10
12
14
16
18
20
Breast milk only Breast milk and
non-nutritious
liquids
Breast milk and
nutritious
supplements
No breast milk
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Source: Popkin BM. Breast-feeding and diarrheal morbidity. Pediatrics 1990; 86: 874-82.
13. Psychological benefits of
breastfeeding
Emotional bonding
• Close, loving relationship between mother and baby
• Mother more emotionally satisfied
• Baby cries less
• Baby may be more emotionally secure
Development
• children perform better on intelligence tests
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14. Disadvantages of artificial feeding
• Interferes with bonding
• More diarrhoea and persistent diarrhoea
• More frequent respiratory infections
• Malnutrition; Vitamin A deficiency
• More allergy and milk intolerance
• Increased risk of some chronic diseases
• Obesity
• Lower scores on intelligence tests
• Mother may become pregnant sooner
• Increased risk of anaemia, ovarian cancer, and
breast cancer in mother
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15. Breast milk in the second year of life
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Percentage
of
daily
needs
100%
75%
50%
25%
0%
Energy Protein Iron Vitamin A
Nutrient
Gap
Provided by
550 ml
breast milk
16. Common breastfeeding difficulties
After completing this session participants will
be able to identify causes of, and help
mothers with, the following difficulties:
• ‘not enough milk’
• a crying baby
• breast refusal
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17. ‘Not enough milk’
• This is one of commonest reasons for stopping
breastfeeding
• Usually when a mother thinks she does not have
enough breast milk, her baby is getting all he
needs
• Sometimes a baby does not get enough breast
milk. But this is usually because of ineffective
suckling. It is rarely because his mother cannot
produce enough
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18. Reliable signs that a baby is not
getting enough milk
Poor weight gain
• less than 500 grams per month
Small amount of concentrated urine
• less than 6 times per day
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19. Possible signs that a baby is not
getting enough breast milk
• Baby not satisfied after breastfeeds
• Baby cries often
• Very frequent breastfeeds
• Very long breastfeeds
• Baby refuses to breastfeed
• Baby has hard, dry, or green stools
• Baby has infrequent small stools
• No milk comes out when mother expresses
• Breasts did not enlarge (during pregnancy)
• Milk did not ‘come in’ (after delivery)
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20. Reasons why babies refuse to
breastfeed
• Baby ill, sedated or in pain
• Difficulty with breastfeeding technique
• Change which upsets the baby
• Apparent, not real, refusal
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21. Importance of complementary feeding
After completing this session participants will
be able to:
• explain the importance of continuing breastfeeding
• define complementary feeding
• explain why there is an optimal age for children to
start complementary feeding
• list the Key Messages from this session
• list their current complementary feeding activities
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22. Key Message 1
Breastfeeding for two years or longer helps a
child to develop and grow strong and healthy
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23. Definition of complementary feeding
• Complementary feeding means giving other
foods in addition to breast milk
• These other foods are called complementary
foods
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24. Energy required by age and the
amount supplied from breast milk
Energy
(kcal/day)
1000
800
0-2 m 3-5 m
Age (months)
Energy Gap
Energy from
breast milk
6-8 m 9-11 m 12-23 m
600
400
200
0
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25. Key Message 2
Starting other foods in
addition to breast
milk at 6 completed
months helps a child
to grow well
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26. Starting other foods too soon
Adding foods too soon may
• take the place of breast milk
• result in a low nutrient diet
• increase risk of illness
• less protective factors
• other foods not as clean
• difficult to digest foods
• increase mother’s risk of pregnancy
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27. Starting other foods too late
Adding foods too late may
• result in child not receiving required nutrients
• slow child’s growth and development
• risk causing deficiencies and malnutrition
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28. Energy required by age and the
amount supplied from breast milk
Energy
(kcal/day)
1000
800
0-2 m 3-5 m
Age (months)
Energy Gap
Energy from
breast milk
6-8 m 9-11 m 12-23 m
600
400
200
0
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29. Foods to fill the energy gap
After completing this session participants will
be able to:
• list the local foods that can help fill the energy
gap
• explain the reasons for recommending using
foods of a thick consistency
• describe ways to enrich foods
• list the Key Message from this session
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33. Foods to fill the iron and vitamin A
gaps
After completing this session participants will
be able to:
• list the local foods that can fill the nutrient gaps for
iron and vitamin A
• explain the importance of animal-source foods
• explain the importance of legumes
• explain the use of processed complementary
foods
• explain the fluid needs of the young child
• list the Key Messages from this session
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34. Gap for iron
Absorbed iron needed and amount provided
1.2
0.8
0.4
0
Iron gap
Iron from
birth
stores
Iron from
breast
milk
0-2 m 3-5 m 6-8 m 9-11 m 12-23 m
Age (months)
Absorbed
iron
(mg/day)
30/2
35. Key Message 4
Animal-source foods are especially good for
children, to help them grow strong and lively
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yoghurt
poultry fish
meat
cheese
eggs
liver
37. Key Message 5
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Peas, beans, lentils, nuts and seeds are
also good for children
lentils
beans
peas nuts
seeds
Groundnut
paste
38. Gap for vitamin A
Vitamin A needed and amount provided
30/5
400
Vitamin A
gap
Vitamin A
from birth
stores
Vitamin A
from
breast milk
0-2 m 3-5 m 6-8 m 9-11 m 12-23 m
Age (months)
Vitamin
A
(µg
RE/day)
300
200
100
0
39. Key Message 6
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Dark-green leaves and yellow-coloured fruits
and vegetables help a child to have healthy
eyes and fewer infections
pumpkin
spinach
papaya
mango
carrot
yellow sweet
potato
40. Feeding techniques
After completing this session participants will
be able to:
• describe feeding practices and their effect on the
child’s intake
• explain to families specific techniques to encourage
young children to eat
• list the Key Message from this session
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42. Key Message 9
A young child needs to learn to eat: encourage
and give help
… with lots of patience
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43. Feeding during illness and low-birth-
weight babies
After completing this session participants will
be able to:
• explain why children need to continue to eat during
illness
• describe appropriate feeding during illness and
recovery
• describe feeding of low-birth-weight babies
• estimate the volume of milk to offer to a low-birth-
weight baby
• list the Key Message from this session
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44. Key Message 10
Encourage children to drink and eat during
illness and provide extra food after illness to
help them recover quickly
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45. Feeding the child who is ill
• Encourage the child to drink and to eat
– with lots of patience
• Feed small amounts frequently
• Give foods that the child likes
• Give a variety of nutrient-rich foods
• Continue to breastfeed – often ill children
breastfeed more frequently
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46. Feeding during recovery
• Give extra breastfeeds
• Feed an extra meal
• Give an extra amount
• Use extra rich foods
• Feed with extra patience and love
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47. Feeding low-birth-weight babies
• 32 weeks gestation
– able to start suckling from the breast
• 30-32 weeks gestation
– can take feeds from a small cup or spoon
• Below 30 weeks gestation
– usually need to receive feeds by tube in hospital
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