Infant and Young Child Feeding

Optimal infant and young child feeding

\- most effective intervention to improve child health

Undernutrition

is associated with at least 35% of child death

Undernutrition

A major disabler preventing children from reaching their full developmental potential.

35

Undernutrition is associated with at least __% of child death

Global Strategy for Infant and Young Child Feeding (IYCF)

In 2002, WHO and UNICEF issued a ____

WHO and UNICEF

In 2002, ____ issued a Global Strategy for Infant and Young Child Feeding (IYCF)

Global Strategy for Infant and Young Child Feeding (IYCF)

Attention to the impact that feeding practices have on nutritional status, growth and development, health, and thus the very survival of infants and young children.

Philippine DOH

The commitment of the _____ to the global strategy is shown in AO 2005-0014 that states the National Policies on Infant and Young Child Feeding

AO 2005-0014

The commitment of the Philippine DOH to the global strategy is shown in ___ that states the National Policies on Infant and Young Child Feeding

National Policies on Infant and Young Child Feeding

The commitment of the Philippine DOH to the global strategy is shown in AO 2005-0014 that states the ____

Introduction of complementary food

\: what to give, how much and often, and how to feed it safely

Micronutrient supplementation
Food fortification
Diet diversification
Deworming

In addition to good feeding practices, other measures to improve nutritional status of infants and young children such as:

EO No. 51 or Milk Code

Prohibits the advertising, promotion, or other marketing materials that shall imply or create a belief that bottle feeding is equivalent or superior to breastfeeding.

EO No. 382 or National Food Fortification Day

Observed every November 7.

EO No. 51

Milk Code: aka?

EO No. 382

National Food Fortification Day EO #

November 7

National Food Fortification Day

Rooming-In and Breastfeeding Act

RA 7600 or ?

RA 7600

Rooming-In and Breastfeeding Act or?

RA 7600 or Rooming-In and Breastfeeding Act

States that newborn infants must be put to the breast of the mother immediately after birth and roomed-in within 30 minutes after NSVD and within 3-4 hours after birth by caesarian delivery.

NSVD: 30 mins

CS: 3-4 hours

States that newborn infants must be put to the breast of the mother immediately after birth and roomed-in within:

(NSVD vs CS)

“ASIN” (Act for Salt Iodization Nationwide) Law

RA 8172 or ?

RA 8172

“ASIN” (Act for Salt Iodization Nationwide) Law or?

RA 8172 or “ASIN” (Act for Salt Iodization Nationwide) Law

Requires all producers of food-grade salt to iodize the salt that they produce, import, trade or distribute. And for LGUs to monitor salt sold in the market for their compliance to iodization of salt.

Philippine Food Fortification Act

RA 8976 or ?

RA 8976

Philippine Food Fortification Act or?

RA 8976 or Philippine Food Fortification Act

• Fortification of rice with iron, wheat flour with vitamin A and iron, refined sugar with vitamin A, and cooking oil with vitamin A.
• Promotes fortification of food products through the **Sangkap Pinoy Seal Program**

Expanded Breastfeeding Promotion Act

RA 10028 or?

RA 10028

Expanded Breastfeeding Promotion Act or?

RA 10028 or Expanded Breastfeeding Promotion Act

Setting up of lactation stations in all health and non-health facilities, establishments, or institutions

RA 10028 or Expanded Breastfeeding Promotion Act

Also grants break intervals for nursing employees to breastfeed or express their milk

AO 36, s2010 Expanded Garantisadong Pambata (GP)

A comprehensive and integrated package of services on health, nutrition, and environment for children available everyday at various setting such as homes, schools, health facilities and communities by government, NGO, private sectors and civic groups.

PD No. 491

Declared July as the Nutrition Month and created the National Nutrition Council

July

Nutrition Month

Letter of Instruction 441

Integration of nutrition education in the school curriculum.

Exclusive Breastfeeding

infant receives breast milk (including expressed breast milk or breast milk from a wet nurse) and allows the infant to receive ORS, drops, syrups (vitamins, minerals, medicines), but nothing else.

Predominant Breastfeeding

predominant source of nourishment has been breast milk, including milk expressed or from a wet nurse as the predominant source of nourishment; however, the infant may also have received liquids- water and water-based drinks, fruit juice, ritual fluids, and Oresol drops or syrups (vitamin, minerals and medicines).

Bottle Feeding

child is given food or drink (including breast milk) from a bottle with a nipple/teat.

Complementary Feeding

from the age of 6 months, an infants’ need for energy and nutrients starts to exceed what is provided by breastmilk and complementary feeding becomes necessary to fill the energy and nutrient gap.

Timely

Adequate

Safe

Properly fed

Ensuring that their nutritional needs are met require that complementary food be:

Timely

\- complementary foods are introduced when the need for energy and nutrients exceed what can be provided through exclusive and frequent breastfeeding

Adequate

\- should provide enough energy, protein, and micronutrients to meet a growing child’s nutritional needs.

Safe

\- foods are hygienically stored and prepared and with clean hands using clean utensils and not bottles and artificial nipples

Properly fed

- Foods are given consistent with a child’s signals of appetite and satiety, and that meal frequency and feeding method-actively encouraging the child, even during illness, to consume enough food using fingers, spoon, or self-feeding- are suitable for age.

Anthropometry

measurement of physical dimension and gross composition of the body.

Weight-for-age

Reflects body weight relative to the child’s age; frequently used to determine underweight

Length/height-for-age

• Reflects attained growth in length or height in relation to child’s age at a given time; used to identify children who are short or stunted due to prolonged undernutrition or repeated illness. However, one must consider the effect of heredity when using this measurement

Mid-upper arm circumference (MUAC)

• Used for rapid screening for malnutrition to identify children who need referral for further assessment or treatment. < 115 mm means severe malnutrition in children aged 6-59 months

Clinical Examination

Recognition of signs of malnutrition. Useful in detecting micronutrient deficiency and severe forms of malnutrition like kwashiorkor and marasmus.

Biochemical Examination

Assessment of specific components of blood or urine samples in order to measure specific aspects of one’s metabolism. These are not routinely done in RHUs and health centers because of the costs the test entails

2008

National Nutrition Survey in ____: conducted blood test-serum retinol determination to detect and determine severity of Vitamin A Deficiency (VAD).

National Nutrition Survey

_______ in 2008: conducted blood test-serum retinol determination to detect and determine severity of Vitamin A Deficiency (VAD).

blood test-serum retinol determination

National Nutrition Survey in 2008: conducted ______ to detect and determine severity of Vitamin A Deficiency (VAD).

Vitamin A Deficiency (VAD).

National Nutrition Survey in 2008: conducted blood test-serum retinol determination to detect and determine severity of ______

Hemoglobin determination

blood serum test for Iron deficiency anemia (IDA).

1. Early initiation of breastfeeding
2. Exclusive breastfeeding for the first 6 months

The national policies and infant and young child feeding advocate for the following practices:

Substances made from galactose build up in the infant’s system
2\. These substances damage the liver, brain, kidneys, and the eyes of the baby

If an infant with galactosemia is given milk:

Phenylketonuria (PKU)

Rare inherited disorder that causes an amino acid called the phenylalanine to build up in the bodyP

Phenylketonuria (PKU)

Rare inherited disorder that causes an amino acid called the phenylalanine to build up in the body

Maple Syrup Urine Disease (MSUD)

Inherited disorder in which the body is unable to process certain building blocks properly

Diet diversification

Refers to changing dietary practices that affect young children, pregnant and lactating mothers, t

– yellowish fluid secreted by the mammary glands in the first few days after birth; rich in white cells and antibodies to protect against infection 3 Breast milk prevents diarrhea because of reduced

Colostrum

IgA

– most abundant antibody;

IgA

protects the mucosal membrane in the baby's gut against pathogens

1 Early initiation of breastfeeding helps to **contracts the uterus** and therefore reduce bleeding


2
Help in the return to **pre-pregnancy weight**

3 Exclusive breastfeeding **delays the return of fertility**


4
Long-term benefit is a lower risk of **premenopausal breast cancer and ovarian cancer**

\
5 **Economic benefits** to the family because it is the least expensive feeding method and infant has reduced risk of infection so cost of healthcare is likewise reduced

BENEFITS OF BREASTFEEDING TO THE MOTHER

on demand

Exclusive breastfeeding _____ results in ample milk production

oxytocin

Putting the infant to breast stimulates ____ release, making the mother's uterus contract after delivery, which helps reduce bleeding

500

In practice, a lactating mother uses about ___ kcal (equivalent to one extra meal) each day to make 750 ml of breast milk for an infant

750

In practice, a lactating mother uses about 500 kcal (equivalent to one extra meal) each day to make ___ml of breast milk for an infant

Galactagogue

– an agent that promotes the flow of milk

manual milk expression

During breast engorgement and when the mother must leave her infant, ____ may be done, or via breast pump

6 months

From the age of ___, an infant's need for energy and nutrients starts to exceed what is provided by breast milk, and complementary feeding becomes necessary to fill the energy and nutrient gap

Timely

Adequate

Safe

Properly fed

Ensuring that their nutritional needs are met requires that complementary food should be:

Timely

Complementary foods are introduced when the need for energy and nutrients exceeds what can be provided through exclusive and frequent breastfeeding

Adequate

Should provide sufficient energy, protein, and micronutrients to meet a growing child's nutritional needs

Safe

Hygienically stored and prepared, and fed with clean hands using clean utensils and not bottles and artificial nipples

Properly fed

Food is given consistent with a child's signals of appetite and satiety

Micronutrient (vitamin and mineral) supplements

are sources in concentrated forms of those nutrients alone or in combinations, marketed in forms such as capsules, tablets, powders, and solutions (taken in small quantities)

Micronutrient (vitamin and mineral) supplements

Purpose: to add to the vitamins and minerals provided by a normal diet

Micronutrient supplementation

is a **short-term intervention** for correcting **high levels of micronutrient deficiencies** until more sustainable food-based approaches can be used effectively

* 0-59 months old children
* Pregnant and lactating women
* Other women in reproductive age (15-49 years old)

Micronutrient Supplemenetation is recommended for:

Infants:
6-11 months old

\
100,000 IU once only

Vitamin A Capsule for Infants (____)

Schedule: ____

Children:
12-71 months old

\
200,000 IU every 6 months

Vitamin A Capsule for Children (____)

Schedule: ____

Infants:
2-6 months old with low birth (

Iron for Infants: (____)

Schedule: ____

Preparation:

Anemic children:
2-59 months old

\
1 tsp once a day for 3 months or 30 mg once a week for 6 months with supervised administration

Iron for anemic children: (____)

Schedule:

Infant:

Less than 6 months old

\
10 mg elemental zinc per day

Zinc supplement for infant: (____)

Schedule:

Children:

6-59 months

\
20 mg elemental zinc per day for 10-14 days

Zinc supplement for children: (____)

Schedule:

Fortification

is defined as the addition of micronutrients to staple food such as rice, sugar, cooking oil, flour, and salt

1-12 years

Deworming of children aged ____ old is done every 6 months

6 months

Deworming of children aged 1-12 years old is done every ____

Albendazole

Mebendazole

Drugs administered for Deworming

200 mg or half tablet

Deworming: dose for Albendazole (for 1-2 years old)

400 mg

Deworming: dose for Albendazole (above 2 years old)

500 mg

Deworming: dose for Mebendazole

full stomach

Both Albendazole and Mebendazole require intake on a ____

antihistamine

Management for adverse effects of anthelmintic drugs: local sensitivity

antispasmodic

Management for adverse effects of anthelmintic drugs: mild abdominal pain

oral rehydrating solution (ORS)

Management for adverse effects of anthelmintic drugs: diarrhea

pull out worms from mouth, nose, or from other body orifices

Management for adverse effects of anthelmintic drugs: erratic worm migration

1. Serious illness requiring hospitalization
2. Abdominal pain
3. Diarrhea
4. History of hypersensitivity to the drug
5. Severe malnutrition

Deworming is NOT advised if the child is known to have any of the following conditions: