Infant and Young child feeding

source

Infant and Young child feeding guidelines 2004

Early breastfeeding

  • within 1 hour in case of NVD and within 4 hrs in case of LSCS
  • baby's first vaccination
  • acts as purgative, clear meconium, prevent neonatal jaundice
  • rich in vitamin A
  • early sucking encourages flow of breastmilk, prevent later problems of breastfeeding
  • for mother
    • useful in expulsion of placenta
    • prevent breast engorgement
    • makes mother feel comfortable

importance of breast feeding

  • for healthy growing of child
  • for establishing relation between mother and child
  • for mother and baby to be sensitive of each other's signals

Exclusive breastfeeding

  • no additional food or water or other fluids starting at birth
  • for first 6 months of age
  • advantages
    • promotes production of milk
    • decreases infection
    • contains all nutrients needed for the baby
    • better iron absorption
    • prevent digestion problems with animal milk

on demand feeding

  • look for cues
    • baby turns around as if looking for breast
    • sucking fingers
    • opens mouth wide open
    • should not wait till crying
    • crying late sign of hunger
  • not necessary to wait for milk production, sucking produces milk
  • feed 8-12 times per day as baby's stomach is small
  • also feed in night
  • LBW babies learn sucking by mother stroking the sides of the lips before feeding

positioning during breast feeding

  • hold the baby close to the body
  • face the baby toward breast
  • hold the head in straight line with the body
  • support the baby's whole body
  • make sure the baby is well attached to the breast

attachment in breastfeeding

  • mouth should be wide open
  • chin close to and touching the breast
  • lower lip everted
  • more areola seen above the baby than below
  • baby can make sound while suckling

expressed breastmilk

  • can be done in cases of breast engorgement, inverted nipples, baby with difficulty in suckling like LBW, working mothers
  • should be done by mother herself
  • wash hands and keep clean katori
  • keep thumb above the areola and pointing finger below the areola, support breast with other fingers
  • press thumb and finger towards the chest wall, press and release alternatively
  • milk can take sometime to come
  • avoid squeezing the nipple
  • express one breast for 5 minutes and wait for the milk flow to slow down
  • entire process may take upto 20-30 minutes

Avoid bottle feeding

bottle feeding will interfere with newborn's suckling
makes difficult for newborn to breastfeed effectively
bottle is difficult to clean

breast feeding after 6 months
6 to 12 months breastmilk provided half of the required calories
>12 months breast milk provided one third of the calories

#complementary feeds

  • should be started at 6 months of age

characteristics of complementary food

  • nutrient rich
  • energy rich
  • locally available

nutrient rich

  • should contain zinc, iron, vitamin A and iodine
  • iron, vitamin A, iodine - for the brain development
  • Zinc - to prevent illness

energy rich

  • food to be prepared thick
  • thin soup and cereals fill the stomach but not fill the stomach
  • katori is 250 ml
  • start with 2 to 3 spoons, 2 to 3 meals everyday then gradually increase
  • do not force

snack

  • panjeeri, laddoo, halwa, upma, idli, poha
  • given between meals
  • no additional spices
  • add additional oil

responsive feeding

Responsive feeding means gently encouraging— not forcing—the child to eat. Showing interest, smiling, or offering an extra bit encourages the child to eat

  • playing game to help the child eat
  • feed young infant directly and help the older children to eat
  • children feed slowly and often get distracted - play game, talk to children, eye to eye contact
  • FEEDING TIME IS A PERIOD OF LEARNING AND AFFECTION
  • keep separate bowl for the child
  • children eat less during illness and as the children recovers for illness the appetite is increased. Mother should be able to identify the hunger and appropriately increase the feeds
  • offer more breastfeed and for longer if the child is sick
  • offer soft foods and well cooked foods if the child is sick or malnourished