IYCF Summary
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
Parameters of Infant and Young Child Feeding Practices (IYCF)
Infant and Young Child Feeding (IYCF) practices are critical public health indicators used to assess the nutritional well-being of children under two years of age. These parameters are designed to track optimal feeding behaviors that reduce mortality and malnutrition.
1. Breastfeeding Indicators
- Early Initiation of Breastfeeding: Putting the newborn to the breast within one hour of birth. This ensures the intake of colostrum and prevents neonatal mortality.
- Exclusive Breastfeeding: Giving the infant only breast milk (no other food or fluids, not even water) for the first 6 months of life. Drops or syrups for vitamins/medicines are permitted.
- Continued Breastfeeding: Continuing breastfeeding alongside complementary foods up to 2 years of age or beyond.
- Frequency of Breastfeeding: Breastfeeding on demand, day and night, at least 8 times in 24 hours to ensure sufficiency.
2. Complementary Feeding Indicators (6–23 Months)
- Timely Introduction: Introduction of solid, semi-solid, or soft foods at 6 months (180 days) of age while continuing breastfeeding.
- Minimum Dietary Diversity: The proportion of children aged 6–23 months who receive foods from 4 or more food groups out of the standard 7 groups (grains/roots/tubers, legumes/nuts, dairy, flesh foods, eggs, vitamin A-rich fruits/veg, other fruits/veg).
- Minimum Meal Frequency: The number of times the child is fed solid/semi-solid foods per day:
- Breastfed infants: 2–3 times/day at 6–8 months; 3–4 times/day at 9–23 months.
- Non-breastfed children: 5 times/day (including milk feeds).
- Minimum Acceptable Diet (MAD): A composite indicator. Children are considered to have a minimal acceptable diet if they meet both the minimum dietary diversity and the minimum meal frequency requirements.
3. Qualitative Parameters
- Consistency: Progression from pureed/mashed foods (6 months) to lumpy/finger foods (9–11 months) and family foods (12–23 months).
- Energy Density: Ensuring foods are energy-dense (e.g., adding oil/ghee/sugar to porridge) rather than bulky and dilute (watery gruels) to match the small stomach capacity.
- Responsive Feeding: Practicing active feeding (e.g., talking to the child, encouraging but not forcing, feeding patiently) and maintaining hygiene.
- Safe Preparation: Use of clean utensils (cups/spoons) and avoidance of feeding bottles.