Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694834483571.pdf (India)
IMPACT AND IMPORTANCE OF INFANT AND YOUNG CHILD FEEDING (IYCF) AND MANAGEMENT OF CHILDREN WITH WASTING Dr Ajay Khera Deputy Commissioner and In-charge (Child & Adolescent Health) Ministry of Health and Family Welfare Government of India Presentation Outline  Optimal infant and young child feeding  Importance of IYCF  Current situation  IYCF interventions under NHM  Care and treatment of children with severe acute malnutrition Infant and Young Child Feeding (IYCF) IYCF is a set of well-known and recommended appropriate feeding practices for newborn and children up to two years of age Optimal IYCF Practices Initial Breastfeeding Exclusive Breastfeeding Complementary Feeding Early initiation of breastfeeding; immediately after birth, preferably within one hour Exclusive breastfeeding for the first six months of life Timely introduction of complementary food (maintaining adequate diet and dietary diversity) beyond six months along with continued breastfeeding d l i h C g n u o Y d n a t n a f n I i g n d e e F Breastfeeding within one hr of birth reduces the risk of neonatal mortality by 33% Exclusive breastfeeding can reduce 13% under five death Breastfeeding has tremendous impact on the Cognitive Development (Gain of up to 8 IQ Points) Complementary growth, deficiencies, Anaemia and Overweight promotes Optimal Stunting, Micronutrient Prevents Feeding Economic gains of $302 billion/year due to increased productivity associated with higher intelligence Key Indicators Status of IYCF: India NFHS-3 (2005-06) NFHS-4 (2015-16) Children under age 3 years breastfed within one hour of birth 23.4% 41.6 % Children under age 6 months exclusively breastfed Children age 6-8 months receiving solid or semi-solid food and breast milk 46.4% 54.9 % 52.6% 42.7 % Breastfeeding children age 6-23 months receiving an adequate diet NA 8.7% MoHFW Strategies for Promotion of IYCF Village Health and Nutrition Days Mother’ s Absolute Affection (MAA) Programme IYCF under NHM Facilitating IMS Act implementation Nutrition Rehabilita tion Centres (NRCs) Mother’s Absolute Attention (MAA) Programme Only 41.6% babies have Early Initiation of Breastfeeding where as Institutional Delivery rate stands at 78.9% (NFHS-4, 2015-16) Facility baced promotion of IYCF under MAA Programme MAA Guidelines, MoHFW, 2016 Health Facility Strengthening: Lactation Management Centres Capacity building of Health care providers MAA PROGRAMME COMPONENTS Mass breastfeeding and child feeding Practices Awareness for appropriate Community level activities: • Mothers’ meetings by ASHAs • IYCF trainings for ANMs of all sub-centres Facility Awards Recognition for best performing “Baby Friendly” facilities Infant Milk Substitute Act IMS Act 2003 The Infant Milk Substitute, feeding Bottles and Infant Foods (regulation of Production, Supply the Act, and Distribution) Amendment Act, 2003 (IMS Act , 2003) is a central law and came in to operation in 1st January, 2004.
1992 and Provisions of IMS Act 2003 Bans advertisement of infant milk substitutes, feeding bottles and infant foods, bans the use of health systems for promotion of these products like display of posters or giving free samples, bans sponsorship of health workers or their associations, bans commission on sales Prohibits donation and distributions of educational equipment, materials related to infant milk substitutes or feeding bottles by health care system Provisions related to labelling and quality control of infant milk substitutes and feeding bottles and infant foods are to be implemented by concerned departments of State Governments Every educational material/ advertisement/ promotional material for Pregnant and Lactating Women must include information for appropriate breastfeeding When prevention fails and Severe Wasting sets in Severe Acute Malnutrition (SAM) Severe Wasting/ Severe acute malnutrition is defined by very low weight-for-height/length (<3SD) Increases significantly the risk of morbidity and mortality in children under five years of age Leads to growth retardation and impaired psychosocial and cognitive development In India estimated 9.3 milliion of Under Five children are SAM and 10% of these i.e estimated 9.3 lakh may develop medical complications Facility Based Management of SAM: Nutrition Rehabilitation Centre (NRC) NRCs as specialised units established in public health facilities for providing facility based care for SAM children with medical complications • 1150 NRCs established across the country • Annually around 1.7 lakh children treated in these units Management of SAM at Nutrition Rehabilitation Centre (NRC)  24 hour care and monitoring of the child and Treatment of medical complications Therapeutic feeding Sensory stimulation and emotional care  Counselling on appropriate feeding, care and hygiene Facility Based Management of SAM Guidelines, MoHFW  Demonstration and practice- by -doing on the preparation of energy dense child foods using locally available, culturally acceptable and affordable food items  Follow up of children discharged from the facility Action Points at District Strengthen Review and Coordination  Monthly review and coordination meetings to be convened with departments of Health, ICDS and Drinking water and sanitation  Review based on a simple checklist covering:  IYCF training status / Orientation and sensitization of FLWs & programme managers under MAA programme  VHND sessions & mothers’ meeting under MAA programme planned and held IFA supplements - supply & stock status   Vitamin A, Albendazole, ORS and Zinc - supply and stock status  Number of children screened and referred to NRC for SAM and followed up  Home based care – number of visits by ASHAs, AWWs  Regular supportive supervision and monitoring visits  Facilitating coordination and service delivery between ANM, AWW and ASHA (Triple A) at common platforms e.g VHNDs