Lactating mother Postnatal care Family planning Community support Groups Care Groups Two meals per day Micronutrient supplements/treatment Vitamin A supplementation (from birth to 6 weeks according to national protocol) WASH Infant 0 up to 6 months Postnatal visits Immunization Sessions Growth Monitoring Promotion (GMP) Family planning sessions Sick Child clinic Community follow-up Good positioning and attachment Exclusive breastfeeding from birth up to 6 months Breastfeeding on demand – up to 12 day and night Ensure mother knows how to express her breast milk Breastfeeding difficulties (plugged ducts which can lead to mastitis, and not enough breast milk) Increase breast milk supply Maintain breast milk supply Continue to breastfeed when infant or mother is ill WASH Infant & young child from 6 up to 24 months GMP Sick child Clinic Community follow-up BF + FADDUA: Frequency, Amount, Density, Diversity, Utilization, Active or Responsive feeding At 6 months, begin to offer foods 2 to 3 times a day - gradually introduce different types of foods (animal foods, staple, legumes, vegetables, and fruits) and continue breastfeeding WASH Infant & young child Health facility IMAM program Community outreach Screen for MAM and SAM Refer to in-patient if necessary WASH Family Discussion groups Community Support Groups Care groups Homestead Food Production for dietary diversity Safe Hand washing Sanitation Clean environment
(6 Early initiation of one hour of birth. Keep newborn warm and dry (skin to skin). Exclusive breastfeeding during first six months. Complementary feeding starting at six months with mashed foods. Continued breastfeeding to 24 months or beyond. Increased feeding frequency with age. Increased amount of food with age. Increased density or thickness of foods with age. Enriched diet with a variety of foods and fortified foods. Active feeding. (Encourage and play with the baby while eating. Hand washing before feeding. Food hygiene. Increased frequency of breastfeeding during and after illness. Increased frequency of complementary feeding during and after illness for children aged 6 up to 24 months. Zinc for children with diarrhea. Vitamin A as recommended. Special care for malnourished child, depending on severity. Kangaroo care for low weight newborns. Diversified diet with vitamin foods (e.g. ripe orange and yellow vegetables and fruits, liver) and fortified foods. Vitamin A for after delivery (as per national protocol). Vitamin A twice a year for children between 6 and 59 months of age. Delayed cord clamping. Diversified diet with iron-rich foods (red meat and dark green, leafy vegetables) and fortified foods. with IFA for six months for pregnant women and continuing after delivery, if needed. Deworming for pregnant women and for children between 12 and 59 months of age, twice a year. In areas: sleep under ITN, IPT for pregnant women. In areas where malaria is not endemic but anemia prevalence is > 50 percent: IFA daily for children aged six months and above. Iodized salt, when available. One additional meal daily during pregnancy. Two additional meals daily during lactation. Breast health during lactation. Less workload and more rest during pregnancy. KEY CONCEPTS OF ESSENTIAL NUTRITION ACTIONS of first pregnancy. Child spacing. Immunization. Clean water, hygiene, and sanitation. Developed by Guyon, Victoria Quinn, and Robert Mwadime. Revised 2013. rich
Additional Essential Nutrition Actions for HIV-Positive Adults, Pregnant and Lactating Women, and Their Children (< 24 OR Support infant feeding option: exclusive breastfeeding or exclusive formula feeding. Encourage exclusive breastfeeding for 6 months for infants confirmed to be Energy intake increased by 10 percent if suspected HIV-positive and not losing weight (one extra feeding per day). Early cessation of breastfeeding when breastmilk can be replaced by other milks (animal or commercial); otherwise breastfeed for at least 1 year. Energy intake increased by 10 percent if suspected and not losing weight (one extra feeding per day). Use fortified, blended foods, when available. Assess health and growth of Counsel on testing child (depending on test availability). Immediate treatment of sickness. Diet management of nausea, vomiting, and oral etc. Energy intake increased by 50 to 100 percent if losing weight (double the daily feedings). Supplementary or therapeutic feeding for moderate or severely malnourished child, per international guidelines. Supplementation at one recommended daily allowance with multiple micronutrients if diet is not adequately diverse. Follow ENA for individuals. Energy intake increased by 10 percent if add one feeding daily. Energy intake increased by 20 to 30 percent if symptomatic or losing weight; add two extra feedings daily. BMI for nutritional monitoring or MUAC for pregnant women. Breastfeeding stopped on affected breast if encounter breast problems. Dietary management of symptoms. Importance of malaria prevention and deworming. Counsel and refer for PMTCT and ART. Diversified diet. Energy intake increased by 10 percent in adults if not symptomatic; add one extra meal daily. Energy intake increased by 20 to 30 percent if symptomatic or losing weight; add two extra feedings daily. Evaluation of interaction of nutrition and ARVs. Monitor weight and BMI. Dietary management of vomiting, nausea, and other symptoms. Physical exercise to build muscle mass. Be sure to assess the household food security situation and to treat all illnesses immediately. Developed by Agnes Guyon, Victoria Quinn, and Robert Mwadime. Revised 2013. negative positive A