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Importance of infant and young child feeding

Importance of infant and young child feeding. Dr Arun Gupta BPNI Jan 21, 2011 Lucknow. First year is critical!. Malnutrition strikes the most in infancy beginning in 3-4 th month , 29-30 % 6 months. Goes up and peaks by 18 months, flat curve after that (NFHS 3). Brain development.

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Importance of infant and young child feeding

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  1. Importance of infant and young child feeding Dr Arun Gupta BPNI Jan 21, 2011 Lucknow

  2. First year is critical! Malnutrition strikes the most in infancy beginning in 3-4th month , 29-30 % 6 months. Goes up and peaks by 18 months, flat curve after that (NFHS 3) Brain development 10 lakh children die during first month, 14 lakhs by 1 year, and 20 lakhs by 5 yrs. Underweight (-2sd) NFHS-3 Over 60 million 1 2 3 4 5 Years of life

  3. IMR / NMR not declining enough SRS Data

  4. Underweight

  5. Estimated Number of Babies Who Die Every Year • 10 Lakhs Under 1 month. • 14 Lakhs Under 1 yr. • 20 Lakhs Under five yrs.

  6. Three Major Killers MOSTLY PREVENTABLE Neonatal disorders Diarrhoea Pneumonia Breastfeeding is the No. 1 preventive intervention compared to any other intervention Lancet Series on child survival, and now on newborn survival : 2003 and 2004 Source: Robert et al. LANCET 2003;361:2226-34

  7. Estimated distribution of direct causes of 4 million neonatal deaths Infection 36% Source: Joy El et al. Neonatal Survival Series. Lancet 2005

  8. Risk of neonatal mortality according to time of initiation of breastfeeding Six times more risk of death Additional benefits Pediatrics 2006;117:380-386

  9. U-5 child deaths (%) saved with key interventions in India Lancet Child Survival Series,2003

  10. Deaths attributed to sub-optimal breastfeeding among children

  11. 1st hour initiation cuts 22% of all newborn deaths INITIATION OF BREASTFEEDING If we enhance initiation of BF within one hour 100% 40% NEONATAL DEATHS SAVED 10 Lac Neonatal Deaths 2.5 lac 2.5 lac babies will be saved Pediatrics 2006;117:380-386

  12. Long term Impact of BREASTFEEDING Subjects who were breastfed experienced lower mean blood pressure and total cholesterol, as well as higher performance in intelligence tests. Prevalence of overweight/obesity and type-2 diabetes was lower among breastfed subjects. WHO, 2007

  13. Exclusive breastfeeding Reduces HIV Transmission Risk(Lancet 2007)

  14. State of breastfeeding within one hour of birth (%) by Districts 155 Lacs out of 260 Lacs born DONOT Source: DLHS Fact Sheets 2007-2008 (http://nrhm-mis.nic.in/ui/Reports/DLHSIII/dlhs08_release_1.htm#BR)

  15. State of exclusive breastfeeding for the first six months by Districts 140 lacs out of 260 lacs born DONOT Source: DLHS Fact Sheets 2007-2008 (http://nrhm-mis.nic.in/ui/Reports/DLHSIII/dlhs08_release_1.htm#BR)

  16. Number of Children age 6-9 months receiving solid/semi-solid food and breastmilk • About 26 million born DLHS 3

  17. Districts Level Performance(Number 534-DLHS 2008)

  18. Lalitpur Model • Breastfeeding counselling and support services have been created for over 2 years • One woman trained as mentor provides supervision and training to about 3 women in each village. • Early breastfeeding ,Exclusive breastfeeding for the first six months and complementary feeding all have shown improvement significantly. • Observation data suggests that IMR and NMR both have shown about 25-30 % decline

  19. Infant and young child feeding practices before and after intervention in Lalitpur District (600 villages)

  20. Trends :Initiation of Breastfeeding Within 1 hour Source: NFHS-3, 2006

  21. Breastfeeding patterns by age Source: NFHS-3, 2006

  22. 1 2 3 4 5 6 7 8 9 10 11 12 Weight for age NFHS3: Status, Programme response in infancy Vaccines and Micronutrients CHILD HEALTH in RCH: IMNCI Curative care dominating (treating diarrhea, pneumonia, malaria etc) NRHM 46% 29 % ICDS Most Babies die here HUNGER DEATHS Breastfeeding is everyone's yet no one’s responsibility

  23. What can you do? • Integrate infant and young child feeding in your programmes • See the results • Scale up to other parts of the districts and adopt new districts.

  24. MEP..the minimum essential programme of services SPECIALIST COUNSELLOR with 7 day training to deal with BREASTFEEDING , COMPLEMENTARY FEEDING and infant feeding and HIV Nutrition support to mothers, maternity benefits ,IGMSY, Family counselor IYCF by a 3 day training, at birth assistance, home visits 4 in 2 weeks, and then every 2 weeks. District level and above, medical colleges. SPECIALIST COUNSELLOR IN ALL PUBLIC AND PRIVATE HOSPS Incentives to ASHA or other health workers to assist at birth to begin breastfeeding within an hour, and later home visits( 4 in first 2 weeks, then every 2 weeks), to maintain exclusive breastfeeding SPECIALIST COUNSELLOR Block/PHC Cluster of 5-10 Family

  25. Thanks !

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