Breastfeeding Resources - Diarrhoea - Mother, Infant and Young Child Nutrition & Malnutrition - Feeding practices including micronutrient deficiencies prevention, control of wasting, stunting and underweight

About Essential Nutrition Actions at Critical Stages in the Life Cycle of Women and Children

Measuring progress in improving infant and young child feeding requires appropriate indicators and instruments to assess current feeding practices and monitor program impact. The M&E tools found here include descriptions of key infant and young child feeding (IYCF) indicators, an IYCF monitoring manual, and questionnaires used in LINKAGES' programs in six countries.

The main purpose of a common set of indicators is to standardize the assessment and evaluation of breastfeeding behaviours across programs implemented and funded by different organizations. LINKAGES used a common set of infant and young child feeding indicators based on WHO definitions (1991) and Wellstart International's toolkit for monitoring and evaluating breastfeeding activities (1996). These standard indicators have all been field tested prior to application. They are limited in number and fairly easy to measure and interpret. This section of the website defines LINKAGES' primary indicators, provides sample surveys for collecting information used to calculate the rates, and notes the indicators' strengths and limitations.

LINKAGES conducted baseline surveys, annual rapid assessment surveys, endline surveys, and special surveys such as media evaluations. The community surveys from Bolivia and Ghana focused on breastfeeding and complementary feeding. The country programs in Ethiopia and Madagascar were in a broader nutrition and child survival context which is reflected in the surveys. In Tanzania and Zambia , infant feeding was integrated within prevention of mother-to-child transmission (PMTCT) of HIV programs.

The key behaviours that LINKAGES promoted are listed in the chart below. Click on a behaviour for technical information and examples of counselling cards developed by LINKAGES and its country program partners to promote that behaviour. Or scroll down and download all the cards developed in each country.

The cards illustrate different ways messages can be visualized. Illustrations and messages should be adapted for each audience and tested with that audience in the place where they will be used. The adaptation should be based on formative research to identify current behaviours in need of improvement, barriers to the adoption of optimal behaviours, and appeals to use in motivating the target audience to change their behaviours.

The strengths and weaknesses of counselling cards and guidelines for their design and use are discussed in "Tips for Communicators"

"Promoting Breastfeeding in Madagascar" describes how counselling cards and other types of print materials and electronic media were developed to promote breastfeeding.

Feeding is a critical aspect of caring for infants and young children. Appropriate feeding practices stimulate bonding with the caregiver and psycho-social development. They lead to improved nutrition and physical growth, reduced susceptibility to common childhood infections and better resistance to cope with them. Improved health outcomes in young children have long-lasting health effects throughout the life-span, including increased performance and productivity, and reduced risk of certain non-communicable diseases.

Child Feeding and Nutrition ( 2-5 years age )

Malnutrition contributes to more than half of all childhood deaths, although it is rarely listed as the direct cause. For most children, lack of access to food is not the only cause of malnutrition. Poor feeding practices and infection, or a combination of the two, are both major factors of malnutrition. Infection - particularly frequent or persistent diarrhoea, pneumonia, measles and malaria - undermines nutritional status. Poor feeding practices, such as inadequate breastfeeding, offering the wrong foods, giving insufficient quantities, and not ensuring that the child gets enough food, contribute to malnutrition.

Malnourished children are, in turn, more vulnerable to disease and the vicious circle is established.

Improved feeding practices to prevent or treat malnutrition could save 800,000 lives per year.

Adolescent Nutrition

Adolescence represents a window of opportunity to prepare for a healthy adult life. During adolescence, nutritional problems originating earlier in life can potentially be corrected, in addition to addressing current ones. It is also a timely period to shape and consolidate healthy eating and lifestyle behaviours, thereby preventing or postponing the onset of nutrition-related chronic diseases in adulthood.

As adolescents have a low prevalence of infections such as pneumonia and gastroenteritis compared with younger children, and of chronic disease compared with ageing people, they have generally been given little health and nutrition attention, except for reproductive health concerns. However, there are nutritional issues, which are adolescent-specific, and which call for specific strategies and approaches.

The main issues in adolescent nutrition are:

Breast Crawl

Initiation of Breastfeeding by Breast Crawl

visit breastcrawl.org for video and complete dossier.

UNICEF, WHO and WABA along with the scientific community strongly recommend initiating breastfeeding within an hour of birth.

Evidence shows that early initiation can prevent 22% of all deaths among babies below one month in developing countries.

Every newborn, when placed on the mother's abdomen, soon after birth, has the ability to find its mother's breast all on its own and to decide when to take the first breastfeed. This is called the "Breast Crawl".

This method is evidence based and has been field tested by us. A documentary on the "Breast Crawl" has been prepared for training, advocacy and for wider dissemination. The video has created a very high level of sensitivity among all the levels of functionaries and was officially endorsed by senior policy makers as the right approach for initiating breastfeeding. This dossier provides the background and a scientific overview to the documentary.

We are sure that this documentary and dossier will greatly help similar initiatives worldwide. It is our strong desire that this information helps every mother and baby to experience the miracle of Breast Crawl. If we all could achieve early initiation of breastfeeding, we will be able to prevent 22% of all deaths among babies below 1 month.

This can be achieved by training all health care providers to initiate breastfeeding, by Breast Crawl, to give infants the best start in life.