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Mother, Infant and Young Child Nutrition and Malnutrition |
Protection, Promotion and Support of Healthy Maternal, Infant and Young Child Feeding
The Essential Nutrition Actions (ENAs) Approach
Exclusive Breastfeeding for Infants 0-6 months
- Exclusive breastfeeding at delivery
All mothers should be assisted by a trained service provider to:
- Give unrestricted skin-to-skin contact immediately after delivery.
- Initiate breast-feeding within 60 minutes (Breast Crawl).
- Give the colostrums or "First Milk" to the baby
- Empty one breast before switching baby to other breast
- Do not give Pre-lacteal - no water, glucose or any other fluids.
- Breastfeed frequently and on-demand, day and night (at least 8 times)
Note: Service provider should observe the breastfeed session to assess positioning and attachment and counsel accordingly.

- Exclusive breastfeeding for the first six months
- Trained service provider should ask about any complications or challenges a mother is facing and counsel on solutions. It is important to observe a breastfeeding session to assess position and attachment and counsel accordingly.
- Trained service provider should make sure the mother:
- Has not introduced other foods/fluids to the baby.
- Feeds the baby on-demand, day and night (at least 8 times);
- Empties one breast before giving the other.
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Prevention of Mother to Child Transmission of HIV/AIDS ( (PMTCT)

- All HIV negative and not-knowing-status breastfeeding mothers should be encouraged to go for HIV Individual counselling and Testing
- All HIV positive mothers should be supported on
infant feeding in the context of HIV
- Control of Infant Iron Deficiency Anaemia
- Control of Infant Vitamin A Deficiency
- Monthly Growth Monitoring and Promotion
- All infants are weighed monthly and their growth is plotted on the
Growth Monitoring Chart.
- Their mothers are adequately informed and counselled using the
counselling Cards.
- Children who do not gain weight for more than two months or are losing weight or fall below the bottom line are promptly referred for malnutrition assessment.
- The Table of Minimum Expected Weight Gain gives the expected weights after one month and after two months. It can be used to check on a child's growth.
- Plotting on the Child Health Card can not be continued from the previous session if the child has missed one monthly weighing session.
02 January, 2009 |