Protection, Promotion and Support of Healthy Maternal, Infant and Young Child Feeding

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The Essential Nutrition Actions (ENAs) Approach

Feeding a Sick Child, during and after Illness

1. Exclusive breastfeeding (infants 0-6 months)

All lactating mothers are encouraged by a trained service provider to:

• Increase the frequency of breastfeeding during and after illness to limit the weight loss and speed recovery.
   
• Consult immediately a health worker for all infants with feeding difficulties or with any condition (including oral thrush)
   
• Not give other fluids, except prescribed medicines. Give ORS for infants with diarrhoea and provide ZINC supplementation (10 mg) for 10-14 days according to protocol.

2. Complementary feeding (children 6-35 months)

All lactating mothers are encouraged by a trained service provider to:

• Increase the frequency of breastfeeding and offer additional food to limit the weight loss during illness.
   
• Give one additional meal of foods with high energy and nutrient density each day for the following two weeks to improve child recovery after illness.
   
• Give ORS for children over 6 months with diarrhoea and provide ZINC supplementation (20 mg)  for 10-14 days according to protocol.

For more information, check energy density of infant foods.

3. Prevention of Mother to Child Transmission of HIV/AIDS

• All HIV positive mothers should be supported on infant feeding in the context of HIV

4. Early detection and referral of children with acute malnutrition

• All mothers should be alerted on the importance to check if the baby is loosing weight during illness or is not regaining weight after illness. When the child is very young, the abrupt lost of weight should be regarded as a crisis.
   
• All children over one year or six months with length above 65 cm should be screened using Mid-Upper Arm Circumference (MUAC) tape if they do not have a previous growth record in the Child Health Card.
   
• All children should be screened for bilateral pitting oedema
   
• Children with suspected acute malnutrition should be promptly referred to sites for admission and malnutrition treatment. Mothers should be alerted that malnutrition treatment is a life-saving measure.

02 January, 2009