SDA-RF-CH-1.46.pdf
Media
- extracted text
-
SDA-RF-CH-1.46
Facts for Feeding
Recommended Practices to Improve
Infant Nutrition during the First Six Months
j
FactsforFeedingis a series
of publications on
recommended feeding
and dietary practices to
improve nutritional status
at various points in the life
cycle. This issue focuses
on tire infant’s first six
months of life. Policy
makers, health care
providers, and
communicators can use
these guidelines for
developing messages and
activities appropriate to
local conditions.
Local assessments should
be conducted to
determine the emphasis
to give to each of the
recommended feeding
F practices, to identify
audiences that are most
; receptive to change, and
to design messages and
activities based on
audience profiles.
Experience shows that
focusing on a limited set
of very specific behaviors
is key to improving
nutrition.
Initiate breastfeeding within about one hour of birth
Early initiation:
4-
Takes advantage of the newborn’s intense suckling reflex and alert
state.
4
Stimulates breastmilk production.
♦
Serves as the baby’s first immunization. The infant will immediately
benefit from the antibodies present in colostrum (the first milk).
4
Minimizes maternal postpartum hemorrhage.
4
Fosters motiier-child bonding.
Establish good breastfeeding skills (proper positioning, attachment,
and effective feeding)
4
Baby should be held close to tire mother, facing the breast with the
baby’s ear, shoulder, and hip in a straight line.
♦
Infant’s moudi should open widejust before attaching so that die
nipple and as much of the areola as possible are in die mouth. If
properly attached, the lips are rolled outward, widr die tongue over
die lower gum.
♦
Signs of effective feeding should be observed: visible jaw movement
drawing milk out, rhythmical suckling widi an audible swallow, and
no drawing in of cheeks.
♦
To encourage effective suckling and to prevent the introduction of
contaminants, no bottles or pacifiers (dummies or artificial teats)
should be used. If a mother has to miss a breastfeed, she can
maintain her supply by expressing milk when she would have
breastfed. Expressed breastmilk can be fed by cup at a later time.
LINKAGES 4 Academy for Educational Development 4 1825 Connecticut Avenue NW, Washington, DC 20009
Phone (202) 884-8000 * Fax (202) 884-8977 4 E-mail iinkagesiSaed.org
Recommended Practices ’
■‘■■a
mouths
Breastmilk should be a baby’s first taste.
There should be no prelacteal feeds
such as water, other liquids, or ritual
foods.
+
Breastmilk completely satisfies an
infant's nutritional and fluid needs for
about the first six months. Infants do not
need water or other liquids such as
herbal teas to maintain good hydration.
even in hot climates. The potential
dangers of water supplementation
include the introduction of
contaminantsand reduced nutrient
intake.
♦
4-
Exclusive!}’ breastfed children arc at a
much lower risk of infection from
diarrhea and acute respiratory infections
than infants who receive other foods.
Offering foods to infants before six
months reduces breasunilk intake and
interferes with full absorption of
breasunilk nutrients.
4-
♦
Babies should be fed 8-12 times per 24
hours, every 2-3 hours or more
frequently if needed, especially in the
early months.
♦
An infant’s stomach is small and needs to
be refilled often. Breastmilk is perfectly
adapted to the baby’s small stomach size
because it is easily digested.
♦
Frequent feedings help maintain the
mother’s milk supply, maximize the
contraceptive effect, and provide
immune factors at each feeding. They
also help to prevent problems, such as
Facts for Feeding
If a baby urinates at least six times in 24
hours, this is a sign that breastmilk intake
is adequate. If not, more breastfeeding is
necessary, or breastfeeding technique
should be assessed.
In areas where vitamin A deficiency occurs.
5 lactating women should lake a high-dose
vitamin A supplement (200,000 IU) as
soon as possible after delivery, but no later
than 8 weeks postpartum, to ensure
adequate vitamin A content in breastmilk
4-
The concentration of vitamin A in
breastmilk depends on a woman's
vitamin A status and the changing needs
of her growing infant. Preterm infants
and infants born in areas where vitamin A
deficiencx is prevalent are at particular
risk of vitamin A deficiency.
4-
The cat Her the single high-dose vitamin
A supplement is given to a lactating
woman, the sooner the vitamin A status of
her breastfed child will improve.
♦
Beginning around eight weeks after
childbirth, women are at heightened risk
of pregnancy (especially if they are not
fully breastfeeding). Because a high-dose
vitamin A supplement can be harmful to
a fetus, women should not be given the
high-dose supplement any time after
eight weeks postpartum.
Exclusive breastfeeding contributes to a
delay in the return of fertility.
A Practice frequent, on-demand breastfeeding,
* including night feeds
•/:
breast engorgement, that might
discourage a woman from breastfeeding.
<7 Breastfeed exclusively for about lite first six
+
■
Continue on-demand breastfeeding and
introduce complementary foods beginning
around 6 months of age (see Pads for
Feeding: Guidelines for Appropriate
Complementary Feeding of Children 6-24
Months of Age)
■
Although most women in developing countries
initiate breastfeeding, the promotion of breastmilk
substitutes, changing societal values, urbanization,
and the erosion of traditional support systems pose
threats to breastfeeding. The benefits of
breastfeeding and the differences between breastmilk
and breastmilk substitutes need to be repeated to
reinforce the message, educate new audiences, and
sustain individual behavior change.
Nutritional Benefits
Chilci Spacing Benefits
During the first six months, frequent and intense
breastfeeding can delay resumption of ovulation and
return of menses, thereby decreasing the likelihood
of pregnancy. The Lactational Amenorrhea Method
(LAM) provides a family planning option for women
who meet three criteria: full breastfeeding, no return
of menses, and less than six months postpartum. If
any one of these criteria is not met, another family
planning method must be used to ensure adequate
birth spacing ol three years.
Meets all of an infant's nutritional requirements for
about the first six months and is
superior to any substitute.
Changes in composition to
meet baby’s changing needs.
Continues to be an important
source of high qualitv protein,
energv, vitamins (especially
vitamin A), minerals, and fatty'
acids for older infants and
toddlers.
Health Benefits
For infant. Protects against
illnesses and enhances the
baby’s immune system,
providing long-term protection
against diabetes and cancer.
Longer intervals between births bring health
benefits to the mother and die
child, allow more time and
resources for care of the child
Knowledge of the health
and siblings, and contribute to
benefits of breastfeeding is
the economic well-being of the
household.
usually inadequate to
motivate women to adopt
optimal practices. Mothers
need specific, culturally
appropriate information
that responds to their
constraints and concerns
to enable them to make
better feeding choices.
For mother. Reduces risk of maternal postpartum
hemorrhage.
Helps shrink the uterus back to normal size.
Psychological and
Developmental Benefits
Fosters mother-infant bonding
and optimal growth and
development, including brain
growth.
Economic Benefits
Saves families die cost of
purchasing breastmilk
substitutes and reduces healdi care costs.
Environmental Benefits
Conserves natural resources and reduces pollution.
Delavs return of menses, helping to protect mother
against anemia by conserving iron.
Reduces risk of developing premenopausal breast
and ovarian cancer.
Recommendations for the First Six Months
.Supporting • Interventions ’.
Barriers to improved breastfeeding practices should
be addressed by ensuring a favorable policy
environment, providing accurate information, offering
practical help and encouragement, and creating social
support.
Health Services
Policies
Establish, enforce, and/or support policies dial
regulate and monitor the marketing and use of
breastmilk substitutes. Set standards of care in health
care institutions.
Workplace
Take advantage of the numerous opportunities to
promote and support optimal breastfeeding practices
in child survival, primary health care, and family
planning programs.
Prenatal and Postpartum Care: Include as part of
prenatal care a breast exam, a breastfeeding history,
and counseling on the benefits of exclusive
breastfeeding, early initiation of breastfeeding, and
colostrum. Provide counseling on the Lactational
Amenorrhea Method (LAM) as a family planning
method. If another method is desired, encourage
using one that does not interfere vvith breastfeeding.
Promote “Mother-Baby Friendly” workplaces and
public locales. Advocate for family leave and die
availability of appropriate areas for milk expression or
breastfeeding.
Community
Promote and affiliate with community-based
breastfeeding support activities: peer counselors,
mother-lo-mother support groups, and community
education networks. Use social marketing techniques
to develop effective breastfeeding messages to spread
throughout tire community.
Health Care Facilities: Support the Ten Steps to
Successful Breastfeeding (WHO/UNICEF 1989
Statement) and coordinate with “Baby-Friendly"
hospitals, health facilities, organizations, and groups
that promote breastfeeding. Ensure adequate
postpartum follow-up lor die breastfeeding mother
and baby.
Women’s Nutrition
Offer appropriate family planning methods for
lactating women, including LAM, non-hormonal
mediods, and progestin-only contraceptives.
Educational Materials
Training
__
Support the training of health care providers in
lactation management skills, as well as curriculum
modification in professional schools to include
lactation management education.
Ensure adequate nutritional status during pregnancy
and lactation, as well as during adolescence and
between pregnancies, to build up and maintain energy
and micronutrient reserves.
Ensure die availability of culturally appropriate and
easily understood educational materials for adolescent
girls and women of child-bearing age and their
families. Messages should address concerns about
water requirements of infants, mothers’ doubts about
the adequacy of titeir breastmilk, and other issues,
such as employment, tliat may act as barriers to
exclusive breastfeeding.
Facts for Feeding is a publication of the LINKAGES (Breastfeeding, Complementary
Feeding, and Maternal Nutrition Program) Project. LINKAGES is supported by
G/PHN/HN, Global, die Limit'd Slates Agencv for International Development
(USAID) under Cooperative Agreement No. HRN-A-00-97-00007-00. LINKAGES is
managed by the Academy for Educational Development. Wellsian International, one
of the members of the project team, contributed io the development of this
publication.
January 1999
Not viewed