An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.
-
Upload
samson-matthews -
Category
Documents
-
view
212 -
download
0
Transcript of An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.
![Page 1: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/1.jpg)
An Overview of Infant and Young Child Feeding, 6-24 Months
Jean Baker, AED/LINKAGES
![Page 2: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/2.jpg)
Outline
I. The “Big Picture” and How to Impact It
II. A Better Understanding of the Issues
III. The Role for Processed Complementary Foods
![Page 3: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/3.jpg)
Complementary Feeding is…
Then: Weaning foods…complementary foods
Period when other foods or liquids are provided along with breastmilk
Now: Period when child receives both breastmilk (or a breastmilk substitute) and solid or semi-solid food.
![Page 4: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/4.jpg)
The ‘Big Picture’ and How to Impact It
![Page 5: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/5.jpg)
General_2000.shp2 - 1111 - 2020 - 2828 - 3737 - 46
150 Million Children are Underweight
Prevalence of underweight in children 0 - 4 years old
de Onis and Blossner, 2001
![Page 6: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/6.jpg)
Malnutrition Happens Early
-2
-1.5
-1
-0.5
0
0.5
0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60
Age (months)
Z-s
core
(N
CH
S)
Africa Asia Latin America and Caribbean
Weight for age by region
![Page 7: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/7.jpg)
-2.5
-2
-1.5
-1
-0.5
0
0.5
0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60
Age (months)
Z-s
core
(N
CH
S)
Africa Asia Latin America and Caribbean
“Virtually all growth faltering occurs in the first 2 years, most of it during infancy”
Length for Age by Region
![Page 8: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/8.jpg)
Malnutrition has a Lasting ImpactWorldwide 182 Million Children are Stunted
Both girls are 3 ½ years old
![Page 9: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/9.jpg)
0
10
20
30
40
50
60
70
Africa Americas E. Medit E. Europe South Asia USA
Anemia Prevalence by Global RegionAges 0-4 years
![Page 10: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/10.jpg)
5 million Children Die Annually from the Underlying Causes of Malnutrition
Estimated contribution of undernutrition to under-five mortality by cause
0%
20%
40%
60%
80%
100%
Diarrhoea Malaria Pneumonia Measles All-cause
Proportion of deaths associated with undernutrition All Deaths
Sources: For cause-specific mortality: EIP/WHO. For deaths associated with malnutrition: Caulfield LE, Black RE. Malnutrition and the global burden of disease: underweight and cause-specific mortality.
![Page 11: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/11.jpg)
Top Three Prevention Interventions
Prevention Intervention Number Deaths prevented (% of all <5
deaths) (thousands)
1. Breastfeeding 1,301 13%
2. Insecticide-treated materials 691 7%
3. Complementary feeding 587 6%
Source: Lancet, 2003
![Page 12: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/12.jpg)
Further EvidenceEfficacy Trials & Programs in 14 Countries
• Child growth improved with increased dietary intake (as measured by anthropometry)
• Nutritional improvements support Lancet estimates of reductions in undernutrition and mortality
• Studies verified importance of feeding practices, not just food
Source: Caulfied, Huffman, Piwoz, 1999
![Page 13: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/13.jpg)
A Better Understanding of the Issues
![Page 14: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/14.jpg)
Causes of Poor Growth in Infants and Young Children
• Poor maternal nutritional status at conception and undernutrition in utero
• Suboptimal feeding practices
• Impaired absorption of nutrients due to intestinal infections or parasites
• Combination of above
![Page 15: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/15.jpg)
Issue One: Suboptimal Feeding Practices (Birth – 24 months)
![Page 16: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/16.jpg)
Non-Exclusive Breastfeeding
Currently only about 39% of infants worldwide are exclusively breastfed during the first 6 months of life
![Page 17: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/17.jpg)
Poorly Timed Complementary Feeding
Prevalence of Timely Complementary Feeding, 1995 and 2002
64
40 4046
6572
5660
0
10
20
30
40
50
60
70
80
Africa Region Region of theAmericas
South EastAsia Region
GlobalEstimates
19952002
![Page 18: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/18.jpg)
Infrequent Feeding
• Because of small stomach size, children need to be fed frequently throughout the day
• Labor, time, and resource constraints are often obstacles to frequent feedings
![Page 19: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/19.jpg)
Inadequate Food Quality & Quantity
• Inadequate energy density
• Too much bulk or too diluted
• Too little variety• Too few
micronutrients, especially iron
![Page 20: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/20.jpg)
Poor Feeding Methods, Hygiene, and Child Care Practices
• Unsupervised feedings • Lack of interaction
and encouragement• Contaminated foods
and utensils• Poor food hygiene
![Page 21: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/21.jpg)
Issue Two: Nutrient Gaps During Complementary Feeding Period
(6-24 months)
![Page 22: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/22.jpg)
Nutrient Gaps
• Breastmilk important source of energy, fat, and other nutrients and continues to protect against illness and death
• But complementary foods needed to meet increasing nutrient needs of the growing child
![Page 23: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/23.jpg)
Energy Gap - Contribution of Breastmilk during Complementary
Feeding Period
![Page 24: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/24.jpg)
The Iron Gap
![Page 25: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/25.jpg)
Issue Three: Measuring Complementary Feeding
![Page 26: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/26.jpg)
Measurement Issues Timely Complementary Feeding (TCF) indicator is
problematic, time-bound, and gives no information regarding:
- Quality
- Frequency
- Food diversity
- Caregiver practices
![Page 27: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/27.jpg)
Issue Four: What Effect Does HIV and AIDS Have on
Complementary Feeding?
![Page 28: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/28.jpg)
Special Challenge: HIV and Infant Feeding
![Page 29: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/29.jpg)
The Role for Processed Complementary Foods
![Page 30: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/30.jpg)
History of Processed Complementary Foods
• 1950s - Concern about protein intake• 1960s - Failure of processed foods to reach low
income kids • 1977 - Review showed little impact on nutrition
(beginning of Nestle boycott)• 1980 - Code of Marketing Breastmilk
Substitutes• Late 1980s - Shift from commercial to
community-based focus
![Page 31: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/31.jpg)
Why now? What’s changed?
• Lancet endorsement of CF• Improved technology • More palatable formulations • Improved marketing, transport, logistics• Increased “demand” for products and
“buying power”• Greater experience in building private/
public sector partnerships • Urbanization
![Page 32: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/32.jpg)
29
1517
5355
42
74
37 37
76
47
85
54
61
82
World Africa Asia Latin America/Caribbean
More DevelopedRegions
1950 2000 2030
Source: United Nations, World Urbanization Prospects: The 2003 Revision (medium scenario), 2004.
Trends in Urbanizationby Region
![Page 33: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/33.jpg)
Summary - Challenges
• Show impact on child growth/health
• Increase geographic coverage & scale
• Ensure safeguards for breastfeeding
• Focus on behaviors and food quality
![Page 34: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/34.jpg)
Global Framework for IYCF
• Recognizes CF has received less attention
• Embraces feeding continuum
• Recommends viewing CF in broader framework
• Updates calorie & nutrient needs
• Provides impetus for new ‘guiding’ principles for CF
![Page 35: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/35.jpg)
Guiding Principles for Complementary Feeding
(PAHO, WHO, 2001)
• Excl BF duration and age of intro of CF
• Maintenance of BF• Responsive feeding• Safe preparation and storage of CF• Amount of CF needed• Food consistency• Meal frequency and energy density• Nutrient content of CF• Use of vitamin mineral supplements or
fortified products for infant and mother• Feeding during/after illness
![Page 36: An Overview of Infant and Young Child Feeding, 6-24 Months Jean Baker, AED/LINKAGES.](https://reader036.fdocuments.us/reader036/viewer/2022070415/56649ef35503460f94c05d82/html5/thumbnails/36.jpg)
Thank You!