Breastmilk meets all of an infant’s nutritional requirements for the first 6 months of life and is superior to any substitute. It confers several benefits on both the infant and mother, the most important of which is its protective effect against infections such as gastrointestinal and respiratory infections in the infant. Hence their commendation by WHO and the National Policy on Breastfeeding is that children be exclusively breastfed for the first 6 months of life. Thereafter, children should continue to breastfeed while receiving appropriate and adequate complementary foods for up to two years of age and beyond.
Personal hygiene and food handling
Good personal hygiene is of great importance in the feeding of infants and young children. The breastfeeding mother needs to maintain good personal hygiene and ensure proper food handling at all times, especially in the preparation and feeding of replacement and complementary foods.
Complementary feeding
Complementary feeding refers to giving a child complementary foods. Complementary food is any food or liquid given when breast milk alone is no longer sufficient to meet the nutritional requirements of infants. Complementary foods are needed to meet the additional nutritional requirements of the infant at the age of 6 months. However, breastfeeding continues to make an important nutritional contribution well beyond the first year of life, providing up to 50% of the nutrient intake of this age group. Good complementary foods should have the following characteristics:
· High energy and adequate, good-quality protein, vitamins, and minerals
· Soft consistency to enable the child to swallow easily
· Low dietary bulk
· Need for minimal preparation prior to feeding and easy digestibility
· No anti-nutritional factors and low indigestible fibre content
· No artificial colours and flavours
Responsive feeding
Optimal complementary feeding depends not only on what is fed, but also on how, when, and by whom the child is fed. Responsive feeding applies the following principles of psycho-social care:
· Feeding infants directly.
· Assisting older children when they feed themselves.
· Being sensitive to their hunger and satiety cues.
· Feeding slowly and patiently and encouraging children to eat, but not forcing them.
· Experimenting with different food combinations, tastes, textures, and methods of encouragement if children refuse many foods.
· Minimising distractions during meals if the child loses interest easily.
· Making feeding times periods of learning and love talk while maintaining eye-to-eye contact with the child.
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Feeding during and after illness
During and immediately after illness, children often have a higher need for fluids and food than usual. Increased fluid intake, including more frequent breastfeeding and consumption of soft, varied, appetising, and favourite foods, should be encouraged.
Feeding children in difficult situations
Special attention is needed towards practical support for families in difficult situations such as HIV/AIDS, emergencies, and low birth weight to enable them to feed their children adequately. In difficult situations, the likelihood of not breastfeeding increases, as do the dangers of artificial feeding and inappropriate complementary feeding. To reduce post-natal transmission of HIV from mother to child, it is critical that infant and young child feeding counseling is fully integrated into all prevention of mother-to-child transmission of HIV(PMTCT) interventions, reproductive health, and sexual health and other related services.
Maternal nutrition
Women’s nutrient needs increase during pregnancy and lactation. Some of the increased nutrient requirements protect maternal health, while others affect birth outcome and infant health. If the requirements are not met, the consequences can be serious for women and their infants’ energy intake. It is important therefore that girls and women obtain adequate energy intake and a diversified diet throughout their life cycle. This is the only way to help ensure that women enter pregnancy and lactation without deficiencies and obtain adequate nutrients during periods of heightened demand.
During Pregnancy and lactation, all women need additional food, a varied diet, and micronutrient supplements to ensure that body reserves are not used up, leaving the Pregnant woman weakened and unable to meet the optimal demands of breastfeeding.
Community participation
Community involvement and participation are imperative in interventions aimed at improving the nutritional Status of infants and young children and ensuring the quality of care and support for mothers and families.
Male involvement
As heads of households, men Should be actively engaged in promoting, protecting, and supporting women in practicing optimal infant and young child feeding. They must also help in breaking down barriers to health care by mitigating distance, Cost, and social-cultural obstacles and enhancing women’s Status and decision-making powers.
Behaviour-oriented communication strategy
Behaviour change communication (BCC) programmes have been shown to affect environments, which influence behaviour. It is important, therefore, that BCC be used as a communication Strategy for modifying practices of families and communities that affect the nutrition of pregnant and lactating women, infants, and children and the utilisation of health care services, including HIV voluntary counselling and testing (VCT).
Policy environment
Effective coordination and collaboration with all relevant ministries and agencies should be promoted to integrate infant and young child feeding interventions into existing programmes to improve the nutritional status of children. In addition, a comprehensive integrated implementation Strategy on infant and young child feeding based on the WHO Global Strategy for Infant and Young Child Feeding should be developed.
Definitions of related terms:
Cup feeding: Feeding an infant from an open cup, irrespective of its contents
Early post-partum: The first 3 -6 weeks after delivery
Exclusive breastfeeding: Feeding an infant with breast milk (including Expressed breast milk) only, without any other food or drink, not even water except drops or syrups consisting of vitamins, mineral supplements, or medicines when medically prescribed
Heat-treated expressed breast milk: Expressed breast milk that is brought to the boil and immediately cooled to room temperature for use as a replacement food for infants
HIV counseling: Confidential dialogue between a client and a health care provider aimed at enabling the client to cope with stress and make personal decisions related to HIV/AIDS. The counseling process includes an evaluation of personal risk of transmission and facilitation of preventive behavior.
Home-prepared formula: Infant formula prepared at home from fresh or processed animal milks, suitably diluted with water and with the addition of sugar.
Infant: A child from birth to 12 months of age
Low birth weight (LBW): Small size for gestational age. There are two variants of low birth weight: pre term (37- 40 completed weeks of pregnancy) and full-term. Pre-term LBW is mainly due to obstetrical complications (premature labour, ante-partum haemorrhage), hypertensive disease in pregnancy. Diabetes in pregnancy, and congenital problems. Full-Herm LBW is commonly a result of intrauterine growth retardation arising from poor maternal nutrition, malaria, short stature, smoking, and alcohol.
Mastitis: Inflammation of the breast which usually results from inadequate or poor drainage of milk. Mastitis frequently affects only one breast and is characterised by hard swelling, severe pain, fever, and localised redness around the affected breast. Poor attachment may lead to mastitis.
Excerpt from the Federal Ministry of Health (Department of Community Development and population activities publication
