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Infant and Young Child Feeding

Introduction

breastfeeding


Indian children have the same growth and development potential as all children worldwide. It is well recognized that the period from birth to two years of age is the “critical window” for the promotion of good growth, health, and behavioural and cognitive development.

Optimal nutrition in the first two years of life – early and exclusive breastfeeding and continued breastfeeding for two years or more, together with nutritionally adequate, safe, age appropriate, responsive complementary feeding starting at six months – are critical to prevent stunting in infancy and early childhood and break the  intergenerational cycle of undernutrition. Optimal breastfeeding in the first year and complementary feeding practices together can prevent almost one fifth of deaths in children under five years of age.

Breastfeeding - Breastfeeding is bestfeeding! 

Breastfeeding within first hour of life is recognized as one of the most important actions for infant survival. Yet in India, only one infant in three  starts breastfeeding within one hour of life. This is lower than the global average of  42 per cent.

Why is breastfeeding within the first hour of life vital to the survival of children?
 
Colostrum, the rich milk produced by the mother during the first few days after delivery, provides essential nutrients as well as antibodies to boost the baby’s immune system, reducing the likelihood of death in the neonatal period. Breastfeeding within one hour of life protects the child from infections and reduces the risk of death by up to 22 per cent in the first month of life. Skin-to-skin contact with the mother through breastfeeding fosters mother-infant bonding and keeps the child warm, reducing the child’s risk of dying of cold (‘hypothermia’).
 

Every child should start breastfeeding within one hour of life to take advantage of the newborn’s intense suckling reflex and alert state and to stimulate breastmilk production. Starting breastfeeding within the first hour of birth and learning to breastfeed properly – the correct position and how to attachment – helps the mother produce more milk for her child and reduces excessive bleeding in mothers after birth and the risk of haemorrhage, a major cause of maternal death.

Exclusive breastfeeding for six months
 
Breastmilk alone is sufficient to meet an infant’s requirement for food and water in the first six months of life. With frequent, on-demand feedings, babies do not need water or any other liquids even in hot climates; mother’s milk is all they need for survival and optimal growth and development. Foods given to infants in the first six months of life do not improve growth and, instead, are dangerous when they replace mother’s milk, because they can result in frequent infections and poor growth and development.
 
In India, only 46 per cent of infants under six months are exclusively breastfed. The proportion of children under six months who are exclusively breastfed decreases with age, from 69 per cent in the first and second months to 28 per cent in the fifth and sixth months of life.
 
What are the benefits of exclusive breastfeeding – to infants and families?
 
Exclusively breastfed infants are at a lower risk of diseases like diarrhoea and pneumonia,  major causes of death among children under five years.  An infant who is not breastfed is more than 14 times more likely to die from all causes than an exclusively breastfed infant.  

Many other benefits are associated with exclusive breastfeeding for both mother and infant.  Exclusive breastfeeding helps to increase the time between pregnancies, which naturally helps to space births.and breastfeeding is more economical because families do not need to spend money on expensive infant foods.
 
Complementary Feeding
 
After six months, infants need both breastmilk and complementary foods to continue to grow strong and develop fully. Mother’s milk alone cannot give infants all the nutrition needed during this period of fast growth and development.

However, breastmilk remains an important source of nutrients in the first two years of life.  Therefore, it is recommended that, along with complementary feeding, breastfeeding should be continued until at least two years of age. Appropriate complementary foods are the solid, semi-solid or soft foods given with mother’s milk after six months.
 
Appropriate and safe complementary feeding – ensuring that children are fed nutritionally rich complementary foods at the right age, at the right frequency and feeding hygiene practices are observed – is a major challenge in India.

Only a little more than half of Indian infants aged six to nine months receive some kind of complementary foods in addition to mother’s milk.  Only one child in five (21 per cent) aged between 6-24 months is fed optimally, that is as per the recommended practices.  Only 35 per cent of children are fed foods from a minimum number of foods groups and 42 per cent are fed a minimum number of times.   
 
A comprehensive programme approach to improving complementary feeding practices includes timely introduction of age appropriate and hygienically prepared complementary foods, counselling for caregivers on feeding and care practices and on the optimal use of locally available foods, improving access to quality foods for poor families through social protection schemes and safety nets, and the provision of fortified foods and micronutrient supplements when needed.
 
What are the benefits of complementary feeding?
 
Optimal complementary feeding is the most effective intervention that can significantly reduce stunting during the first two years of life. Stunted children are more susceptible to sickness. In school, they often fall behind in class. They enter adulthood more likely to become overweight and more prone to non-communicable disease. When they start work, they often earn less than their non-stunted co-workers.
 
 

MAA - National Breastfeeding Programme


Big Picture

Rates of early initiation of breastfeeding in India increased from 25 per cent in 2006 to 34 per cent in2009. 
 
However, only 46 per cent of infants under six months are exclusively breastfed, and the proportion of children under six months who are exclusively breastfed decreases with age – from 69 per cent in the first and second months to 28 per cent in the fifth and sixth months of life. 
 
Only a little more than half of Indian infants aged six to nine months receive some kind of complementary foods in addition to mother’s milk. 

In India, only one child in five (21 percent) between 6-24 months is fed optimally, i.e. fed as per the recommended practices.  Only 35 per cent children are fed foods from a minimum number of foods groups and 42 per cent are fed a minimum number of times. 

UNICEF In Action

Infant and Young Child Feeding (IYCF): UNICEF’s focus for India
 
The Government of India and UNICEF’s Country Programme Action Plan for 2013-17 support national policies and programmes that protect, promote and support optimal Infant and Young Child Feeding (IYCF) and nutrition and care for pregnant women and breastfeeding mothers.

UNICEF supports governments and partners to scale up programmes that provide essential nutrition services, counselling and support to improve the survival, growth and development of children aged under two and their mothers, with a special emphasis on the most deprived.

UNICEF also supports Integrated Child Development Services (ICDS) and the National Rural Health Mission (NRHM), India’s flagship programmes whose goal it is to improve nutrition, health and development outcomes in infants and young children. 
 
To reach IYCF goals, UNICEF supports governments and other stakeholders to develop and implement policies and plans of action which promote, support and protect: early initiation of breastfeeding; exclusive breastfeeding to six months; continued breastfeeding from six to 24 months and beyond; and appropriate feeding of complementary from six months onwards. To do this, UNICEF is supporting: 
 
Partnerships with professional bodies, academic institutions and NGOs to model skill-based training approaches on IYCF for frontline workers and community volunteers. 
Building capacities of training institutes to bring about qualitative improvements in the training of Anganwadi workers about IYCF.
. Development of a large-scale multi-channel communication strategy to promote and support IYCF practices.
 
 
To know more about breastfeeding visit UNICEF’s global website