INFANT AND YOUNG CHILD

FEEDING / IYCF
AIDA V. GARCIA, RN MAN
OLFU COLLEGE OF NURSING
INFANT AND YOUNG CHILD
FEEDING / IYCF
LEGAL BASIS
 EO 51
National Code of Marketing of Breastmilk Substitutes,
Breastmilk Supplement & Other Related Products
“ MILK CODE”
 EO 51

“ MILK CODE”
RA 7600
RA 7600
 RA 7600
Normal Spontaneous Deliveries. — shall be put to the

breast of mo. stat after birth & forthwith roomed-in w/in 30 mins.

a) well infants regardless of age of

gestation; and

b) infants with low birth weights but who

can suck.

Deliveries by Caesarian. — shall be roomed-in & breast-fed

w/in 3

to 4 hrs after birth

 Rooming-in
- place nb in same room as the mother
right after delivery up to discharge
- facilitate mother-infant bonding and
initiate breast-feeding
Exemptions
— Infants whose cond. do not permit rooming-in &
BF as determined by physician, & infants whose
mothers are either:
a) seriously ill;
b) taking medications contraindicated to breast-
feeding;
c) violent psychotics; or
d) whose conditions do not permit breast-feeding
and rooming-in as determined by the attending
physician
Exemptions
—Seriously ill mothers — are those who are:
w/
-Severe infections;
-in shock;
-in severe cardiac or respiratory distress;
-or dying;
-or those with other conditions that may be
determined by the attending physician as serious
 RA 7600
ACT PROVIDING INCENTIVES TO ALL GOVT &
PRIVATE HEALTH INSTITUTIONS W/ ROOMING-IN &
BREASTFEEDING PRACTICE
 RA 7600
MBFHI Certification
 Lactation Management
— gen. care of mother-infant nursing couple during
prenatal, stat postpartum & postnatal periods.

- deals w/ educ. & providing knowledge/ info to preg. &

lactating mo. on advantages of bf, physiology of
lactation, establishment & maintenance of lactation,
proper care of breasts & nipples for successful bf
Right of the Mother to Breast-feed
—child equally has the right to her breastmilk
 Essential Intrapartum Newborn Care (EINC) / Unang Yakap
a series of time-bound and evidence-based interventions for newborn
babies and their mothers

step-by-step interventions in EINC are

(1) immediate and thorough drying of the baby,
(2) early-skin-to-skin contact between the mother and the newborn,
(3) properly-timed cord clamping, and
(4) non-separation of the mother and baby for early breastfeeding
initiation.
 Bootlefeeding
- allowed only after mo. has been informed health
personnel of:
- advantages of bf & proper techniques of infant
formula feeding
- mo. opted in writing to adopt infant formula feeding
the infant.
 RA 10028
“EXPANDED BREASTFEEDING
PROMOTION ACT”
 RA 10028
“EXPANDED BREASTFEEDING
PROMOTION ACT”
 RA 10028
“EXPANDED
BREASTFEEDING
PROMOTION ACT”
 RA 8976
“PHILIPPINE FOOD
FORTIFICATION ACT’
 RA 8172
ASIN LAW
EO 382
AO No. 2011-0303 “Micronutrient
powder supplementation for
children 6-23 months”
 AO 32, S2010
EXPANDED GARANTISADONG
PAMBATA
 f AO 2005-0014

National Policy on Infant

and Young Child May 23, 2005
Feeding
IYCF FEEDING
PRACTICES
 IYCF
FEEDING PRACTICES
EXCLUSIVE BREASTFEEDING
EXCLUSIVE
Breastfeeding
 wet nursing
- feeding from another
mother’s breast
 expressed milk

• MANUAL
milk
expression
 EXCLUSIVE Breastfeeding
: BEST food except if w/ Galactosemia

: DO NOT GIVE plain water

sugared water
chewy sticky rice
herbals
or starved the baby
: BF day & night (per demand)
: Use breast alternately
Breastmilk
Breastmilk
Breastmilk
 Variations of BMilk

• 1. Colostrum – thick/yellowish
– More whey than mature milk - antibodies
– Purgative – meconium
– Growth factors – helps intestine to grow
– Rich in Vit A
 Variations of BMilk

2. Mature Milk
Larger in quantity

A. Foremilk- produce early in feeding.

B. Hindmilk-produce later. More fat
 Breastmilk

Breastmilk is the best food

- contains essential nutrients
- complete
- nature’s first immunization
- growth factors
 POSITIONING AND ATTACHMENT
Positioning
refers to how you hold the baby at your

Techniques
breasts during breastfeeding.
Attachment
also can describe how the baby latches
to the breast ( how the baby's mouth holds

of BF
the breast).

Correct positioning and attachment is key

to successful breastfeeding,
- protects the mother's milk supply,
- protects the nipple from getting
injuries (engorgement, cracking and
soreness and infection).
- helps the mother bond w/ their child
 1.Position

• Infant close to
mo
• Tummy to
tummy * (baby 's stomach should
touch your stomach)

• Diff. positions
are:
 BF POSITION

a. Cradle
hold Ensure you sit comfortably
Support baby's head in the crook of the arm(inside
around the elbow)
The palm of the hand should hold the baby's bottom
Turn the baby to his/her side such that you are belly
to belly
Raise the baby to the breast
You can use the other arm to support the baby too
Post CS moms can use this too it's not causing them
alot of pain or discomfort.
 BF POSITION

Use the opposite arm to b. CROSS

support the baby's head
from around the back, while CRADLE HOLD
supporting the neck,
shoulders and the Head.
The other hand can hold the
breast.
Mother should be belly to
belly with the child.
 BF POSITION

c. SIDE-LYING
hold Lower lying arm should hold the baby or
you can tuck a rooled up blanket behind
the baby for more support.
Support the breast with the other hand.
PS: DO NOT LEAVE THE BABY ON
THE BREAST WHILE YOU
SLEEP.TURN THEM FROM THE
BREAST OR RETURN THEM TO THEIR
CRIB.
 BF POSITION
d. FOOTBALL /
HOW?
Hold the baby facing the
CLUTCH /
nipple UNDERARM HOLD
The hand supports the neck
and the baby closely to the
moms side
The baby's feet and the legs
are tucked under the arm
Lift the baby to the breast
Acceptable or not acceptable?

It is not acceptable.
- upright or koala
hold
 3. Small
breast
.
4. Flat , inverted
nipple • Shape of nipple- not
impt
– Position well
– Syringe method (pull
plunger)
- Shape breast (c-
hold)
4. Flat , inverted nipple

• Syringe method
(pull plunger)
4. Flat , inverted nipple

- Shape breast
(c-hold)
5.PROPER LATCHING
GOOD LATCH
-mouth wide open
Lower lip turned
outward
- Chin touching breast
- More areola visible
above
SIGNS SUCKLING EFFECTIVELY
SUCKLING EFFECTIVELY ?
SUCKLING EFFECTIVELY ?
Signs that baby is not getting enough
milk

●Urinates less than 6 x /

day
Usual: 6 – 8 x in 24 hrs
Signs that baby is not getting enough
milk

• Poor wt. gain – less than 500 grms / mon

–Usual: 1st 6 mons – wt gain of 500g in a

month
 6. BREAST ENGORGEMENT
• breast
engorgement.
• caused by an
imbalance
between milk
supply and infant
demand.
 6. BREAST ENGORGEMENT

• BF-both
• MANUAL milk
expression
• Breast pump
6. BREAST ENGORGEMENT
 Expressed breastmilk

- — human milk extracted from breast by hand

or by breast pump

- fed using dropper,nasogatric tube,

cup & spoon, or bottle

milk
expression -
collected milk
7. Breast – no need to wash before and after
feeding
8. Mo. Food intake
9. Causes uterine pain
 PREDOMINANT Breastfeeding
> BREAST milk
> BEST food
⮚ Wet nurses
⮚ w/ liquid” …water-based food , fruit juice
ritual fld, oresol,drops, syrup, vit, mineral
Covid pt.
 care of the newborn during the
prevailing COVID-19 pandemic
1. Non-separation of clinically stable mother (suspected or
confirmed Covid-19 infection) from her newborn
2. Kangaroo mother care (KMC) for stable premature & low
birth weight newborns
3. Rooming in or co-location of stable mother-infant dyads
with suspected or confirmed COVID-19 infection
4. optimal source of nutrition is direct exclusive BF. if not
feasible assist mother to express her own milk(MOM), If
MOM is not available,pasteurized donor milk (PDM)
EXTENDED BF
COMPLIMENTARY FEEDING
 COMPLIMENTARY FEEDING

• TIMELY . . . They are INTRODUCED when

the need for energy & nutrients EXCEEDS
what can be provided by exclusive frequent
BF
• ADEQUATE. . . Provide SUFFICIENT
energy. . .CHON. . . Micronutrient to meet
nutritional needs
 COMPLIMENTARY FEEDING

• SAFE. . . HYGIENICALLY STORED & prepared.

Fed w/ clean hands using clean utensils

. PROPERLY FED . . . Given consistently w/ a

CHILD’s SIGNALS of HUNGER
. . MEAL FREQUENCY & METHOD . . .
Shd be SUITABLE for CHILD’s age
 Bottle feeding
Given from bottle w/ nipple , teats
- Interference of bottle feeding
- Increase diarrhea, morbidity,
mortality
 6 to 9 months (IMCI)
-Breastfeed as often
-Give thick porridge or well mashed foods. Include
animal source foods & vit A-rich fruits & veg.
- Start: Give 2 tbsp
- Gradually increase to ½ cups (1 cup = 250 ml)
-Give 2 to 3 meals/day
-Offer 1 to 2 snacks/day bet meals when hungry
 9 mon -12 mon (IMCI)
-Breastfeed as often
-Give variety of mashed or finely chopped family
food, include animal source foods & VitA rich
fruits/veg.
-Give ½ cup at each meal
-Give 3 to 4 meals /day
Offer 1 to 2 snacks bet meals when hungry
REPLACEMENT FEEDING /

COMMERCIAL INFANT FEEDING

 IEC
MATERIALS
 Early Initiation of BF
After birth w/in 90
mins of life ..EINC
NUTRITIONAL
ASSESSMENT OF INFANT
AND YOUNG CHILD
Anthropometry

• Anthropometry
• measurement of
physical dimensions &
gross mass
composition of body
Antropometry
Weight-for-Age
• Body weight relative the child’s
age
• Determines underweight
Weight for height
• Low wt for height
• Wasting
Length / height for Age

• identifies short or
stunted d/t prolonged
undernutrition or
repeated illness
• Consider heredity
Length / height for Age

• Low height for age

• stunted (bansot)
Weight-for-Age
MUAC – MID UPPER ARM
CIRCUMFERENCE
• Rapid screening of
malnutrition
• MUAC below 115mm
for children 6-59
mons…severe
malnutrition
MUAC – MID UPPER ARM
CIRCUMFERENCE
MUAC – MID UPPER ARM
CIRCUMFERENCE
Weight-for-Age
CLINICAL EXAMINATION
• P.E.
• Eye exam –
VAD ..nightblindness
(micronutrient def.)
• Marasmus
• Kwashiorkor
CLINICAL EXAMINATION
BIOCHEMICAL EXAMINATION

• Assessment of specific
component of bld, urine
sample..measures
metabolism
BIOCHEMICAL EXAMINATION
Thank you for listening
REFERENCES
• Community Public Health Nursing 2nd Philippine Edition,
Neis, Sumile C & E Publishing
• Famorca, Z. 2013. Nursing Care of the Community, a
comprehensive text on community and public health
nursing in the Philippines, 2013, 357 – 370.
• Maglaya, A. 2009. Nursing Practice in the Community,
Argonauta Corporation
• Gesmundo,M. 2010 The Basic of Community Health
Nursing, C & E Publishing, p. 353