FAMILY HEALTH CARE/ADVISORY

SERVICE

Yubraj Parajulii
62071
Sociodemographic Profile of the
Family
Location: Duwakot, Phanintar
Municipality: Changunarayan
Ward number: 2
Type of family: Three generation family
Number of family members: 5
Head of the family: Bharat Prasad Ghimire
Religion: Hindu
Caste: Brahmin
 HOUSING CONDITION
• Type of house: Detached
• Roofing: Concrete Terrace
• Walls: Bricks
• Flooring: Cemented
• Lighting and Ventilation: Present
• Cross Ventilation: Absent
• Natural Lighting: Inadequate
• Kitchen: Drainage present
• Number of rooms: 5, sleeping 2, living 1, others 2
• Overcrowding: Present
• Dampness: Absent
• Latrine: Sanitary type
ECONOMIC STATUS

• Total Income: Rs 20,000 to Rs 30,000 per month

• Expenditure: Rs 10,000 on education, Rs 3,000 on
electricity and rest
on food, water, clothing, medical aid and
entertainment
• Savings Per Month: None
• Debt: Rs 13,00,000
• Land: 15-20 Ropani land in Dolakha
• Savings: Rs 4,00,000 in Sahakari
Social Problems in the Family
• Addiction in the family: None
• Unemployment: One adult (wife)
• Gamble: none
• Free Time: Household work, gossiping,
TV, Tiktok
BREASTFEEDING
• Exclusive breastfeeding means that the infant receives

only breast milk. No other liquids or solids – not even

water – with the exception of ORS, or drops/syrups of

vitamins, minerals or medicines.

CONTENTS of Breast Milk

• Nutritional superiority- lactose, PUFA, lactalbumin and

lactoglobulin. Lactose enhances absorption of calcium
and enhances growth of lactobacilli.
• Immunological superiority- IgA, macrophages,
lymphocytes, macrophages, lysozyme, bifidus factor and
interferon.
• Sufficient vitamins minerals electrolytes and water
(88%).
• Growth factors, enzymes and hormones eg- epidermal
growth factor, lipases
BENEFITS OF BREASTFEEDING
Benefits Child Mother
1 protects acquiring infection uterine involution

2 respiratory infection reduces chances of

PPH

3 14 times less likely to die of diarrhea the risk of breast and

ovarian cancer

4 ear infections, allergy lactational amenorrhea

5 diabetes, heart diseases and

lymphoma

6 overweight or obese

7 higher IQ
Global scenario

• 42% babies were breastfed within 1 hour.

• Only 41% of infants aged 0-6 months were exclusively
breastfed.
• 71% of children were still breastfed at 1 year of age.
• 45% of children were still breastfed at 2 year of age.
In context of Nepal

• 55% children are breastfed within 1 hour of birth.

• 66% children under 6 months are exclusively breastfed.
• The median duration of breastfeeding has increased
from 2.5 months in 2006 to 4.2 months in 2016.
• Almost all children (99%) are breastfed for some time.
• 98% children are breastfeeding until the age of 1 years
and 89% children receive breast milk until 2 years of
age.
• Optimal breastfeeding (0-23 months) can save the lives
of over 820,000 children under the age of 5 years each
year
i.e breastfeeding can reduce under 5 mortality rate by
13%
Ten Steps to Successful Breastfeeding

Critical Management Procedure-

1a. Comply fully with international Code of Marketing of
Breast-milk Substitutes and relevant World Health
Assembly resolutions.
1b. Have a written infant feeding policy that is routinely
communicated to staff and parents.
1c. Establish ongoing monitoring and data-
management.
2. Ensure that staff have sufficient knowledge,
competence and skills to support breastfeeding.
Key Clinical Practices-
3. Discuss the importance and management
of breastfeeding with pregnant women and
their families.
4. Facilitate immediate and uninterrupted
skin-to-skin contact and support mothers to
initiate breastfeeding as soon as possible after
birth.
5. Support mothers to initiate and maintain
breastfeeding and manage common difficulties.
 6. Do not provide breastfed newborns any food and
fluids other than breast milk, unless medically
indicated.
7. Enable mothers and their infants to remain together
and to practise rooming in 24 hours a day.
8. Support mothers to recognize and respond to their
infants cues for feeding.
9. Counsel mothers on the use and risks of feeding
bottles, teats and pacifiers.
10. Coordinate discharge so that parents and their
infants have timely access to ongoing support and
care.
Hiv positive mother and breastfeeding
• CDC recommends not to breastfeed child
if mother is tested positive.
• In resource limited countries like Africa,
WHO recommends exclusive
breastfeeding for 6 months and continued
breastfeeding till 1 year. Mothers should
be provided with antiretroviral.
Sdg and breastfeeding
• Goals 1, 8 and 10- ending poverty, promoting
economic growth and reducing inequalities.
US $302 billion.
• Goals 2 and 3- hunger, health and well being.
• Goal 4- education. Associated with higher IQ.
• Goal 5- gender equality. Birth spacing and
workplace rights (maternity protection)
• Goal 12- sustainable consumption.
ECOLOGICAL
THANK YOU