key and supporting messages - window of opportunity · 2010-12-23 · or her lightly and keep the...

Key and Supporting Messages

UNIVERSITYRESEARCH CO., LLC

CENTER FORHUMAN SERVICES

C o u n s e l l i n g C a r d s

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Counselling Card 1

AntenatalKey messages

�. Breastfeedyourbabywithin�hourofbirth.(counsellingcards2aand2b)

2. Breastfeedyourbabyfrequently,dayandnight,toestablishyourbreastmilksupply.(counsellingcard6)

3. Exclusivelybreastfeedyourbabybygivingonlyyourownmilkforthefirst6months.(counsellingcard7)

4. Makesureyourbabyiswellattachedtothebreast.(counsellingcard4)

5. Makesurebabyisinacomfortablepositionatthebreastandisabletoeffectivelysuckleinthefirstweeksandmonths.(counsellingcard5)

6. Youshouldeattohungeranddrinktothirsttokeepyouandyourbabyhealthyandtoprepareyourbodyforbreastfeeding.

• Increasefoodintake:“anadditionalmeal,morefoodthanusual,andavarieddiet”.

• TakevitaminAatdeliveryorwithin6weeksafterdelivery.

• EatfoodsrichinvitaminA(papaya,mangoes,carrots,pumpkins,liver).

• Continueiron/folicacidsupplementationtocomplete6monthsintotal(duringpregnancyand/orlactation).

• Useiodizedsaltforthewholefamily.

• Usetreatedbednetstoreducemalariainfection.

• Ifavailable,takede-wormingtreatmentduring3rdtrimesterofpregnancytoreducehookworminfection.

• Reduceworkloadtoensureopportunityforresttohelpconserveenergy

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Counselling Cards 2a and 2b

Delivery in Facility (Card 2a) Home Delivery (Card 2b)Key Messages

• Assoonasyourbabyisborn,letthemidwifeputthenakedbabybetweenyourbreasts,coverhimorherlightlyandkeepthebabythereforatleastonhour–—oraslongasyouwant.Thebabymayjustrestforatime,keepingwarmandlearninghowyoufeelandsmell

• Yourbabywillstartshowingsignsofinterestinbreastfeedingandmaytrytomovetothebreastwithinthehour.Letthebabystartsucklingthen—thisisthebesttimeforyouandyourbabytolearnaboutbreastfeedingandtobond.

• Thebaby’ssucklinghelpsyourwombcontract,whichpushesouttheplacentaandreducesbleeding.Youmayfeelquiteastrongcontractionatthistime;itisagoodsignthatthingsareworkingwell.

• Thefirstmilkthatcomesiscalledcolostrum.Itisyellowandstickyandfullofgoodthingswhichhelpprotectyourbaby.Makesurethatyourbabytakesthecolostrum.

• Breastfeedingfrombirthhelpsthemilk“comein”andensuresplentyofbreastmilk.

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supporting Messages

• Itiseasierforyourbabytolearntosuckleifs/hestartsearlywhilethebreastisstillsoft.

• Theamountofcolostrummaybesmall,butevenafewdropshelpprotectyourbaby.

• Colostrumwillhelpyourbabypasshis/herfirstdarkstool.

• Yourbabydoesnotneedwaterorotherfeedsgivenbeforebreastfeeding(foods,sugarwaterorliquids/fluids).Theycancauseadelayinyourmilk“comingin”(orstartingtoflow)andcanmakeyourbabyill.Calvesandbabygoatsdonotneedextrawaterafterbirth.

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Counselling Card 3

Grandmother Offering Food to Breastfeeding Daughter/Daughter-in-lawFor the caregiver of mother:

Key Messages

• Keepthemotherandbabytogetherfrombirth.Stayingtogetherhelpsthemotherandbabyrestandrecover,breastfeedondemand(asoftenasthebabywants),andbond.

• Ensurethatthebreastfeedingmothereatsanadditionalmealeachdaybecausesheiseatingfortwo,herselfandthebaby.

supporting Messages

• EnsurethatthebreastfeedingmothereatstheporridgefromthePLP(PregnantandLactatingProgramme)andpartoftheextrarationthatisgivenwhenthebabyisregistered.Eatingmorehelpshermaintainherhealthandthehealthofthebaby.

• Bringfoodandwatertothemotherandletherbreastfeedthebaby.

• Mothersneedtobeprioritizedforfamilyfoodandneedhelpwithhouseholdwork.

• Mothersneedtotakeadvantageofallopportunitiestoeatmorefood.

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Counselling Card 4

How to Attach Baby to the Breastskills

• Startwiththebaby’snoseoppositeyournipple,sothatthebabyhastoreachuptothenipple.

• Touchthebaby’slowerlipwiththenipple.Waituntilthebaby’smouthopenswide,andthenquicklymovethebabyontothebreast.

• Aimthebaby’slowerlipwellbelowthenipplesothatthenipplegoestothetopofthebaby’smouthandthebaby’schintouchesthebreast(thishelpstoensurethatthebaby’stongueisundertheareolasothatthebabycanpressoutthemilk).

• Fromtheoutsidethereshouldbemoreareolashowingabovethanbelowthenipple(thisiseasierforthecounsellortoseethanyouwhocannotseewhatisbelowthebaby’smouth).

• Thebaby’slowerlipshouldbeturnedoutwards(thisiseasierforthecounsellortoseethanyouwhocannotseewhatisbelowthebaby’smouth).

effective suckling

• Tosucklewell,ababyneedstobewellattachedatyourbreast.

• Thebaby’smouthshouldbeopenwide,sothats/hecantakeinplentyoftheareolaandnotjustthenipple.

• Thebabyshouldbeheldclosetothebreast.

• Thebabytakesslowdeepsuckles,sometimespausing.

• Youmaybeabletoseeorhearyourbabyswallowingafteroneortwosuckles.

• Sucklingiscomfortableandpainfreeforyou.

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• Babyfinishesthefeed,releasesbreastandlookscontentedandrelaxed.

• Thebreastissofterafterthefeed.

• Sucklingwellhelpsyouproducemilkandsatisfyyourbaby.

risks of poor attachment

• Soreandcrackednipples.

• Poormilkrelease.

• Slowmilkproduction.

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Counselling Card 5

Breastfeeding Positionsskills

• Toensuregoodattachment,yourbabyneedstobewellpositionedatthebreast.Thereareseveraldifferentpositionsthatyoucanuse.

• Youcanbreastfeedsittingorlyingdownorstandingifyouwish.

– Cradle position(mostcommonposition)

– opposite arm—usefulfornewbornsandsmallorweakbabies,oranybabywithadifficultyattaching

– lying down(usefulsoonafterdeliveryandatanytimetorestwhilebreastfeeding)

– under-arm position(usefulfortwins,low-birth-weightbabies)

supporting Messages

• Whateverpositionyouchooseyouneedtobecomfortablewithyourbacksupported.

• Bringthebabytoyou;donotleanforwardtothebaby.

• Thebaby’sbodyshouldbestraight,notbentortwisted,butwiththeheadslightlyback.

• Thebaby’sbodyshouldbefacingyouandclosetoyousothatyouaresupportingthebaby’swholebody,notjusttheneckandshoulders,withyourhandandforearm.

• Thebabyshouldbeabletolookupintoyourface,notheldflattoyourchestorabdomen.

• Holdyourbreastwithyourfingersina“Cshape”,withthethumbabovethedarkpartofthebreast(areola)andtheotherfingersbelow.

• Fingersshouldnotbein“scissorhold”becausethismethodtendstoputpressureonthemilkductsandcanpullthenippleoutofthebaby’smouth.

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Counselling Card 6

Breastfeed on Demand, Both Day and Night Key Messages

• Breastmilkprovidesallthenourishmentyourbabyneedsforthefirst6months.

• Breastfeedthebabyoften,atleast�–�0times,dayandnight,toproducelotsofbreastmilkandensurethatyourbabygrowshealthy.(Dependingonageofbaby,s/hemaynotneed�0feedsadayifsucklingeffectively.)

• Letbabysuckleaslongass/hewants—letbabycomeoffthebreasthim/herself.Donottakethebabyoff.

supporting Messages

• Moresucklingmakesmorebreastmilk(providedbabyiswellattached),andifababysucklesless,thebreastsmakelessbreastmilk.

• Thebreastsmakeasmuchmilkasthebabytakes—ifbabytakesmore,thebreastsmakemore(thebreastislikea“factory”—themoredemandformilk,themoresupply).

• Signsthatababywantstobreastfeed:

A combination of: (not just one alone)

– Restlessness

– Openingmouthandturningheadfromsidetoside

– Puttingtongueinandout

– Suckingonfingersorfists

Note: Begin breastfeeding before the baby starts crying. Crying is a late sign of hunger.

• Feedsthatareregularlymorethanhalfanhour(exceptinthefirstweekorsoorwhenbabyislow-birth-weight)orfeedsthatareveryfrequent(moreoftenthanevery�–�.5hoursallthetime)maybeasignthatyourbabyisnotwellattached.Askthecounsellortowatchthebabyfeed,andtrytoimprovetheattachment.

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Counselling Card 7

During the First 6 Months, Your Baby Needs ONLY Your BreastmilkKey Messages

• Breastfeedingmakesyourbabygrowstrongandhealthyandhelpstopreventdiarrhoeaandrespiratoryinfections.

• Breastmilkisthebestfoodanditisallthatyourbabyneedsforthefirst6months.

• Givingotherfeedscanmakeyourbabyill.

• Donotgiveanythingelsetoyourbabybefore6months,NOTevenwater(tea,sugarwater,gripewater,otheranimalmilks,infantformulaorporridge).

• Evenduringveryhotweather,breastmilkcansatisfyyourbaby’sthirstduringthefirst6months.You may need additional water to satisfy your own thirst.

supporting Messages

• Thereisenoughwaterforbabyinyourbreastmilk.

• Therisksofgivingwatertoyourbabyare:Riskofdiarrhea,baby’sstomachgettingfullwithwaterandfeedingless,loosingweight,malnutrition,infrequentfeedingleadingtodecreasedbreastmilkproduction.

• Ifyourbabytakeswaterorotherliquids,s/hesucklesthebreastlessandyouproducelessmilk.Thisleadstopoorgrowthofyourbaby.

• Ifyoufeedanyotherfoodsorliquidstoyourbreastfedbaby,youriskbecomingpregnantinthefirstmonthsafteryougivebirth.

• Babycamelsandgoatsdonotneedextrawaterwhentheyareborn.

• Breastfeedingisanaturalresourceforfoodsecurity.

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• Therearedifferentwaystopositionthebaby:

—Cradleposition(mostcommonposition)

—Side-lyingposition(canbeusedrightafterdeliveryandtorestwhilebreastfeeding)

—Under-armposition(bestusedafteraCaesareansection;whenthenipplesarepainful;andtobreastfeedtwins

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Counselling Card 8

How to Hand Express Breastmilk and Cup Feed• Sometimesyouneedtoexpress

milkforyourbaby:

– ifyourbabyistooweakorsmalltosuckleeffectively

– ifyourbabyistakinglongerthanusualtolearntosuckle,forexamplebecauseofinvertednipples

– ifyouhavetobeawayfromyourbabyforsomehours

– tofeedalow-birth-weightbabywhocannotbreastfeed

– tofeedasickbaby,whocannotsuckleenough

– tokeepupthesupplyofbreastmilkwhenyouorbabyisill

– torelieveengorgementorblockedduct

• Toexpressmilkfollowthesesteps:

– Washhands

– Prepareacleancontainer

– Gentlymassagebreastsinacircularmotion—lightmassageisskinstimulationforthereflex

– Positionthumbontheupperedgeoftheareolaandtheotherfingersontheundersideofthebreastbehindtheareola

– Presstheareolabehindthenipplebetweenthefingersandthumb

– Milkmaystarttoflowindrops,orsometimesinfinestreams—collectitinthecontainer

– Ifitisverysmalldropsofcolostrum,itmayhelptocollectitinasyringedirectfromthenipple

– Avoidrubbingtheskin,whichcancausebruising;orsqueezingthenipple,whichstopstheflowofmilk

– Forlargebreasts,firstliftthebreast

– Rotatethethumbandfingerpositionsandcompressandreleaseallaroundtheareola

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– Expressonebreastforatleast3–5minutesuntiltheflowslows,thenexpressotherside,thenrepeatbothsidesagain(20–30minutestotal)

• Storebreastmilkinaclean,coveredcontainer.Milkcanbestored�–�0hoursatroomtemperatureinacoolplaceand72hoursintherefrigerator.

• Givebabyexpressedbreastmilkfromacup.Bringcuptothebaby’slowerlipandallowbabytotakesmallamountsofmilk.Donotpourthemilkintobaby’smouth.

• Bottlesareunsafetousebecausetheyaredifficulttowashandcanbeeasilycontaminated.

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Counselling Card 9

Optimal Child SpacingKey Messages

• Feedingyourbabyonlybreastmilkforthefirst6monthscanhelpspacebirthsinawaythatishealthyforbothyouandyourbaby.

• Optimalchildspacinghelpsensurehealthychildrenandalsoprotectsyou.

• Youarenotlikelytobecomepregnantwhenyoumeetthefollowing3criteria:

– youhavenoreturnofmenses,and

– youexclusivelybreastfedyourbabyfor6months,and

– yourbabyisyoungerthan6months

• Whenyounolongermeetoneofthesecriteria,youneedtostartafamilyplanningmethodtoavoidpregnancy

supporting Messages

• Whenyoudonotexclusivelybreastfeedfrombirthyoucanbecomepregnantasearlyas6weeksafterdelivery.Closelyspacedpregnanciesriskyourhealth,andthatoftheolderbabyandthenewborn.

• Ifyouwantfurtherinformationaboutchildspacing,pleasegotothefamilyplanningclinic.

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Counselling Card 10

Complementary Feeding Starting at 6 MonthsKey Messages

• Continuebreastfeedingyourbabyondemand,dayandnight,tomaintainhis/herhealthandstrength.

• Breastmilkcontinuestobethemostimportantpartofyourbaby’sdiet.

• Atabout6months,yourbabyisdevelopmentallyreadyandbeginstoneedotherfoodsinadditiontobreastmilk.

• Thinkofthefollowingcharacteristicswhengivingcomplementaryfoodstoyourbaby:F=Frequency,A=Amount,T=Thickness(consistency),V=Variety(differentkindsoffoods),A=Active/responsivefeeding,andH=Hygiene(FATVAH)

• Introducesoftfood(mashedpotato,mashedbananaorporridge)at6monthsofage,2-to-3timesaday.(F)

• Startwith2-3tablespoonfulsperfeed.(A)

• Whenpossibleusebreastmilk,goat,camel,coworsheepmilktopreparethesoftfood.

• Theconsistencyofthesoftfoodshouldbethickenoughsothatitdoesnotrunoffthespoon.(T)

• Bepatientandactivelyencourageyourbabytoeat.(A)

• Avoidusingbottlestofeedyourbaby.Theyareverydifficulttokeepcleanandcanmakeyourbabysickwithdiarrhoea.(H)

• Foodsgiventothebabymustbestoredinhygienicconditionstoavoidcontaminationandillness.(H)

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safe preparation and storage of complementary foods

Guideline: practice good hygiene and proper food handling by

• Washyourownandbaby’shandsbeforefoodpreparationandeating,andafterusingtoiletandcleaningbaby’sbottom

• Usecleanutensilstoprepareandservefood;cleansurface,keepcleanutensilscovered;usecleancupsandbowlstofeedchildren

• Treatwaterfordrinking;keepdrinkingwaterincleancoveredcontainer

• Servefoodsimmediatelyafterpreparation

• Storefoodssafely:keepintightlycoveredcontainers,storefoodsdryifpossible

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Counselling Card 11

Complementary Feeding from 6–8 MonthsKey Messages

• Continuebreastfeedingyourbabyondemand,dayandnighttomaintainhis/herhealthandstrength.

• Breastmilkcontinuestobethemostimportantpartofyourbaby’sdiet.

• Thinkofthefollowingcharacteristicswhengivingcomplementaryfoodstoyourbaby:F=Frequency,A=Amount,T=Thickness(consistency),V=Variety(differentkindsoffoods),A=Active/responsivefeeding,andH=Hygiene(FATVAH)

• From7monthsonwards,feedyourbaby3timesaday.(F)

• Graduallyincreasetheamountoffoodto½ofa250mlcup.Babieshavesmallstomachsandcanonlyeatsmallamountsateachmeal.(A)

• Mashandsoftenthefoodssothebabycaneasilychewandswallow;breastmilkorotheranimalmilkcanbeusedtopreparethesoftfood.

• Thickenthebaby’sfoodasthebabygrowsolder,makingsurethatitisstillabletoeasilyswallowwithoutchoking.(T)

• Trytoincludeatleastasmallbitofafoodfromeachgroupinatleastonemealperday,orasoftenaspossible:a)wheatflour,bulgurflour,maizemeal,CSB,orpotatoes;b)lentils,greengrams,beansoryellowsplitpeas,c)meat,poultry,orfish,d)eggs,e)darkgreenvegetable,fruitssuchasmango,papaya,orangesorbananas,andf)oilorghee.(V)

• Animalmilks(goat,camel,etc.)arealsousefulsourcesofnutrients.

• Ifpossible,alsoincludegroundnutsthathavebeenroastedandthengroundorsmashedintoafinepowder.

• Bepatientandactivelyencourageyourbabytoeat.Useaseparateplatetofeedthebabytomakesures/heeatsallthefoodgiven.(A)

• Foodsgiventothebabymustbestoredinhygienicconditionstoavoiddiarrhoeaandillness.(H)

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Counselling Card 12


• Continuebreastfeedingyouryoungchildondemand,dayandnighttomaintainhis/herhealthandstrength.

• Breastmilkcontinuestobethemostimportantpartofyouryoungchild’sdiet.

• Thinkofthefollowingcharacteristicswhengivingcomplementaryfoodstoyouryoungchild:F=Frequency,A=Amount,T=Thickness(consistency),V=Variety(differentkindsoffoods),A=Active/responsivefeeding,andH=Hygiene(FATVAH)

• From�monthsonwards,feedyouryoungchild4timesaday(3mealsand�snack).(F)snacks:

– extrafoodsbetweenmealsthatareeasytoprepare

– theseextrafoodsareinadditiontothemeals—theydonotreplacemeals

– goodsnacksprovideenergyandnutrients(nottobeconfusedwithsweets)

– (giveexamplesoflocalsnacks)

• Giveyouryoungchild½ofa250mlcup/bowlateachfeed.Youngchildrenhavesmallstomachsandcanonlyeatsmallamountsateachmeal.(A)

• Thickentheyoungchild’sfoodasthechildgrowsolder,makingsurethatitisstillabletoeasilyswallowwithoutchoking;breastmilkorotheranimalmilkcanbeusedtopreparethefood.(T)

• By�monthstheyoungchildshouldbeabletobegineatingfingerfoodssuchaspiecesofripemangoandpapaya,bananaandvegetables

• Trytoincludeatleastasmallbitofafoodfromeachgroupinatleastonemealperday,orasoftenaspossible:a)wheatflour,bulgurflour,maizemeal,CSB,orpotatoes;b)lentils,greengrams,beans

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oryellowsplitpeas,c)meat,poultry,orfish,d)eggs,e)darkgreenvegetable,fruitssuchasmango,papaya,orangesorbananas,andf)oilorghee.(V)



• Bepatientandactivelyencourageyouryoungchildtoeat.Useaseparateplatetofeedtheyoungchildtomakesures/heeatsallthefoodgiven.(A)

• Foodsgiventotheyoungchildmustbestoredinhygienicconditionstoavoiddiarrhoeaandillness.(H)

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Counselling Card 13


• Continuebreastfeedingyouryoungchildondemand,dayandnighttomaintainhis/herhealthandstrength.

• Inyouryoungchild’s2ndyear,breastmilkcontinuestomakeup�/3ofhis/herdiet.

• Thinkofthefollowingcharacteristicswhengivingfoodstoyouryoungchild:F=Frequency,A=Amount,T=Thickness(consistency),V=Variety(differentkindsoffoods),A=Active/responsivefeeding,

andH=Hygiene(FATVAH)

• From�2monthsonwards,feedyouryoungchild5timesaday(3mealsand2snacks).(F)

snacks

– extrafoodsbetweenmealsthatareeasytoprepare

– theseextrafoodsareinadditiontothemeals—theydonotreplacemeals

– goodsnacksprovideenergyandnutrients(nottobeconfusedwithsweets)

– (giveexamplesoflocalsnacks)

• Giveyouryoungchild¾to�250mlcup/bowlateachfeed.(A)

• Cutthefoodintosmallpiecessotheyoungchildcaneasilychewandswallow.

• Thickentheyoungchild’sfoodasthechildgrowsolder,makingsurethatitisstillabletoeasilyswallowwithoutchoking.(T)

• By�2monthsothersolidfoodscanbegiveasmanytimesaspossibleeachday.

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• Trytoincludeatleastasmallbitofafoodfromeachgroupinatleastonemealperday,orasoftenaspossible:a)wheatflour,bulgurflour,maizemeal,CSB,orpotatoes;b)lentils,greengrams,beansoryellowsplitpeas,c)meat,poultry,orfish,d)eggs,e)darkgreenvegetable,fruitssuchasmango,papaya,orangesorbananas,andf)oilorghee.(V)



• Bepatientandactivelyencourageyouryoungchildtoeat.Useaseparateplatetofeedtheyoungchildtomakesures/heeatsallthefoodgiven.Childreneatmoreslowlythanadults,soputthechild’sportionofthefamilymealinhisownbowl.(A)

• Youngchildrenshouldbesupervisedduringmealtimetomakesuretheyeatallthefoodputontheirplate.(A)

• Foodsgiventotheyoungchildmustbestoredinhygienicconditionstoavoiddiarrhoeaandillness.(H)

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Counselling Card 14

Hygiene: Wash Your Hands with Soap and WaterKey Messages

• Washyourhandswithsoap(orash)andwaterbeforepreparingfood,beforeeating,andbeforefeedingyoungchildren.

• Washyourchild’shandswithsoap(orash)andwaterbefores/heeats.

• Washyourhandswithsoap(orash)andwaterafterusingthelatrineorcleaningthebaby’sbottom.

• Feedyouryoungchildusingcleanhands,cleanutensilsandcleancups.Avoidusingfeedingbottles,asthismaycauseyouryoungchildtogetdiarrhoea.

• Keepfoodsincoveredcontainersandstorefooddry,ifpossible.

– Foodshouldbetightlycoveredtopreventinsectsanddirtgettingintoit.

– Foodcanbekeptlongerwhenitisinadryformthanwhenitisinliquidorsemi-liquidform.

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Counselling Card 15

Breastfeeding a Sick Baby Less than 6 MonthsKey Messages

• Breastfeedingmoreduringillnesswillhelpbabyfightthesicknessandnotloseweight.

• Breastfeedingalsoprovidescomforttoasickbaby.

• Ifthebabyittooweaktosuckle,itisimportanttoexpressbreastmilktogivethebaby,eitherbycuporbyexpressingdirectlyintothebaby’smouth.Thiswillhelpthemotherkeepuphermilksupplyandpreventengorgement.

• Practiceexclusivebreastfeedingfrom0–6months.

NOTE: The mother may need support to re-establish exclusive breastfeeding.

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Counselling Card 16

Feeding a Sick Child Greater than 6 Months Key messages

• Duringillness,increasethefrequencyofbreastfeedingandofferadditionalfoodtoyourchildtomaintainhis/herstrength,reduceweightlossandrecoverfaster.(Oftenillyoungchildrenbreastfeedmorefrequently).

• Fluidandfoodrequirementsarehigherduringillness.

• Taketimetopatientlyencourageyoursickchildtoeatashis/herappetitemaybedecreasedbecauseoftheillness.

• Itiseasierforasickchildtoeatsmallfrequentmeals.

• Feedthechildfoodss/helikesinsmallquantitiesthroughouttheday.

• Offertheyoungchildsimplefoodslikeporridge,evenifs/hedoesnotexpressinterestineating.Avoidspicyorfattyfoods.

• Keepencouragingtheyoungchildtoeat.

Feeding during recovery

• Whenyouryoungchildhasrecovered,givehim/heroneadditionalmealofsolidfoodeachdayduringthenexttwoweeks.Thiswillhelpthechildregainweightlostduringillness.

• Alsobreastfedmorefrequentlyduringtwoweeksafterrecovery.

• Takeenoughtimetoactivelyencourageyouryoungchildtoeatthisextrafoodandbreastfeedmorefrequentlywhenhis/herappetitereturns.

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Counselling Card 17

Signs that Require Mother/Caregiver/Family to Seek CareTake your baby or young child to health post if s/he shows the following signs

• Anaemia(lookforpalmarpallor)

• Diarrhoea(bloodinstoolorpersistentdiarrhoea,sunkeneyes)

• Fever(possibleriskofmalaria)

• Vomiting(cannotkeepanythingdown)

• Respiratoryinfections(cough,pneumonia/chestin-drawing)

• Malnourishedchild:visiblewastingoroedema

• Refusaltoeat

key and supporting messages - window of opportunity · 2010-12-23 · or her lightly and keep the...

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