Overview

This Model Chapter brings together essential knowledge about infant and young child feeding that health professionals should acquire as part of their basic education. It focuses on nutritional needs and feeding practices in children less than two years of age – the most critical period for child nutrition after which sub-optimal growth is hard to reverse. The Chapter does not impart skills, although it includes descriptions of essential skills that every health professional should master, such as positioning and attachment for breastfeeding.

The Model Chapter is organized in nine sessions according to topic areas, with scientific references at the end of each section. These references include articles or WHO documents that provide evidence and further information about specific points.

Contents

• Acknowledgments
• Abbreviations
• Introduction
• SESSION 1. The importance of infant and young child feeding and recommended practices
  • 1.1 Growth, health and development
  • 1.2 The Global Strategy for infant and young child feeding
  • 1.3 Recommended infant and young child feeding practices
  • 1.4 Current status of infant and young child feeding globally
  • 1.5 Evidence for recommended feeding practices
  • References
• SESSION 2. The physiological basis of breastfeeding
  • 2.1 Breast-milk composition
  • 2.2 Colostrum and mature milk
  • 2.3 Animal milks and infant formula
  • 2.4 Anatomy of the breast
  • 2.5 Hormonal control of milk production
  • 2.6 Feedback inhibitor of lactation
  • 2.7 Reflexes in the baby
  • 2.8 How a baby attaches and suckles at the breast
  • 2.9 Effective suckling
  • 2.10 Causes of poor attachment
  • 2.11 Positioning the mother and baby for good attachment
  • 2.12 Breastfeeding pattern
  • References
• SESSION 3. Complementary feeding
  • 3.1 Guiding Principles for Complementary Feeding
  • 3.2 Recommendations for micronutrient supplementation
  • 3.3 Local adaptation of complementary feeding recommendations
  • References
• SESSION 4. Management and support of infant feeding in maternity facilities
  • 4.1 The Baby-friendly Hospital Initiative
  • 4.2 Policy and training
  • 4.3 Antenatal preparation
  • 4.4 Early contact
  • 4.5 Showing mothers how to breastfeed
  • 4.6 Creating a supportive environment for breastfeeding
  • 4.7 Follow-up support
  • References
• SESSION 5. Continuing support for infant and young child feeding
  • 5.1 Support for mothers in the community
  • 5.2 Infant and young child feeding counselling
  • 5.3 Using good communication and support skills
  • 5.4 Assessing the situation
  • 5.5 Managing problems and supporting good feeding practices
  • 5.6 Follow-up
  • References
• SESSION 6. Appropriate feeding in exceptionally difficult circumstances
  • 6.1 Low-birth-weight babies
  • 6.2 Severe malnutrition
  • 6.3 Infants and young children living in emergency situations
  • 6.4 Relactation
  • 6.5 Infants of HIV-positive mothers
  • 6.6 Feeding non-breastfed children 6–23 months of age
  • References
• SESSION 7. Management of breast conditions and other breastfeeding difficulties
  • 7.1 Full breasts
  • 7.2 Breast engorgement
  • 7.3 Blocked duct
  • 7.4 Mastitis
  • 7.5 Breast abscess
  • 7.6 Sore or fissured nipple
  • 7.7 Mastitis, abscess and nipple fissure in an HIV-infected woman
  • 7.8 Candida infection (thrush) in mother and baby
  • 7.9 Inverted, flat, large and long nipples
  • 7.10 Perceived insufficiency and low breast-milk production
  • 7.11 Crying baby
  • 7.12 Oversupply of breast milk
  • 7.13 Refusal to breastfeed
  • 7.14 Twins
  • 7.15 Caesarean section
  • 7.16 Mother separated from her baby
  • 7.17 Illness, jaundice and abnormality of the child
  • References
• SESSION 8. Mother's health
  • 8.1 Mother's Illness
  • 8.2 Maternal nutrition ()
  • 8.3 Medication and drugs ()
  • 8.4 Family planning and breastfeeding
  • References
• SESSION 9. Policy, health system and community actions
  • 9.1 Strengthening national policies and legislation
  • 9.2 Strengthening the health system and health services
  • 9.3 Strengthening family and community practices
  • 9.4 Assessing progress in coverage of effective interventions
  • References
• Annexes
  • ANNEX 1 Acceptable medical reasons for use of breast-milk substitutes
  • ANNEX 2 Growth standards
  • ANNEX 3 Growth velocity (weight-for-age) tables
  • ANNEX 4 Indicators for assessing infant and young child feeding practices
• Useful resource materials
• Spanish

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