148x Filetype PPT File size 0.13 MB Source: www.ennonline.net
Complementary feeding is a Complementary feeding is a key window for intervention key window for intervention Age range of complementary feeding (6- Age range of complementary feeding (6- 24 mo) is the time of peak incidence of 24 mo) is the time of peak incidence of – Growth faltering Growth faltering – Micronutrient deficiencies Micronutrient deficiencies – Morbidity, e.g. diarrheal disease Morbidity, e.g. diarrheal disease After 2 years, difficult to reverse effects of After 2 years, difficult to reverse effects of malnutrition malnutrition – Stunting Stunting – Effects on brain function due to micronutrient Effects on brain function due to micronutrient deficiency? deficiency? A food-based, comprehensive approach A food-based, comprehensive approach may be more effective and sustainable may be more effective and sustainable than programs targeting individual than programs targeting individual nutrient deficiencies nutrient deficiencies Guiding principles for Guiding principles for complementary feeding of the complementary feeding of the breastfed child (PAHO/WHO 2003) breastfed child (PAHO/WHO 2003) 1. Age of introduction of complementary foods 1. Age of introduction of complementary foods 2. Maintenance of breastfeeding 2. Maintenance of breastfeeding 3. Responsive feeding 3. Responsive feeding 4. Safe preparation & storage of complementary foods 4. Safe preparation & storage of complementary foods 5. Amount of complementary foods needed 5. Amount of complementary foods needed 6. Food consistency 6. Food consistency 7. Meal frequency and energy density 7. Meal frequency and energy density 8. Nutrient content of complementary foods 8. Nutrient content of complementary foods 9. Use of vitamin/mineral supplements or fortified 9. Use of vitamin/mineral supplements or fortified products products 10. Feeding during and after illness 10. Feeding during and after illness Scope of Review Scope of Review Interventions in developing countries Interventions in developing countries that targeted children 6-24 mo that targeted children 6-24 mo Outcomes measured: growth, morbidity, Outcomes measured: growth, morbidity, child development, micronutrient intake, child development, micronutrient intake, micronutrient status micronutrient status Studies that assessed only the impact Studies that assessed only the impact on feeding practices were not included on feeding practices were not included Generally focused on reports from 1996- Generally focused on reports from 1996- 2006 2006 Number of papers included Number of papers included Source Efficacy Effectiveness Source Efficacy Effectiveness trials studies/program trials studies/program reports reports PubMed 12 0 PubMed 12 0 Snowball 11 7 Snowball 11 7 technique technique Personal 6 6 Personal 6 6 contacts contacts Total (42) 29 13 Total (42) 29 13 Intervention Strategies Intervention Strategies Education as the main treatment Education as the main treatment Complementary food or a food product Complementary food or a food product offering extra energy (with or without added offering extra energy (with or without added micronutrients) provided as the only micronutrients) provided as the only treatment treatment Provision of food combined with some other Provision of food combined with some other strategy, usually education for mothers strategy, usually education for mothers Fortification of complementary foods (central Fortification of complementary foods (central or home-fortification) with micronutrients or home-fortification) with micronutrients (with no difference in energy provided to (with no difference in energy provided to intervention vs. control groups) intervention vs. control groups) Increased energy density and/or nutrient Increased energy density and/or nutrient bioavailability of complementary foods via bioavailability of complementary foods via simple technologies simple technologies
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