Tackling malnutrition through Infant and young child feeding counselling sessions

Critical for child growth during the first 1000 days

By Proscovia Nakibuuka Mbonye
infant and young child feeding IYCF
21 February 2019

It is feeding time at the UNICEF-supported Inpatient Therapeutic Centre (ITC) at Padibe Health Center IV and Cecilia Ikito, a 28-year-old South Sudanese refugee feeds her two-year-old son, John Lomoro. Lomoro is recovering from Severe Acute malnutrition (SAM) with complications and has spent five days at the centre. The health facility serves both refugees and host communities.

“I was referred to this health center from the refugee settlement. When I came here, my baby was very sick, he was swollen, had frequent diarrhea and was vomiting. His appetite was very low, he would just look at food and not eat at all. I feared he would die,” recalls Ikito. “The health workers told me I was not feeding him well.”

Today, Ikito can afford a smile. Lomoro has received treatment and is steadily recovering. He has been on nutrition management with specialized therapeutic feeds of F75 and F100 that have boosted his nutritious status and promoted recovery from severe acute malnutrition(SAM).

“His appetite is back, and the swelling has gone down,” Ikito mentions as she stares down at her son.

 Ikito is among many other mothers that have benefitted from the nutrition services supported by UNICEF with European Union humanitarian funding at Padibe Health center IV and three other health Centers in Lamwo District. In addition to the therapeutic feeds, the facilities have also received IYCF counselling cards (including those translated in local languages), anthropometric tools including weighing scales, Height boards and MUAC tapes which health workers use to screen for malnutrition at the facilities and during community outreaches.

The European Union humanitarian supported nutrition programme also prioritizes counselling on infant and young child feeding practices (IYCF) as a preventive measure for malnutrition including early initiation of breast feeding, exclusive Breast feeding(EBF) for the first 6 months, timely complementary feeding, Vitamin A supplementation, Immunization and deworming. A total of 29 health workers have been trained, Infant and Young Child feeding counselling, early detection of malnourished children through community mass screening, integrated management of acute malnutrition (IMAM) and Health management information system(HMIS), thanks to UNICEF with European Union humanitarian funding. Also, 281 village health teams have been trained on key family care practices.

The trained health workers conduct the daily IYCF counselling sessions at the health center for mothers admitted in the ITC and those visiting the facilities for other services. At community level village health teams are conducting nutrition screening and referral of the identified children with Severe Acute Malnutrition to the health facilities in addition to providing infant and young child feeding at household level .

infant and young child feeding IYCF

Infant and Young Child Feeding counselling sessions and why they are important

According to Amos Ndungutse, UNICEF’s Nutrition Officer, IYCF counselling sessions are critical to preventing malnutrition and other infections. During the sessions, health workers educate mothers on key issues like early initiation of breastfeeding i.e. breast feeding within the first hour of delivery, exclusive breastfeeding for the first six months and timely complementary feeding after 6 months since breast milk is no longer enough alone to meet nutrition demands  rapidly growing infant at this stage.

The counselling also involves sharing of information about key practices that mothers should to adopt, to prevent infections which can easily cause malnutrition for example proper hygiene and sanitation practices like hand washing with water and soap before preparing food, before feeding the child, and after using the toilet; washing vegetables and fruits before they are eaten, benefits of immunization and why it is important for children to complete the immunization  as per schedule, vitamin A supplementation and deworming. “Many times, when a child has worms, they end up malnourished,” Ndungutse stressed.

Counselling on IYFC therefore is a critical component of the UNICEF-supported nutrition programme because it provides mothers and caregivers in remote areas with knowledge and information that they need for the growth and survival of children during the first 1000 days. “The IYCF counselling sessions provide mothers with knowledge that can help them avert malnutrition among their children, which would otherwise damage the physical and mental status of their children in initial stages of life,’ Ndugutse adds.

At Padibe HC VI, the IYCF counselling sessions are held in the mid-morning. Ikito and fifteen other mothers attend the session and listen attentively to health workers. They are using various foods stuffs to demonstrate the several types of food required for a balanced diet. Demonstrations of proper handwashing, breastfeeding and positioning of the child on the breast, mixing of foods for a nutritious meal, among others, are done. Mothers are then given an opportunity to demonstrate to others what they have learnt. They are all learning from each other and from the health workers, it is participatory.

Ikito boasts of acquiring knowledge about good feeding practices and other practices like handwashing with soap and water before preparing food in the home, after using the toilet and using clean utensils from these educative sessions. “When I return home, I will construct a rack for drying the clean utensils. I have also learnt that I must feed my child at least four times a day with several types of foods like porridge, fruits, beans, greens and sometimes meat when I can afford. I will also teach my neighbours how to prepare nutritious meals for their children if they want them to be healthy.”

Francis Okumu, In-charge Palabek Health Centre, affirms that the EU supported programme has registered several achievements.

“Before the programme, assessment of the nutrition status of children visiting health facilities and community outreaches was never done and nutrition data for Lamwo District was never captured and reflected in the national health management information system but today, this is done and if we continue like this, the nutrition status of children in Lamwo will improve,” Okumu ends.