This is the process of providing nutritional education and support to caregiver on gradual introduction of new foods; alongside breastfeeding after age 6 months until the child becomes accustomed to new foods/the usual family diet to promote growth and development.
Aims
· Promote child growth and development
· Establish wellness
· Detect and manage nutritional deficiencies
· Prevent nutrition-related complications
· Facilitate referral
Requirements
· Pen
· Paper/electronic health chart
· Food guide/Pyramid
· Measuring tape
· Stadiometer/height measure/Infantometer
· Weighing scale (Age appropriate)
· MUAC Tape
· Growth chart (child health record)
· Flip chart
· Food samples
· Audio visual materials (Age appropriate)
Steps
1. Receive child/caregiver into a comfortable seat
2. Perform five (5) moments of hand hygiene as and when necessary
3. Introduce self to child/caregiver
4. Establish rapport (refer steps)
5. Explain procedure to child/caregiver (refer steps)
6. Incorporate developmentally appropriate strategies in dealing with the child
7. Provide privacy
8. Explain to caregiver that complimentary feeding starts from six months and continues up to two years of child’s age
9. Ask child/caregiver about nutritional allergies and intervene as necessary
10. Support caregiver to understand that complimentary feeding is a continuation of breastfeeding alongside introduction of liquid to semi-solid food
11. Use the child growth record chart to determine the rate and pattern of growth and development of the child for appropriate intervention
12. Perform Anthropometric measurement/assessment (include weight, height, head circumference and MUAC)
13. Evaluate breastfeeding practices and intervene appropriately
14. Educate on the benefits of breastfeeding to child and mother up to 2 years of child’s life
15. Improve caregiver’s knowledge about nutrition and effective food supplementation of iron, iodine and vitamin A to reduce the risk of malnutrition and related illnesses
16. Incorporate the AFASS (Acceptable, Feasible, Affordable, Sustainable and Safety) principles in the counselling using audio-visual materials
17. Educate caregiver to breastfeed child on demand throughout day and night alongside the following complementary feeding schedule;
· 6 months: at least twice a day
· 6 - 9 months: at least three times a day
· 9-12 months: 4 - 5 times
· 1-2 years : at least 5 times a day
18. Encourage caregiver to ask questions and provide appropriate responses (ask about food allergies for child/lactating mother)
19. Use visuals aids/audio-visual materials and demonstration to discuss the incorporation of the age appropriate four-star diet
· Animal protein (eg. meat, chicken, fish, liver, eggs, and milk products)
· Legumes and seeds (eg. beans, groundnut, lentils
· vitamin A-rich fruits and vegetables (pawpaw, mangoes and dark green leaves)
· Staple foods (e.g. grains such as maize, wheat, sorghum, millet; and tubers such as yam, sweet potatoes and cocoyam)
20. Discuss weanimix preparation and proportions needed for mixing child’s meals (e.g. double mix, triple mix, quadri-mix, etc.)
21. Educate on food amounts for safe cooking time, food preservation and storage to maintain nutritional value
22. Assess for mal-distribution of food at home and other negative cultural and religious practices/beliefs that affect child feeding and counsel appropriately
23. Express appreciation to child/caregiver for their cooperation
24. Encourage follow up/refer if necessary/home visits as appropriate
25. Document procedure
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