Week 1 : Lecture 3 : MIYCF framework

NPTEL IIT Bombay - Week 1: Lecture 3: MIYCF framework - Notes

1. Summary:

The video discusses a Maternal Infant and Young Child Feeding (MIYCF) framework developed and implemented by the speaker and their team at an NGO. The framework focuses on improving breastfeeding practices and complementary feeding to address malnutrition in children. The lecture emphasizes the importance of early initiation of breastfeeding, proper techniques (specifically the cross-cradle hold), comprehensive counseling, and growth monitoring, with an emphasis on the importance of also including the mothers’ nutrition. The speaker highlights how the framework helped to improve various anthropometric measurements such as weight, height and length in children.

2. Key Takeaways:

* **Importance of Breastfeeding**: Focus on exclusive breastfeeding for the first six months and effective breastfeeding techniques.

* **Cross Cradle Hold**: This hold proved effective in improving latch and weight gain.

* **45 Counseling Points**: A comprehensive set of guidelines for mothers.

* **Emphasis on Growth Monitoring**: The importance of assessing and monitoring baby's growth.

* **Junk food awareness**: A vital aspect of the program and preventing health problems.

* **Mothers' education**: This is extremely important in building mothers capacity to meet nutritional requirements of their children.

* **Early assessment**: Early assessment and support for mothers during pregnancy and post-delivery in hospitals and clinics.

3. Detailed Notes:

**I. Introduction and Background (0:00:16 - 0:00:49):**

* Lecture focuses on the MIYCF framework.

* Framework developed by the speaker at an NGO.

* The framework took 6-7 years to develop.

* Framework aims to address malnutrition through improved breastfeeding and complementary feeding.

**II. Previous Knowledge and Data Analysis (0:00:49 - 0:01:33):**

* The speaker previously discussed data on exclusive breastfeeding and complementary feeding, and growth charts.

* The presentation will show a reduction in wasting, underweight, and stunting from the NGO program.

**III. Focus on Breastfeeding (0:01:33 - 0:03:11):**

* Early focus on breastfeeding.

* Speaker struggled with results initially, with children not gaining weight as expected.

* Experience from U.S. and comparison with slums, where formula use is not an option.

* Emphasis on exclusive breastfeeding.

* Figured out that most cases are not gaining weight.

**IV. The 45 Counseling Points and Cross Cradle Hold (0:03:11 - 0:04:31):**

* 45 counseling points developed.

* Cross cradle hold proved effective.

* The importance of training pregnant mothers in cross cradle hold before delivery.

* Training of pregnant mothers during antenatal care.

**V. Practical Application (0:04:31 - 0:06:15):**

* Importance of teaching and empowering pregnant mothers.

* Results: Timely breastfeeding, weight gain.

* Empowering mothers with knowledge to make informed decisions.

**VI. Complementary Feeding (0:06:15 - 0:07:41):**

* Emphasis on mothers' nutrition during pregnancy and lactation.

* Early involvement and education of pregnant mothers.

* Focus on low birth weight.

* Monthly or bi-weekly sessions with mothers.

* Focus on nutrition, recognizing red flags during pregnancy and understanding pregnancy-related issues.

**VII. Breastfeeding Techniques and Support (0:07:41 - 0:09:58):**

* Focus on cross cradle hold, opposite of the traditional method.

* Medical officers teaching techniques through home visits.

* Babies opening their mouth wide.

* U-shaped hold of the breast, different from traditional c-shape.

* Importance of the 45 counseling points.

**VIII. Resources and Standardization (0:09:58 - 0:10:29):**

* Creating concise documents.

* Brochures and wall hangings in multiple languages for use by NGOs.

* The availability of this in a local language.

**IX. Breastfeeding Assessment (0:10:29 - 0:11:00):**

* Importance of assessing breastfeeding.

* Modified assessment tool, based on WHO.

* Modification of WHO assessment tool.

**X. Effective Breastfeeding and Its Impact (0:11:00 - 0:14:18):**

* The importance of effective breastfeeding, not just timely initiation and exclusivity.

* Understanding why mothers might choose top feeds.

* Understanding the cause of SAM and Stunting.

* Study at UC Davis.

**XI. Growth Monitoring (0:16:57 - 0:17:31):**

* Importance of growth monitoring for the program.

* Social workers taking height and weight.

* The program for lactating mothers.

* Clinic for young children, pregnant and lactating mothers.

**XII. The Importance of a Good Scale (0:19:50 - 0:20:06):**

* Emphasis on the importance of the weighing scale

* Use of Seca weighing scales.

**XIII. Length Checking Protocols (0:20:56 - 0:22:57):**

* Difficulty in training on checking length.

* Role reversal in teams.

* Protocols for accuracy in length measurement.

* Importance of this.

**XIV. Complementary Feeding and Strong Foundation (0:22:58 - 0:24:08):**

* Babies becoming big and tall.

* Good appetite and food uptake.

* Strong foundation in first 6 months for effective complementary feeding.

**XV. Type 2 Nutrients and Recipes (0:25:57 - 0:26:10):**

* Importance of well growing kids.

* The example in the region of Annaprasham.

* The use of different and diverse food.

**XVI. Cookery Demo (0:29:37 - 0:31:05):**

* Making recipes from the locally available food.

**XVII. Junk Food Awareness (0:31:05 - 0:31:58):**

* Junk food awareness and providing nutritional food.

**XVIII. Home Visits and Environment (0:31:58 - 0:36:32):**

* Home visits as an integral part of the program.

* The importance of checking environmental factors during home visits.

* Assessment of the household and the cleanliness of the water and food storage.

**XIX. The Role of Data and EMR (0:36:32 - 0:38:32):**

* Benefits of electronic medical records and streamlining the process.

* The value of data collection, monitoring, and evaluation.

* Software made the growth charting efficient.

**XX. Key Contact Points for MIYCN (0:39:21 - 0:44:19):**

* The importance of plotting the growth charts.

* Showing expected weight gain to mothers.

* Emphasizing the root cause of malnutrition.

* Key opportunities to discuss MIYCN at different stages: ANC, labor, PNC, immunization, and OPDs.