Week 1 : Lecture 3 : MIYCF framework

Week 1 : Lecture 3 : MIYCF framework - Summary Notes

1. Summary:

The video discusses the Maternal Infant and Young Child Feeding (MIYCF) framework developed by the speaker at an NGO. The framework focuses on improving infant and young child nutrition, primarily by emphasizing effective breastfeeding techniques, proper nutrition for pregnant and lactating mothers, and providing guidance on complementary feeding. The lecture highlights the importance of a holistic approach, including the training of healthcare workers, home visits, and the use of electronic data monitoring to track progress and address issues at their root cause. The framework had led to substantial improvements in child health outcomes, including reductions in stunting, wasting, and underweight rates.

2. Key Takeaways:

* **Importance of Effective Breastfeeding:** The primary focus is on effective breastfeeding, not just timely initiation. Emphasis on proper latching, and mother's posture for maximum milk transfer.

* **45 Counseling Points:** A detailed 45-point counseling protocol was developed, covering breastfeeding techniques, maternal nutrition, and problem-solving.

* **Cross Cradle Hold:** This breastfeeding position was emphasized to address common latching issues.

* **Comprehensive Assessment:** The use of a modified WHO assessment tool to evaluate breastfeeding techniques and identify problems.

* **Maternal and Child Health:** The need to address maternal nutrition, offer developmental classes to the mothers and provide support for the baby.

* **Importance of Complementary Feeding:** Emphasizes the timing, and quality of complementary food.

* **Junk Food Awareness:** Awareness about avoiding junk food

* **Home Visits and Environment:** Importance of assessing the home environment and providing guidance on hygiene, diet, and feeding practices.

* **Electronic Data Monitoring:** The benefits of electronic data monitoring for tracking growth and evaluating program effectiveness.

3. Detailed Notes:

**I. Introduction (0:00:00 - 0:00:15)**

* Lecture overview.

**II. Background and Framework Development (0:00:16 - 0:01:11)**

* Discussing a framework developed at an NGO for MIYCF practices.

* Framework aimed to create a protocol to improve breastfeeding and complementary feeding.

* Framework development took 6-7 years of learning in the field.

* The NGO saw reductions in wasting, underweight, and stunting.

**III. Breastfeeding Focus (0:01:33 - 0:04:46)**

* Emphasis on breastfeeding techniques.

* Initial challenges and data-driven improvements.

* 45 Counseling points developed for breastfeeding.

* Focus on proper latching and techniques.

* Importance of training pregnant mothers on breastfeeding techniques before delivery.

**IV. Counseling and Training Approaches (0:04:46 - 0:06:19)**

* Teaching pregnant mothers the 45 points of counseling, including how to use the cross cradle hold.

* Training of healthcare workers, medical officers, ANMs, and ASHAs on breastfeeding techniques.

* Empowering mothers with knowledge and skills.

* Emphasis on proper feeding techniques.

**V. The Approach for Better Outcomes (0:06:20 - 0:07:31)**

* The NGO offered both nutrition and breastfeeding counseling for pregnant and lactating mothers.

* Early intervention with pregnant mothers, starting from the first trimester.

* Importance of addressing maternal nutrition to improve birth weight and overall child health.

* Offering classes regarding nutrition counseling, breastfeeding counseling and general issues

**VI. Growth Monitoring (0:07:38 - 0:08:11)**

* Importance of growth monitoring in the program.

* Involving social workers in height and weight measurements.

* Program for lactating mothers including nutrition and breastfeeding

* Follow up was decided upon depending upon weight gain

**VII. Assessment and Analysis (0:08:11 - 0:08:57)**

* The importance of assessing the latch and other parameters in the program.

* The NGO had come up with the 45 points for counseling the mothers.

**VIII. Importance of Effective Breastfeeding (0:08:57 - 0:10:56)**

* The 45 points of counseling includes mother's preparation, the way the baby is to be held and baby's position.

* Electronic tools are used to monitor the baby.

* Key points for effective breastfeeding.

* A study showed that, even in the institutes with lactation consultant, a lot of mother's had many issues.

* The use of traditional holds in a lot of cases

**IX. Data From a Developed World (0:10:56 - 0:15:42)**

* A study on breastfeeding concerns in a hospital in the US, and the need to focus on the effectiveness of breastfeeding techniques.

* The 52 mothers feeling as if they were not feeding well and other 40 mothers had pain

* 40 mothers had perceived that there was not enough milk produced

**X. The importance of Growth Monitoring(0:15:42 - 0:17:59)**

* Importance of growth monitoring and protocol for follow-up visits.

* Regular clinic visits for weighing and assessing babies.

* Frequency of visits determined by weight gain.

* The importance of the child's weight and measuring length

**XI. Importance of Length Checking (0:17:59 - 0:23:03)**

* Emphasis on accurate length measurement.

* Challenges in training healthcare workers on length checking.

* Protocol for length measurement with two healthcare workers to ensure accuracy.

* The implications of inaccurate length measurements on the growth chart.

**XII. Complementary Feeding (0:23:03 - 0:25:38)**

* Improved breastfeeding leads to healthy babies with good appetites.

* Benefits of good growth in the first 6 months for the development of complementary feeding.

* Emphasis on the type 2 nutrient rich foods and their recipes

* Prevent the children from going to type 2 nutrition deficiency

* Show them all the ingredients and their nutrients

**XIII. Cooking Demos, and Addressing Junk Food (0:25:38 - 0:29:45)**

* Cooking demonstrations to teach mothers how to prepare nutritious, affordable foods, using locally available ingredients.

* Junk food awareness programs and the problem with babies being given biscuits at an early age.

* Examples of recipes and how to feed properly

**XIV. Home Visits (0:29:45 - 0:35:55)**

* Home visits as an essential component of the program.

* Assess the environment around the baby.

* Seeing the mother burping the baby

* Assessing how the mother made the baby sit.

* The importance of the environment to avoid issues of diarrhea.

* The use of breastfeeding dolls during home visits to demonstrate proper techniques.

* What were the 30, 40 things, they were looking for

* Analyzing what the mothers are doing at home

**XV. Electronic Data and the MIYCF Framework (0:35:55 - 0:39:21)**

* Transition to electronic data monitoring for better analysis.

* The benefits of electronic data for mother's

* Show them, the result, with the growth chart

* The use of the growth chart

* Tell her what the expected weight gain is.

**XVI. Program Implementation (0:39:21 - 0:43:58)**

* The importance of showing how the child is growing

* The myths about the chart

* Emphasis on the root cause

* A point of contact for the medical officer

**XVII. Program Implementation (0:43:58 - 0:45:39)**

* Focus on having a point of contact for the pediatricians

* The role of the ASHA and how to address the problem in labor room

* The use of PNC award is absolutely important.

* Importance of breastfeeding skill

* Importance of nutrition skills

* The continuation of breastfeeding

**XVIII. Conclusion (0:45:39 - 0:46:03)**

* Summarizing the key components of the framework.

* Replicating this model for positive results.