Early initiation of breastfeeding; immediately after birth, preferably within one hour
Exclusive breastfeeding for the first six months of life - give only breast milk; not even water should be added
Timely introduction of complementary food beyond six months along with continued breastfeeding
Feeding during the illness: Give as much as the child will take; do not reduce the quantity of food. After the illness, to catch up with growth, add an extra-feed. Recurrent illness is a major cause of malnutrition.
Five Things to Remember about Complementary Feeding
1. Consistency: Initially the food has to be soft and mashed. But later, anything that adults eat can be given to the child, with less spices. Do not dilute food. Keep it as thick as possible, for e.g. ‘give daal not daal ka pani’.
2. Quantity: Gradually increase the amount of such foods.
3. Frequency: The amount of complementary foods given should be equal to about half what the adult needs in terms of nutrients. But since the child’s stomach is small, this amount has to be distributed into four to five, even six feeds per day.
4. Density: The food also has to be energy dense, low in volume, high in energy, therefore, add some oil or fats to the food. Family could add a spoon of it to every roti/every meal. Whatever edible oil is available in the house is sufficient.
5. Variety: Add protective foods – green leafy vegetables. The rule is that the greener it is, or the more red it is the more its protective quality. Similarly meat, eggs, fish are very nutritive and protective.
References:
• Proceedings of the World Health Organization/ UNICEF/World Food Programme/United Nations High Commissioner for Refugees Consultation on the Management of Moderate Malnutrition in Children under 5 Years of Age. Food and Nutrition Bulletin, vol. 30, no. 3 © 2009 (supplement), The United Nations University
• GUIDING PRINCIPLES FOR COMPLEMENTARY FEEDING OF THE BREASTFED CHILD . PAN AMERICAN HEALTH ORGANIZATION WORLD HEALTH ORGANIZATION
• GOI, IYCF guidelines
For Lecture in Hindi on dietary counseling for Moderately Malnourished child: http://www.ihatepsm.com/resource/dietary-counselling-guide-health-worker...
Terms used in Family Health Study: Definitions and Explanations: http://www.ihatepsm.com/blog/terms-used-family-health-study-definitions-...