THE CHILD HEALTH PROGRAMS

( NEWBORNS,INFANTS AND CHILDREN)

Introduction:
Newborns,infants and children are vulnerable age group for common childhood
diseases.The risk of infection among children is higher when not screened for metabolic
disorder not exclusively breastfed,unvaccinated,not properly managed when sick,not given
with vitamin supplementation and many others.To address problems,child health programs
have been created and available in all health facilities which includes:

•Infant and Young Child Feeding

•Newborn screening
•Expanded Program on Immunization
•Management of Childhood Illnesses
•Micronutrient Supplementation
•Dental Health
•Early Child Development
•Child Health Injuries

Its main goal is to reduce morbidity and mortality rates for children 0-9 years with the
strategies necessary for program implementation.

The strategic thrusts for 2005-2010 are as follows:

● Develop local capacity to deliver the whole range of essential health packages for
children.Pursue the Sentrong Sigla initiative to ensure quality of health services at
the peripheral levels,and identify priority areas for health systems development.
● Implement programs and projects that favor disadvantaged populations.Tgese
programs should be able to address the needs of children with disabilities,children in
areas of armed conflict,street children,children among indigenous peoples,among
others.
● Apply the Reaching Every Barangay(REB) strategy for immunization to reach every
child.
● Intensity health education and information campaigns at the ground level to increase
the proportion of mothers (and caretakers) practicing behaviors that promote
children's health, such as breastfeeding, ensuring child's immunization,oral
rehydration for sick children, knowledge of danger signs of common childhood
diseases and control of child labor and other child abuse practices.
● Enhance medical,nursing and midwifery education with cost-effective life-saving
strategies such as the integrated Management of childhood illness and the Basic
Emergency Obstetric Care.
● Pursue the implementation of laws and policies for the protection of newborns,infants
and children such as Early Childhood Development Act of 2000,Newborn Screening
Act of 2004, Executive Order 51 also known as the Milk code,the Rooming-In and ,
Breastfeeding act,etc.
Infant and Young Child Feeding

● There is global evidence that good nutrition in the early months and years of life
plays a very significant role,affecting not only the health and survival of infants and
children but also their intellectual and social development,resulting in life-long impact
on school performance and overall productivity.Breastfeeding,especially exclusive
breastfeeding during the first half-year of life is an important factor that can prevent
infant and childhood morbidity and mortality.Timely,adequate,safe and proper
complementary feeding will prevent childhood malnutrition.

● Mothers and children form an inseparable biological and social unit.The health and
nutrition of mothers is important since intrauterine life effectively establishes the
potential for ultimate growth and development of the child.The state of maternal
nutrition during pre-pregnancy and pregnancy also affects the weight of the baby at
birth.Low birth weight newborns are at increased risk of infection,death and long-term
ill-health.

● To reverse the disturbing trends in infant and young child feeding practice,a Global
Strategy for Infant and Young Child Feeding(IYCF) was issued jointly by the World
Health Organization (WHO) and UNICEF in 2002,as endorsed by consensus in the
55th World Health Assembly in May 2002 and the UNICEF Executive Board in
September 2002.

● The strategy calls for the promotion of breastmilk as the ideal food for the healthy
growth and development of infants; and of exclusive breastfeeding for the first 6
months of life as the means to achieve optimal growth,development and health of
newborns.Thereafter,to meet their evolving nutritional requirements,infants should
receive nutritionally adequate and safe complementary foods while breastfeeding
continues for up to two years of age or beyond.Since breastfeeding is also a learned
behavior,all mothers need accurate information and skilled support and counseling
within their families,communities and health care's system to successfully breastfeed.

The overall objective is to improve the survival of infants and young children by improving
their nutritional status,growth and development through optimal feeding.

The National Plan of Action for 2005-2010 for infant and Young Child Feeding:

Goal
● Reduce Child Mortality Rate by 2/3 by 2015

Objective
● To improve the health and nutrition status of infants and young children.

Outcome
● To improve exclusive and extended breastfeeding and complementary feeding.
Specific Objectives
● 70% of newborns are initiated to breastfeeding within one hour after birth.
● 60% of infants are exclusively breastfed up tp 6 months.
● 90% of infants are started on complementary feeding by 6 months of age.
● Median duration of breastfeeding is 18 months.

Key Messages on Infant and Young Child Feeding

● Initiate breastfeeding within 1 hour after birth.
● Exclusive for the first 6 months of life.
● Only breastmilk and nothing else
● Complemented at 6 months with appropriate foods, excluding milk supplements
● Extend breastfeeding up to two years and beyond.

Definition of Exclusive Breastfeeding and Complementary Feeding

Exclusive breastfeeding means giving a baby only breast milk, and no other liquids or
solids, not even water. Drops or syrups consisting of vitamins, mineral supplements or
medicines are permitted.

Importance of breastfeeding
Exclusive breastfeeding of infants recommended for the first six months of their lives
and breastfeeding with complimentary foods thereafter. Breastfeeding has many
psychological benefits for children and mothers as well as economic benefits for families
and societies.

The benefits of Breastfeeding to Infants

● Provides nutritional complete food for the young infant.
● Strengthens the infants immune system, preventing many infections.
● Safely rehydrates and provides essential nutrients to a sick child, especially to
those suffering from diarrheal diseases.
● Reduces the infants exposure to infection
● Increase IQ points

To Mother
● Reduces woman’s risk of excessive blood loss after birth
● Provides natural methods of delaying pregnancies.
● Reduces the risk of ovarian and breast cancers and osteoporosis.

To Household and the Community

● Conserve funds that otherwise would be spent on breast milk substitute, supplies
and fuel to prepare them.
● Saves medical cost to families and government by preventing illnesses and by
providing immediate postpartum and contraception.

NATIONAL IYCF STRATEGY

Health facilities
● Mother -baby friendly hospitals
● Health Workers: advocates, protectors, promotes of IYCF
● Enforcers of laws, not violators.

Family/Community
● Supportive family
● Milk Code “vigilantes”
● IYCF “bayanihan” spirit
● Mother-baby friendly public places

Working Places
● Maternity leave
● Lactation/breastfeeding room
● Breastfeeding breaks

Industry
● Comply with the “code’
● Apply Codex Alimentarius standards

Schools
● Introducing the “breastfeeding culture”

Complementary Feeding
● After six months of age, all babies require other foods to complement breast milk- we
call these complementary foods. When complementary foods are introduced
breastfeeding should still continue for up to two years of age or beyond

Complementary foods should be:

● Timely - meaning that they are introduced when the need for energy and nutrients
exceeds what can be provided through exclusive and frequent breastfeeding.
● Adequate - meaning that they provide sufficient energy, protein and micronutrients to
meet a growing child's nutritional needs.
● Safe - meaning that they are hygienically stored and prepared and fed with clean
hands using clean utensils and not bottles and teats.
● Properly fed - meaning that they are given consistent with a child's signals of hunger
and that meal frequency and feeding methods are suitable for the child's age.

Low- birth weight babies

● The term low-birth weight (LBW) means a birth weight of less than 2,500 grams. This
includes babies who are born before term, and who are premature and babies who
are small for gestational age. Babies may be small for both these reasons. In many
countries 15.20% of all babies are low birth-weight. Low-birth weight babies are at
particular risk of infection, and they need breast milk more than larger babies.
 ● Many LBW babies can breastfeed without difficulty. Babies born at term, who are
small-for-dates, usually suckle effectively. They are often very hungry and need to
breastfeed more often than larger babies, so that their growth can catch up. Babies
who are born preterm may have difficulty suckling effectively at first. But they can be
fed on breast milk by tube or cup, and helped to establish full breastfeeding later.
Breastfeeding is easier for these babies than bottle feeding.

The fluid needs of the young child

● The baby who is exclusively breastfeeding receives all the quid he needs in the
breast milk. When other foods are added to the diet, the baby may need extra fluids.
Likewise, a baby who is under six months of age and only receiving replacement
milks does not need extra water. Extra fluid is needed if the child has a fever or
diarrhea.

Fluid Needs of the Young Child

● Water is good for thirst. A variety of pure juices can be used also. Too much fruit juice
may cause diarrhea and may reduce the child's appetite for foods.
● Drinks that contain a lot of sugar may actually make the child thirstier as their body
has to deal with the extra sugar. If packaged juice drinks are available in your area,
find out which ones are pure juices and which ones have added sugar. Fizzy drinks
(sodas) are not suitable for young children.
● Teas and coffee reduce the iron that is absorbed from foods. If they are given, they
should not be given at the same time as food or within two hours before or after food.
● Sometimes a child is thirsty during a meal. A small drink will satisfy the thirst and they
may then eat more of their meal.
● Drinks should not replace foods or breastfeeding. If a drink is given with a meal, give
only small amounts and leave most until the end of the meal. Drinks can fill up the
child's stomach so they do not have room for food.
● Remember that children who are not receiving breast milk need special attention and
special recommendations. A non-breastfed child aged 6-24 months of age needs
approximately 2-3 cups of water per day in a temperate climate and 4-6 cups of
water per day in a hot climate. This water can be incorporated into porridges or
stews, but clean water should also be offered to the child several times a day to
ensure that the infant's thirst is satisfied.

Feeding the Child who is Ill

● Encourage the child to drink and to eat with lots of patience
● Feed small amounts frequently
● Give foods that the child likes
● Give a variety of nutrient rich foods
● Continue to breastfeed - often ill children breastfeed more frequently

Feeding during recovery

The child's appetite may be poor during illness, Even with encouragement to eat, the child
may not eat well. The child's appetite usually increases after the illness so it is important to
continue to give extra attention to feeding after the illness. This is a good time for families to
give extra food so that lost weight is quickly regained. This allows 'catch - up’ growth. Young
children need extra food until they have regained all their lost weight and are growing at a
healthy rate.
● Give extra breastfeeds
● Feed an extra meal
● Give an extra amount
● Use extra rich foods
● Feed with extra patience

Breast milk and breastfeeding

● Breast Milk is the best food for the baby from birth up to 6 months.
○ It meets all the food and fluid needs of the baby from birth up to 6 months.
○ It protects the baby from disease and malnutrition,
● Give colostrum to the baby.
○ It prepares your baby's stomach to digest milk.
○ It contains many protective substances against infection.
○ It does not cause tummy ache or diarrhea.
● Do NOT give plain water, sugared water, chewed sticky rice, herbal preparations or
starve the baby while waiting for the milk to come in.
○ Giving feeds other than breast milk will deprive the baby of needed nutrients
and other protective substances from colostrums,
○ Water, chewed sticky rice or herbal preparations may be contaminated with
germs that may cause diarrhea.
○ Giving feeds other than breast milk after birth will deprive you of the crucial
time for immediate breastfeeding which will help to prevent breast problems.
● Give only breast milk and no other food or drink to your baby from birth up to 6
months
○ Breast milk will satisfy all the nutrient and fluid needs of your baby from birth
up to 6 months.
○ Giving other food and drinks may cause digestion problems and infection in
the baby and will decrease your milk production.
● Breastfeed as often as the baby wants, day and night.
○ Breastfeeding per baby's demand ensures that he/she gets sufficient
nutrients.
○ This is the best stimulus for continued milk production.
● Use both breasts alternately at each feeding
○ This will prevent engorgement and infection.
● After one breast is emptied, offer first the breast that has not been emptied in the
next feeding.

Key message on feeding babies over six months old

1. Breastfeeding for two years or longer helps a child to develop and grow strong and
healthy,
2. Starting other foods in addition to breastmilk at 6 complemented month helps a child
to grow well.
3. Foods that are thick enough to stay in the spoon give more energy to the child.
4. Animal-source foods are especially good for children to help them grow strong and
lively.
 5. Peas, beans, lentils, nuts and seeds are also good for children.
6. Dark green leaves and yellow-coloured fruits and vegetables help a child to have
healthy eyes and fewer infections.
7. A growing child needs three meals plus snacks: give a variety of foods.
8. A growing child needs increasing amounts of food.
9. A growing child needs to learn to eat, encourage and give help... with lots of
patience.
10. Encourage children to drink and eat during illness and provide extra food after illness
to help them recover quickly.

Laws That Protects Infant and Young Child Feeding

1. Milk Code (EO 51) - Products covered by Milk Code consist of breastmilk substitutes,
including infant formula; other milk products, foods and beverages, including bottle
fed complementary foods
2. The Rooming- in and Breastfeeding Act of 1992 requires both public and private
health institutions to promote rooming-in and to encourage, protect, and support the
practice of breastfeeding. It targets the creation of "an environment where basic
physical, emotional and psychological needs of mothers and infants are fulfilled
through the practice of rooming-in and breastfeeding. The law also requires
institutions adopting rooming -in to provide a human milk bank to ensure collection,
storage and utilization of breastmilk.
3. Food Fortification Law or An Act Establishing the Philippine Food Fortification
Program and for Other Purposes-Food Fortification Law (Republic Act 8976) passed
by Congress in 2000 declares as a policy that food fortification is vital in the
promotion of optimal health and to compensate for the loss of nutrients due to
processing and / or storage of food.

Food fortification shall be carried out to compensate for the inadequacies in the Filipino diet,
based on present needs as measured using the most recent Recommended Dietary
Allowance. The law requires a mandatory food fortification of staple foods - rice, flour, edible
oil and sugar and a voluntary food fortification of processed food or food products. The law is
applicable to all manufactures, or producers, importers, traders, tollees, retailers, repackers,
of food products as well as restaurants and food service establishments where such fortified
foods are encouraged to be served.