Madhya Pradesh World Breast Feeding Week -2009

NORWAY INDIA PARTNERSHIP INITIATIVE (NIPI)

World Breastfeeding Week 2009 1-7 August 2009 In

NIPI FOCUS DISTRICT’s Hoshangabad, Raisen, Narsinghpur.

Under NIPI Assisted Programs

Submitted To:- Mission Director,

Madhya Pradesh.

Dr Rajan Dubey Senior Program Officer, (M.P) Dr Rajan Dubey

District Level Workshop on Exclusive Breastfeeding (EBF) 1.1 • • • • • • • • • •

Objectives of the Workshop To reorient the mothers about the exclusive breastfeeding. To change the myths and misconception of mothers on breastfeeding for the infants. To aware the mothers of infants for exclusive breastfeeding up to 6 months. Onsite technical correction for proper positioning of breastfeeding. To provide counselling on the optimal duration of exclusive breastfeeding; To ensure the practice on the optimal duration of exclusive breastfeeding; Demonstrate proper positioning of BF through toy models. To satisfy the queries of participants on BF. To introduce flipchart on BF for the service providers. To disseminate calendars to the mothers about good infant care.

The Agenda and the list of Participants are presented as Annexes 1.

Exclusive Breastfeeding. Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers. A recent review of evidence has shown that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants. Thereafter infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond. To enable mothers to establish and sustain exclusive breastfeeding for 6 months, NIPI recommend: Initiation of breastfeeding within the first hour of life. -The infant only receives breast milk without any additional food or drink, not even water -Breastfeeding on demand – that is as often as the child wants, day and night -No use of bottles, teats or pacifiers. Breast milk is the natural first food for babies, it provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life.

Breast milk promotes sensory and cognitive development, and protects the infant against infectious and chronic diseases. Exclusive breastfeeding reduces infant mortality due to common childhood illnesses such as diarrhoea or pneumonia, and helps for a quicker recovery during illness. These effects can be measured in resource-poor and affluent societies (Kramer M et al Promotion of Breastfeeding Intervention Trial (PROBIT): A randomized trial in the Republic of Belarus. Journal of the American Medical Association, 2001, 285 (4): 413- 420). Breastfeeding contributes to the health and well-being of mothers; it helps to space children, reduces the risk of ovarian cancer and breast cancer, increases family and national resources, is a secure way of feeding and is safe for the environment. Dr Rajan Dubey

While breastfeeding is a natural act, it is also a learned behaviour. An extensive body of research has demonstrated that mothers and other caregivers require active support for establishing and sustaining appropriate breastfeeding practices.

World Breastfeeding Week - In Hoshangabad District In Hoshangabad District the Yashoda Team celebrated World Breastfeeding Week with lactating mothers as well as the medical professionals. The workshop on exclusive breastfeeding was conducted in district hospital (near maternity ward).

“ In Madhya Pradesh the IMR is higher in comparison to the other states; we have to take steps to aware public about the Exclusive Breastfeeding and help to improve the status of Health Indicators”, said Dr S Gangrade, Civil Surgeon, while addressing the workshop. He further claimed that effective counselling and proper implementation of govt schemes can change the scenario in the state. “Infants who are deprived of colostrums become easy victims of infection and others complications”, said Dr Jiterndra Khare, Child Specialist, and Hoshangabad. Mrs Yaogita Gambhir, Child Health Supervisor, Yashoda Program, Hoshangabad, also addressed the workshop to the mothers about the benefits of exclusive breastfeeding and early breastfeeding. She also discuss on the general query and myths of mothers on breastfeeding. The Deputy Child Health Supervisor (DCHS) Mrs D Masih, also discuss about technical positioning during breastfeeding. She discuss on general mistakes done by mother while doing breastfeeding. She demonstrated the positioning of mother on toy model on breastfeeding. Yashoda Play the role and demonstrate the positioning on breastfeeding on toy model.

Dr Rajan Dubey

Hoshangabad

Reported data of World Breastfeeding Week of Hoshangabad District Hospital (NIPI Focus District).

World Breastfeeding Week - In Narsinghpur District In Narsinghpur District Mrs Rajana Ananad and Mrs Tripati Dubey, Deputy Child Health Supervisor (DCHS), of Yashoda Program of NIPI, celebrated World Breastfeeding Week with lactating mothers as well as the medical professionals. Address the workshop to the mothers about the benefits of exclusive breastfeeding and early breastfeeding. She also discuss on the general query and myths of mothers on breastfeeding, also discuss about correct positioning of child and mother during breastfeeding. She discussed about benefits of breastfeeding. Yashoda also demonstrated the positioning of mother on toy model on breastfeeding.

Reported data of World Breastfeeding Week of Narsinghpur District Hospital (NIPI Focus District)

World Breastfeeding Week - In Raisen District In Raisen District Dr Chobey, Cheif Medical and Health Officers, addressed the objective of the workshop, Ms Sunita Chobey, Child Health Supervisor (CHS), of Yashoda Program of NIPI, celebrates World Breastfeeding Week by with lactating mothers as well as the medical professionals. Dr Abha Jasani, Gynaecologist and Dr Gurwinder, Child Specialist, address the workshop to the mothers about the benefits of exclusive breastfeeding and early breastfeeding. Child Health Supervisor (CHS) also discuss on the general query and myths of mothers on breastfeeding, also discuss about benefits of breastfeeding. She discuss on Dr Rajan Dubey

general mistakes done by mother while doing breastfeeding. positioning of mother on toy model on breastfeeding.

Yashoda demonstrated the

Reported data of World Breastfeeding Week of Raisen District Hospital (NIPI Focus District)

Activities undertaken during World Breastfeeding Week Media Wise Print Media

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a) Flip Chart - Yashoda Flip Chart is provided to Yashoda :- which she uses for counselling the mother about breastfeeding.

b) Calendars - Yashoda are provided by NIPI; yearly calendars to be given to mothers in order to help the mother to remember the immunization day of their child and Infants care.

c) Guideline Publications - Yashoda during their training are revised with the guideline and updating about Child Care.

d) Printed Information (flyers). Inter Personal Communication (IPC). a) Workshop b) Counselling c) Toy Model Demonstration d) Training about proper positioning Electronic Media All Yashoda attended the Sat-Com training provided by the State Officers.

Dr Rajan Dubey

a) Awareness about World Breastfeeding Week on NIPI MP Site http://www.mpnipi.webs.com.

b) Blogs on the NIPI site were started to discuss any query, suggestion, solution and views.

Traditional Media a) Role plays were performed by YASHODA’s for early initiation and on Exclusive Breastfeeding

Dr Rajan Dubey

Analysis Report on Exclusive Breastfeeding in NIPI Focus District at the District Hospital Fact Sheet of DLHS_3 Data on Child Feeding Practices of Hoshangabad

In which indicators has been taken about child feeding practice , The Child Breastfeeding within One Hour of Birth is only 47.0 in the rural, and the exclusive breastfed (EB) is only 30.6. AIM of the district is to make sure that the above indicator can be >90% achieved if the mothers are properly counselled about early initiation of breastfeeding and at continue exclusive breastfeeding till the age of 6 months. The Norway India Partnership Initiative (NIPI) under NIPI assisted Yashoda Program has taken initiative on this health indicator child feeding practices in which all the mothers are now properly counselled and after delivery >90% babies are breastfed within one hour. Special emphasis is now placed on speaking to attendants of the mother coming to the institution. Being the social decision maker of the house mother in law is considered to be a key player in this behaviour change and child care, Hoshangabad:

Dr Rajan Dubey

Fact Sheet of DLHS_3 Data on Child Feeding Practices of Narsinghpur

The Child Breastfeeding within One Hour of Birth is only 36.5 in the rural, and the exclusive breastfed (EB) is only 23.2. Narsinghpur Breast Feeding Week report:

Dr Rajan Dubey

The photographs of celebrating World Breastfeeding Week in Narsinghpur, by Yashoda

Fact Sheet of DLHS_3 Data on Breast feed of Raisen:

The Child Breastfeeding within One Hour of Birth is only 47.6 in the rural, and the exclusive breastfed (EB) is only 37.8. Raisen Breast Feeding Week report:

The photographs of celebrating World Breastfeeding Week in Raisen, by Yashoda.

Dr Rajan Dubey

FACTORS AFFECTING BREASTFEEDINGING PRACTICES The basic problem identified for the Breastfeeding while counselling the mother.

1) The myths and misconception of family on breastfeeding for the infants. 2) The Traditional systems followed by Older women of the house 3) Low level of awareness among family for colostrum feeding and Exclusive Breastfeeding 4) The Mother after the labour pain is not mentally prepared for breastfeeding within one hour of the delivery. 5) Low intensity I.P.C. for this cause by ASHA, AWW. 6) Poor PNC follow-ups resulting in drop-outs in Exclusive Breastfeeding. 7) Young mothers and ill mothers need support for child care, lack of rest and non availability of food results in low milk production. 8) Commercial organizations exploiting the consumers to sell baby food products through medical professionals advice.

Dr Rajan Dubey

Summary of the findings The below graphs is plot between the Live Birth Vs Total number of infant’s breastfed within one hour in which we find the Live Birth = Total number of infant’s breastfed within one hour

Dr Rajan Dubey