Cover Image
close this book Community Nutrition Action for Child Survival
View the document Table of contents
View the document Introduction
View the document How to use community nutrition action for child survival
close this folder Part I - Community nutrition problems and interventions
close this folder Unit 1 - The nutrition of women and children
View the document Session 1: What is malnutrition?
View the document Session 2: Focus on the nutrition of women and children
View the document Session 2: Focus on women and children
View the document Session 3: Important causes of malnutrition in women and children
View the document Session 4: Community nutrition action for child survival
close this folder Unit 2: Measuring and monitoring growth in young children
View the document Session 1: Measuring growth
View the document Session 2: Arm circumference
View the document Session 3: The road to health chart
View the document Session 4: The thinness chart
View the document Session 6: Counseling, referral and follow-up of malnourished children
close this folder Unit 3: PROMOTING BREASTFEEDING
View the document Session 1: The importance of breastfeeding
View the document Session 2: Helping mothers breastfeed
View the document Session 3: Breastfeeding information for Kenyans
close this folder Unit 4: Introducing weaning practices in the community
View the document Session 1: Changing weaning practices
View the document Session 2: Making improved meaning foods in the home
View the document Session 3: Weaning food practice
View the document Session 4: Case study: Village weaning food projects in Thailand
View the document Session 5: Weaning foods - Village production techniques
close this folder Unit 5: Preventing diarrhea
View the document Session 1: Preventing diarrhea*
View the document Session 2: Diarrhea home management
View the document Session 3: Community activities to prevent diarrhea*
close this folder Unit 6: Immunization
View the document Session: Improving immunization coverage - The community's role
close this folder Unit 7: Family planning and nutrition
View the document Session 1: Family planning and nutrition
View the document Session 2: Providing the facts about family planning
View the document Session 3: Community-based distribution of family planning methods
close this folder Part II - Planning nutrition action projects
close this folder Unit 1: Working with the community to improve nutrition
View the document Session: Simulation exercise
close this folder Unit 2: Finding the causes of malnutrition
View the document Session 1: Conducting a community nutrition mini-survey
View the document Session 2: Analyzing community nutrition information
close this folder Unit 3: Deciding what to do
View the document Session 1: Visits to on-going nutrition projects
View the document Session 2: Case studies/panel discussion
close this folder Unit 4: Planning nutrition action projects
View the document Session 1: Describing the problem
View the document Session 2: Writing project goals and objectives
View the document Session 3: Choosing project activities
View the document Session 4: Developing a project work plan
View the document Session 5: Planning how to evaluate
View the document Session 6: Preparing a budget
close this folder Unit 5 - Session: Writing a project proposal/Mini-Workshop
View the document Session: Writing a project proposal Mini-Workshop
close this folder Part III - Project management systems
close this folder Unit 1: Training community nutrition workers
View the document Session 1: Introduction
View the document Session 2: Assessing training needs/writing objectives
View the document Session 3: Choosing training methods
View the document Session 4: Scheduling training content
close this folder Unit 2: Evaluating progress
View the document Session 1: What do he need to know? How can we find out?
View the document Session 2: Records and reports
View the document Session 3: A prototype record keeping system
View the document Session 4: Evaluating activities with the community
close this folder Unit 3 - Supervising community nutrition activities
View the document Session 1: The role of the supervisor
View the document Session 2: Identifying and solving problems
View the document Session 3: Problem-solving/role play
View the document Session 4: Planning and conducting supervision visits

Session 2: Focus on the nutrition of women and children

Purpose:

To describe critical events during pregnancy, breastfeeding and weaning that place women and children at high risk of malnutrition. To illustrate the relationship between malnutrition, infection and child spacing.

Time: 1-2 hours

Materials:

- Newsprint and marking pens or chalkboard and chalk

- Wall chart - "Stages of Fetal and Infant Growth"

- Handout - "Stages of Fetal and Infant Growth"

- Handout - "Focus on Women and Children"

Steps:

1. Ask trainees: " Who suffers most from malnutrition?" List their answers on the flipchart. Then explain that poor women and children under three years suffer most from malnutrition in both normal and disaster situations because of their special nutritional needs and susceptibility to diseases that can lead to malnutrition.

2. Display the chart - "Stages of Fetal and Infant Growth." Review the characteristics of pregnancy, early infancy and weaning in terms of the nutritional requirements and common illnesses and problems at each stage.

Use the table on the next page to prepare your presentation.

HANDOUT

STAGES OF FETAL AND INFANT GROWTH

Stage

Nutritional Requirements

Common Symptoms

Pregnancy

- 350 extra calories per day or about ½ extra plate of food each day*
- green leafy vegetables and meat to prevent anemia
- weight gain of at least 12.5 kg

- anemia
- inadequate weight gain
- low birth weight(<2500 grams)
- premature delivery
- maternal depletion

Breastfeeding
(0-6 months)

Mother:
- 550 extra calories per day or about one extra plate of food each day
extra liquids for the breastfeeding mother
Child
:
breastfeeding should begin immediately after birth (give colostrum)
- breastfeeding should be on demand
- breastfeeding for 4-5 months without supplements

- early introduction of foods other than breast milk leading to diarrhea and decreased production of breast milk
- early termination of
- use of feeding bottles leading to diarrhea and other infections

Weaning/ Breastfeeding
(6 months -2 years)

- begin giving semi- solid food by 6 months
- give 4-6 small meals per day from 6 months to 2 years
- continue breastfeeding
- high energy/mixed diet

- inadequate weight gain
- diarrhea
- measles
- other infections

* Calculation of additional caloric requirements are for a woman weighing 50 kg. Normal daily requirement is 2,000 calories; in pregnancy, calorie requirement increases to 2,350 calories; during the first six months of breastfeeding, it increases to 2,550 calories per day. Calculations for extra plates of food are based on the assumption that women eat three meals per day, under normal circumstances.

During the presentation, encourage trainees' participation in the following ways:

3. Emphasize the importance of a woman's health and nutrition to the health and survival of her child. Ask trainees to tell the group about cases of women they know who have been sick during pregnancy and how this affected the child.

4. Ask trainees: "What happens when an infant is not breastfed during the first year of life? Why do women stop breastfeeding?" Emphasize the role of maternal nutrition in successful breastfeeding. (This topic will be discussed in greater detail in a later session.)

5. Discuss the incidence and the effects of illness, especially diarrhea and measles, during the weaning period. Trainees should understand the need to deal with both illness and feeding habits to improve the nutrition of women and children.

6. Draw the chart below - Effects of Birth Spacing on Child Survival. Ask trainees to brainstorm reasons why large, poorly spaced families are more likely than smaller families to have malnourished children and children who die.


Effects of Birth Spacing on Child Survival

7. To summarize this session, divide trainees into small groups (four-five persons) and ask the groups to agree on one important rule to improve nutrition for each of the topics discussed during this session:

- Pregnancy

- Breastfeeding

- Weaning

- Illness

- Birth Spacing

Each rule should improve some aspect of the nutrition status of women and/or children.

8. When groups finish, ask them to present their rules for improved nutrition. Rules might look like this:

- Eat one extra plate of food every day during pregnancy.

- Begin breastfeeding immediately after birth.

- Do not give foods besides breast milk to infants under four months.

- Breastfeed to prevent diarrhea.

- Allow at least three years between the births of your children.

9. Close the session and bridge to the next:

"In this session, we reviewed the reasons for increased risk of malnutrition during pregnancy, early infancy and wearing. As managers, we are concerned with using our limited resources to produce the best results possible. In order to do that, we must decide who needs our help the most and who will benefit the most from it. In nutrition and health care, we emphasize the needs of mothers and children and strategies for working with them because they are the ones who suffer the most from malnutrition."

Distribute the Handout - "Focus on Women and Children" as a reference.


Stages of fetal and infant growth

HANDOUT

STAGES OF FETAL AND INFANT GROWTH

Stage

Nutritional Requirements

Common Symptoms

Pregnancy

- 350 extra calories per day or about ½ extra plate of food each day*
- green leafy vegetables and meat to prevent anemia
- weight gain of at least 12.5 kg

- anemia
- inadequate weight gain
- low birth weight(<2500 grams)
- premature delivery
- maternal depletion

Breastfeeding
(0-6 months)

Mother:
- 550 extra calories per day or about one extra plate of food each day
extra liquids for the breastfeeding mother
Child
:
breastfeeding should begin immediately after birth (give colostrum)
- breastfeeding should be on demand
- breastfeeding for 4-5 months without supplements

- early introduction of foods other than breast milk leading to diarrhea and decreased production of breast milk
- early termination of
- use of feeding bottles leading to diarrhea and other infections

Weaning/ Breastfeeding
(6 months -2 years)

- begin giving semi- solid food by 6 months
- give 4-6 small meals per day from 6 months to 2 years
- continue breastfeeding
- high energy/mixed diet

- inadequate weight gain
- diarrhea
- measles
- other infections

* Calculation of additional caloric requirements are for a woman weighing 50 kg. Normal daily requirement is 2,000 calories; in pregnancy, calorie requirement increases to 2,350 calories; during the first six months of breastfeeding, it increases to 2,550 calories per day. Calculations for extra plates of food are based on the assumption that women eat three meals per day, under normal circumstances.