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Nutrition and pregnancy refers to the nutrient intake,
Nutrition and pregnancy refers to the nutrient intake,
and dietary planning that is undertaken before, during
and dietary planning that is undertaken before, during
and after pregnancy. In a precursory study into the
and after pregnancy. In a precursory study into the
link nutrition and pregnancy in 1950
link nutrition and pregnancy in 1950
EXCLUSIVE BREASTFEEDING -
women who consumed minimal amounts over
women who consumed minimal amounts over
EXCLUSIVE BREASTFEEDING -
the eight-week period had a higher mortality or
the eight-week period had a higher mortality or
COMPLEMENTARY FEEDING -
disorder rate concerning their offspring than women
disorder rate concerning their offspring than women
COMPLEMENTARY FEEDING -
who ate regularly, attributed to the fact that the
Essential who ate regularly, attributed to the fact that the
VITAMIN A, IRON, ZINC - BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC - EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC - EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, INC - EXCLUSIVE BREASTFEEDING - COBREASTFEEDING - VITAMIN A, IRON, ZINC - BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC - EXCLUSIVE BREASTFEEDIN - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC - EXCLUSIVE BREASTFEEDING -COMPLEMENTARY - VITAMIN A, IRON, ZINC EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
children born to well-fed mothers had less
children born to well-fed mothers had less
VITAMIN A, IRON, ZINC -
restriction within the womb. Not only have physical
restriction within the womb. Not only have physical
BREASTFEEDING - COMPLEMENTARY
disorders bpoor nutrition before and during
disorders bpoor nutrition before and during
BREASTFEEDING - COMPLE-
pregnancy, but neurological disorders and handicaps
Nutrition pregnancy, but neurological disorders and handicaps
FEEDING - VITAMIN A, IRON, ZINC -
are a risk that is run by mothers who are malnour-
are a risk that is run by mothers who are
MENTARY FEEDING - VITAMIN A,
ished, a condition which can also lead to the child
malnourished, a condition which can also lead to
EXCLUSIVE BREASTFEEDING - COMPLEMENTARY
becoming more susceptible to later degenerative
the child becoming more susceptible to later
Actions IRON, ZINC - EXCLUSIVE BREAST-
disease(s) of babies are estimated to be born with
degenerative disease(s) of babies are estimated to
FEEDING - VITAMIN A, IRON, ZINC
lower t optimal weights at birth due to lack of
be born with lower t optimal weights at birth
FEEDING - COMPLEMENTARY
proper nutrition. It is very important that
IMPROVING MATERNAL, due to lack of proper nutrition. It is very
EXCLUSIVE BREASTFEEDING -
expecting mothers should change their personal
that expecting mothers should change
FEEDING - VITAMIN A, IRON,
Home-modified animal milk is not recommended as a
Home-modified animal milk is not recommended as a
habits like smoking, alcohol, caffeine, using
their personal habits like
medications and street
NEWBORN, INFANT AND YOUNG COMPLEMENTARY FEEDING -
replacement food in the first six months of life. Recommenda-
replacement food in the first six months of life. Recommenda-
certain medications and street drugs as soon as
drugs as soon as they know they are pregnant
ZINC - EXCLUSIVE BREAST-
tion 5 indicates that HIV-infected mothers sonly give com-
tion 5 indicates that HIV-infected mothers sonly give com-
they know they are pregnant or even when they
or even when they are planning to conceive. All these
VITAMIN A,
mercial infant la when all the following specific conditions are
CHILD HEALTH AND NUTRITION mercial infant la when all the following specific conditions are
are planning to conceive. All these can affect the
can affect the development of the organs like brain,
FEEDING - COMPLE-
met: clean water and sanitation are assured; the mother or
met: clean water and sanitation are assured; the mother or
development of the organs like brain, which happen
which happen in early stages of pregnancy. They can
IRON,
other caregiver can reliably provide sufficient infant formula
other caregiver can reliably provide sufficient infant formula
in early stages of pregnancy. They can cause irrepara-
cause irreparable damage to the foetus. Nutrition MENTARY
milk; the mother or caregiver can prepare it cleanly and
ble damage to the foetus. Nutrition and preg-milk; the mother or caregiver can prepare it cleanly and
and pregnancy refers to the nutrient intake, and
ZINC
frequently enough; the mother or caregiver can exclusively
frequently enough; the mother or caregiver can exclusively
nancy refers to the nutrient intake, and dietary
dietary planning that is undertaken before, during and FEEDING
give infant formula milk in the six months; the family is
give infant breast milk in the six months; the family is
planning that is undertaken before, during and after
after pregnancy. In a precursory study into the link
BREAST
supportive of this practice; and the mother or caregiver can
pregnancy. In a precursory study into the link supportive of this practice; and the mother or caregiver can
between nutrition and pregnancy in 1950 - VITA-
access health care that offers child health services. Recom-
access health care that child health services. Recommen-
between nutrition and pregnancy in women who
Home-modified animal milk is not recommended as a
women who consumed minimal amounts over the
FEEDING
mendation 6 is based on laboratory which demonstrated that
dation 6 is based on laboratory which demonstrated that heat
consumed minimal amounr t e eight-week period had
replacement food in the first six months of life. Recommen-
eight-week period had a higher mortality or MIN A,
heat treatment of expressed breast milk from HIV-infected
a higher mortality or disorder rate concerning treatment of expressed breast milk from HIV-infected
dation 5 indicates that HIV-infected mothers sonly give
disorder rate concerning their offspring than
VITAMIN A,
mothers, if correctly done, inactivates HIV. This option is
mothers, if correctly done, inactivates HIV. This option is
their offspring than women who ate regularly,
commercial infant la when all the following specific condi-
women who ate regularly, attributed to the fact
IRON, INC -
recommended in special infant born with low birth weight
recommended in special infant born with low birth weight
attributed to the fact that the children born to
tions are met: clean water and sanitation are assured; the
that the children born to well-fed mothers had
IRON , ZINC -
or otherwise ill in the neonatal period and unable to
well-fed mothers had less restriction within the or otherwise ill in the neonatal period and unable to
mother or other caregiver can reliably provide sufficient
less restriction within the womb. Not only have
EXCLUSIVE
breastfeed); when the mother is unwell and temporarily
breastfeed); when the mother is unwell and temporarily
womb. Not only have physical disorders been linked
infant formula milk; the mother or caregiver can prepare it
physical disorders been linked with poor nutrition
BREAST
unable to breastfeed; to a mothers to stop breastfeed-
unable to breastfeed; to a mothers to stop breastfeed-
with poor nutrition before andduring pregnancy,
cleanly and frequently enough; the mother or caregiver can
before andduring pregnancy, but neurological
ing; or if ARVs are temporarily not available Home-modified
ing; or if ARVs are temporarily not available Home-modified
but neurological disorders and handicaps are a risk
exclusively give infant formula milk in the first six months; the
disorders and handicaps are a risk that is run by
FEEDING - VITAMIN A,
animal milk is not recommended as a replacement food
that is run by mothers who are malnourished, a animal milk is not recommended as a replacement food
family is supportive of this practice; and the mother or
mothers who are malnourished, a condition which
BREASTFEEDING - CO-
in the first six months of life. Recommendation 5
in the first six months of life. Recommendation 5
condition which can also lead to the child becoming
caregiver can access health care that offers child health
can also lead to the child becoming more susceptible
IRON, ZINC EXCL
indicates that HIV-infected mothers sonly give commercial
indicates that HIV-infected mothers sonly give commercial
more susceptible to later degenerative disease(s) of
services. Recommendation 6 is based on laboratory which
to later degenerative disease(s) of babies are
BREAST- infant la when all the following specific conditions are met:
infant la when all the following specific conditions are met:
babies are estimated to be born with lower than
demonstrated that heat treatment of expressed breast milk
estimated to be born with lower than optimal
REASTFEED COMPL
clean water and sanitation are assured; the mother or other
optimal weights at birth due to lack of proper clean water and sanitation are assured; the mother or other
from HIV-infmothers, if correctly done, inactivates HIV.
weights at birth due to lack of proper nutrition. It is
FEEDING - VITA-
caregiver can reliably provide sufficient infant formula milk;
caregiver can reliably provide sufficient infant formula milk;
nutrition. It is very important that expecting mothers
This option is recommended in special infant born with low
very important that expecting mothers should
LEMENTARY FEEDING
the mother or caregiver can prepare it cleanly and frequently
the mother or caregiver can prepare it cleanly and frequently
should change their personal habits like smoking,
birth weight or otherwise ill in the neonatal period and
change their personal habits like smoking, alcohol,
MIN A, IRON, ZINC -
enough; the mother or caregiver can exclusively give infant
enough; the mother or caregiver can exclusively give infant
alcohol, caffeine, using certain medications and street
unable to breastfeed when the mother is unwell and
caffeine, using certain medications and street drugs as
VITAMIN A, IRON,
formula milk in the first six months; family is supportive
formula milk in the first six months; family is supportive
drugs as soon as they know they are pregnant or
temporarily unable to breastfeed; to amothers to stop
soon as they know they are pregnant or even when
BREAST- FEED-
of this practice; and the mother or caregiver can access health
of this practice; and the mother or caregiver can access health
even when they are planning to conceive. All these
breastfeeding; or if temporarily not available Home-modified
they are planning to conceive. All these can affect the
ZINC - EX CLUSIVE
care that offers child health services. Recommendation 6 is
care that offers child health services. Recommendation 6 is
can affect the development of the organs like brain,
animal milk is not recommended as a replacement food in
development of the organs like brain, which happen
ING - COM- PLE-
based on laboratory which demonstrated that heat treatment
based on laboratory which demonstrated that heat treatment
which happen in early stages of pregnancy. They can
the first six months of life. Recommendation 5 indicates
in early stages of pregnancy. They can cause
BREAST - FEEDING - COMPLEMENTARY - VITAMIN A, IRON, ZINC EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
of expressed breast milk from HIV-infected mothers, if
cause irreparable damage to the growing foetus. of expressed breast milk from HIV-infected mothers, if
that HIV-infected mothers sonly give commerci infant la
irreparable damage to the growing foetus.
MENTARY FEEDING - VITAMIN A,
correctly done, inactivates HIV. This option is recom infant
correctly done, inactivates HIV. This option is recom infant
when all the following specific conditions are met: clean
FEEDING - VITAMIN A, IRON, ZINC -EXCLUSIVE BREASTFEEDIN- COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
born with low birth weight or neonatal period and unable to
born with low birth weight or neonatal period and unable to
water and sanitation are assured; the mother or othearegiver
IRON, ZINC - EXCLUSIVE
can reliably provide sufficient
XCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
infant formula milk; the mother or caregiver can prepare it
BREAST- FEEDIN - COMPLEMEN-
cleanly and frequently enough; the mother or caregiver can
BREAST FEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC -EXCLUSIVE BREASTFEEDIN- COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
exclusively give infant formula milk in the first six months;
TARY FEEDING - VITAMIN A,
family is supportive of this practice; and the mother or
ITAMIN A, IRON, ZINC - EXCLUSIVE BREASTFEEDIN- COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
caregiver can access health care that offers child health
IRON, ZINC - EXCLUSIVE
services. Recommendation 6 is based on laboratory
CLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
which demonstrated that heat treatment of expressed breast
BREAST- FEEDING -COMPLEMEN-
milk from HIV-infected mothers, if correctly done, inactivates
BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC -EXCLUSIVE BREASTFEEDIN- COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
HIV. This option is recom infant born with low birth weight
or neonatal period and unable to breastfeed); when the
EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
motheris unwell and temporarily unable to breastfeed; to
assist mothers to stop breastfeeding; or if temporarily not
BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC -EXCLUSIVE BREASTFEEDIN- COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
available.
EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC -EXCLUSIVE BREASTFEEDIN- COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC -EXCLUSIVE BREASTFEEDIN- COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
EXCLUSIVE BREASTFEEDING - COMPLEMENTARY FEEDING - VITAMIN A, IRON, ZINC
Essential Nutrition
Actions: improving
maternal, newborn,
infant and young child
health and nutrition
WHO Library Cataloguing-in-Publication Data
Essential nutrition actions: improving maternal, newborn, infant and young child health
and nutrition.
1.Malnutrition – prevention and control. 2.Child nutrition disorders – prevention and control.
3.Infant nutrition disorders – prevention and control. 4.Maternal welfare. 5.Nutritional
status. I.World Health Organization.
ISBN 978 92 4 150555 0 (NLM classification: WD 100)
© World Health Organization 2013
All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int)
or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland
(tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int).
Requests for permission to reproduce or translate WHO publications – whether for sale or for non-commercial
distribution– should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/
copyright_form/en/index.html).
The designations employed and the presentation of the material in this publication do not imply the expression of
any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country,
territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on
maps represent approximate border lines for which there may not yet be full agreement.
The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or
recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.
Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by the World Health Organization to verify the information contained in
this publication. However, the published material is being distributed without warranty of any kind, either expressed
or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the
World Health Organization be liable for damages arising from its use.
Cover design by Elysium Creative Company. Formatting template by Blossoms Communications.
Printed by the WHO Document Production Services, Geneva, Switzerland.
Contents
Abbreviations vi
Acknowledgements ix
Preface xi
Executive summary 1
Global nutrition challenges 2
Part I. Recommendations, rationale and evidence
for nutrition actions 10
1. Interventions targeted at young infants (0–5 months) 11
1.1 Early initiation of breastfeeding 11
1.2 Exclusive breastfeeding 12
1.3 Counselling and support for appropriate feeding of
low-birth-weight infants 15
1.4 Infant feeding in the context of human
immunodeficiency virus 16
2. Interventions targeted at infants and young children
(6–23 months) 20
2.1 Continued breastfeeding 20
2.2 Complementary feeding 20
2.3 Use of multiple micronutrient powders for home
fortification of foods consumed by infants and young
children 6–23 months 24
2.4 Vitamin A supplementation for children under five years 25
2.5 Vitamin A supplementation in children with measles 27
2.6 Daily iron supplementation for children 6–23 months 27
2.7 Zinc supplementation for diarrhoea management 29
2.8 Reaching optimal iodine nutrition in young children 30
2.9 Management of children with severe acute malnutrition 31
2.10 Management of children with moderate acute
malnutrition 33
2.11 Nutritional care and support of HIV-infected children
6 months to 14 years 34
iii
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