BPNI NEWS DESK, NEW DELHI: Mrs.Shantha Sinha, chairperson, NationalCommission for Protection of Children'sRights, while addressing a group of NGOssaid that the Commission, which wasrecently constituted by Government ofIndia, was committed for protection of therights of children. “We are looking atchildren in their social, cultural andeconomic contexts. Commission's mandateis to cover all children including infants andyoung children,” she said.

Explaining the role of the Commission, Mrs.Shantha Sinha said that the Commissionwould raise public awareness on childrights. “It will take cognizance of theviolations of the child rights and makenecessary recommendations to theGovernment for protection of the rights ofchildren,” informed Mrs. Sinha.

Mrs. Sinha visited BPNI office on April 17 toattend a meeting on children's right tonutrition. She asked the members of theNGOs to bring only those issues, which are

concerned to the rights of children.

In the consultation meet, the members ofthe NGOs discussed legal framework andpublic awareness on child rights,

revitalization of IMS Act, child and woman'snutrition, maternity entitlements,prevention of maternal, neonatal, infant andunder-5 mortality and morbidity rate and atechnical protocol for childbirth.

In the consultation meet, Dr. Arun Gupta,national coordinator of BPNI, raised theneeds of a protocol for childbirth and its

legal framework. “Women should get thetechnical support during child birth. Theimportant issue here is to provide educationto women”, opined Dr. Gupta.

The existing welfare schemes of the countrydon't support infants within the age group0-6 months. There is a special requirementto emphasize and recognize the needs of theinfants, especially their rights on nutrition.The right to survival, growth anddevelopment should be the first right of theinfants and a legal protection of this rightwould actually lead to the fulfillment ofnutritional needs of the children.

Commission's member secretary Mrs. ShaliniPrasad and its member Mrs. Sandhya Bajajwere also present. The other dignitariesattended the meeting were Mrs. MridulaBajaj and Mrs. Devika Singh from MobileCrèches; Dr. Mira Shiva from AIDAN/JSA;Mrs. Lakshmi Menon from WABA GenderProgramme; Mrs. Radha Holla and Mr.Subrata Dutta from BPNI.

Children's Rights Commission will raise publicawareness on child issues: Mrs. Shantha Sinha

IN

SI

DE ������ �� ������ ��

���� ��������� � ����� ���� ��� ���� ���� ���� ��������

�

�� ��� ��� ����������� ���� ������������� ���� ������

�

���� ������ � �������� �� ���� ��������� ���������� �������� �� �������

�

����� ������ ��� ��� �� �������

�

Alm

ora

Bageshw

ar

Cham

oli

Cham

pavat

Dehra

dun

Harid

war

Nain

ital

Pauri

Pithora

garh

Rura

prayag

Tehri

US

Nagar

Utta

rkashi

Utta

rakhand

0%

20%

40%

60%

80%

100%

74%

13%

67%

11%

32%

18%

9% 11%

51%

79%

24%

32%

74%

38%

�������� ������� ������ � ������

��

!������ �� ��������� �� � ��������������

��

��� �� ��� �����

BPNI BULLETINBPNI BULLETINBPNI BULLETINB P N I

151991-2006

Protecting, Promoting andSupporting BreastfeedingProtecting, Promoting andSupporting Breastfeeding

Years

From National Coordinator's Desk

���������

Infants in dilapidated condition

2

NFHS-III, which was released recently, shows that all is not well on theinfant nutrition front. NFHS-III reveals that 23.4% newborns across thecountry begin breastfeeding within an hour of birth. Although incomparison with NFHS-II, there is a marginal improvement of 7.4% inearly initiation of breastfeeding. This figure is abysmally low, given itsimportance as an intervention for child survival. The better performingstates are some of the northeastern states and Goa. The initiation rate inMizoram is 65.4%, which is highest in the country followed by 59.7% inGoa and 58.6% in Meghalaya. The other states with relatively higherrates of early initiation of breastfeeding are Kerala (55.4%), Tamil Nadu(55.3%), Arunachal Pradesh (55%), Orissa (54.3%), Maharashtra(51.8%), Nagaland (51.5%) and Assam (50.6%). In states like Bihar, Uttar Pradesh, Punjab,Jharkhand, Rajasthan, Madhya Pradesh, and Delhi, it is far below from the level of 40%. Bihar andUttar Pradesh account lowest, only 4% and 7.2% respectively.

The trend of exclusive breastfeeding for six months is not so impressive either. Only 46.3% childrenare exclusively breastfed in the country. The rate of exclusively breastfeeding is highest inChhattisgarh (82%). The other relatively better performing states are Assam (63.1%), AndhraPradesh (62.7%), Manipur (61.7%), Arunachal Pradesh (60%), West Bengal (58.6%), Karnataka(58%), Jharkhand (57.8%), Kerala (56.2%), Maharashtra (53%), Uttar Pradesh (51.3%) and Orissa(50.2%). The poor performing states are Haryana (16.9%) and Goa (17.7%). Thus, there is still ahuge chunk of children in India who are not exclusively breastfed for the first six months of life.

The rate of complementary feeding is somewhat better. The NFHS-III data shows that an average of55% children are reportedly receiving complementary feeding in the country with Kerala havinghighest rate (93.6%), Rajasthan is lowest at 38.7%. The NFHS-III data indicates that infantsbetween 6-9 months of age receive complementary diet consisting of solid or semi solid foodsalong with mother's milk. However, the survey did not ascertain how many mothers continuedbreastfeeding up to 2 years.

The improvements in NFHS-III nowhere near enough to counter the Infant Mortality Rate (IMR).The IMR which is whopping at the rate of 57 per 1000 live births, a decline of just 11% from itsearlier NFHS-II record of 68%. India is still far from the target set by the National Plan of Action forChildren and the Millennium Development Goal. Universalization of early initiation ofbreastfeeding within one hour of birth has the tremendous potential in reducing 31% of neonataldeaths, i.e. about 10% of total child deaths. Together with the universalization of exclusivebreastfeeding for six months, the figure becomes even higher. Exclusive breastfeeding goesbeyond helping children to survive. It enhances their physical and metal development. Thus, thechallenge of improving breastfeeding and optimal IYCF rates is as immense as ever.

Dr. Arun Gupta, MD, FIAPNational Coordinator

Demand for incorporating IYCF counseling in all maternal and

child health care programmes

BPNI NEWS DESK: BPNI in collaborationwith UNICEF, WABA and IBFAN organizedsecond international training on Infantand Young Child Feeding Counseling tocoach the trainers of various countries.This training was held at UCMS & GTBhospitals of Delhi from 15th January2007 to 28th January 2007.

The first phase of the training startedfrom January 15 and lasted up to January20, 2007. Acting principal DrS.K.Bhargav of UCMS and additionalmedical superintendent Dr N.K.Sinha ofGTB inaugurated this trainingprogramme on 15th January 2007 inpresence of Dr Tarsem Jindal, chiefcoordinator, BPNI and Dr Arun Gupta,regional coordinator, IBFAN Asia.

Dr Arvind Saili, president of NationalNeonato logy Fo rum of Ind ia ,inaugurated the second phase of thetraining, which started from January 22,and ended on January 28, 2007. DrK.K.Sharma, principal of UCMS,welcomed all participants and other

guests attended in the trainingprogramme.

Dr Arun Gupta while addressing theparticipants of the 2nd internationaltraining programme said infant andyoung child feeding counseling shouldbe the integral part of all maternal andchild health care programmes.

Dr MMA Faridi, who was the coursedirector of this training programme,described the process of infant andyoung child feeding counseling.

The entire training was conducted byusing latest training tools developed by

BPNI, IBFAN, WABA and UNICEF. Thetraining tools encompass trainers guide,participants manual, counseling flipchart, power point presentation, peercounseling session, demonstrationthrough role play, written exercises,video clips and clinical practices.

A total of 8 master trainees and 43 IYCFcounse l ing spec ia l i s t t ra ineesparticipated in the training programme.The master trainees and IYCF counselingspecialists were from Indonesia, Nepaland Indian states of Delhi, UttarPradesh, Uttranchal, Karnataka, MadhyaPradesh, Punjab and Haryana. Seven ofthem were medical doctors specialize inPediatrics, Obst. & Gynaecology andCommunity Medicine. Other traineescomprised of medical officers, nurses,postgraduate medical students, PhDscholars in nutrition, professionals fromNGOs working in the field of childnutrition, faculties of medical collegesand prevention of parent to childtransmission (PPTCT) counselors.

2nd international training on IYCF counseling in Delhi

3

Infant and young childfeeding counseling

should be the integralpart of all maternal and

child health careprogrammes.

4

Mothers and caregivers need proper counseling about breastfeeding

BPNI NEWS DESK: DEHRADUN: BPNItook the audacious task of bringingvarious stakeholders into this nationalconsultative meet held at Dehradun on19th and 20th January 2007. It wasactually intended to improve the overallsituation of infants and their survival.The trio organizations - NIPCCD, BPNI andUNICEF - jointly organized this nationalconsultation for developing a plan ofaction on infant and young child feeding(IYCF).

IYCF is crucial for the survival of infantsand young children. Several studiesconducted on infants and young childrenindicate that IYCF plays a vital role inreducing child mortality. Initiation ofbreastfeeding within the first hour ofbirth, exclusive breastfeeding for the firstsix months of life and continuedbreastfeeding with adequate andappropriate complementary feeding arethe three most crucial componentsalready identified in IYCF.

National guidelines on Infant and Young

Child Feeding in India are based on thecardinal guidelines of Global Strategy forInfant and Young Child Feeding thatincorporate all the three crucialcomponents mentioned above. The majorobjective of this consultation meet was todevelop a 5-year National Plan of Actionon IYCF and this would be presented tothe Planning Commission.

NIPCCD and BPNI took the leading role indeveloping an action plan for achievingstandard practices of IYCF. In theconsultation meet, it was decided thatcertain policy framework and need-basedinterventions and actions would berecommended to the P lann ingCommission for inclusion in the 11thPlan. If things move in the right direction,it is believed that the objectives and goalsof IYCF will be achieved in India.

Dr. Neelam Bhatia, joint director ofNIPCCD, explained the steps used for theconsultative process. Explaining thedevelopment of an action plan, sheemphasized to improve present draft

document and requested all theparticipants to focus on the pertainingissues, which can be achieved.

Dr. Arun Gupta stressed the need to createa network of stakeholders in reducinginfant mortality at the district level. “Wehave to create a congenial environment toensure the right of every infant to survivewith optimal health and development”, hesaid.

Reminding the participants about theuniversalization of ICDS programme, hesaid that prime minister had sent a letterto all chief ministers of the states andunion territories to ensure the needs ofquality services being provided underICDS programme. Prime minister, in hisletter to all chief ministers, had alsomentioned that 11 crore out of 16 crorechildren between 0-6 years are out of theambit of any support and services. Thesechildren, according to Dr. Gupta, include avast percentage of children between theages of 0 to 6 months who do not need anyfood supplementation support from ICDS.

National action plan on Infant and Young Child Feeding was drawn at consultation meet in Dehradun

5

But their mothers and other caregiversneed proper counse l ing aboutbreastfeeding practices.

Ms. Deepika Shrivastava, project officer,UNICEF, recognized the spirit ofpartnership working for the protection ofinfants and young children that actuallyhelped to centerstage IYCF in infantsurvival strategies. She howeversuggested for incorporating allocation ofresources and a budget provision for IYCF,recognize infants' (0-6 months) right tohave proper nutr i t ion throughbreastfeeding, declare 'breastfeedingeducation' as a basic service delivery, set atarget for early initiation, exclusivebreastfeeding and complementaryfeeding in the 11th plan as indicators foreach and every districts and states ofIndia. Ms. Shrivastava, however, askedthe participants to discuss therecommendations of consultation meetand the new WHO growth charts based onbreastfeeding standards with all statesecretaries in 2-day meeting on 8th and9th February 2007.

Sixteen high level experts representingvarious government departments,institutions, national and internationalorganizations participated in theconsultation meet. They were Dr. R.P.Aggarwal, president, Indian Academy ofPediatrics; Dr. Susan Passah, CMAI; Dr.Mira Shiva, AIDAN; Mrs. Evelyn. P.Kannan, general secretary, TNAI; Dr.Vikas. K. Desai, addl. director (FW), DFW,Government of Gujarat, Dr. P.Subramaniyam, director, CDRT; Mrs. RadhaHolla, BPNI consultant; Dr. Dinesh Khosla,BPNI state coordinator, Haryana; Dr.Parbati Sengupta, BPNI centralcoordination committee; West Bengal;Prof. K.P. Kushwaha, BPNI statecoordinator, Uttar Pradesh; Dr. C.R.Banapurmath, BPNI central coordinationcommittee; Dr. J.P. Dadhich, coordinatorBPNI Task Force on HIV-AIDS and Dr. K.Kesavulu, BPNI state coordinator, AndhraPradesh.

�

�

�

�

�

�

�

�

�

�

�

�

�

Growth monitoring should start from birth and breastfeeding standards

should be followed.

IYCF should be centrestaged as core intervention.

Upscaling of targets to achieve 90% early initiation of breastfeeding and

exclusive breastfeeding. Midterm goal should be 70%.

Setting up of IYCF resource centres at national, state and district levels

Setting up a Hall of Fame and a Hall of Shame for institutions in all

sectors based on whether they are breastfeeding friendly or not

Allocation of Rs. 2/- per child under 6 years of age for 300 days towards

food (as per the directions of Supreme Court) should be allocated for

'breastfeeding education' and towards 'supporting mothers' of 0-6

months infants.

Setting up mother support groups.

BFHI standards should be criteria for setting up Indian Public Health

Standards, NRHM, RCH, etc.

A 'BFHI task force' should be set up at national and state level

Setting up breastfeeding education and support centers (1 per

population of 5000 at least)

Establish a National Commission for protection of child rights which

should also include right to nutrition

Work with NREG to develop ways to support IYCF matching NREG to

breastfeeding support

Develop cards for tracking maternity protection

IMPORTANT RECOMMENDATIONS OF CONSULTATION MEET

6

Breastfeeding in the agenda of child survival

and development programmes in Uttarakhand

Study report on status of Infant and Young Children Feeding, Uttarakhand released

BPNI NEWS DESK: In a major step toimprove the condition of infants andchildren, the Government of Uttarakhandwill introduce “breastfeeding” in its coreagenda of chi ld surv iva l anddevelopment. Such initiative will help toreduce infant mortality in the state andaddress the problems of malnutrition inwhich thousands of infants and youngchildren die every year.

A state action plan will be shortlydeveloped incorporating early initiationo f b r e a s t f e e d i n g , e x c l u s i v ebreastfeeding for six months andcomplementary feeding along with

continued breastfeeding for two years ormore. Emphasizing its genuine needs andimportance, Mr. S. K. Das, chief secretaryof Uttarakhand, articulated that“breastfeeding” as core of child healthprogramme should be given top prioritykeeping in view the high rate of infantmortality and the fertility rate in thestate. The IMR has gone up and thefertility rate has become stagnant in thestate.

Pointing out the needs of “breastfeedingpromotion”, he further said that theinfo rmat ion on “NHFS-3” and“breastfeeding initiation within one

hou r ” a s we l l a s “exc l u s i v ebreastfeeding” should be widelydisseminated in the state referring to itshigh urgency and importance to dealwith the current trends of IMR andfertility rates. He, however, has alsoemphasized to involve PRIs and otherpublic utility services for this purpose.

Smt. Vibha Puri Das, principal secretaryof Forest and Rural Development ofUttarakhand while inaugurating thisconsultation meet held at Dehradun on18 January, 2007 had urged to double therate of early initiation of breastfeedingfrom its current level, within a year.

Smt. Vibha Puri Das, principalsecretary of Forest and RuralDevelopment of Uttarakhand,urged to double the rate of earlyinitiation of breastfeeding from itscurrent level, within a year.

Mrs. Hemlata Dhaundiyal,director of WCD, shared the statusof health and nutrition of childreno f U t t r a k h a nd w i t h t heparticipants and gave her valuableinsights for an appropriate actionplan.

Smt Radha Raturi, secretary ofWomen and Child Development ofUttarakhand, suggested a suitableact ion p lan to showcaseimprovements in the status ofinfants and young children.

7

Key recommendations:

Key actions:

�

�

�

�

�

�

�

�

�

�

�

�

�

�

�

�

Focus on infants in all policies and programmes of

Uttarakhand Government

Identify ORS and exclusive breastfeeding for low cost

intervention.

Develop a State Model by promoting IYCF

Promotion of breastfeeding within 1st hour, exclusive

breastfeeding for 0-6 months

Develop a weight monitoring system of infants in each

month for 0-12 months

Prevent child malnutrition in first few months and draw a

monitoring mechanism for 0-12 months

Proper monitoring and evaluation of the child

programmes in the state

Universalization of first hour breastfeeding, exclusive

breastfeeding for improvisation of nutrition of infants

and to rapidly bring down infant mortality rate

Establish a coordination committee at state level to

identify resources/ funds for immunization programmes

in both ICDS and health programmes

Creation of breastfeeding /IYCF support centers in

health establishments run by trained nurses who can act

as coordinators at block level

Ensure legislative support to first hour breastfeeding

Ensure nutrition support to lactating mothers

Enhance trainers pool for counseling of IYCF

Develop a core group for capacity building and training

of workers for enhancing their skills in IYCF counseling

Develop IEC materials for the family members

Create breastfeeding mother support network at village

level to support infant health and nutrition.

RECOMMENDATIONS AND ACTIONS

Speaking at the consultation meet shesaid that the indicators measured byBPNI should be closely monitored,assuring a comprehensive actionprogramme and mechanisms drawn formonitoring and evaluation. Capacitybuilding for women would also directlycontribute to proper health care of theinfants and young children, sheinformed. She stressed on the needs tocreate a network of mother supportgroups at family level and spreading ofbreastfeeding education among thewomen.

Before this, Dr. Arun Gupta, nationalcoordinator of BPNI, made apresentation highlighting the needs ofuniversalization of timely initiation ofbreastfeeding. He presented the findingsof the survey conducted in 13 districts of

Uttarakhand, the first of its kind researchprogramme on infants initiated in thestate.

A sharp focus on infant nutrition inputs,action plan for universalization of earlyinitiation, ORS and breastfeeding wouldrapidly bring down infant morality andimprove infant nutrition status in thestate, suggested Dr. Gupta.

Smt Radha Raturi, secretary of Womenand Child Development of Uttarakhand,appreciated the findings of the studyconducted by BPNI and suggested asuitable action plan to showcaseimprovements in the status of infantsand young children and the impact ofthis work should reflect in the evaluationdone in another 3 to 4 years down theline.

Mrs. Hemlata Dhaundiyal, director ofWCD shared the status of health andnutrition of children of Uttrakhand withthe participants and gave her valuableinsights for an appropriate action plan.Dr J. P. Dadhich of BPNI in hispresentation suggested three majorareas of intervention, which includeactions at policy, health service andcommunity level.

Health secretary of UttarakhandGovernment in his remarks said thathealth programmes run in the state arerespons ib le to implement theintervention of “breastfeeding” but itremains a distant priority. “A suitableplan should be formulated touniversalize this intervention”, heobserved.

8

Infant feeding practices in UttarakhandStudy report reveals mix trends of infant feeding in various districts of Uttarakhand

The survey, conduced by BPNI under theauspices of Department of WomenEmpowerment & Child Development,Uttarakhand, revealed that timelyinitiation of breastfeeding within 1 hourwas just 38% with wide variation in eachdistrict that range from 9% to 79%. Pre-lacteal feeding practices are mostlytradition-based with majority of thenewborn children receiving gur, water, milkand honey which are common in each andevery district of the state.

Exclusive breastfeeding for 6 months wasonly 21%, which is quite a disappointingfinding in respect of quality of nutritionalinputs during this critical period of a child’shealth. Proper nutritional input is a mustfor better health during infancy.Pe rcentage of bab ies rece iv ingcomplementary feeding between 6-9months of age was found encouraging.Although there is a need to look at itsqualitative and quantitative aspects aspercentage of underweight children under3 remains very high.

In the studied population of Uttarakhand,84% women having 0-3 year old childrenhad received antenatal check-up.

ANM/Nurse did check up of 47% of thesemothers, while 34% mothers got theircheck-up from a doctor. Majority (61%) ofthem were having home deliveries and only19% of them delivered at Governmenthospitals, whereas barely 9.8% went toprivate hospitals. Most of these mothershad normal deliveries.

It is recommended that breastfeedingshould be initiated within one hour of birthand nothing should be given to the infantbefore starting breastfeed. The findings ofthe study (Fig. 1) show breastfeedingwithin 1 hour was initiated only in 38% ofthe newborns. Whereas 41% of themreceived breastmilk between 1-4 hours andit was delayed by more than 4 hours in case

of 21% newborns. Differences andvariations in initiation of breastfeedingwithin 1 hour have also been noticed in thesurvey conducted in various districts ofUttarakhand. Nainital, Pauri, Champavat,Bageshwar districts had a very poorperformance and these districts failed torecognize the needs of initiation ofbreastfeeding within 1 hour. Fig.-2 willprovide you a more clear picture and trendsof initiation of breastfeeding within 1 hourof birth.

The wide variation has been observed inprelacteal feeding. Almost half (47%) ofthe newborns reportedly have receivedprelacteal feeds in the state. Pithoragarh,Ruraprayag and Pauri are three districtswherein the newborns, the findings of thesurvey recorded, have the lowestpercentage of receiving prelecteal feeds.

BREASTFEEDING PRACTICESINITIATION OF BREASTFEEDING WITHIN 1HOUR

PRELACTEAL FEEDING

0%

20%

40%

60%

80%

100%

Within 1 hour Within 1-4 hour More than 4 hours

38.0% 41.3%

20.5%

Fig. 1: Initiation of breastfeeding

Alm

ora

Bageshw

ar

Cham

oli

Cham

pavat

Dehra

dun

Harid

war

Nain

ital

Pauri

Pithora

garh

Rura

prayag

Tehri

US

Nagar

Utta

rkashi

Utta

rakhand

0%

20%

40%

60%

80%

100%

74%

13%

67%

11%

32%

18%

9% 11%

51%

79%

24%

32%

74%

38%

Fig. 2: Districts wise distribution: Initiation of breastfeeding

Yes

47.2%

No

52.8%

Fig. 3: Giving prelacteal feeds

9

EXCLUSIVE BREASTFEEDING

CONTINUED BREASTFEEDING

COMPLEMENTARY FEEDING PRACTICESDURING 6-9 MONTHS AGE BOTTLE-FEEDINGThe survey report shows that exclusive

breastfeeding was confined to only 37%children within the age group of 0-3months, which got reduced drastically toonly 5% children of 4-6 months age group.As a whole, 21% of the newborn children ofthe state were exclusively breastfed for 0-6months. It was found that children withinthe age group of 0-3 months had receivedplain water as supplementary food alongwith breastmilk. However, children withinage group of 4-6 months had beenreceiving other foods along withbreastmilk. The supplementary foodsconsist of several types of foods and fluidslike cow milk and goat milk, fruit juice, softdrinks, sweet water, tea/coffee,powder/tin milk etc. This trend is prevalentamong 98% of the population in the state.

It is recommended that breastfeedingshould continue for a period of two years orbeyond along with appropriate andadequate complementary feeding. Motherswere interviewed about the duration ofcontinuation of breastfeeding and 67% ofthem responded it to be 18-24 months.Moreover, 19% respondent mothers saidthat they breastfed their children for morethan 24 months and 14% mothers said itwas less than 18 months.

It is recommended that after six months ofage babies should receive complementaryfeeding with solid home made indigenousfoods along with continued breastfeeding.Almost all (98%) children of 6-9 months ofage received mother's milk along withwater and other supplementation of solidfoods. And 93% of these children had beenreceiving mushy food. However more than ahalf (61%) were found receiving top milk ofcow, buffalo or goat and 47% of thesechildren also found receiving gripe water orghutti.

The practice of giving fruit juice, softdrinks, sweet water, tea/coffee,powder/tin milk and such others to thechildren of age group 6-9 months isrampant across Uttarakhand. The surveyreported that children were receiving suchfoods, which is considered not a healthypractice.

It was interesting to note that motherswere aloof from bottle-feeding practices.The survey revealed that there were only37% newborn babies who received bottle-feeds and rest 63% children were debarredfrom bottle-feeding practices.

In this studied population of Uttarakhandmost of the mothers having childrenranging 0 to 3 years were within the agegroup of 21 to 25 years and receivededucation up to higher secondary level.Most women, who follow Hindu religion,were not working outside home. Amongthis population about half of the womenbelong to schedule tribe and rest are fromother castes.

The survey was conduced in all 13 districtsof Uttarakhand with an intention todevelop a state plan of action to improveinfant and young child feeding practices.This is the most fundamental step to lookinto quantitative and qualitative aspects offeeding practices, which were scientificallyexamined and verified using modernresearch methods and tools. All findings ofthe study were systematically documentedand reports of study were submitted to theconcerned department of the governmentof Uttarakhand.

Exclusive breastfeeding Artificial feeding

0-3 months 4-6 months Total (0-6 months)

0%

20%

40%

60%

80%

100%

Age Group

37%

22.9%

5.0%

36.9%

21.0%

29.9%

Fig. 4: Status of exclusive breastfeeding during 0-6 months

No

63%

Yes

37%

Fig. 6: Bottle-feeding rate

Breastfeeding: TheBreastfeeding: The1st

1stHourHour

SaveSave NENE million babies!million babies!

Celebrate World Breastfeeding Week

18 -24 months

67%

Less than

18 months

14%

More than 24 months

19%

Fig. 5: Women’s plan tocontinued breastfeeding

10

BPNI NEWS DESK, LUDHIANA: A 3-d a y z o n a l w o r k s h o p o nstrengthening pre-service medicaleducation on Infant and YoungChild Feeding was held at Ludhianafrom April 19 to April 21 for thefaculty members of pediatrics, OBGand community medicine ofgovernment and private medicalcolleges. BPNI in collaboration withUNICEF and Christian MedicalCollege organized this zonalworkshop at Ludhiana.

The purpose of this workshop was to discuss IYCF curricula with thefaculty members of pediatrics, OBG and community medicine. It wasmade explicit in the workshop that IYCF training was prepared in lineof Medical Council of India's recommendations made in its 1997document on graduate medical education. IYCF curricula could easilybe covered within the existing syllabus and time frame. The purpose oflearning IYCF was also shared with the participants of threedepartments.

Director of Christian Medical College, Ludhiana, inaugurated thiszonal workshop and welcomed all participants. Also there wereprincipals and superintendents of the hospitals. Dr J C Sobti,coordinator-BPNI task force, and Dr S Aneja, national task forcecoordinator of BPNI highlighted the objective of the workshop anddiscussed important areas related to IYCF. Prof. Tejinder Singh was thecourse coordinator and a local coordination committee was formed by

involving head of the departmentsof community medicine PSM andOBY.

The participants were given a time-wrap for teaching IYCF in varioussemesters. An attempt was made formaking evaluation tools on broad-based objectives so that it couldhave a far more reaching effect onteaching and learning methods toensure needs of the students. Amodel lecture on optimal IYCFfocusing on the physiology of

lactation and its practical implications on infant feeding was alsomade in the workshop.

There was an extensive discussion by all the participants suggestingincorporation of many new things connected with IYCF. In a separatesession, there was a lecture on complimentary feeding followed bydemonstrations on assessment of breastfeeding.

A total of 51 participants from Christian Medical College, Ludhiana,Ross Hostel Warden's Residence, Dayanand Medical College & Hospital,Govt. Medical College of Patiala, S.G.R.D. Institute of MedicalSciences, Shri Guru Ram Das Institute of Medical Sciences & Research,Gandhi Medical College, Govt Medical College, Jammu; Dr. RPG MedicalCollege, Kangra; Adesh Institute of Medical Sciences & Research,Bathinda; Government Medical College, Chandigarh and Indira GandhiMedical College, Simla; participated in the workshop.

����������� ���� � ���� �� ��������

BPNI NEWS DESK, VADODARA: BPNI incollaboration with UNICEF and StateGovernment of Gujarat organized a 3-dayworkshop on “Strengthening Pre-serviceMedical Education on IYCF” from 12th to14th April at Vadodara.

The workshop, attended by the facultymembers of undergraduate medical collegesof Gujarat, was organized with an intentionto discuss the methodology for teachingglobal and national guidelines on Infant andYoung Child Feeding (IYCF) practices,especially for the students of pediatrics,obstetrics, gynaecology and communitymedicine.

In her keynote address, Dr. Vikas Desai,additional director, Ministry of Health andFamily Welfare (GOI), emphasized thatmedical colleges should impart theknowledge of IYCF to the students andprovide them the basic skills of IYCF. Eachdepartment of the medical colleges shouldportray the same idea and there should be anintegrated approach in teaching. Shereiterated that Integrated Management ofNeo-natal Childhood Illness (IMNCI) andIYCF should be practiced in outpatientsdepartment (OPD) so that students couldobserve it. She also agreed to establishnutrition counseling centers in medical

colleges, which will also serve the purposesof IYCF counseling.

All pre-service doctors should have the rightskills and knowledge about IYCF. These basicskills are extremely important to be acquiredby the doctors before they go to thecommunity, informed UNICEF's regionalrepresentative Dr. Yogendra Mathur.

Prof. Dulari Gandhi of Baroda Medical College

stressed the need of informing all theundergraduate medical students about IYCF.This, according to her, will help to promote,protect and support IYCF practices,especially in critical situations likepreterm/LBW/ HIV+ve mother.

Dr. Tejinder Singh presented a trainingmodule of IYCF to be incorporated inteaching schedule and asked theparticipants to incorporate it in theformative and summative assessments.Before this, Prof. S. Aneja discussed theoverview of the workshop and thenecessities of the undergraduate medicalstudents.

In the workshop, four modules of IYCF werediscussed with the participants. Theseinclude, concept of IYCF and breastfeeding,early initiation of breastfeeding support,complementary feeding and infant milksubstitutes and IMS Act. In the workshop, itwas also discussed how to set up an IYCFcounseling centers. A practical session wasalso organized in the hospital whereparticipants interacted with the mothers.

In this zonal workshop, a total of 44 facultymembers from the Department of Pediatrics,Community Medicine and Obstetrics andGynaecology of 8 medical colleges of Gujaratparticipated.