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149
Overhead Figures
Kent Page, UNICEF, DRC, 2003
Ove
rhea
d Fi
gure
s
150
Ove
rhea
d Fi
gure
s
151
Ove
rhea
d Fi
gure
s
Insi
de th
e br
east
IFE 2
/1
Adap
ted
from
WH
O/U
NIC
EF B
FC, 1
993
milk
sec
reting c
ells{
pro
lact
in m
akes
them
secr
ete
milk
lact
ifer
ous
sinuse
s(m
ilk d
uct
s){
milk
colle
cts
her
e
nip
ple
areo
la
alve
oli
152
Ove
rhea
d Fi
gure
s
153
Ove
rhea
d Fi
gure
s
1
Goo
d at
tach
men
t
2
Poor
att
achm
ent W
HO
/UN
ICEF
BFC
, 199
3
Insi
de th
e ba
by’s
mou
thIFE
2/2
154
Ove
rhea
d Fi
gure
s
155
Ove
rhea
d Fi
gure
s
Obs
ervi
ng a
ttach
men
t at t
he b
reas
t
WH
O/U
NIC
EF B
FC, 1
993
12
Areo
la,
mou
th,
low
er l
ip,
chin
IFE 2
/3
156
Ove
rhea
d Fi
gure
s
157
Ove
rhea
d Fi
gure
s
Eval
uatin
g at
tach
men
t at t
he b
reas
tIFE
2/4
12
158
Ove
rhea
d Fi
gure
s
159
Ove
rhea
d Fi
gure
s
Eval
uatin
g at
tach
men
t at t
he b
reas
tIFE
2/5
12
160
Ove
rhea
d Fi
gure
s
161
Ove
rhea
d Fi
gure
s
Milk
flow
: the
oxy
toci
n re
flex
Wor
ks before
or dur
ing
feed
to
mak
e m
ilk flow
IFE 2
/6
Oxy
toci
nin
blo
od
Bab
ysu
cklin
g
Sen
sory
impuls
esfr
om
nip
ple
WH
O/U
NIC
EF B
FC, 1
993
162
Ove
rhea
d Fi
gure
s
163
Ove
rhea
d Fi
gure
s
Com
pani
onsh
ip a
nd p
rote
ctio
n he
lp m
ilk fl
owIFE
2/7
Janet Griffin/Nepal, from IFE, WEMOS/IBFAN
164
Ove
rhea
d Fi
gure
s
165
Ove
rhea
d Fi
gure
s
Milk
pro
duct
ion:
the
prol
actin
refle
xIFE
2/8
Prola
ctin
in b
lood
Bab
ysu
cklin
g
Sen
sory
impuls
esfr
om
nip
ple
WH
O/U
NIC
EF B
FC, 1
993
166
Ove
rhea
d Fi
gure
s
167
Ove
rhea
d Fi
gure
s
Brea
stfe
d tw
ins:
Sw
azila
nd a
nd A
ngol
aIFE
2/9
Mary Lungaho, Cubal, Angola
By F. Savage, Swaziland
168
Ove
rhea
d Fi
gure
s
169
Ove
rhea
d Fi
gure
s
Four
ele
men
ts o
f sup
port
ive
care
IFE 2
/10
Adap
ted
from
F. S
avag
e, A
. Bur
gess
-N
utrit
ion
for D
evel
opin
g C
ount
ries.
199
3
Adeq
uat
e nutr
itio
nContinuin
g a
ssis
tance
and s
oci
al s
upport
Appro
priat
e hea
lth
serv
ices
Hel
pfu
l m
ater
nity
serv
ices
© J
oyce
Kel
ly (E
NN
) 200
1
170
Ove
rhea
d Fi
gure
s
171
A m
alno
uris
hed
mot
her b
reas
tfeed
s IFE
2/1
1
Feed
the
mot
her
and
let h
er fe
ed th
e in
fant
Mon
itor
the
wei
ght
and
urin
eou
tput
. Te
mpo
rary
sup
plem
ents
by
cup
may
be
need
ed w
hile
the
mot
her´
s m
ilk p
rodu
ctio
nin
crea
ses.
© J
oyce
Kel
ly (E
NN
) 200
1
Sier
ra Le
one,
200
1
Ove
rhea
d Fi
gure
s
172
Ove
rhea
d Fi
gure
s
173
Ove
rhea
d Fi
gure
s
Prev
ent d
ehyd
ratio
n
Prov
ide
plen
ty o
f dr
inki
ng w
ater
whe
reve
r th
ere
are
brea
stfe
edin
gw
omen
in:
• tr
ansi
t re
st a
reas
• re
gist
rati
on/i
ntak
e ce
ntre
s•
long
que
ues
for
heal
th a
nd o
ther
serv
ices
.
IFE 2
/12
Adap
ted
from
UN
ICEF
. BFH
I New
s
174
Ove
rhea
d Fi
gure
s
175
Ove
rhea
d Fi
gure
s
Skin
-to-
skin
cont
act i
mm
edia
tely
afte
r bir
th
A ne
wbo
rn s
how
s th
at h
e is
rea
dy t
o fe
ed a
nd a
ctiv
ely
seek
s th
e ni
pple
.H
e is
in
full
skin
-to-
skin
con
tact
wit
h hi
s m
othe
r.
The
mot
her
and
baby
are
kep
t w
arm
tog
ethe
r.
IFE 2
/13
R. Lemoyne/UNICEF C-95 Thailand
176
Ove
rhea
d Fi
gure
s
177
Ove
rhea
d Fi
gure
s
If 10
0 w
omen
bre
astfe
ed w
here
HIV
is p
reva
lent
IFE 2
/14
H=
30 o
f th
ese
wom
en a
re
= 10
of
the
HIV
-pos
itiv
e w
omen
tra
nsm
itH
IV-p
osit
ive
and
untr
eate
d th
e vi
rus
befo
re/d
urin
g bi
rth
= 4
of t
he H
IV-p
osit
ive
wom
en t
rans
mit
the
viru
s by
bre
astf
eedi
ng
UN
AID
S/U
NIC
EF/
WH
O. H
IVC
. 200
0
178
Ove
rhea
d Fi
gure
s
179
Ove
rhea
d Fi
gure
s
Supp
ortiv
e ar
rang
emen
ts a
nd p
erso
nal a
ttent
ion
•re
duce
iso
lati
on
•pr
ovid
e pr
ivac
y if
cu
ltur
ally
req
uire
d
•en
cour
age
age-
appr
opri
ate
feed
ing
•ed
ucat
e fa
mily
and
co
mm
unit
y m
embe
rs
•re
mov
e co
nflic
ting
m
essa
ges
•lis
ten
•bu
ild c
onfi
denc
e.
IFE 2
/15
Adap
ted
from
F. S
avag
e, A
Bur
gess
- N
utrit
ion
for D
evel
opin
g C
ount
ries.
199
3
180
Ove
rhea
d Fi
gure
s
181
Ove
rhea
d Fi
gure
s
Deci
ding
who
nee
ds h
elp
IFE 2
/16
Sim
ple
rapi
das
sess
men
tCo
ntin
uing
supp
ortiv
e ca
re
Full
asse
ssm
ent
Basi
c aid
Furt
her h
elp
182
Ove
rhea
d Fi
gure
s
183
Ove
rhea
d Fi
gure
s
Sim
ple
Rapi
d As
sess
men
t (S
RA):
Age-
appr
opri
ate
feed
ing
Ask:
1.H
ow o
ld i
s th
e ba
by?
Age_
____
_mon
ths
2.Ar
e yo
u br
east
feed
ing
him
her
?3.
Is t
he b
aby
gett
ing
anyt
hing
els
e to
dri
nk o
r ea
t?
IFE 2
/17
Reas
ons t
o re
fer f
or Fu
ll Ass
essm
ent:
•
not
bre
astf
ed•
b
reas
tfed
but
fee
ding
not
age
-app
ropr
iate
- u
nder
6 m
onth
s, n
ot e
xclu
sive
ly b
reas
tfed
- o
ver
6 m
onth
s, g
iven
no
com
plem
enta
ry f
ood.
184
Ove
rhea
d Fi
gure
s
185
Ove
rhea
d Fi
gure
s
Sim
ple
Rapi
d As
sess
men
t (SR
A): B
reas
tfeed
ing
ease
Ask:
4.Is
the
bab
y ab
le t
o su
ckle
the
bre
ast?
5.H
ave
you
any
othe
r di
ffic
ulti
es w
ith
brea
stfe
edin
g?
IFE 2
/18
Reas
ons t
o re
fer f
or Fu
ll Ass
essm
ent:
•
bab
y no
t ab
le t
o su
ckle
•
mot
her
has
othe
r di
ffic
ulti
es w
ith
brea
stfe
edin
g•
mot
her
requ
ests
bre
astm
ilk s
ubst
itut
e.
186
Ove
rhea
d Fi
gure
s
187
Ove
rhea
d Fi
gure
s
Sim
ple
Rapi
d As
sess
men
t: Lo
okin
g at
bab
y’s c
ondi
tion
Look
:
6.D
oes
the
baby
loo
k ve
ry t
hin?
7.Is
the
bab
y le
thar
gic,
per
haps
ill?
IFE 2
/19
Reas
ons t
o re
fer f
or Fu
ll Ass
essm
ent:
•
loo
ks v
ery
thin
•
let
harg
ic,
perh
aps
ill.
188
Ove
rhea
d Fi
gure
s
189
Ove
rhea
d Fi
gure
s
Full
asse
ssm
ent S
tep
1:O
bser
ving
a b
reas
tfeed
•
Atta
chm
ent
- a
reol
a, m
ore
abov
e-
mou
th w
ide
open
- l
ower
lip
tur
ned
out
- c
hin
clos
e to
or
touc
hing
bre
ast
- n
o ni
pple
pai
n or
dis
com
fort
.
•
Suck
ling
- s
low
, de
ep s
ucks
, so
met
imes
pau
sing
- a
udib
le o
r vi
sibl
e sw
allo
win
g.
•
Mot
her c
onfid
ent
- e
njoy
men
t, r
elax
atio
n (n
ot s
haki
ng b
reas
t or
bab
y)-
sig
ns o
f bo
ndin
g (s
trok
ing,
eye
con
tact
, cl
ose
gent
le h
oldi
ng).
•
How
the
feed
end
s-
bab
y co
mes
off
the
bre
ast
by i
tsel
f (n
ot t
aken
off
by
mot
her)
- b
aby
look
s re
laxe
d an
d sa
tisf
ied,
and
los
es i
nter
est
in t
he b
reas
t-
mot
her
keep
s th
e br
east
ava
ilabl
e, o
r of
fers
the
oth
er b
reas
t.
IFE 2
/20
190
Ove
rhea
d Fi
gure
s
19¡
Ove
rhea
d Fi
gure
s
Full
Asse
ssm
ent S
tep
2: L
isten
ing
and
lear
ning
Brea
stfe
edin
g?__
_yes
___n
oHo
w of
ten
by d
ay?_
____
by
nig
ht?_
____
(U
sing
a pa
cifier
?__
_yes
___n
o)
Othe
r drin
ks a
nd fo
ods?
___y
es__
_no
Wha
t drin
ks?
____
____
____
____
____
____
__
How
give
n?__
____
____
____
____
____
____
_Ho
w m
any
times
a d
ay?
____
____
____
____
____
____
____
____
____
____
____
____
____
___
Wha
t sor
t of f
amily
food
s?__
____
____
____
____
____
____
____
____
____
____
____
____
___
How
man
y tim
es a
day
?__
____
____
____
____
____
____
____
____
____
____
____
____
____
_
Belie
fs a
nd w
orrie
s ab
out f
eedi
ng; h
ow m
othe
r/car
egive
r dec
ided
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
How
is m
othe
r/car
egive
r phy
sicall
y an
d em
otio
nally
?__
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
__
Inte
rest
in in
crea
sing
brea
stm
ilk o
r rela
ctat
ion
___y
es _
__no
This
tran
spar
ency
sum
mar
izes
the
topi
cs to
cov
er in
lear
ning
from
the
mot
her o
r car
egiv
er. B
ut it
can
not s
how
how
to a
sk o
pen
ques
-tio
ns, t
o lis
ten
atte
ntiv
ely
and
to b
e se
nsiti
ve to
eac
h w
oman
in a
ccor
d w
ith h
er c
ultu
re a
nd h
er fe
elin
gs.
IFE 2
/21
192
Ove
rhea
d Fi
gure
s
193
Ove
rhea
d Fi
gure
s
Appr
opri
ate
help
rest
ores
bre
astfe
edin
g an
d gr
owth
IFE 2
/22
Ella
at
four
wee
ksElla
at
four
month
s
Sourc
e: F
elic
ity
Sav
age
194
Ove
rhea
d Fi
gure
s
195
Ove
rhea
d Fi
gure
s
Basi
c Aid
for b
reas
tfeed
ing
Step
1. E
nsur
e ef
fect
ive
suck
ling
• im
prov
e at
tach
men
t •
help
wit
h po
siti
onin
g, i
f ne
cess
ary
• av
oid
dist
ract
ions
• re
mov
e in
terf
eren
ce w
ith
suck
ling
(bot
tles
, pa
cifi
ers)
.
Step
2. B
uild
the
mot
her’s
conf
iden
ce a
nd h
elp
milk
flow
• en
cour
age
skin
-to-
skin
con
tact
, fa
ce-t
o-fa
ce i
nter
acti
on•
have
a r
eass
urin
g, f
rien
dly
man
ner,
wit
hout
cri
tici
sm o
r co
mm
ands
• pr
aise
wha
t m
othe
r an
d ba
by a
re d
oing
wel
l•
give
her
rel
evan
t in
form
atio
n in
an
enco
urag
ing
way
• tr
y to
fin
d w
arm
com
pani
onsh
ip f
or h
er.
IFE 2
/23
196
Ove
rhea
d Fi
gure
s
197
Ove
rhea
d Fi
gure
s
Age-
appr
opri
ate
feed
ing
incl
udes
star
ting
com
plem
enta
ry fo
ods a
t the
age
of 6
mon
ths
From
six
mon
ths
to t
wo
year
s of
age
, ch
ildre
n sh
ould
rec
eive
app
ropr
iate
co
mpl
emen
tary
foo
ds i
n ad
diti
on t
o co
ntin
ued
freq
uent
bre
astf
eedi
ng.IFE
2/2
4
Brian Gleeson, CRS Angola
198
Ove
rhea
d Fi
gure
s
199
Ove
rhea
d Fi
gure
s
Basi
c Aid
for b
reas
tfeed
ing
Step
3. I
ncre
ase
milk
pro
duct
ion
• Enco
ura
ge
the
moth
er t
o let
the
bab
y su
ckle
fre
quen
tly.
• Exp
lain
how
to let
the
bab
y su
ckle
longer
at
each
fee
d.
• H
elp t
he
moth
er t
o g
et e
nough w
ater
to d
rink.
(Support
ive
care
as
sure
s m
oth
er g
ets
enough f
ood.)
• Rem
ove
any
inte
rfer
ence
; re
duce
supple
men
ts b
y 30-6
0 m
l/day
.
Step
4. E
ncou
rage
age
-app
ropr
iate
feed
ing
•If
nec
essa
ry h
elp t
he
moth
er t
o r
e-es
tablis
h e
xclu
sive
bre
astf
eedin
guntil th
e bab
y is
six
month
s old
.•
If m
ilk s
upple
men
ts a
re n
eeded
, te
ach h
er t
o g
ive
them
by
cup,
not
bott
le.
• Show
her
how
to p
repar
e an
d g
ive
adeq
uat
e co
mple
men
tary
foods
from
six
month
s of
age.
IFE 2
/25
200
Ove
rhea
d Fi
gure
s
201
Ove
rhea
d Fi
gure
s
Feed
ing
with
a cu
pIFE
2/2
6 Adapted from UNICEF BFHI News
If a
n in
fant
can
• su
ck (
or l
ap m
ilk w
ith
the
tong
ue)
and
• sw
allo
w
he o
r sh
e ca
n be
fed
wit
h an
y op
en c
up
Use
of
feed
ing
bott
les
incr
ease
s ri
sks
of i
llnes
s.
202
Ove
rhea
d Fi
gure
s
203
Ove
rhea
d Fi
gure
s
How
to cu
p fe
ed
The
milk
just
rea
ches
the
infa
nt’s
lips.
The
care
giv
er d
oes
not
pour
the
milk
into
the
bab
y’s
mouth
. The
infa
nt
take
s up t
he
milk
with h
is/h
er t
ongue,
suck
s or
sips.
IFE 2
/27
F. Savage / Philippines & UK
204
Ove
rhea
d Fi
gure
s
205
Ove
rhea
d Fi
gure
s
Cup
feed
ing
a Lo
w-B
irth
-Wei
ght (
LBW
) in
fant
with
exp
ress
ed b
reas
tmilk
A m
oth
er in K
enya
fee
ds
her
ow
nfr
eshly
exp
ress
ed b
reas
tmilk
to
her
low
-birth
-wei
ght
bab
y.
In t
his
mat
ernity
faci
lity,
m
oth
ers
hel
p e
ach o
ther
to lea
rnth
e sk
ills
of
han
d e
xpre
ssio
n a
nd
cup f
eedin
g u
ntil th
eir
bab
ies
are
read
y to
suck
le.
LBW
infa
nts
are
dis
char
ged
excl
usi
vely
bre
astf
eedin
g.
UNICEF/HQ91-0505/Betty Press
IFE 2
/28
206
Ove
rhea
d Fi
gure
s
207
Ove
rhea
d Fi
gure
s
Kang
aroo
Car
e
To re
duce
hea
t loss
whe
n ve
ry co
ldco
ver t
he in
fant
´s h
ead
with
a ca
p or
the
mot
her’s
shaw
l.
The
infa
nt
is k
ept
in f
ull
skin
-to-s
kin c
onta
ct w
ith t
he
moth
er d
ayan
d n
ight,
and b
reas
tfee
ds
as m
uch
as
his
/her
conditio
n a
llow
s.
IFE 2
/29
208
Ove
rhea
d Fi
gure
s
209
Ove
rhea
d Fi
gure
s
Bond
ing
is im
prov
ed b
y Ka
ngar
oo C
are
The
infa
nt’s h
ands
sho
uld
be le
ftfree
so
he o
r sh
e ca
n m
ove
them
in
or
out of
the
war
mth
.
Kan
garo
o Car
e in
fant
s m
ay r
egul
ate
thei
r ow
n te
mpe
ratu
re in
thi
s w
ay.
IFE 2
/30 UNICEF/HQ94-0632/Dora Gutierrez
210
Ove
rhea
d Fi
gure
s
211
Ove
rhea
d Fi
gure
s
The
need
for r
esto
rativ
e ca
reIFE
2/3
1
UNHCR/Sudan/V. Sparre-Ulrich/10068
Str
ess,
tra
um
a, g
rief
, or
sexu
al v
iole
nce
do n
ot
spoil
a m
oth
er’s
bre
astm
ilk,
but
she
nee
ds
care
that
hel
ps
to r
esto
re h
er e
motional
bal
ance
.
212
Ove
rhea
d Fi
gure
s
213
Ove
rhea
d Fi
gure
s
“Hou
seho
ld” c
ondi
tions
whe
n th
ere
is n
o ho
use
IFE 2
/32
UNHCR/C. Sattleberger. From WHO, Reproductive health during conflict and displacement. 2000
214
Ove
rhea
d Fi
gure
s
215
Ove
rhea
d Fi
gure
s
Full
Asse
ssm
ent S
tep
3: O
bser
ving
arti
ficia
l feed
ing
What
res
ourc
es a
re a
vaila
ble
in t
he
house
hold
?
Brea
stm
ilk su
bstit
ute
___Suitab
le b
reas
tmilk
subst
itute
(o
r in
gre
die
nts
and r
ecip
e)
___Exp
iry
dat
e cl
ear, n
ot
pas
t___In
stru
ctio
ns
in u
ser’s
ow
n lan
guag
e___H
ouse
hold
mem
ber
able
to r
ead inst
ruct
ions
___Supply
ass
ure
d u
ntil nee
d n
o longer
exi
sts.
Stor
age
___Saf
e st
ora
ge
for
ingre
die
nts
, fe
eds
___W
ater
boile
d (
spec
ial cl
ean c
onta
iner
, co
ver)
___Ref
riger
atio
n a
vaila
ble
(if f
eeds
mad
e in
adva
nce
).
Prep
arat
ion
faci
litie
s___Adeq
uat
e fu
el f
or
pre
par
atio
n___Adeq
uat
e drinki
ng w
ater
for
pre
par
atio
n___Adeq
uat
e oth
er w
ater
, so
ap f
or
ute
nsi
ls,
han
ds
___Cle
an s
urf
ace,
cle
an c
loth
to c
over
ute
nsi
ls___M
eans
of
mea
suring m
ilk a
nd w
ater
(not
bott
le).
Extr
a tim
e___Tim
e to
pre
par
e 6-8
fre
sh f
eeds/
day
.
IFE 2
/33
216
Ove
rhea
d Fi
gure
s
217
Ove
rhea
d Fi
gure
s
Full
Asse
ssm
ent S
tep
3: O
bser
ving
arti
ficia
l feed
ing
How
does
the
care
giv
er m
anag
e th
e fe
edin
g?
Prep
arat
ion
___Car
egiv
er w
ashes
han
ds
___Cup w
ashed
with s
oap
, w
ater
___Bott
le,
teat
was
hed
and b
oile
d b
efore
this
use
___Car
egiv
er m
easu
res
milk
, w
ater
corr
ectly.
Feed
ing
tech
niqu
e___In
fant
fed w
ith c
up,
take
s m
ost
of
milk
___In
fant
fed w
ith b
ott
le,
artifici
al t
eat
___In
fant
fed w
ith a
noth
er m
ethod:
_____________
Inte
ract
ion
and
end
___In
fant
is h
eld t
hro
ughout
feed
___Car
egiv
er inte
ract
s lo
vingly
during f
eed
___In
fant
finis
hes
milk
___N
one
of
feed
kep
t fo
r giv
ing t
o infa
nt
late
r.
Adeq
uacy
of m
ilk fe
eds
___Corr
ect
num
ber
and a
mount
of
milk
fee
ds
for
age
or
wei
ght.
Age-
appr
opri
ate
feed
ing
___U
nder
6 m
onth
s, o
nly
milk
is
giv
en___O
ver
6 m
onth
s, m
ilk a
nd c
om
ple
men
tary
foods
are
giv
en.
IFE 2
/34
218
Ove
rhea
d Fi
gure
s
219
Ove
rhea
d Fi
gure
s
The
drop
and
dri
p te
chni
que
IFE 2
/35
220
Ove
rhea
d Fi
gure
s
221
Ove
rhea
d Fi
gure
s
Usin
g a
brea
stfe
edin
g su
pple
men
ter
IFE 2
/36
222
Ove
rhea
d Fi
gure
s
223
IFE 2
/37
Mot
her u
sing
bre
astfe
edin
g su
pple
men
ter
Ove
rhea
d Fi
gure
s
UNICEF, Somalia
The update to Module 2, v1.1 was funded by the UNICEF-ledInter-Agency Standing Committee (IASC) Nutrition Cluster.
