| Visual Cue
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Narration
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| Title Slide
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Welcome to the spoken tutorial on essential nutrition actions
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| Collage: Steps
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In this tutorial we will learn about the best ways to prevent malnutrition.
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| Image: First 1000 days
Image: Infant
Image: Conception to the second birthday
Image: Malnutrition
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Essential nutrition actions are a preventive approach to tackle malnutrition.
They are required during the first 1,000 days.
First 1,000 days start from conception to the second birthday of the baby.
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| Image: ENA
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Essential nutrition actionsare also known as ENA.
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| collage: Actions
Image: Delayed cord clamping
IMage: Additional iron
Image: feeling the pulse
IMage: Stop pulsating
Image: Delayed cord clamping
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For a newborn, the first ENAto be done is delaying the clamping of the cord.
The umbilical cord should not be cut immediately after delivery.
The nurse should first feel the pulsation of the cord.
The cord should be cut when it stops pulsating.
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| IMage: improves baby's stores
Image: Prevention of anemia
IMage: Complementary food and iron rich food
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Delayed cord clamping allows blood flow between placenta and the baby.
This may improve the iron store in the baby for the first 6 months.
Doing so prevents anemia in babies during these months.
After 6 months, iron rich food should be given through complementary food.
Along with complementary food, the baby should be breastfed until 2 years of age.
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| Image: Breastfeeding
Image: Place baby on abdomen
Image: babies finding mothers breast
Image: Breast crawl
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After clamping the cord, the baby should be breastfed.
To do so, the baby should be placed on the mother's bare abdomen.
A baby is born with an instinctive feeding behavior.
With this behavior it can find the mother's breast and initiate breastfeeding.
This entire process is called breast crawl.
More about breast crawl has been explained in another tutorial.
Please visit our website for this tutorial.
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| Image: breastfeeding immediately after birth
Image: colostrum
Image: Breast milk
Image:Breast milk containing antibodies
Image: Good fats
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It is important to start breastfeeding within one hour of birth.
The first milk is called the colostrum.
It is the primary source of nutrients for a newborn.
Colostrum has infection-fighting elements and good fat.
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| Image: Breast milk
Image: Eye health and immunity
Image: Vitamin A supplementation
Image: Vitamin A rich food
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Breast milk is also the first source of vitamin A for the baby.
Vitamin A is vital for healthy eyes and immunity.
Breastmilk is enough to meet the vitamin A requirements for the first 6 months.
After 6 months, vitamin A rich complementary food should be given.
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| Image: correct latching
Image: Poor attachment
Image: very little milk
Image: baby getting sufficient milk
Image: Areola
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For effective breastfeeding, correct latching is most important.
Poor attachment of the baby’s mouth to the breast will result in nipple feeding.
This will give very little milk to the baby.
Baby's mouth should attach to the lower part of the areola.
This way the baby will get sufficient milk.
Areola is the dark area around the nipple.
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| Image: correct technique
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Breastfeeding techniques are discussed in other tutorials.
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| Image: 6 month old baby
Collage: Breastfeeding
Collage: Breastfeeding and complementary feeding
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On completion of 6 months, the baby's nutrient requirement increases rapidly.
At this stageexclusive breastfeeding is not enough.
Complementary food should be introduced, along with breastfeeding.
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| Image: 6 month old baby
Collage: Puree, khichdi, finger foods
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It should start as soon as the baby completes 6 months of age.
6 months of age does not mean the start of the 6th month of a baby’s life.
It means she has completed 6 months and has started the 7th month of her life.
Also, the quantity and consistency of the food should be changed as per the age.
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| Collage: cereals, millets, seeds, vegetables and fruits
Collage: Grains, roots, tubers
Collage: legumes, seeds, nuts
Collage: milk products
Collage: Non veg
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A baby’s diet must include different food groups.
The first food group is grains, roots, and tubers.
Legumes, seeds, and nuts are the second group.
The third group is milk products. Meat, fish, and chicken are the fourth group.
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| Collage: Egg
Collage: Vitamin A rich food
Collage: Other fruits and vegetables
Image: Breastfeeding
Image: 8 food groups
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Egg is the fifth group.
Vitamin A rich fruits and vegetables are the sixth group.
The seventh group is other fruits and vegetables.
Lastly, breastfeeding is the eighth group but the most important one.
Ideally, a baby’s diet must include all 8 food groups.
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| Image: Growth
Collage: Complementary feeding
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All these foods provide nutrients that help in the growth of the baby.
The details of complementary feeding have been discussed in another tutorial.
Please visit our website for this tutorial
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| Collage: supplements
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Let us now look at the supplements that should be given to the babies.
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Image: Iron folic acid supplement
Image: Twice a week
Image: Vitamin A supplementation
Image: 9 months to 5 years
Image: Asha worker
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From 6 months to 5 years, iron-folic acid supplements should be given.
It has to be given to babies twice a week by healthcare workers.
Vitamin A supplement should be given twice a year.
This supplement is given from 9 months to 5 years of age.
The supplements should be given under the guidance of a health care provider.
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| Collage: Diarrhea
Image: sodiumand potassiumloss
Image: Infant deaths
Collage: Diarrhea management
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We will now see ENAto treat a baby having diarrhea.
Diarrhea is a major cause of malnutrition.
It causes water loss and imbalance of sodiumand potassiumin the body.
In severe cases, infant deaths may also happen.
Hence, it is very important to treat diarrhea.
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Image: ORSsachet
Image: Zinc supplementation
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ORSand zinc supplements help in treating diarrhea.
ORSis Oral rehydration salts.
Itreplenishes the water and Sodium and potassium in the body.
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| Image: ORSsachet
Image: Boiled and cooled water
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It is easily available in the market as powder form in packets.
To use it, mix one packet of ORS in 1 litre of boiled and cooled water.
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| Image: Zinc supplementation
Image: Diarrhea
Image: Immunity
Image: Zinc supplementation calendar
Image: 10 ml zinc
Image: 20 ml Zinc
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Along with ORS, Zinc supplement is necessary too.
Zinc reduces the duration, frequency, and severity of diarrhea in children.
It improves the immunity of the baby.
It should be given once a day for 14 days.
10 milligrams of zinc per day should be given to babies below 6 months.
20 milligrams of zincper day should be given to 6 months old and above.
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| Image: Dissolving tablets
Image: Boiled and cooled water
Image: health care provider
Image: breastfeeding
Image: Complementary feeding
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In a small spoon, dissolve Zinctablets in breast milk or ORS.
You may also use boiled and cooled water.
ORSand zinctablets should be given after consulting a healthcare provider.
Along with ORSand zinc, less than 6 month old babies should be breastfed.
6 to 24 month old babies should be breastfed and given complementary food.
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| Image: breastfeeding
Image: weight gain and recovery
Image: KMC
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Remember a baby during sickness should be breastfed often.
It helps in faster recovery and weight gain.
It also comforts the sick baby.
With breastfeeding, kangaroo mother care should be provided to every baby.
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| Image: Kangaroo mother care
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Kangaroo mother care is also recommended for low birth weight babies.
More about kangaroo mother care has been discussed in another tutorial.
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| Image: Increase food
Image: Appetite
Image: variety of foods
Collage: type 1 and type2
Image: Breastfeeding
Collage: type 1 and type2
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If the baby is older than 6 months, increase the food to one and a half times.
Do this when the baby’s appetite comes back during the recovery period.
Encourage the baby to eat by offering a variety of foods.
Give her type 1 and type 2 nutrient-rich food as per her hunger cues.
More about type 1 and type 2 nutrients has been discussed in another tutorial.
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| Image: consulting doctor
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In severe conditions, the mother should consult a health worker immediately.
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| Image: Malnourished baby
Image: Nutrition rehabilitation center
Collage: Malnourished baby and healthy baby
Collage: Home cooked food and a health worker is talking to a mother
Image: A health worker talking
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Health workers should refer the severely malnourished babies to the NRC.
NRC is anutrition rehabilitation center.
It is a unit for restoring the health of severely malnourished children.
This center provides specialized nutrition therapy to babies.
It makes them ready for home-cooked food if they have completed 6 months of age.
It also educates mothers about breastfeeding, child nutrition, and child care.
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| Collage: ENA
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Follow the Essential Nutrition actions to keep the baby healthy.
They also help in preventing malnutrition in babies.
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| Acknowledgement slide
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This brings us to the end of this tutorial.
Thanks for joining.
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