1. UNICEF Programme Division Nutrition Section
Integrated Early Childhood Development at UNICEF: Targeting the Mother-Child Dyad - Vital to MTSP Success
UNICEF
Programme Division
Nutrition Section

2. What is Optimal Infant and Young Child Feeding?
Six months exclusive breastfeeding
Continued breastfeeding with appropriate complementary foods and feeding for 2 years and beyond
Related maternal nutrition and care
(Birth Interval of 3 years or more)

3. A World Fit for Children
By 2010:
Reduction of child malnutrition among children under five years of age by at least one-third, with special attention to children under two years of age, and reduction in the rate of low birth weight by at least one third of the current rate.
Other Millenium Goals for <5MR and MMR

4. Nutrition related MTSP target indicators
Reduction in anemia prevalence among women of reproductive age by 15%
> 60% of pregnant women use adequate antenatal services
> 60% of children receive appropriate home care for prevention and treatment of malnutrition

5. Focus of I/ECD
Integrated-ECD is based on child’s rights principles and the life-cycle approach, developed to co-ordinate actions at different levels, aiming to improve:
Quality of family care
Family access to good basic services and adequate livelihoods
Community & policy environment needed to support the previous points.
General Goals:
Survival, Growth and Development

6. Breastfeeding is the Heartbeat of Primary Health
Breastfeeding supports:
Nutrition
Oral Rehydration
Birth Spacing
and Fertility
Growth
and Development
Maternal Health
and Survival
Immunization
Reduced Cancer
and Chronic Disease
Logo, Breastfeeding Division, IRH

7. I/ECD: Health, Nutrition, WES, ECD, & Child Protection: The Importance of the Mother-Child Dyad
Maternal nutrition for birth weight and maternal survival, early initiation of exclusive breastfeeding (EBF)
EBF, appropriate CF which includes responsive feeding, VitA, Birth spacing
Mother-child vs Child orientation, empowering caretaker to act and interact
If mom survives, the child is 3- 5 times more likely to survive
“A good start on life”
“Children under 3 y.o.”
“Support women’s health, nutrition, and well-being”
“Links to maternal health and survival”

8. Other MTSP Strategies Girl’s Education Immunisation Plus HIV/AIDS
Child Protection
Cognitive and psycho-social achievement highly associated with breastfeeding
Breastfeeding provides first immune protection, and Vitamin A, among others, helps fight disease
Strong nutrition link; EBF decreases transmission
Nurtured and breastfed children less likely to be deserted and abused

9. Current and Planned I/ECD Interventions:
The Same Target Audience for All
FP(UNFPA)
ECD
LAM
BF/CF
ANTENATAL CARE
AT LEAST THREE YEARS
BIRTH SPACING VIA
FAMILY PLANNING USE
“Expanded Step Ten”
CODE
MNI CF
IMCI/CIMCI
IMM WES
CARE SEEKING
OPTIMAL AND RESPONSIVE
INFANT AND
YOUNG CHILD FEEDING
Expanded MPS/SM
BFHI
SAFE DELIVERY
ADEQUATE BIRTH WEIGHT
MPS
MNI
Malaria Presumptive Tx/Nets
ANTENATAL CARE

10. Optimal Breastfeeding Remains Central
Mother-Child Dyad:
The Heart of ECD
Three years birth spacing for mother’s nutritional recovery
Three years as youngest child
Three years of stimulation and responsive feeding
Three years of health-care seeking and preventive actions
Optimal Breastfeeding Remains Central
Maternal Protein, Calorie and Micronutrient Stores

11. Baby Friendly and Beyond
Is it time to expand beyond BFHI?
If so, in what direction?
How can we support the World Fit for Children goals, the new UNICEF priorities, the war on HIV, while maintaining support and interest in best start for children: the caring of an empowered mother?
What specific components would extend the effort towards increased empowerment of women while maintaining the focus on the importance of optimal breastfeeding?
Other ideas?

12. Countries that have adopted the Code into Law
16 countries have measures drafted awaiting final approval, and a further 26 are studying how best to implement the Code.

13. Infant Feeding and HIV: Draft Action Framework
1. Create comprehensive Infant and Young Child Feeding policies
2. Support the International Code of Marketing of Breastmilk Substitutes
3. Promote, protect and support optimal infant and young child feeding practices, especially in HIV prevalent areas
4. Support HIV-positive women to succeed in their infant feeding choice
5. Support country level learning, monitoring and evaluation, and operational research

14. Conclusion: Breastfeeding support is central to the helath of the mother-child dyad, and central to I/ECD!

15. Thank you
Asante-sana
Salamat po
Merci
Gracias
Danke
Spasibo
Abrigato
Barakallaofik

16. Breastfeeding -> Early Childhood Development
Increases in breastfeeding are associated with:
Decreased child desertion in hospitals
Best growth in first 6 months
Improved elements of neuro-psycho-motor development at age 1-2, and up to 12
Improved vision from a few months to years
Increased independence and parental trust
Increased intelligence quotient (IQ) assessed at ages 8 and 9 years; at age 18 years
Decreased infectious and chronic illness, and decreased impact of several metabolic conditions, supporting continued thriving

17. Breastfeeding -> Early Childhood Development
Increased adolescent perceptions of maternal caring
Higher reading comprehension, mathematical ability, and scholastic ability assessed during the period from 10 to 13 years;
Higher teacher ratings of reading and mathematics assessed at 8 and 12 years;
Higher levels of attainment in school leaving examinations
Contribution to birth intervals, allowing more attention to care and feeding, and maternal nutritional recovery:
Result: children are alive and thrive!

18. Conclusions
Interactive Breastfeeding and Responsive feeding are major elements in the life of the 0-3 year old
Early, Exclusive and Sustained Breastfeeding are responsive to intervention programs
Survival, growth and development benefit inescapably from the presence of a living, health, and well-informed mother who is supported by her community - breastfeeding is empowering
If optimal infant and young child feeding is programmed, nearly all aspects of ECD are addressed and supported.
Targeting the maternal-child dyad may be a key to cross-sectoral integration