Neobook — clinical reference

If the Mother Reports Difficulty with Breastfeeding

If the Child is Less than 6 Months Old

If the Caregiver is Using a Bottle to Feed the Child

If the Child is Not Being Fed Actively, Counsel the Caregiver to

If the Child Above 6 Months Old

If There is No Food Available in the House

Children Who Are Overweight/ Obese

If Mother Reports Difficulty with Breastfeeding, Assess Breastfeeding

(Refer to Feeding and Growth Breastfed and Non-breastfed Infants or Correct volumes and frequency of feeds)

Identify the reason for the mother’s concern and manage any breast condition
If needed, show recommended positioning and attachment
Build the mother’s confidence
Advise her that frequent feeds improve lactation

If The Child is Less than 6 Months Old,

AND

the child is taking foods or fluids other than breastmilk:
- Build mother’s confidence that she can produce all the breastmilk that the child needs. Water and other milk are not necessary
- If she has stopped breastfeeding, refer her to a breastfeeding counsellor to help with relactation
- Suggest giving more frequent, longer breastfeeds, day or night, and gradually reducing other milk or foods
the mother or infant are not able to breastfeed due to medical reasons, counsel the mother to:
- Make sure she uses an appropriate infant formula
- Prepare formula correctly and hygienically, and give adequate amounts
- Discard any feed that remains after two hours.

If the Caregiver is Using a Bottle to Feed the Child

Recommend a cup instead of a bottle. Show the caregiver how to feed the child with a cup

If the Child is Not Being Fed Actively, Counsel the Caregiver to

Sit with the child and encourage eating
Give the child an adequate serving in a separate plate or bowl

If the Child Above 6 Months has a Poor Appetite, or is Not Feeding Well During this Illness, Counsel the Caregiver to

Breastfeed more frequently and for longer if possible
Use soft, varied, favourite foods to encourage the child to eat as much as possible
Give foods of a suitable consistency, not too thick or dry
Avoid buying sweets, chips and other snacks that replace healthy food
Offer small, frequent feeds. Try when the child is alert and happy, and give more food if he/shes hows interest
Clear a blocked nose if it interferes with feeding
Offer soft foods that don’t burn the mouth, if the child has mouth ulcers / sores e.g. eggs,mashed potatoes, sweet potatoes, pumpkin or avocado
Ensure that the spoon is the right size, food is within reach, child is actively fed, e.g. sits on caregiver’s lap while eating
Expect the appetite to improve as the child gets better

If There is No Food Available in the House

Help caregiver to get a Child Support Grant for any of her children who are eligible
Put her in touch with a Social Worker and local organisations that may assist
Encourage the caregiver to have or participate in a vegetable garden
Supply milk and enriched (energy dense) porridge from the Food Supplementation programme
Give caregiver appropriate local recipes for enriched (energy dense) porridge

Counsel the Caregiver of Children who are Overweight / Obese

Avoid giving your child unhealthy foods like chips, sweets, sugar, and fizzy drinks
Give appropriate amount of food and milk (Refer to Correct volumes and frequency of feeds and Feeding recommendations from 6 months)
Encourage on physical activity

Integrated Management of Childhood Illness 2022; Young Infant (Birth up to 2 months); Counsel the Mother or Caregiver on Infant and Young Child Feeding (Birth up to 2 months); Counsel the Caregiver about Feeding Problems

Last checked for updates: June 2023