An assessment of the causes of malnutrition in Ethiopia: A ...

Table 4.1: Optimal infant and young child feeding practices
Optimal breastfeeding
Optimal complementary feeding (FADUA)
• Initiate breast feeing within 1 hour after
delivery.
• Exclusive breastfeeding for the first six months
(5.9 months).
• Give colostrum and no prelacteal feeds.
• Proper positioning and attachment.
• Frequent feeding on demand or on cues day
and night at least 8-12 times (every 2-3 hours).
• Maternal nutrition (the mother should take at
least two additional meals per day that usual=
650 Kcal/day).
• Increased frequency of feeding when the baby
is sick.
• Active/ responsive feeding.
• Complementary feeding at six months.
abbreviation FADUA can guide mothers as they carry out optimal complementary feeding
practices to supplement their breast-milk with other foods for the young child.
4.2.2.4. Contribution of improved nutrition for mothers and children to achieving the
MDGs and poverty reduction
The Millennium Development Goals and poverty reduction strategies cannot be
realized without addressing the nutrition security of the most vulnerable segments of the
population (mothers and children). This can be achieved by proper caring practices, which are
hitherto the missing piece in all nutrition interventions. Three of the MDGs are directly
related to nutrition and their achievement is measured by the reduction in the level of child
malnutrition. In addition, the long-term intergenerational consequences of malnutrition will
reduce both physical and intellectual productivity, resulting in the perpetuation of poverty and
underdevelopment. The long-term economic benefits of maternal nutrition during pregnancy
to prevent low birth-weight are depicted in Table 4.2. The cost-benefit ratio of efforts to
reduce low birthweight range from 0.014 : 1 to 0.101 : 1 or an average net economic gain of
$972 to $886 per low birth weight averted. It is clear that all interventions to increase child
growth, development and survival, and economic growth and poverty reduction should
consider maternal nutrition seriously.
4.2.3. Health Care
• Introduce complementary foods at 6 months of
age (180 days) while continuing to breastfeed
• Continue frequent, on-demand breastfeeding until
2 years of age or beyond
• As child gets older, increase the number of times
that the child is fed complementary foods (F).
• Start with small amounts of food and increase the
quantity as the child gets older (A).
• 200 kcal per day at 6-8 months.
• 300 kcal per day at 9-11 months.
• 550 kcal per day at 12-23 months.
• Gradually increase food consistency and variety
as the infant gets older (D).
• Practice good hygiene and proper food handling
(U).
• Practice responsive feeding, applying the
principles of psychosocial care (A).
Access to health services, together with a healthy environment, is the third necessary
condition for good nutrition. Prenatal and post-natal care, immunization (particularly against
measles), oral rehydration therapy, distribution of micronutrient supplements, de-worming,
family planning, and health education are all important health services with great impact on
nutrition (Gillespie & Haddad 2003). It is well known that infection and malnutrition have a
synergistic effect on health. Adequate health includes access to curative and preventive
services, a hygienic and sanitary environment, and access to clean water. Access to health
care services creates an opportunity to deliver behavior-change messages about the link
between of malnutrition and health (Save the Children Fund (UK) 2002).
In Ethiopia, the basic health service coverage is low (MOH 2003/2004). This is
reinforced by a low utilization, especially of care-related preventive health services, resulting
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