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eSymposia | Optimizing Nutrition for Maternal, Newborn and Child Health


Food security at the start of life: A Prevention model for Malnutrition


Oct 21, 2020 12:00am ‐ Oct 21, 2020 12:00am

Description

Food security at the start of life: A Prevention model for Malnutrition Marcos Arana_Cedeño· Sofía Matienzo**, Valentina Arana** and Cecilia Monroy*** Food security during the first three years of life is crucial for the prevention of infant and young child malnutrition, the prevention of chronic disorders later in life. Its three basic principles are: (1) exclusive breastfeeding during the first six months of life, followed by (2) nutritional complementary feeding based on locally produced foods coupled with (3) continued breastfeeding. This strategy is implemented thorough a model called Consultas Colectivas (Collective consultations, CC) CC is the product of a project designed and implemented by the Training Center on Ecology and Health for Peasants[i] (CCESC) in collaboration with the Mexico´s National Institute of Medical Sciences and Nutrition Salvador Zubirán (INNSZ), The project, funded by UNFPA (1997-1999) consisted in designing and validating a model of continuous care for Mayan indigenous women and Guatemalan refugees in order to offer culturally appropriate care to pregnant women and accompany them during their pregnancy, childbirth, and the first 24 months of their children; This follow-up covers the birth interval period and supports women to make their reproductive decisions explicit, lengthen birth spacing through exclusive and prolonged breastfeeding and support the use of family planning methods that do not undermine breastfeeding. CC consists of periodic gatherings of mothers sharing the same conditions of being pregnant or having their youngest child of the same age. After birth, the mothers takes part of a second CC with other women with babies aged less younger than 6 months.; this CC focuses on breastfeeding counselling and LAM[1] and to support women to make their reproductive decisions explicit. When the infant is six months, a more frequentfollow up is carried out weekly, in which introduction of complementary foods is advocated from six months of age, emphasizing five priority subjects: adequate complementary food, production in the vegetable patch garden, hygiene and psychomotor development. Likewise, demonstrative preparations of purees produced with a mix of locally available seasonal foods to improve the biological availability of nutrients were carried out to encourage the consumption of locally available and traditional foods. The purpose was to reinforce the benefits of exclusive breastfeeding during the first six months, and then trigger an effective introduction of complementary nutrition, accompanied with stimulation. In addition to averting malnutrition in this critical period, the project seeks to foster “nutritional imprinting”. This promotes early development of tastes and preferences favoring the flavors, colors, and textures of traditionally and locally produced foods, free of additional sugar and salt. This strategy has great relevance as an early measure against obesity and Type II Diabetes, one of the greatest health threats in the country. The fourth CC brings together mother with children from 9 to 24 months. Apart from the continued anthropometric follow up of small children, the gatherings are centered in maternal health and well being. CC was adopted as a public policy in the state of Chiapas, Mexico in 2000 with the name Vida Mejor para las Mujeres, niñas y niños de Chiapas (Better Life for the women and children of Chiapas), and included improved health care, safe water, elimination of wood smoke exposure, as well as the promotion of the participation of women in the community decisions. Although the program was interrupted six years later due to budgetary constrains , CC was recognized as a successful experience. CC was used as a methodology to promote Breastfeeding Friendly Communities. The implementation of CC continued in some regions and incorporated important innovations: The Photographic and anthropometric follow-up of children accordingly with CC; Printed images are given to mothers to improve understanding of the growth and development of their using an analogy with the growth of a corn plant phrased using images and local languages. Recently work with traditional midwives has been included, using photography to stimulate and register early attachment, conditions of the neonate, a visual semi APGAR assesment , birth weight and identification of visible birth defects. These images will be the starting point for the child´s anthropometric and visual follow-up during the following 24 months. This photographic record will be promoted as a valid document to obtain the birth certificate. · Director of Centro de Capacitación en Ecología y Salud para Campesinos (CCESC); researcher in the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; technical secretary of the Committee for Safe Motherhood in Chiapas. ** Researcher at CCESC *** Coordinator of CCESC Midwives Photography Project. [1] Lactational amenorrhea method Template for visual follow-up of infants and young children by mothers and family with the use of photography during the first 24 months of life Lekil Chi`el: Right growing up in Mayan languages

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