Infant and Young Child Feeding Recommendations (Uganda Context)

Clinical assessment

Assess current feeding practices against these recommendations during growth monitoring or nutrition counseling.

Investigations

• Dietary history/recall.

Diagnostic criteria

Alignment with age-appropriate recommendations.

Non-pharmacological management

• Birth up to 6 months:
• - Exclusive Breastfeeding: Breastfeed as often as child wants, day and night (on demand, at least 8 times/24h). NO other foods or fluids (not even water).
• 6 up to 9 months:
• - Continue Breastfeeding on demand.
• - Introduce Complementary Foods: Start with thick porridge (maize, millet, soya, cassava flour) mixed with energy (oil) and protein (milk, pounded groundnuts). Gradually introduce well-mashed family foods (matooke, potato, posho, rice) mixed with protein source (beans, fish, G-nuts) and green vegetables.
• - Quantity: Start 2-3 tablespoons, gradually increase to 1/2 cup (125ml) per meal.
• - Frequency: 2-3 meals per day, PLUS 1-2 nutritious snacks (e.g., egg, banana, bread) between meals.
• - Consistency: Thick porridge/puree initially, progressing to mashed.
• 9 up to 12 months:
• - Continue Breastfeeding on demand.
• - Complementary Foods: Increase variety and texture. Give finely chopped or mashed family foods. Include animal source foods and Vitamin A-rich fruits/vegetables.
• - Quantity: Increase to 3/4 cup (approx 180ml) per meal.
• - Frequency: 3-4 meals per day, PLUS 1-2 snacks.
• 12 up to 24 months:
• - Continue Breastfeeding on demand (up to 2 years or beyond).
• - Complementary Foods: Give chopped family foods. Ensure variety, including animal source foods and Vitamin A-rich fruits/vegetables.
• - Quantity: Increase to 1 full cup (250ml) per meal.
• - Frequency: 3-4 meals per day, PLUS 1-2 snacks.
• Age 2 years and over:
• - Give variety of family foods.
• - Quantity: At least 1 full cup (250ml) per meal.
• - Frequency: 3-4 meals per day, PLUS 1-2 snacks.
• Responsive Feeding: Feed slowly and patiently, encourage but do not force. Talk to child, maintain eye contact. Minimize distractions.
• Hygiene: Wash hands before preparing food and feeding. Use clean utensils. Store food safely.
• Feeding During Illness: Breastfeed more often. Offer frequent small meals. Encourage fluid intake.
• Stopping Breastfeeding: Gradual process over ~1 month. Ensure safe preparation/storage of replacement feeds (if used). Cup feeding preferred.
• Persistent Diarrhoea Feeding: Increase breastfeeding. If taking other milk, replace with fermented milk (yoghurt) or half milk + mashed foods. Follow age-appropriate feeding otherwise.

Pharmacological treatment

• Micronutrient powders (MNPs) may be available through programs for home fortification of foods (6-23 months).

Monitoring

Monitor growth regularly using WHO charts. Assess feeding practices at each visit.