Friday, March 02, 2007

An 18 hour Breastfeeding counselling course at IGMH

The first 18 hour breastfeeding counselling training program (to train breastfeeding counsellors) was completed yesterday at IGMH. IGMH being a certified Baby Friendly Hospital (by UNICEF) needs to train all medical staff who come in contact with mothers and babies to acquire skills necessary to assist, support and sustain breastfeeding both within the hospital and once mothers return to their homes.

10 counsellors were successfully trained in this program and all of them are expected to start work immediately.

I am hoping that this program continues throughout the year and brings out more consellors into practice.

Thursday, February 15, 2007

Baby food for less than 6 month old babies

I am trying to catalog all the baby food available for purchase in male' (the islands could join too) that specifically target infants less than 6 months. This "early weaning" is not recomended and could be dangerous.

Please assist me in this work by sending me picture of any such products you find at any shop. Pictures taken on mobile phones would also be helpful as long as the label is clearly visible. Please don't send web images.........they would not be helpful for this cause.

މާލޭގެ އެކިއެކި ފިހާރަތަކުގައި އުމުރުން 6 މަހަށް ވުރެ ތުއްތުކުދިންނަށް ދިނުމަށް ލޭބަލް ކުރެވިފާ ހުރި ކާތަކެތި ކެޓަލޮގް ކުރުމުގެ މަސައްކަތް އަޅުގަޑު އެބަ ކުރަމެވެ
މިކަމުގައި ތިޔަބޭފުޅުންގެ އެހީ އަޅުގަޑު ބޭނުންވެއެވެ
މަތީގައި އެ ދެންނެވުނުފަދަ ކެއުމަށް ބޭނުންކުރެވޭތަކެތި (ބަކުން، ނުވަތަ އެހެނިހެން ފުޅިފުޅީގައި ނުވަތަ ދަޅުގައި ބަންދުކުރެވިފައި ހުންނަތަކެތި) ފެނިވަޑައިގެންފިނަމަ އެ އެއްޗެއްގެ ފޮޓޯއެއް ނެންގެވުމަށްފަހު އަޅުގަޑަށް ފޮނުވާދެއްވާށެވެ

Sunday, January 28, 2007

Weaning at 4 months!!!

The recommended age for introduction of non-milk food to infants is 6 months. Most international bodies (WHO, UNICEF, AAP, and many many others) agree that this is the best practice for the nutrition of the child.

As most of you would know, in the past (in fact many years before) this age used to be 4 months. However, with increased understanding of nutritional needs of the infant and research international agencies changed their recommendation from 4-6 months to 6 months for "weaning".

Many national and international organisations have ( particularly since then) kept a close watch on the different infant nutrition products, particularly those marketed for less than 6 month olds. IBFAN (International Baby Food Action Network) is one that has put in much work.

We in the Maldives do not have the best monitoring system to ensure that vulnerable population is not led away from internationally accepted and recommended norms of infant feeding. This has led to many dubious products (from internationally recognised multinational companies) to end up on the shop shelves.

Starting "weaning foods" at 4 months could be harmful! They may not be fully digestable. Giving them will take up space within the small intestinal capacity of the infants with a food that is less easily digested and absorbed than the recommended food breastmilk (or infant formula).

I have had mothers who were advised (or under pressure from family and friends) to start "weaning foods" at 4 months because their baby was not gaining weight. In most instances the weight gain was in fact adequate and the kids were thriving well. Starting early "weaning" is not a solution to inadequate weight gain in this age group. What is needed is an increase in caloric intake from a readily digestable and safe food such as milk (Breastmilk always preferred).

What has made it so easy for parents to make that jump is the availability of food products for ages 4-6 in the super markets and general stores. These products because they are from so-called internation leaders in infant nutrition makes them very attractive and acceptable.

Here are some produc labels that are to blame:












These products are clearly labelled for kids less than 6 months and are available for purchase in Maldives!

The authorities must be aware of their presemce on the shop shelves! They need to act in the best interest of the child and set guidelines (I did see a draft of the CODE for the Maldives) and ENFORCE them.

As a parent and a Paediatrician I am urging the authorities to take notice of this practice. I also urge that all super markets (STO included) and general stores to remove these items from their shelves immediately. If for some reason (I don't see any genuine one if we consider the infants best interest) they need to be on the shelf place labels to show parents that the products are not recommended by WHO, UNICEF and many many international authorities.