A small experiment in a backward district of Lalitpur in Uttar Pradesh has shown that breastfeeding can be promoted through simple counselling by locally trained women. Promoting breastfeeding and focussing on complementary feeding education is crucial for improving nutrition status of children – under two years of age – and saving their lives.

The pre-intervention (2006) and post-intervention (2007) showed a significant improvement in four feeding practices – reduction in prelacteal (giving some food before the baby is initiated to mother's milk) feeding from 44.4 per cent to 28.3 per cent, increase in initiation of breastfeeding within one hour of birth from 39.2 per cent to 57.9 per cent, exclusive breastfeeding for the first six months from 6.85 per cent to 24.9 per cent and introduction of complementary foods along with continued breastfeeding between 6-9 months from 4.6 per cent to 35.8 per cent.

Independent evaluation in 2008 recorded further improvement in the feeding practices in which initiation of breastfeeding within one hour went up to 72 per cent, exclusive breastfeeding for the first six months to 50 per cent and complementary feeding along with continue breastfeeding between 6 to 9 months went up to 85 per cent while prelacteal feeds went down to 15 per cent.

Child nutrition is closely linked to child mortality, morbidity and malnutrition. Uttar Pradesh has high infant mortality with high levels of under-nutrition and extremely low level of breastfeeding. It was keeping these factors in mind that a project Baby Friendly Community Health Initiative (BFCHI) was initiated in 2006 and implemented in Lalitpur by the Department of Paediatrics BRD Medical College at Gorakhpur, UNICEF and the State Government.

The experiment focussed primarily on children below the age of two years and the mode adopted was counselling for which 48 local graduate women were trained as mentors who in turned trained the Anganwadi workers, Accredited Social Health Activists (ASHAs) and traditional birth attendants.

According to Prof K. P. Kushwaha of the B.R.D.Medical College who led the experiment ``Reaching the Under 2s -- universalising delivery of nutrition interventions in district Lalitpur, Uttar Pradesh'' the project has demonstrated real convergence at village level and heightened motivation of workers to prevent malnutrition and morbidity associated with it in infants and young children. He believes establishing a nearly universal system is possible within two to three years through additional human resource and good quality training and supervision.

“Women can be identified and trained locally with some incentives. It is evident that real convergence between the National Rural Health Mission and the Integrated Child Development Scheme is also possible and by including medical colleges in the chain,'' Prof Kushwaha explained.

He recommended budgetary support for taking the programme further as mid course correction leading to the 12th Five Year Plan.

Keywords: UNICEFmalnutrition

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