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Learning Objectives Methodologies Training Aids

1. Name the practices for feeding the sick child and describe what responsive feeding and care practices look like

Working groups – rotation of flipcharts

 CC 11: Feeding your sick baby less than 6 months of age

 CC 19: Feeding your sick child older than 6 months of age

 CC 12: Good hygiene practices prevent disease 2. Identify signs requiring the

mother/father/caregiver to seek care for the child

 Brainstorming  Small Group

Work

 CC 22: When to bring your child to the health facility

 Key Message Booklet

Materials

 Flipchart papers and stand (+ markers + masking tape or sticky putty)

 Illustrations from Training Aids: refusal to feed, vomiting, diarrhoea, convulsions, respiratory infection, fever, malnutrition

Duration: 1 hour

Learning Objective 1: Name the practices for feeding the sick child and describe

what responsive feeding and care practices look like

Methodology: Working groups – rotation of flipcharts

Suggested Time: 45 minutes

Instructions for Activity

1. Divide participants into 4 groups

2. Set-up 4 flipcharts throughout the room with the following titles: a) How to feed a child less than 6 months old during illness? b) How to feed a child less than 6 months old after illness? c) How to feed a child older than 6 months during illness? d) How to feed a child older than 6 months after illness?

3. Ask each group to go to a flipchart and answer the question on that flipchart; after 2 minutes the Facilitator asks the groups to rotate to the next flipchart; repeat until all groups have a

Community IYCF Counselling Package: Facilitator Guide 154 chance to visit each flipchart

4. Groups do not repeat the same information, but only add new information 5. Each team presents in plenary

6. Ask groups to observe and study CC 11: Feeding your sick baby less than 6 months of age, CC 19: Feeding your sick child older than 6 months of age, and to review CC 12: Good hygiene practices prevent disease

7. Review together Key Messages from Key Messages Booklet

8. Discussion and summary

Key Information

 See counselling discussion points/messages on CC 11: Feeding your sick baby less than 6 months of age

 See counselling discussion points/messages on CC 19: Feeding your sick child older than 6 months of age

Diarrhoea: more than 3 loose stools a day for two days or more and/or blood in the stool

Note:

 During the first few days of life: baby’s stools are dark green to black (colostrum helps to expel this tar-like stool called meconium)

 It is normal for the stools of the breastfed baby to be mostly liquid, with small curds that resemble cottage cheese. This is not diarrhoea.

 A breastfed baby should have two or more good-sized bowel movements every day for the first 6-8 weeks.

 At around the age of six weeks, the stooling pattern of a breastfed baby may change. It is not uncommon for the breastfed baby to skip days between bowel movements. Some babies skip every other day, some go every two or three days, some once every 5 - 7 days.

Sick baby under 6 months

 A sick baby often does not feel like eating, but needs even more strength to fight the illness.

 Breastfeed more frequently during diarrhoea to help the baby fight the sickness and not lose weight.

 Breastfeeding also provides comfort to a sick baby.

 If the baby is too weak to suckle, express breast milk to give to the baby either by cup or by expressing directly into the baby’s mouth. This will help the mother keep up her milk supply and prevent engorgement.

Responsive Feeding and Care Practices

 Recognizes and responds to signs of baby’s illness  Encourages baby until he or she takes the breast again

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Sick baby over 6 months

 Increase breastfeeding during diarrhoea, and continue to offer favourite foods in small quantities.

 During recovery, offer more foods than usual (an additional meal of solid food each day during the next two weeks) to replenish the energy and nutrients lost during illness.

 Offer the young child simple foods like porridge, even if s/he does not express interest in eating.

 Avoid spicy or fatty foods.

 Breastfeed more frequently during two weeks after recovery.  Animal milks and other fluids may increase diarrhoea (the origin of

the belief that milk brings about diarrhoea). However, this is not true of breast milk. Stop giving other milks, but give more fluids and water (and ORS if child is severely dehydrated).

Responsive Feeding and Care Practices

 Recognizes and responds to signs of childhood illness

 If child’s appetite is decreased, encourages him or her to eat small frequent meals.

 During illness gives the baby small frequent meals and more fluids, including breast milk or other liquids.

 Encourages the baby to eat a variety of (his or her) favourite soft foods. After illness feeds more food and more often than usual for at least 2 weeks.

Learning Objective 2: Identify signs requiring the mother/father/caregiver to seek

care for the child

Methodology: Brainstorming; Small Group Work

Suggested Time: 15 minutes

Instructions for Activity:

1. Ask participants to brainstorm signs that require mother/father/caregiver to refer child to health facility.

2. As Participants mention the signs that require referral place the illustrations on the wall or mat so all can see.

3. Ask Participants to study CC 22: When to bring your child to the health facility 4. Orient Participants to the Key Messages from Key Messages Booklet

5. Discuss and summarise

Key Information

 See CC 22: When to bring your child to the health facility and Key Message Booklet

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