New IYCN materials

IYCN series

About IYCN

Agriculture resources

Community program resources

Country briefs

Formative assessments

Our approaches

Technical materials

Training and behavior change communication tools 

Welcome to the eleventh and final issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project.

A message from the project director

Greetings,

The IYCN Project has now completed activities in most of our countries and we will officially close on March 19, 2012. Over the past year, we have been enthusiastically documenting and sharing our experiences from five years of global maternal, infant, and young child nutrition programming. Highlights are included in this newsletter: 

• A recently enhanced website, which will continue to offer a wealth of information and resources for several years.  
• A roundup of our 2011 event series.  
• Two publication series documenting our experiences and approaches.
• An array of new materials, including a breastfeeding literature review plus a Q&A with the author.

Many thanks to our newsletter subscribers—more than 3,000 of you in 130 countries—for your valuable comments, questions, and contributions over the past several years. I have enjoyed engaging with many of you by email and face to face, and I am immensely grateful for your support. I hope our experience and tools will continue to assist you in your efforts to prevent malnutrition during the critical first 1,000 days.

I would also like to thank our communications team, Christine Demmelmaier and Jay Ward, for their outstanding work on this newsletter and our new website. 

Although this is our concluding newsletter, we are not saying our goodbyes just yet. Please look for another message to announce the arrival of our final report.

Warm regards,

Denise Lionetti
Project Director, IYCN Project 

IYCN Project news

Enhanced website offers a wealth of information and resources

IYCN recently launched an enhanced website to offer improved access to our project accomplishments and lessons learned, in addition to hundreds of resources. The website offers up-to-date information on the 16 countries where we worked, an improved resources database, and a collection of IYCN’s publication series (see links on the right). We will post final summaries of our legacy and accomplishments soon. Although it will no longer be updated after March 2012, the website will remain available for several years.

Please visit iycn.org.

Series of events to mark progress and look ahead

Over the past year, IYCN has hosted more than a dozen events—including a series of meetings in Washington, DC, and end-of-project gatherings in seven countries—to celebrate accomplishments, share experiences and resources, and discuss future directions for nutrition programming.

View highlights from our 2011 event series.

Documenting our experiences

We are pleased to share several new reports as part of our collection of country briefs launched last year. The collection offers a summary of IYCN’s experiences and accomplishments in each country where we worked.

View all country briefs.

Sharing our approaches 

We have also completed our series of four brief documents examining our approaches in selected countries. New publications include:

• Mobilizing social workers to prevent malnutrition in Côte d’Ivoire.
• Promoting breastfeeding as an option for HIV-positive mothers in Haiti.

 View the series.

Featured resource: Review of breastfeeding literature

Our latest literature review examines evidence on community interventions to promote optimal breastfeeding. We are grateful to our colleague Dr. Miriam Labbok, Director of the Carolina Global Breastfeeding Institute at the University of North Carolina at Chapel Hill, for expertly composing this publication. Dr. Labbok shared her thoughts on the findings of the review in a recent Q&A.

See the Q&A with Dr. Labbok.

Download Community interventions to promote optimal breastfeeding: Evidence on early initiation, any breastfeeding, exclusive breastfeeding, and continued breastfeeding.

More new IYCN resources

Global

• Counseling card: Risks of Infant Feeding Options for HIV-positive Mothers
• Helping an HIV-positive breastfeeding mother decide how to feed her child at 12 months: A checklist for health care providers
• Technical brief: Maternal dietary diversity and the implications for children’s diets in the context of food security

Côte d’Ivoire

• Success story: Preventing malnutrition among orphans and vulnerable children through social workers

Ethiopia reports

• Focusing on Improving Complementary Feeding in Ethiopia: Trials of Improved Practices in an Urban Area
• Integration of nutrition education into the Ethiopia Urban Gardens Program: Results of recipe trials and focus group discussions
• Ethiopia Urban Gardens Program—2011 Baseline Data: Summary and Analysis of Responses to Nutrition Questions
• Opportunities to Improve Nutrition through Urban Gardens Program Activities in Ethiopia: Summary Report of Current Practices from Qualitative and Quantitative Research Studies
• Review of Existing Nutrition-Related Policies, Materials, and Institutions
• Literature Review on Maternal, Infant, and Young Child Nutrition prepared for the Message and Materials Development Workshop

Ethiopia training materials and tools

• Mother-to-Mother Support Groups: Trainer’s Manual and Facilitator’s Manual with Discussion Guide
• Ethiopia Training of Trainers Manual for Counseling on Maternal, Infant, and Young Child Nutrition
• Nutrition Education Training for Agriculture Extension Officers: Training Sessions and Trainer Resources
• Maternal, infant, and young child nutrition counseling cards
• Urban Gardens Program Group Nutrition Education Discussion Cards

 Ghana

• Complementary feeding leaflet and poster
• Three food groups poster
• Ghana Promotion of Complementary Feeding Practices Project: Baseline Survey Report

Haiti

• Training module: Infant Feeding Counseling in the Context of Early Infant Diagnosis (French)

Kenya

• Rapid Qualitative Assessment: Beliefs and attitudes around infant and young child feeding in Kenya

Madagascar

• Building up the Blood: Barrier Analysis on a Maternal Iron-Folic Acid Supplementation Program in Madagascar

Malawi

• Maternal, Infant, and Young Child Nutrition in Malawi: Community Nutrition Workers Training Package

Photos: PATH/Mike Wang; PATH/Evelyn Hockstein; PATH/Evelyn Hockstein

New IYCN materials

IYCN materials

Lesotho brief

Madagascar brief

Nigeria brief

Good nutrition, healthy futures

IYCN social and behavior change communication approach

Our approach: Shaping national policy in Nigeria

PowerPoint: Results and lessons learned in Nigeria

Find more IYCN resources at the end of the newsletter.

Helpful links and publications

Portal for the Scaling Up Nutrition Movement

WHO electronic Library of Evidence for Nutrition Actions (eLENA)

Join Up, Scale Up: How Integration Can Defeat Disease and Poverty (PATH) 

Uganda NuLife Final Report (URC)

Welcome to the tenth issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project. Distributed four times per year, each issue offers updates on the latest research, new resources, and project news.

Research highlights

Peer counseling increases exclusive breastfeeding rates

Results of the PROMISE-EBF study, a cluster-randomized trial published in The Lancet in July 2011, showed that a low-intensity peer counseling intervention may have the potential to increase exclusive breastfeeding in sub-Saharan Africa for infants up to 6 months of age. Read more.

Effects of vitamin A or beta carotene supplements on maternal and infant mortality

A randomized controlled trial, published in the May 2011 edition of the Journal of the American Medical Association, examined the impacts of weekly vitamin A or beta carotene on maternal and infant mortality in Bangladesh. Researchers found no significant differences in all-cause maternal, fetal, or infant mortality in the vitamin A group or the beta carotene group as compared to the control. While the findings differ dramatically from a similar study in Nepal, a recent large-scale trial in Africa showed similar results. Read more.

Balanced protein energy supplementation beneficial during pregnancy

In a meta-analysis published in Biomed Central Public Health in April 2011, researchers found a 31 percent reduction in the risk of delivering a baby who was small for gestational age when mothers were provided with a balanced protein energy supplementation during pregnancy. The authors conducted the review in order to recommend a point estimate for the intervention’s inclusion in the Lives Saved Tool. Read more.

Human nutrition as a benefit of agricultural ecosystems

The authors of a paper published in a supplement to the Food and Nutrition Bulletin in March 2011 make a case for treating agriculture as an ecological system serving human nutrition. They suggest that ecological knowledge, tools, and models have an important role to play in efforts to direct food systems at improved human nutrition. Read more.

Featured resource: Strengthening community nutrition programming

In July, we launched our new collection of tools for reaching caregivers, households, and communities. The collection includes literature reviews, training materials, and monitoring and evaluation tools that program implementers can adapt and use to enhance community nutrition programs. IYCN has employed the resources in several countries to reach mothers and engage key influencers, such as fathers, grandmothers, and community leaders, to improve nutrition during the first 1,000 days of life. Learn more and download the resources.   

Country spotlight: Nigeria

Building a strong foundation for nutrition programming

Since 2009, IYCN has supported the government of Nigeria’s efforts to reduce maternal and child malnutrition and improve HIV-free survival of children. In collaboration with a wide range of partners, IYCN’s efforts have increased understanding of gaps in nutrition assessment, counseling, and support; influenced and strengthened five national nutrition policies and guidelines; and improved the capacity of health workers and community workers.

The project also developed several new social and behavior change communication tools for health providers and caregivers and strengthened nutrition services through a quality improvement approach.   

At an October 27 end-of-project event, partners committed to scaling up capacity building activities to 28 states.

View a summary of our activities and accomplishments in Nigeria.

View a summary of our approach to shaping infant feeding and HIV policy in Nigeria. 

Project news

New and improved tools for agriculture project designers

After making several improvements and revisions, IYCN recently launched new versions of two tools to help agriculture projects maximize nutritional benefits of interventions. The project shared the new resources with more than 70 participants during a September 7 forum in Washington, DC, and presented them to a crowd of more than 300 colleagues at the Federation of African Nutrition Societies Congress in Abuja, Nigeria on September 14.  View the new tools.

Read an IRIN news article on IYCN’s Nutritional Impact Assessment Tool. 

Supporting SUN, ending stunting in Malawi

The IYCN team recently joined with the Office of the President and Cabinet and a wide range of partners to support the Scaling Up Nutrition (SUN) movement in Malawi, one of the first countries to launch the movement.

To build broad support for the country’s new SUN strategy and ensure its success, the project has encouraged civil society participation, developed a new package of training materials for community workers, led a working group on monitoring and evaluation to develop indicators for the SUN strategy, and participated in a high-level SUN event during the UN General Assembly in New York in September 2011. 

Read IYCN Malawi Country Coordinator Janet Guta’s post on the 1,000 Days blog to learn more.

Events

Bringing nutrition to the forefront of agriculture: a forum for agriculture project designers

On September 7, more than 70 colleagues joined IYCN and the Alliance to End Hunger to discuss the linkages between agriculture and nutrition programming. The half-day event featured a forum on the integration of nutritional concerns into agricultural programming, and a practicum on the assessment and improvement of agricultural project designs to maximize nutrition and food security outcomes. Learn more.

Preventing maternal malnutrition: evidence, challenges, and opportunities

IYCN hosted a panel discussion on preventing maternal malnutrition on August 16. Panelists shared findings from three IYCN studies revealing insights on dietary practices of mothers; discussed the links between maternal and child nutrition; and explored barriers, challenges, and solutions for programs to prevent malnutrition of mothers.  Learn more.

Brown bag: Engaging grandmothers and men to prevent malnutrition

On August 10, IYCN hosted a brown bag presentation and discussion with Dr. Judi Aubel of The Grandmother Project. Dr. Aubel shared findings from IYCN’s review of literature from more than 40 countries on the roles and influence of grandmothers and men and discussed recommendations for effectively engaging key household members to improve nutrition. Learn more.

What works for community nutrition programming?

More than 150 participants joined IYCN on July 19 for a half-day meeting on community programming to prevent malnutrition. Speakers included IYCN country coordinators from five countries and the project’s partners, who shared challenges, experiences, and future directions for community nutrition interventions during a lively discussion moderated by Denise Lionetti, IYCN Project Director. Learn more.

Additional IYCN materials

Technical briefs

• Combating Malnutrition: What Can be Done?
• Men as positive agents of change
• Summary of sociocultural and epidemiological findings on infant and young child feeding in 11 countries
• Understanding Challenges and Opportunities for Improved Maternal Nutrition
• Measuring the quality of mother-child feeding interactions

Tools and guides

• Tools for reaching caregivers, households, and communities
• Bangladesh: Communications tools
• The Basics: Planning for Formative Research for Infant and Young Child Feeding Practices

For agriculture project designers

• Nutritional Impact Assessment Tool (Revised)
• Integrating Household Nutrition and Food Security Objectives into Proposed Agriculture Projects (Revised)

We welcome your feedback and suggestions for our next issue. Please contact: info@iycn.org.

Photos: Aurelio Ayala III, Evelyn Hockstein, Oluseyi Akintola, Jay Ward

New IYCN materials

Assessments and literature reviews

The roles and influence of grandmothers and men

Malawi infant and young child feeding study

Engaging grandmothers and men: Report of a formative assessment in Kenya

Qualitative assessment of nutrition, PMTCT, and OVC services in Ethiopia

Service provision assessment of nutrition services and support in Nigeria

Zambia materials

Video: Connecting with the community: Kabwe’s story

Country brief: Preventing malnutrition of mothers and children

Our approach: Improving nutrition counseling across the continuum of care

PowerPoint: IYCN achievements and lessons learned

Training tools

Mother-to-mother support groups: Trainer’s manual and facilitator’s manual

Strengthening health talks: Training manual

Helpful links and publications

World Breastfeeding Trends Initiative: The State of Breastfeeding in 33 Countries: 2010

UNICEF: The State of the World’s Children 2011

News from our colleagues

1,000 Days blog: A Turning Point in the Global Fight to End Child Hunger

New York Times: The Breast Milk Cure

Washington Post: Michael Latham, nutritionist who advocated breast-feeding, dies at 82

Welcome to the ninth issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project. Distributed four times per year, each issue offers updates on the latest research, new resources, and project news.

Research highlights

Shorter course of zinc therapy as effective as longer treatment for diarrhea
In the February 2011 issue of the Journal of Nutrition, researchers who conducted a randomized trial in Bangladesh found that a shorter course of zinc therapy (five days) is as effective as the standard zinc therapy (ten days), recommended by the World Health Organization and United Nations Children’s Fund, on the incidence and duration of diarrhea among children ages 4 to 59 months. Read more.

What is the role of responsive feeding in child undernutrition?
A paper published in the Journal of Nutrition in March 2011 provides a review and history of published literature on the role of responsive feeding (RF) on child undernutrition. The authors found that while many interventions have demonstrated a positive association between RF and child eating behaviors, dietary intake, and growth, lack of uniformity in defining RF prevents comparisons across studies and may cause confusion when interpreting research results. They call for standardization of the definition and measurement of RF, and additional research. Read more.

Making low-dose micronutrient powders effective in improving nutritional status
A double-blind controlled trial, published in the Journal of Nutrition in December 2010, aimed to test whether low iron/zinc micronutrient powders (MNPs) using more-absorbable iron, more vitamin C to aid iron absorption, and a phytase to break down phytates that inhibit iron absorption would improve iron and zinc status and growth of South African children (ages 5–11). The authors found that adding this modified low-dose MNP to a high-phytate maize porridge just before consumption resulted in significant improvements in growth and reductions in iron and zinc deficiency. Read more.

Multi-country analysis of child nutrition programs reveals limited improvements
An April 2011 special supplement of Maternal and Child Nutrition is devoted to a series of situational analysis to evaluate infant and young child nutrition activities in six Sahelian countries. Findings revealed limited positive achievements for most countries but also identified important gaps preventing success in ensuring adequate nutrition for 80 percent of the children in the region. The authors present an executive summary of activities, six situational analysis, and a final paper providing a road map for the way forward. Read more.

Country spotlight: Zambia

Improving nutrition counseling across the continuum of care

In Kabwe, Zambia, mothers, health workers and volunteers are working together to prevent malnutrition.

An IYCN-supported demonstration project in two health facilities in Kabwe District, Zambia, established a scalable model for making improvements in health facility- and community-based nutrition assessment, counseling, and support. Using a quality improvement approach, IYCN facilitated joint planning and collaboration within facilities and between facilities and communities to identify problems and feasible solutions. The project showed that efforts to improve nutrition throughout the continuum of care can achieve success when activities at the community and health facility levels are linked.

Download a summary of IYCN’s approach for improving nutrition across the continuum of care in Zambia.

Featured resource: Nigeria

Clearly communicating national recommendations on infant feeding and HIV
A new brochure is helping health workers, donors, United Nations agencies, and other stakeholders understand Nigeria’s recent National Consensus on Infant Feeding in the Context of HIV. IYCN supported the Federal Ministry of Health (FMOH) and collaborated closely with WHO and UNICEF to create the user-friendly brochure aiming to clearly explain the consensus, which responds to the 2010 WHO guidelines on HIV and infant feeding. IYCN printed 50,000 copies, and the FMOH launched the resource during a May 8 gathering of health officials from all 36 Nigerian states and the Federal Capital Territory.

Download the brochure.

Project news

A nurse shares how IYCN has made a difference at Chawama Health Centre.

Looking ahead in Zambia
The IYCN team in Zambia marked the completion of activities with a half-day event on March 23. More than 100 stakeholders gathered in Lusaka to discuss how to build on IYCN’s achievements and lessons over the past three years and to explore future directions for infant and young child nutrition programming.

The Permanent Secretary, Dr. Peter Mwaba, and René Berger of USAID/Zambia, made opening remarks and encouraged participants to build upon IYCN’s experiences. Representatives from the National Food and Nutrition Commission, the Federal Ministry of Health, and UNICEF participated in a panel discussion on advances and gaps in efforts to reduce malnutrition.

Download our Zambia Brief for a summary of IYCN’s achievements and lessons learned.

Download IYCN’s PowerPoint presentation from the event.

Côte d’Ivoire team continues vital work despite a national crisis
In recent months, the IYCN team has faced uncertainty, obstacles, and dangers resulting from Côte d’Ivoire’s post-election crisis. Yet despite all adversities, the eight-person staff, based in Abidjan, found solutions for moving forward with activities. They continued conducting follow-up calls to prevention of mother-to-child transmission of HIV (PMTCT) and social center sites even though they couldn’t make site visits, and worked on a national scale-up plan for nutrition activities at PMTCT sites. Currently, team members are working from their homes until the situation in Abidjan stabilizes and USAID gives the go-ahead to resume working at the IYCN office.

New report illuminates feeding problems in Malawi
On February 21, IYCN joined the Ministry of Health, the World Bank, and other partners to disseminate a final report on the IYCN-led Malawi Infant and Young Child Feeding and Nutrition Study. Following the meeting, The Nation, Malawi’s national newspaper, reported on the findings of the study, warning that feeding “junk food,” such as tea, fizzy drinks, and orange squash, to children is contributing to Malawi’s high prevalence of stunting (47.5 percent). The study found that mothers were relieved to find that they could replace sugary snacks and drinks with more nutritious and less costly fruits to improve child nutrition. At the meeting, Dr. Mary Shawa, Principal Secretary for Nutrition and HIV, called for the government and the private sector to work together to address the information gaps that are contributing to the problem.

Download the report.

Literature review highlights grandmothers and men as key influencers
Our new literature review examines evidence of the roles and influence of grandmothers and men related to child nutrition practices and offers recommendations for program implementers to strengthen community approaches for addressing malnutrition.

Download the literature review.

Please email us to request hard copies: info@iycn.org.

Coupling micronutrient powders with a behavior change strategy in Bangladesh
IYCN recently collaborated with CARE to introduce an innovative approach for using micronutrient powders (MNPs) to motivate behavior change in Bangladesh. The approach—a first-ever effort to use a nutritional product as a means to encourage changes in child feeding—included identifying age-specific feeding practices from the Ministry of Health’s infant and young child feeding promotion strategy, such as avoiding use of feeding bottles and enhancing complementary foods with vegetables and animal-source foods, that can be linked to MNP use. IYCN created behavior change communication materials for community-based workers to promote the improved practices.

Events

SAVE THE DATE: July 19, 2011
On July 19, 2011, from 9:00 AM to 1:00 PM, IYCN will host a meeting at PATH in Washington, DC, to discuss approaches for effective community-based nutrition programming and share new behavior change communication tools. Look for more information soon.

38th Annual International Conference on Global Health
On June 15, IYCN hosted a satellite session at the 38th Annual International Conference on Global Health, Innovations in micronutrient powder programs: opportunities to reduce child anemia. Learn more.

Also at the conference, Janet Guta, IYCN Country Coordinator, Malawi, presented a poster on June 14: Addressing barriers to healthy feeding in Malawi. Learn more.

A2Z Investing in Micronutrients: From Past Experience to Current Challenges
Tom Schaetzel, IYCN Technical Director, moderated a panel, Micronutrients for Infants and Children, at A2Z’s event on June 13. On behalf of IYCN, Marcia Griffiths, from The Manoff Group, joined the same panel to share Lessons from applying Trials of Improved Practices (TIPS) methodology to improve infant feeding behaviors in Malawi, Ethiopia, and Rwanda.

CORE Group Spring Meeting
IYCN hosted a session on Influencing the Influencers, to explore the role of community and household members who influence health behaviors, at the CORE Group Spring Meeting on May 12. Learn more.

On May 11, Nicole Racine, IYCN consultant, presented IYCN’s experience and findings from pretesting Infant and Young Child Feeding Counseling Cards in Haiti. View the PowerPoint presentation.

A2Z Micronutrient Nutrition: Program Integration and Innovation Meeting
On May 4, Dr. Nanthalile Mugala, former IYCN Country Coordinator, Zambia, presented on Integration of nutrition in Zambia across PMTCT and the continuum of care as part of a panel on integration of nutrition programming into other health platforms. IYCN’s Stephanie Martin moderated the panel. Learn more.

As part of a panel on innovations in program delivery, Tom Schaetzel, IYCN Technical Director, presented on the Nutritional Impact Assessment Tool: Focusing agriculture on nutritional outcomes. Learn more.

We welcome your feedback and suggestions for our next issue. Please contact: info@iycn.org.

Photos: Aurelio Ayala III, 2007 Virginia Lamprecht, Courtesy of Photoshare

New IYCN materials

2010 annual report

Fact sheet: Achieving Nutritional Impact and Food Security through Agriculture

Nutrition and Food Security Impacts of Agriculture Projects: A Review of Experience

Integrating Household Nutrition and Food Security Objectives into Proposed Agriculture Projects: Illustrative Guidance

Nutritional Impact Assessment Tool

Haiti: Infant and young child feeding counseling cards

Nigeria: Formative assessment of infant and young child feeding practices

Zambia: Formative assessment of infant and young child feeding practices at the community level

Zambia: Recipe Book on Zambian Traditional Foods

Slide show: Engaging fathers to boost child nutrition

Video: IYCN’s Tom Schaetzel on World AIDS Day 2010

Video: Better feeding, healthy babies

Helpful links and publications

Bread for the World: 2011 Hunger Report

International Food Policy Research Institute: 2010 Global Hunger Index

News from our colleagues

PATH: New meningitis vaccine to wipe out deadly epidemics in Africa

University Research Co., LLC, launches new website

Welcome to the eighth issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project. Distributed four times per year, each issue offers updates on the latest research, new resources, and project news.

Research highlights

Kesho Bora study results offer great promise for prevention of mother-to-child transmission of HIV during breastfeeding
Findings of the Kesho Bora study in Burkina Faso, Kenya, and South Africa are now available in the January 14, 2011, edition of Lancet Infectious Diseases. Results revealed that maternal triple antiretroviral therapy during pregnancy and breastfeeding is safe and prevents more HIV infections than short-course prophylaxis. The findings were influential in the development of the most recent World Health Organization guidelines on HIV and infant feeding. IYCN previously reported on the Kesho Bora results, released in July 2009.

Can breastfeeding reduce children’s malaria risk?
In the October 2010 issue of Journal of Acquired Immune Deficiency Syndrome, researchers examined the effect of breastfeeding on malaria risk. Among the results, they found that HIV-exposed and HIV-infected children ages 6 to 15 months were significantly less likely to get malaria when breastfed. Read more.

Potential benefits of zinc with oral rehydration solution to treat diarrhea in young infants
In an article published in the October 2010 Bulletin of the World Health Organization, researchers reported a reduction in episodes of diarrhea and acute lower respiratory infections among children younger than 6 months after receiving zinc and oral rehydration solution together with caregiver education on zinc. Their findings suggest that zinc supplementation may play an important role in reducing illness in young infants. Read more.

Improving infant diets—with and without food supplements
As reported in the August 2010 issue of Maternal and Child Nutrition, researchers in rural Zimbabwe found that mothers were more likely to practice behaviors to improve complementary feeding of their children after receiving culturally appropriate messages alone or together with a lipid-based nutrient supplement. Researchers concluded that significant improvements to infant diets can and should be made using locally available resources. Read more.

Country spotlight: Kenya

Engaging fathers to boost child nutrition

Meet Henry, Gerishom, and other men who are supporting mothers to nourish their children in Western Kenya. Through the stories of these inspiring fathers, IYCN’s new slideshow illustrates the important role men can play in improving their children’s nutrition. View slideshow.

Featured resource: Haiti Infant and Young Child Feeding Counseling Card

The counseling card above encourages mothers to take their babies with them or leave expressed breastmilk behind when away from home.

IYCN collaborated with the government of Haiti and partners to create a nationally validated set of Creole-language counseling cards to help health workers and community workers counsel mothers on good feeding practices. After conducting formative research, we developed key messages addressing common barriers to good nutrition, such as negative beliefs about breastfeeding in public. Pre-testing the cards with mothers and caregivers helped make sure they were effective in fostering positive change. The government will disseminate the cards to health facilities across the country in early 2011, and IYCN will facilitate training on how to use them. Download the counseling cards.

Q&A: Kenya

Integrating nutrition and HIV
In a Q&A, IYCN’s Stephanie Martin shares insights on integrating nutrition and HIV programs in Kenya. By collaborating with USAID’s AIDS, Population and Health Integrated Assistance II Western Program, led by PATH, the project incorporated infant feeding counseling and support into existing community-level HIV activities. Stephanie says the collaboration was a great opportunity to deliver integrated messages on HIV prevention while achieving efficiencies of both time and cost. Read the Q&A.

Project news

New resources for agriculture project designers
We recently launched a set of resources to help agriculture project designers maximize nutritional benefits for women, children, and other vulnerable groups. IYCN’s Tom Schaetzel shared the new materials at the International Food Policy Research Institute’s Leveraging Agriculture for Improving Nutrition and Health Conference in New Delhi, India, February 10–12, 2011.

View the new materials:

Fact sheet: Achieving Nutritional Impact and Food Security through Agriculture

Nutrition and Food Security Impacts of Agriculture Projects: A Review of Experience

Integrating Household Nutrition and Food Security Objectives into Proposed Agriculture Projects: Illustrative Guidance 

Nutritional Impact Assessment Tool

IYCN annual report recaps 2010 highlights
View a copy of our brief 2010 annual report for a summary of IYCN’s accomplishments from last year. The report includes highlights from Haiti, Kenya, Malawi, Zambia, and other countries, and updates on our global activities.

Download IYCN’s 2010 annual report.

We welcome your feedback and suggestions for our next issue. Please contact: info@iycn.org.

Photos: Aurelio Ayala III, PATH/Evelyn Hockstein

New IYCN materials

Kenya: Infant and Young Child Feeding and Gender: A Training Manual for Male Group Leaders

Selected Abstracts on HIV and Infant Feeding from the XVIII International AIDS Conference

Zambia: Radio program scripts

AIDS 2010 poster: Improving child health and HIV-free survival
(now available in French)

Map of IYCN country activities

News from our colleagues

Read about PATH’s work on the Millennium Development Goals

Support 1,000 Days: Change a Life, Change the Future

Welcome to the seventh issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project. Distributed four times per year, each issue offers updates on the latest research, new resources, and project news.

Research highlights

Can improved complementary foods prevent anemia without added micronutrients?
In the June issue of Public Health Nutrition, researchers in Burkina Faso found that improved gruel made with locally available ingredients and processed to reduce iron-inhibiting factors increased hemoglobin status as well as micronutrient-fortified gruel. The authors conclude that improved complementary foods can help prevent anemia. Read more.

Expressing and heat-treating breastmilk: a feasible and beneficial strategy for many HIV-positive moms
In the August issue of the Journal of Nutrition, researchers in Zimbabwe found that, with adequate support, HIV-infected mothers could safely express and heat-treat breastmilk for long periods of time, and that infants who consumed a higher proportion of energy from expressed and heat-treated milk in comparison with complementary foods showed more improvement in weight and length. The authors conclude that expressing and heat-treating breastmilk may be a useful strategy for many HIV-positive mothers in countries implementing the 2009 World Health Organization guidelines on infant feeding and HIV. Read more.

Iron/folic acid supplementation during pregnancy protects against neonatal deaths
Findings presented in the August Bulletin of the World Health Organization suggest that 20 percent of neonatal deaths in Indonesia could be averted through routine iron/folic acid (IFA) supplementation of pregnant women. The authors hypothesize that IFA may indirectly prevent neonatal death by reducing the risk of low birth weight. Read more.

Point of view: Nigeria

A reason to celebrate breastfeeding in Nigeria
In a commentary shared during World Breastfeeding Week (August 1–7), IYCN’s Wasiu “Prince” Afolabi discussed a major reason to celebrate breastfeeding in Nigeria. His country recently came to a consensus to promote and protect breastfeeding for HIV-positive mothers by adopting the 2010 World Health Organization recommendations on infant feeding and HIV. He explained why the decision will help ensure the long-term health and survival of children who are vulnerable to HIV. Read the commentary.

Project news

New resource summarizes infant feeding sessions at the AIDS 2010 conference
Our team gathered a great deal of new research and program experiences in infant feeding and HIV at the XVIII International AIDS Conference in Vienna, Austria, in July. To share what we learned, we have collaborated with PATH to compile more than 70 infant feeding abstracts from the conference in a new publication. We have categorized the sessions by themes to make it easy to reference information on everything from HIV-free survival to male involvement. We hope you find the resource helpful.

Download: Selected Abstracts on HIV and Infant Feeding from the XVIII International AIDS Conference

Curriculum for men’s groups makes infant feeding a family issue
As part of our comprehensive approach to preventing malnutrition, IYCN engages men’s groups to support improved nutrition in their communities. Our new curriculum, tested during a two-day workshop for men’s group leaders in Kenya, encourages men to understand the importance of good feeding practices and to view infant feeding as a family issue—not just a women’s issue. We are currently conducting operations research with USAID’s AIDS, Population and Health Integrated Assistance II Western Project, led by PATH, to evaluate the impact of our male engagement activities on feeding practices Kenya. We will share updates as the results come in.

Download: Infant and Young Child Feeding and Gender: A Training Manual for Male Group Leaders

Visit the IYCN country map
Check out our new map of IYCN countries for an update on where we are working. Learn about new activities and read the latest highlights from our programs around the world.

Visit the IYCN country map.

Celebrating World Breastfeeding Week
IYCN joined colleagues around the globe to celebrate World Breastfeeding Week August 1–7, 2010. Our team worked with partners to coordinate a range of activities in support of this year’s theme: Breastfeeding: Just 10 Steps. The Baby-Friendly Way. 

View updates and photos from Haiti, Ethiopia, Kenya, Malawi, and Zambia.

Conferences and meetings

Join us at USAID’s Global Health Mini-University
IYCN will lead two sessions at the Global Health Mini-University in Washington, DC, on October 8, 2010.

Engaging Men at Home and in the Workplace

Uniting Agriculture and Nutrition for Healthier Mothers and Children

CORE Group Fall Meeting: Exploring links between agriculture and nutrition
On September 14, Dr. Tom Schaetzel, IYCN Technical Director, participated in a plenary, Designing Agricultural Investments that Support Improved Maternal and Child Nutrition, at the CORE Group’s Fall Meeting. Learn more.

Congressional briefing: Sharing lessons on integrated health programs
Former IYCN Zambia Country Coordinator Catherine Mukuka joined USAID’s Amy Batson and Dr. Ambrose Misore of USAID’s AIDS, Population and Health Integrated Assistance II Western project, led by PATH in Kenya, for a congressional briefing hosted by PATH and Women’s Policy, Inc., on September 14 in Washington, DC. The panel discussed lessons from integrated health programs for women and children. Visit the PATH website to learn more.

We welcome your feedback and suggestions for our next issue. Please contact: info@iycn.org.

Photos: Aurelio Ayala III, PATH/Evelyn Hockstein, PATH/Oluseyi Akintola 

New IYCN materials

AIDS 2010 poster: Improving child health and HIV-free survival

AIDS 2010 PowerPoint: National interpretations of WHO guidelines

Zambia: Infant and young child feeding integrated course

PowerPoint: Maximizing Nutritional Benefits from Agricultural Interventions

Helpful links and publications

Feed the Future website

UNICEF: Consolidated Report of Six-Country Review of Breastfeeding Programmes

Sweetpotato Action for Security and Health in Africa: Project brief

PATH: Improving Health for Families Everywhere

Welcome to the sixth issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project. Distributed four times per year, each issue offers updates on the latest research, new resources, and project news. 

Research highlights

Nutrition education improves growth in rural China
An article in the April 2010 issue of Public Health Nutrition presents findings from a randomized controlled trail of an education intervention designed to improve complementary feeding practices in China. Children in villages that received the intervention gained significantly more weight and length and experienced faster growth velocity compared to a control group. These results offer further evidence that educational messages alone can improve linear growth in food-secure low-income groups. Read more.

Local micronutrient fortification of school meals improves nutrition
The June 2010 issue of The Journal of Nutrition revealed results from a trial in India that tested the nutritional impact of giving school meals fortified with micronutrients onsite. The treatment group experienced significant improvements in total body iron, serum retinol, and folate compared to the control group. The authors concluded that point-of-use fortification of school meals using existing infrastructure is a cost-effective, locally acceptable, and sustainable way to implement micronutrient fortification programs. Read more.

Can low-phytate maize or zinc supplements enhance growth?
An article published in the May 2010 issue of The Journal of Nutrition presents the results of a trial that measured the effect of giving low-phytate maize, zinc supplements, or both on linear growth velocity among Guatemalan infants aged 6 to 12 months. Low-phytate maize did not show any effect, but the zinc supplements increased serum zinc concentration. Even so, the authors found no impact on child growth, leaving the cause of early stunting in Guatemala still unexplained. Read more.

Why does exclusive breastfeeding reduce HIV transmision from mother to child?
An article in the March 2010 issue of Clinical Infectious Diseases explores the hypothesis that lower levels of mastitis among women who exclusively breastfeed is the mechanism by which exclusive breastfeeding protects against mother-to-child transmission of HIV (MTCT). Results showed no association between mixed feeding and mastitis. Mastitis was predictive of MTCT, but only when maternal plasma HIV load was high. Read more.

Q&A: Nigeria

Responding to the 2009 World Health Organization recommendations

Wasiu "Prince" Afolabi, IYCN Nigeria

In a Q&A, the IYCN Project’s Wasiu “Prince” Afolabi shares the latest on his country’s interpretation of the November 2009 World Health Organization recommendations on infant feeding and HIV.

After much debate and examination, national nutrition and prevention of mother-to-child transmission of HIV stakeholders reached a consensus to adopt the new guidelines. The decision, he says, is a major step toward increasing HIV-free survival of children. Prince will present this experience at the XVIII International AIDS Conference.

Read our Q&A with Prince.

Country spotlight: Zambia

Provincial training teams increase nutrition support for HIV-positive mom

Eastern Province Trainers, including Sydney (back, left), on a supervisory visit to Mwami Hospital in Eastern Province.

Offering better nutrition support to keep HIV-exposed children healthy in Zambia’s Eastern Province was a problem that Sydney Kambobe, a provincial nutrition specialist, had grappled with for several years. In Zambia, poor feeding practices put children of HIV-positive mothers at high risk of HIV transmission. With the support of the IYCN Project, Sydney is now part of a local team that is training health workers to support HIV-positive moms to practice safer feeding. Learn more.

Update from the field: Côte d’Ivoire

Equipping social centers to meet the nutrition needs of orphans and vulnerable children

Venance Kouakou, IYCN technical advisor, Côte d’Ivoire

Venance Kouakou, IYCN technical advisor in Côte d’Ivoire, joined US President’s Emergency Plan for AIDS Relief and government officials on May 18 for a ceremony marking the launch of efforts to support social centers in improving nutrition for orphans and vulnerable children (OVC).

At the event, IYCN presented directors of 21 social centers from across the country with anthropometric tools to identify malnourished OVC and equipment for cooking demonstrations.

Read a message from Venance to learn about how IYCN is helping to meet the nutrition needs of OVC.

Project news

Investing in nutrition is key to feeding the future
In May, the US Government launched the Feed the Future Guide, describing its strategy to address global hunger and food security. The strategy emphasizes that investments in addressing the root causes of undernutrition can improve the lives of mothers and their children. The guide highlights the role IYCN is playing in preventing malnutrition in Haiti. View the guide.

Educating US policymakers on maternal and child health
IYCN’s Altrena Mukuria joined policymakers, congressional staff, and global health colleagues to discuss the role of health systems in improving maternal and child health during a May 25 Capitol Hill briefing in Washington, DC. Dr. Mukuria highlighted the vital work that IYCN does to improve health systems and increase the capacity of health workers, as well as how health systems are integral to improving the health of women and children throughout the world. Learn more.

Conferences

Maximizing Nutritional Benefits from Agricultural Interventions
The IYCN team brought together nutrition, agriculture, and other global health colleagues on June 14 for a lively session at the Global Health Council’s annual conference. Participants discussed the intersection between agriculture and nutrition and explored a nutritional impact assessment tool to help program planners meet the vision of the many new initiatives addressing nutrition, global hunger, and food security. Read a summary of the session and download the PowerPoint presentation.

XVIII International AIDS Conference
Last week at the AIDS 2010 conference in Vienna, Austria the IYCN team hosted three exciting infant feeding and HIV sessions:

Poster: Improving child health and HIV-free survival
Monday, July 19

Workshop: Safer feeding for HIV-exposed children
Tuesday, July 20

Satellite session: New opportunities to prevent pediatric HIV and improve child survival
Thursday, July 22

We welcome your feedback and suggestions for our next issue. Please contact: info@iycn.org.

Photos: Aurelio Ayala III, Christine Demmelmaier, Nampo, Jay Ward, Oluseyi Akintola

New IYCN materials

Zambia: Qualitative Assessment of Maternal Nutrition Practices

Kenya: Engaging men to increase support for optimal infant feeding

Lesotho: Infant and young child feeding counseling materials

Success story: Connecting communities with health care facilities to prevent malnutrition in Lesotho

News from our colleagues

PATH: Sweet potato holds promise for reducing malnutrition

Helpful links and publications

World Bank video: Investing in Nutrition: Let’s Grow Together

World Bank publication: Scaling Up Nutrition: What Will It Cost?

Bread for the World brief: New Hope for Malnourished Mothers and Children

Welcome to the fifth issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project. Distributed four times per year, each issue offers updates on the latest research, new resources, and project news.  

Research highlights

How do household rice expenditures impact nutritional status?
In a study published in The Journal of Nutrition in January 2010, researchers used data from the Bangladesh Nutrition Surveillance Project from 2000 to 2005 to explore the relationship between household rice and non-rice expenditures on childhood stunting and maternal underweight. Families who spent more on higher nutritional value non-rice foods were less likely to have stunted children in all age groups. Read more.

Ultra Rice® highly effective in boosting iron stores in young children
Promising new research published in The Journal of Nutrition in January 2010 found that rice fortified with iron-containing. Ultra Rice, developed by PATH, was more effective than iron supplement drops in fighting iron deficiency in children aged 6 to 24 months. Read more.

Continued breastfeeding through two years improves survival of HIV-negative children of HIV-positive moms
In an article published in Clinical Infectious Diseases in February 2010 the authors aim to identify an age at which weaning could safely be recommended to HIV-infected mothers of uninfected infants. Early weaning was associated with a doubled risk of non-HIV-infected mortality, even for mothers receiving support for safer replacement feeding. Read more.

Are multiple RDA multivitamin doses more effective than a single RDA to improve pregnancy outcomes for HIV-positive women?
In a study published in February 2010 in the American Journal of Clinical Nutrition, investigators compared the efficacy of multivitamins at multiple RDA doses and single RDA doses on pregnancy outcomes of HIV-positive women in Tanzania. Analysis showed similar impact from both on all of the studied outcomes. The authors conclude that multiple RDA doses are no more effective, so HIV-infected pregnant women should receive at least a daily single RDA multivitamin. Read more.

Country spotlight: Haiti

Rose Mireille Exumé has hope for Haiti’s mothers and children

Rose Mirielle Exumé, IYCN Country Coordinator, trains emergency health workers in Haiti.

Supporting mothers to breastfeed and nourish their children is helping Rose Mireille Exumé, IYCN’s Haiti Country Coordinator, cope with the aftermath of the January 12 earthquake. She finds comfort in knowing that families can improve nutrition for their children despite the adverse conditions they now face.
 
“I am grateful that I can continue to assist mothers and babies with good nutrition under difficult circumstances. I have hope that we can prevent malnutrition for many children,” said Rose Mireille.
 
Together with UNICEF and other partners, Rose Mireille is training emergency health workers to provide vital infant feeding counseling for new mothers as they strive to keep their babies healthy after the earthquake.

Learn more about Rose Mireille’s work and read the stories of Solange and Nadine, who have benefited from IYCN’s activities in Haiti.

Update from the field: Zambia

The making of a radio campaign

Josephine Nyambe, IYCN behavior change specialist, Zambia.

This month in Zambia, IYCN will launch a radio series promoting good nutrition for infants and young children. IYCN’s behavior change communications specialist, Josephine Nyambe, led development of the series called “Bushes That Grow Are the Future Forest.”

The campaign follows Sister Loveness, a health worker, as she travels around the country to hospitals, mothers’ club meetings, and markets, teaching families about improved infant feeding practices and addressing common barriers to good nutrition.

Read a message from Josephine to learn about her experiences using formative research to design radio scripts, training broadcasters on infant feeding, and producing radio spots.

Conferences

Meet us at the Global Health Council’s Annual Conference
June 14, 2010, 5:30-7:30pm
Join us for Maximizing Nutritional Benefits from Agricultural Interventions, an auxiliary session at the Global Health Council’s 37th Annual International Conference. The project will offer a seminar addressing the interface between agriculture and nutrition, highlighting intervention designs that have the potential either to improve or diminish the nutritional outlook for vulnerable populations. Learn more.

Join us at the XVIII International AIDS Conference
July 18-23, 2010
Planning on attending the upcoming AIDS 2010 conference in Vienna, Austria? Please join the IYCN team for two sessions on infant feeding and HIV. The project will present a poster featuring a literature review of current research on the risks and benefits of infant feeding options for HIV-positive moms and a workshop on how to promote safer breastfeeding within the context of HIV. Learn more.

IYCN presents a program to engage men in infant feeding
IYCN and the AIDS, Population and Health Integrated Assistance (APHIA) II Western Project in Kenya presented a poster at the 5th Breastfeeding and Feminism Symposium on March 20, 2010, in Greensboro, North Carolina. The poster describes a pilot activity that aimed to integrate infant and young child nutrition into community-level male involvement activities in Western Province, Kenya. Learn more.

Download a handout: Engaging men to increase support for optimal infant feeding in Western Kenya

We welcome your feedback and suggestions for our next issue. Please contact: info@iycn.org.

Photos: Aurelio Ayala III, Oluseyi Akintola, Nicole Racine, Kali Erickson

New IYCN materials

New IYCN materials

Slideshow: Promoting better nutrition for children in Kenya’s communities

Video: Celebrating World Breastfeeding Week in Lesotho

Lesotho Infant and Young Child Feeding Curriculum

Fact sheet: IYCN’s approach to infant feeding and HIV activities

Helpful links and publications

UNICEF, WHO, WFP: Call for support for appropriate infant and young child feeding in Haiti

UNICEF, WHO, PAHO: Haiti Earthquake Technical Note on HIV and infant feeding

WHO’s new guidelines on HIV and infant feeding

UNICEF’s Tracking Progress on Child and Maternal Nutrition

Bill & Melinda Gates Foundation’s Living Proof Project highlights the success of a breastfeeding program

New collection of national nutrition policies and guidelines on the IYCN website

Welcome to the fourth issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project. Distributed four times per year, each issue offers updates on the latest research, new resources, and project news. 

Research highlights

Evidence supports coupling prevention with treatment of acute malnutrition

Following the Niger food crisis of 2004-2005, programs for community-based treatment of acute malnutrition found that the prevalence of acute malnutrition remained high. In an anthropological study published in the January 2009 issue of Disasters, researchers investigated social factors that may predispose children to acute malnutrition and contribute to its high prevalence. The authors found several harmful infant and young child feeding practices. They recommended that treatment-based nutrition programs should include integrated, long-term approaches to improve infant and young child feeding. Read more.

Can water safety interventions reduce diarrhea during weaning?

In a study published in the Journal of Infectious Diseases in September 2009, investigators implemented a set of household water safety interventions to determine whether preventing exposure to waterborne pathogens would reduce diarrhea during weaning among HIV-exposed infants. During the weaning period, the frequency of diarrhea was the same in both the intervention and non-intervention groups. The authors concluded that diarrhea during the weaning period may be attributable to factors other than waterborne pathogens. Read more.

Continued breastfeeding lowers the risk of serious gastroenteritis for HIV-exposed kids

The January 2010 issue of the Journal of Acquired Immune Deficiency Syndromes features several articles on gastroenteritis and early cessation of breastfeeding. One study analyzed the risk of serious gastroenteritis in HIV-exposed infants who participated in two different trials in the same hospital in Uganda during different time periods. In one trial, mothers stopped breastfeeding their babies before 6 months of age, while mothers in the other trial stopped after 6 months. Stopping before 6 months of age led to higher rates of serious gastroenteritis through 18 months, and higher cumulative mortality. Read more.

Country spotlight: Kenya

View our new photo slideshow featuring dedicated community volunteers who help HIV-positive mothers boost nutrition for their children in Kenya. Since April 2009, IYCN has collaborated with the Society for Women and AIDS in Kenya and PATH to train more than 400 volunteer counselors on improving infant feeding practices in Western Province. See how the volunteers are spreading the infant feeding message to mothers and families through home visits, support groups, and discussions at health centers. View the slideshow.

Project news

Haiti update

Our thoughts are with the victims and families affected by the Haiti earthquake. Over the past few weeks, we have been very concerned about the safety and well-being of our IYCN team in Haiti. We are relieved to report that we have been in contact with all three of our staff members, who are employed by IYCN’s partner CARE: Rose Mireille Exume, Jennifer LaTortue, and Natacha Pierre-Pierre. Our sympathies are with them as they cope with losses of family members and homes. IYCN Country Coordinator, Rose Mireille Exume, is helping coordinate emergency nutrition activities as a member of the Nutrition Cluster team led by the United Nations Children’s Fund (UNICEF). Check the IYCN website for future updates on the situation.  

Please view and share the following important statements on appropriate infant and young child feeding during the Haiti emergency.

UNICEF, the World Health Organization, and the World Food Programme: Call for support for appropriate infant and young child feeding in Haiti

UNICEF, the World Health Organization, and the Pan American Health Organization: Haiti Earthquake Technical Note on HIV and infant feeding

Introducing new programs in Bangladesh, Ethiopia, and Malawi

IYCN will expand its work to three new countries to reach mothers and children with nutrition interventions.

• In Bangladesh, IYCN is working with CARE to provide families with micronutrient powders to mix with their children’s food to combat anemia and motivate beneficial feeding practices. Learn more.
• In Ethiopia, the team is working with partners to provide training and support for improving nutrition practices for HIV-positive mothers and HIV-exposed children. Learn more.
• In Malawi, the project will support the Office of the President and Cabinet to build capacity for community-based nutrition and HIV services. Learn more.

Making a difference in Lesotho

The project will wrap up activities in Lesotho this month. For the past two years, IYCN supported the Ministry of Health and Social Welfare to improve infant feeding practices by enhancing national policies, training more than 1,100 community-based workers to counsel mothers, improving linkages between health facilities and communities, and more. Program highlights include the recent launch of the national infant and young child feeding training curriculum for health workers.

Read the stories of Mamorena and Tsepo to learn about the impact of IYCN’s efforts in Lesotho. 

View a new video featuring Lesotho’s launch of demonstration gardens to improve complementary feeding, during World Breastfeeding Week in August 2009

Looking for the latest research on infant feeding and HIV?

Next month, the IYCN Project will launch a series of technical briefs to assist program implementers in understanding the evidence behind the new World Health Organization guidelines on HIV and infant feeding. Summaries of research on exclusive breastfeeding, formula feeding, and continued breastfeeding beyond six months will help nutrition and prevention of mother-to-child transmission of HIV program implementers and providers sort through the risks and benefits of promoting different feeding options to HIV-positive mothers. Look for the new materials soon.

Update from the field: South Africa

Training community volunteers

In October 2009, consultant Benny Sikhakhane helped IYCN start up a pilot project to integrate nutrition interventions into economic and educational development programs in South Africa’s Nigel District. Through a unique partnership with J&J Development Projects Trust, a private investment and management company, IYCN is introducing nutrition activities for mothers and children into community development plans. Read Benny’s message to learn about his experiences training community volunteers on infant feeding, reaching new mothers in the Nigel community, and educating community leaders on nutrition.

Read Benny’s message.

We welcome your feedback and suggestions for our next issue. Please contact: info@iycn.org.

Photos: Aurelio Ayala III, Evelyn Hockstein, Nkoate Thamae, Albertha Nyaku

New IYCN materials

New IYCN materials

Haiti: National norms for safe feeding of HIV-exposed infants and young children

Success story: Improving infant feeding to protect babies from HIV in Zambia

Handout: The Case for Preventing Malnutrition

Helpful links and publications

Read a Q&A with Bread for the World’s Eric Munoz to learn about proposed US food security legislation

View hunger and food security resources  

View a new USAID fact sheet on nutrition and food security

Learn about successful community-based nutrition approaches from our partners

News from our colleagues

PATH’s Ultra Rice named a 2009 Tech Award Laureate by The Tech Museum of Innovation

Welcome to the third issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project. Distributed four times per year, each issue offers updates on the latest research, new resources, and project news.  

Research highlights

Promising new research on HAART during breastfeeding
New research on highly active anti-retroviral treatment (HAART) and breastfeeding shows great promise for the prevention of mother-to-child transmission of HIV. In July 2009, researchers announced findings from several highly anticipated studies at the International AIDS Society Conference (IAS) in Cape Town, South Africa. Researchers showed that giving HAART to women who do not qualify for treatment or infants during breastfeeding can significantly reduce transmission of HIV to infants during breastfeeding. Read more and view summaries of the studies. 

New analysis of outcomes and costs for school feeding programs
In a study to be published in the Food and Nutrition Bulletin in October 2009, researchers conducted a systematic review of school feeding programs in four African countries and found that the average cost of school feeding programs was $40 per child—double the World Food Program’s most recent cost estimate of $20 per child. Read more.

The impact of Integrated Management of Childhood Illness in Bangladesh
In a cluster randomized trial published in The Lancet in August 2009, investigators evaluated the impact of the Integrated Management of Childhood Illness (IMCI) strategy on health workers’ skills and support, care-seeking practices, feeding practices, and health outcomes in children under five in rural Bangladesh. They found no differences in mortality between the IMCI intervention and non-intervention areas. However,  children in IMCI areas were more likely to have been exclusively breastfed and less likely to be stunted. Read more.

Adding zinc to iron/folic supplementation for pregnant women improves growth
In a study published in the Journal of Clinical Nutrition in July 2009, investigators examined the growth outcomes of children six to eight years old in Nepal whose mothers had received one of five micronutrient combinations during pregnancy: folic acid, folic acid + iron, folic acid + iron + zinc, multiple micronutrients, or a control. The only micronutrient formulation to show a positive effect on growth was folic acid + iron + zinc. The authors suggest further exploration of the potential benefits of adding zinc to the standard iron/folic acid supplement. Read more.

Continued breastfeeding increases HIV-free survival
The Zambia Exclusive Breastfeeding Study randomized HIV-positive mothers to wean their infants after four months (intervention) or to continue breastfeeding for as long as they wished and found no HIV-free survival advantage for early weaning. A secondary analysis, published in PLOS One in June 2009, investigated whether maternal disease severity modified the relative risks of HIV infection and death associated with adherence to the intervention. Among infants whose mothers had higher CD4 counts or less advanced disease, breastfeeding continued to have a protective effect until the age of 15 months. Read more.

Point of view

Better nutrition is central to addressing hunger and food security
In a new commentary on the IYCN website, Denise Lionetti, IYCN project director, talks about the importance of prioritizing nutrition programs as part of a comprehensive strategy to alleviate global hunger and promote food security. She urges the nutrition community to engage now in dialogue on global food security policy.

Read the commentary.

Country spotlight: Madagascar

A mother in Madagascar who receives nutrition support from the WFP.

Helping partners address nutrition gaps

For Flora Bertizzolo, 30, a health and nutrition program officer at the United Nations World Food Program (WFP), getting food to children in need in Madagascar is her first priority. She and her colleagues at the WFP office in Madagascar run a program that provides food assistance to more than 65,000 mothers and children in the most food-insecure areas of the country during the lean season.

But she believes the families she serves need more than food to prevent malnutrition. That is why the WFP team—located in the capital city of Antananarivo and in sub-offices around the country—collaborates with other organizations to make sure that food is part of an integrated effort to prevent malnutrition and improve health. 

“Food is not the only solution to nutritional problems. We need to work with a range of partners who offer behavior change interventions, health systems strengthening, and capacity building in order to effectively reduce malnutrition,” she said.

Read more.

Project news

Celebrating World Breastfeeding Week

IYCN joined partners around the globe during World Breastfeeding Week, August 1 to 7, 2009, to highlight the critical role of breastfeeding before and during emergencies. IYCN worked with partners in several countries to commemorate the campaign. Highlights included:

Zambia introduced a new media campaign to promote exclusive breastfeeding. View a television spot from the campaign.  

Kenya held a National Infant Feeding Stakeholders’ Meeting, sponsored by IYCN. Read a message from IYCN’s project director Denise Lionetti about her experience at the meeting.

Haiti and Lesotho held community and national events to promote good infant feeding practices. Read more.

New infant feeding guidance for health workers in Haiti

In Haiti, a lack of infant feeding guidance for health workers resulted in the spread of potentially harmful messages for mothers—especially messages for counseling HIV-positive mothers on good feeding practices for their babies. To offer clear direction for health workers to effectively support mothers on infant feeding, IYCN worked with the Ministry of Health to introduce a new national guide, National Norms for Safe Feeding of HIV-exposed Infants and Young Children.

To help create the guide and get support from key stakeholders, IYCN brought together more than 100 partner organizations to discuss conflicting messages about infant feeding for children affected by HIV. In August, the Ministry of Health started introducing the guide to health workers across the country.  

View the national norms for safe feeding of HIV-exposed infants and young children (in French).

Conferences

Join us in Bangkok at the International Congress of Nutrition
Planning on going to this year’s International Congress on Nutrition (ICN) conference? Join IYCN and USAID on October 8, 2009, for a symposium: Communication and Partnership Building to Improve Child Nutrition. Panelists, including IYCN’s Tom Schaetzel, will share experiences of how communication and partnership building has been critical to the successful implementation of programs in diverse contexts. Dr. Schaetzel will also present An Evaluation of AIN-C Community-Based Growth Promotion in Honduras as part of another panel.

Learn more.

CAPGAN 2009: Making a case for prevention of severe acute malnutrition
IYCN presented a poster on the case for prevention of severe acute malnutrition (SAM) at the 10th Commonwealth Association of Paediatric Gastroenterology and Nutrition (CAPGAN) Congress on Diarrhoea & Malnutrition in Blantyre, Malawi, which took place from August 12 to 16, 2009. The poster outlines arguments for investing in prevention of SAM rather than in the universal introduction of SAM treatment.

Also at the conference, IYCN presented results from the first phase of a study which aims to understand infant feeding practices in Malawi. The project will publish results from the study later in the year after the second phase has been completed.

Learn more and download a handout of IYCN’s poster on the case for preventing malnutrition. 

IAS 2009: IYCN assessment reveals lack of adequate infant feeding training in Kenya
IYCN presented observations of provider practices from an infant feeding assessment in Kenya at the 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa, on July 19, 2009. Among the results, IYCN found that lack of training leads to inappropriate infant feeding information given to mothers. The presentation was part of a satellite session, Infant Feeding and HIV: Science and Practice, hosted by the Elizabeth Glaser Pediatric AIDS Foundation.

Learn more and view the presentation. 

We welcome your feedback and suggestions for our next issue. Please contact: info@iycn.org.

Photos: Aurelio Ayala III, World Food Program, PATH/Evelyn Hockstein, Jennifer Latortue.

New IYCN materials

New IYCN materials

IYCN fact sheet in French

Kenya: Infant feeding and HIV trainer’s guide and participant’s manual

Kenya: Infant Feeding and HIV Reporting Tools

Haiti: Stakeholder’s Workshop Report in French

Helpful links and publications

Bread for the World’s blog: Breaking the Cycle of Diarrhea and Malnutrition 

A Roadmap for
US Leadership to End Global Hunger

News from our colleagues

New PATH report:
Diarrheal Disease: Solutions to Defeat a Global Killer

World Breastfeeding Week is August 1-7, 2009.

Welcome to the second issue of the IYCN Update, a newsletter from USAID’s Infant & Young Child Nutrition (IYCN) Project. Distributed four times per year, each issue offers updates on the latest research, new resources, and project news. 

Research highlights

Can current food aid commodity formulations meet energy needs for kids?

A study published in May 2009 in the International Journal of Food Sciences and Nutrition found that it is difficult to meet the energy requirements of infants and young children with complementary foods made from current food aid commodity formulations. The authors call for new formulations and specifications in order to enable food programs to improve infant and young child nutrition. Read more.

Does early breastfeeding cessation for mothers with low CD4 counts increase infant mortality?

In an article published in April 2009 in the International Journal of Epidemiology, investigators in Zambia confirmed that both CD4 count and early breastfeeding cessation were associated with increased infant mortality. However, only a small percentage of the association between low CD4 count and high mortality could be attributed to early breastfeeding cessation. Read more.

Flexible administration of Sprinkles for anemia control improves adherence and impact

In a trial published in the European Journal of Clinical Nutrition in February 2009, researchers in Bangladesh gave mothers 60 sachets of Sprinkles to use daily for either two months, three months, or four months to reduce anemia.  Those given four months to consume the 60 sachets showed the best adherence and improvement in hemoglobin status. The authors concluded that giving mothers the ability to decide when to use Sprinkles motivated them to improve adherence and resulted in better outcomes. Read more.

Benefits of daily nutritional supplements for children in Malawi

In January 2009, the American Journal of Clinical Nutrition published a study in which three groups of Malawian children received different daily nutritional supplements from 6 to 18 months of age—a maize-soy flour that required cooking, and either 50 grams or 25 grams of a peanut-based, ready-to-eat food. While after two years of follow-up those receiving the higher dose of ready-to-eat food were least likely to be severely stunted, the cost of that intervention would be prohibitive for most families. Read more.

Point of view

Meeting the challenge of growth faltering

In a new commentary on the IYCN website, The Manoff Group’s Marcia Griffiths discusses how the global nutrition community can improve feeding for children from 6 to 23 months of age. Lessons from successful global programs show that we must go beyond the offer of nutrient-dense foods and focus on approaches that help caregivers find an appropriate balance among many critical feeding practices as they nourish their children during the critical first two years of life.

View the commentary.

Country spotlight: Lesotho

Tsepo, with his mother Malehloa, at the Litsoeneng Health Centre in Lesotho

Tsepo’s story

At the Litsoeneng Health Centre, a small clinic in a remote area of Lesotho, Adelina, 40, a nurse, and Mabeata, 62, a community health worker in the nearby village of Khopolo, proudly tell the story of Tsepo. He’s a healthy, 17-month-old boy who is learning how to walk and loves playing with other children. Mabeata and Adelina meet monthly to monitor his growth and make sure that he stays healthy.  

But this wasn’t always the case for Tsepo. When he was 8 months old, Mabeata visited his home to monitor his growth and discovered that he wasn’t gaining weight at a normal rate. Immediately, she encouraged his mother, Malehloa, only 16 years old, to take him to the clinic to correct the problem. After participating in a training workshop conducted by the IYCN Project, the community health worker knew that it was critical to send babies with growth problems to the clinic as soon as possible. She even walked with Malehloa and Tsepo from Khopolo to visit the clinic.

“I was very concerned about Tsepo. I wanted to be there to help Malehloa understand the problem and coordinate with the nurses to follow up after the visit,” Mabeata explained.

Read more.  

Message from the field: Lesotho

Makatleho Masoabi, IYCN Country Coordinator, Lesotho

Pretesting in Pitseng
By Makatleho Masoabi, IYCN Country Coordinator

In April, I worked with the Ministry of Health and Social Welfare to pretest Lesotho’s new infant and young child feeding training curriculum for health workers. More than 20 trainers from health facilities in all ten districts of the country joined us for a training workshop in the mountains of Pitseng—about a two-hour drive from the capital city of Maseru.

We asked the trainers—mostly nurses, one doctor, and a few national stakeholders—to take turns facilitating counseling role plays, demonstrating good breastfeeding techniques, and leading other activities. During each session of this week-long course, participants gave feedback to help us make future training workshops appropriate for health workers in their districts.

Read more.

Project news

Announcing new activities in Nigeria

Mothers with their babies at a clinic in Nigeria. (Use of this image does not indicate or imply HIV status.)

IYCN recently received funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR) to launch activities in Nigeria, where there is a pressing need to improve infant and young child nutrition within the context of HIV. The project plans to support the government’s efforts to reduce the high burden of maternal and child undernutrition and improve HIV-free survival.

The IYCN team will provide technical assistance to the Ministry of Health and state and local government partners to update nutrition policies, train health care workers, and enhance behavior change programs targeting HIV-positive mothers and HIV-affected children. The project expects to open an office in Abuja, the capital city, and start up activities later in the summer.

Join us at IAS 2009

IYCN will participate in the 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa from July 19 to 22, 2009. PATH’s Margaret Waithaka, who works with the IYCN Project in Kenya, will participate in Infant Feeding and HIV: Science and Practice, a satellite session to be hosted by the Elizabeth Glaser Pediatric AIDS Foundation on July 19, 2009. 

Learn more.

IYCN Country Coordinators prepared for a brown bag in Washington, DC on May 21. From left to right: Makatleho Masoabi, Lesotho; Hortense Angoran-Benié, Côte d'Ivoire; and Catherine Mukuka, Zambia.

Conferences

Here’s a rundown of IYCN’s participation in conferences and events over the past few months. Check the IYCN website for more information, selected PowerPoint presentations, and links. 

• IYCN team members participated in Project Concern International’s Africa Forum 2009, focusing on HIV/AIDS and nutrition and food security, in Mangochi, Malawi from June 21 to 26, 2009. Hortense Angoran-Benié facilitated a skills-building session on infant feeding counseling for HIV-positive mothers, and Makatleho Masoabi presented IYCN’s multi-sectoral approach to improving infant feeding in Lesotho. Read more.

• Dr. Tom Schaetzel, IYCN’s Technical Director, talked about effective actions for preventing malnutrition among children younger than two years of age as a panelist in Bread for the World’s Getting Nutrition on the Development Agenda in Washington, DC on June 15, 2009.

• IYCN moderated two nutrition panels at the Global Health Council’s 36th Annual International Conference in Washington, DC, from May 26 to 29, 2009. The panels highlighted the importance of interventions that focus on prevention and the need to prioritize improved complementary feeding in order to reduce malnutrition among children. Read more.

Also at the conference, PATH’s Dr. Kiersten Israel-Ballard presented new research on feeding HIV-exposed infants in Kenya. This assessment is informing IYCN’s activities in the country. Read more.

• IYCN Country Coordinators from Zambia, Côte d’Ivoire, and Lesotho shared challenges, good practices, and lessons learned from IYCN activities in their respective countries at a brown bag event in Washington, DC on May 21, 2009. Read more.

• On May 11, 2009, more than 85 individuals working toward integrated programming for maternal, infant, and young child nutrition joined a satellite session, organized by IYCN, the Global Alliance for Improved Nutrition, and the University of California, Davis, at the Second International Meeting of the Micronutrient Forum in Beijing, China. Participants discussed solutions and successful approaches to integrate interventions to improve nutrition during the critical period from prior to conception through the first two years of life. Read more.

We welcome your feedback and suggestions for our next issue. Please contact: info@iycn.org.

Photos: Aurelio Ayala III, Kali Erickson, Christine Demmelmaier, David and Lucile Packard Foundation, Ashley Hughes