Breastfeeding

·        Avoiding giving the newborn child any drink or food other than breast milk (exclusive breastfeeding) for 6 months.

·        Breastfeeding on demand, day and night, without limiting its duration.

·        Keeping the mother and child together in her bed (Rooming-in).

·        It is sufficient to bathe or wash the breast once daily while avoiding wiping the nipple and areola with soap or alcohol, as this removes the natural oils secreted by the areola by which the child recognizes their mother.

·        After feeding the child, gently pat the breast dry or leave it bare for minutes to dry automatically. There is no need to use oils. A few drops of milk can be expressed onto the areola and nipple and left to dry.

Incorrect Practices in Breastfeeding

·        Giving glucose or sugar-sweetened water to the child after birth.

·        Giving water to the child, especially in the summer.

·        Giving anise and caraway to the child to relieve colic, which affects exclusive breastfeeding.

·        The mother stopping breastfeeding when she is sick or has a high fever.

·        Pacifiers lead to mouth and dental deformities and help cause oral thrush.

·        Scheduling breastfeeding, which contradicts the practices of exclusive breastfeeding.

·        Introducing complementary foods to the child before the sixth month.

·        Giving the child complementary foods that are not suitable for their age.

·        Not breastfeeding the child at night based on a misconception about resting the stomach.

Breastfeeding Assessment

·        What do you observe about the mother? (Her age - general health - nutrition - social and financial status).

·        What is the condition of the mother's breasts? (Size - signs of oxytocin reflex activity).

·        Look also for the following signs:

o   Fullness of the breast before the feed and its softness afterward.

o   Extreme fullness of the breast all the time, indicating the infant is not drawing milk from the breast.

o   Healthy appearance of the skin of the breast and nipples.

o   Redness of the skin or presence of cracks in the nipple.

o   Inflammation of the nipple or the appearance of a line on its tip or side when the infant releases the breast from their mouth is a sign of poor attachment.

·        What do you observe about the infant? (Nasal congestion - difficulty breathing - dehydration - tongue-tie - oral thrush fungal infections - cleft lip or palate).

·        How does the mother place the infant on her breast?

·        Does the infant appear to be well attached to the breast?

·        Is the infant suckling effectively?

·        How does the feed end and does the infant appear satiated? (The infant releasing the breast on their own, appearing full and sleepy - or the mother removing the infant from her breast before they finish feeding).

Feeding Guidelines by Age Group

Recommended Foods from 6 Months to 5 Years

·        Breastfeeding up to two years.

·        Staple foods give your child energy and include grains and tubers.

·        Staple foods do not contain sufficient nutrients on their own and must be accompanied by animal sources and other nutritious foods such as:

o   Foods of animal origin (liver, meat, eggs).

o   Dairy products (cheese, yogurt).

o   Legumes.

o   Colored leafy vegetables (yellow and green).

o   Fruits.

o   Oils and fats.

o   Ground nuts.

·        Give your child different types of the above foods alongside staple foods.

Preparing Safe and Clean Food

·        Wash your hands with soap before preparing food, before feeding your child, and after using the toilet.

·        Obtain clean drinking water and handle it properly (boil water for seconds, then let it cool on its own without adding ice. This water is considered safe and secure for the child to drink). Store it in clean, covered containers and use it in a clean cup.

·        Wash the cup and bowl the child drinks from well with soap and water, or boil them.

·        A feeding bottle must not be used as it leads to the detachment of the child from the mother, in addition to being difficult to clean.

·        Food is prepared using clean containers and the child is fed with a clean spoon.

·        Food preparation surfaces are washed with soap and water and detergents after each use.

·        Food is cooked well, especially meat, poultry, eggs, and fish.

·        Well-cooked food is prepared up to the boiling point.

·        Leftover food is covered or ideally placed in the refrigerator. It must be discarded if left at room temperature for more than two hours.

·        Avoid placing cooked food with raw food in the same container; it is best placed in separate containers.

Instructions for Dispensing Subsidized Artificial Milk for Eligible Children

Through Maternal and Child Healthcare Centers and Urban Health Centers in all governorates.

The primary role of maternal and child centers and clinics is to encourage, protect, and support breastfeeding and to help the mother breastfeed the newborn. Artificial milk is dispensed if any of the following reasons exist (Eligible Categories):

·        Twins (3 or more).

·        A sick mother taking medications that can be excreted in the milk and harm the child.

·        Complete cessation of breastfeeding for at least a month.

·        Death of the mother.

If the Guardian Requests Subsidized Formula, the Following Must be Done:

1.     When the guardian attends to request artificial milk, ensure the presence of the child's original birth certificate and the child's health card, along with valid national ID cards for the father and mother, while directing the necessity of the mother and child attending the assessment session.

2.     The guardian is directed to the designated center for dispensing milk close to their residence.

3.     The child's condition is assessed by the health team at the center designated for the maternal and child health clinic.

4.     The child is registered in the artificial milk dispensing registry, regardless of whether the child is eligible or ineligible for the milk.

5.     If the child is eligible for dispensing (within the eligible categories), this is recorded on both the original birth certificate and the third page of the health card, approved by the responsible center physician, and stamped with the center's seal.

6.     The number of milk cans to be dispensed is determined according to the instructions in each visit to dispense the specified monthly amount until the infant reaches 12 months of age (first stage up to 6 months, then second stage from the beginning of the seventh month until 12 months).

7.     The guardian is given a special card for milk dispensing recording the date of dispensing and the quantity dispensed, matching the registry.

8.     Proceed to the designated person responsible for collection, where the value of the milk scheduled for dispensing is paid with receipt voucher 33 A.H.

9.     A copy of the voucher with the ticket is handed to the guardian to proceed to the responsible pharmacist for dispensing.

10.  The financial document (receipt voucher 33 A.H.) and the package fee ticket Health/19 are collected with the financial officer at the center, as well as the cash amounts corresponding to the number of subsidized infant milk packages distributed, and regularly deposited to the health administration.

11.  The center prepares a daily/weekly/monthly report detailing the number of children attending for artificial milk, the number identified as eligible categories, and the amount of milk dispensed. The report is sent to the administration, then the directorate, where reports from all administrations are collected and a consolidated report is sent to the General Administration for Maternal and Child Healthcare.