Nutritional requirements during breastfeeding are higher than during pregnancy because the mother has to produce enough milk to sustain a baby (bigger than the foetus) for the first six months and beyond. Breast-feeding women need to eat a wide variety of foods.

Nutrition guidelines for pregnant women as well apply here but a lactating mother needs to eat much more; that is to say one extra meal (five meals in total).

Breastfeeding mothers should also take a lot of fluids to cater for the high amounts of water used to make breast milk. They should avoid self-medication, smoking and alcohol to prevent intoxicating the baby.

Breastfeeding mothers should avoid stress and have enough rest.
Nutrition for children 0 to 6 months

Breastfeeding and complementary feeding behaviours are important predictors of infant and child nutrition, health and survival. Breast milk is the best food for babies and is all the baby needs up to six months of age. Children from birth to six months of age should be exclusively breastfed. If you introduce any food before six months you will poten-tially expose the baby to unsafe and poor quality meals.

Exclusive breastfeeding refers to feeding a child on breast milk only for the first six months. Mothers are advised to breastfeed their babies as many times as the baby demands to be fed (at least 8 times a day, every 2-3 hours). This will help maintain milk production. Even when the child is ill, continue breast feeding.
Advantages of breastfeeding

Breast milk is the best nutritionally balanced food for the baby. It contains all the nutrients required by the baby in the correct pro-portions. The nutrients are in forms that are easy for the baby to digest and absorb.

Breast milk contains substances that help the baby to fight infec-tions and stay healthy. Most of these substances are found in the yellowish milk (colostrum) that is produced in the first few days afterbirth.

Breast milk is released at a correct temperature suitable for baby.

Breast milk is safe, there is no danger of contamination during preparation.

Breast feeding is relatively cheap compared to other alternatives.

Breast feeding promotes bonding between mother and baby.

Delays return of menstruation and delays the next pregnancy there-by spacing the children.

Helps the mother to shrink the uterus back to its normal size.

Exclusive breastfeeding for the first six months helps a child's mental (brain) development.
Weaning/complementary feeding practices

Weaning is the gradual introduction of food into the diet of the child. Alongside breast milk at the age of six months, beyond 6 months, breast milk alone is not enough to meet the child's increased nutritional needs for proper growth and development. During weaning there are six princi-ples to follow: meal frequency, amount, thickness, variety, active feeding and hygiene. This is commonly referred to as the FATVAH.

1. Frequency of meals refers to the number of meals eaten in a day. In order to meet the child's body's needs, for growth, development, and activity, we must feed them frequent meals, meaning 3 meals and 2 snacks each day.

 Amount of foods refers to how much food is eaten at each meal. It is important to eat foods in the appropriate amounts, again to ensure that we are not getting too little or too much food. For example, the youngest child needs less while the eldest child needs more amount of food for each meal as shown on table 3.

 Thickness of foods/consistency (not too thick as to have difficulty chewing or swallowing, not too watery). The thickness of foods/consis-tency is an important factor to eating well, because if food is too thick, it might make it difficult to chew and swallow. However, if food is too watery, the energy value of the food is reduced.

  Variety of different foods from each food group. In session 2 we learned about the food groups and their importance. We now know that each food serves the body differently ("GO", "GLOW", "GROW"), therefore it is important to have a variety of foods from each food group in order to eat well. Use fortified foods, when available; give vitamin/mineral supplements when animal products, fortified foods, or micronu-trient (vitamin A, Fe & Zn) rich foods are not readily available.

1. Actively feed and support is important, particularly for PLHIV. This is more than just feeding PLHIV (both adults and children), but involves a number of actions to support PLHIV to have access to food, grow foods, and prepare these foods.
2. Food Hygiene. Proper hygiene practices will prevent disease occur-rences and hence ensure good child growth and development: washing hands before eating and handling foods, clean utensils and clean water. This is a very important factor needed for eating well. Good hygiene reduces the risk of diseases.
KEY MESSAGES

From 6 months and beyond, children should be fed on other foods on top of the mother's breast milk. Milk should form the foundation of the child's diet between the ages of 0 to 2 years.

Use biofortified and/or fortified foods, when available; give vitamin/mineral supplements when animal products, fortified foods, or micronutrient (vitamin A, Fe & Zn) rich foods are not readily available.