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Beavan Dhliwayo Features Writer

As Zimbabwe and the rest of world remain confronted with Covid-19 — declared by the World Health Organisation (WHO) as a pandemic — the care of infant and young child feeding (IYCF) should also be taken cautiously.

While cases of Covid-19 across the globe are evolving more rapidly, the agreed recommendation is that individuals suspected or with confirmed mild symptoms be managed at home.

Therefore, the caring for infants and mothers at home requires practising WHO-recommended infection prevention and control measures.

In Zimbabwe, the lockdown presents limited availability and access to food markets and health facilities hence information and support on feeding infants and young children is most important now than ever.

For all stakeholders in the country, from Government, private players to developmental partners intensifying the protection, promotion and support to adequate infant and young child feeding is therefore a critical action.

There is need to consider specific barriers and bottlenecks in the country.

To this end, the United Nations Children’s Fund (UNICEF), Global Nutrition Cluster and Global Technical Assistance Mechanism for Nutrition (GTAM) released a document on March 30, titled “IYCF Programming in the context of Covid-19 Brief 2” which outlined key recommendations and considerations based on the global guidance and learning so far.

The recommendations align with WHO’s interim guidance on home care for patients with Covid-19 presenting with mild symptoms and management of contacts (March 17, 2020); the clinical management of severe acute respiratory infection (SARI) when Covid-19 disease is suspected (March 13, 2020) and operational guidance on infant feeding in emergencies (2017).

The document outlines key messages and priorities that nations should religiously follow in the wake of Covid-19 to promote infant and young child feeding.

The document recommends that programmes and services that protect; promote and support optimal breastfeeding (early and exclusive) and age-appropriate and safe complementary foods and feeding practices should remain a critical component of the programming and response for young children in the context of Covid-19.

Mothers with suspected or confirmed Covid-19 and isolated at home should be advised to continue recommended feeding practices with necessary hygiene precautions during feeding.

Recommended also is the alignment and coordination in the mitigation plans across nutrition, health, food security and livelihood, agriculture, WASH, social protection and mental health and psychosocial support to focus on reaching infants and young children in the context of Covid-19.

Actions through relevant systems (food, health, WASH, and social protection) should prioritise the delivery of preventive services to mitigate the impact of the pandemic on young children’s diets and wellbeing with strong linkages to early detection and treatment of child wasting.

The document also encourages full adherence to the International Code of Marketing of Breast-milk Substitutes and subsequent WHA resolutions (including WHA 69.9 and the associated WHO Guidance on ending the inappropriate promotion of foods for infants and young children) in all contexts.

Additionally, according to the document, donations, marketing and promotion of unhealthy foods — high in saturated fats, free sugar and/or salt — should not be sought or accepted.

During the pandemic mothers should always wash hands with soap and water at critical times, including before and after contact with the infant.

Encouraged also in homes is to routine cleaning of the surfaces around the home that the mother has been in contact with, using soap and water.

If the mother has respiratory symptoms, they should use facemasks when feeding or caring for the infant.

In case one cannot afford to buy facemasks, adaptive facemasks must be used as an alternative.

Mothers with infants should always maintain physical distancing from other people (at least 1m) and avoid touching eyes, nose and mouth.

According to the document, breastfeeding mothers should be counselled to continue breastfeeding even if the infant or young child becomes sick with suspected, probable, or confirmed Covid-19 or any other illness.

For artificial feeding, mothers are advised to feed the infant or young child with a cup, wash hands with soap and water before handling cups and bottles, etc.

It is also important to limit the number of caregivers feeding the infant, the document further says.

With the potential for limited availability of and access to nutritious food choices at household level, coupled with increased demands on parents due to the lockdown, caregivers could feel overwhelmed with childcare and feeding responsibilities.

During the period, the document points out that provision of specific guidance on age appropriate and safe complementary foods and feeding practices, using digital, broadcast and social media platforms, will support parental decision-making.

According to the document, caregivers should be counselled/advised/receive practical, feasible and context specific information on the importance of healthy diets and solutions to enable families in maintaining a healthy diet together with intake of safe and palatable drinking water for their young children.

Again, if access to fresh produce is difficult, caregivers are advised to identify healthy food options to replace fresh produce, limit highly processed foods that are of low nutritional value being typically high in saturated fat, free sugars and salt, and avoid sugary drinks and follow-on milks.

It is important for young children to consume sufficient fruits and vegetables, wholegrains and protein sources.

These types of food can be cooked fresh, dried, tinned or frozen.

Such information will need to be adapted to address specific barriers as per the prevailing Covid-19 response within a country.

Before preparing or eating food, caregivers should ensure they practise the recommended hygiene behaviours such as handwashing with soap and regular cleaning and disinfecting of food preparation areas.

Countries are also encouraged to ensure integration of targeted context-specific feasible/doable messages on safe hygiene into all relevant opportunities and harmonised across multiple communication channels to ensure its reach and application.

Additionally, in communities where eating at a common bowl or feeding children by hand is common, it is preferable to use the child’s own plate and spoon to avoid transmission.

Nutritionist Kudakwashe Zombe told The Herald that although there is no concrete evidence regarding specific dietary factors that can reduce risks of acute infections like Covid-19, everyone above six months should eat healthy and balanced diet.

“Let’s include a variety of fruits and vegetables in our diets as they help in boosting our immune system,” he said.

“I also urge everyone to take heed of the Ministry of Health and Child Care tips in sanitising our hands, homes and surroundings while washing our hands with soap under running water regularly to prevent the spread of Covid-19.”

In the context of Covid-19, communities should ensure integration of harmonised messages on safe hygiene into all relevant opportunities and multiple communication channels through the health system to ensure its reach and application.