NUTRITION PROGRAM • To increase commitment of the local chief executives and other

What is Nutrition? partners.

​ The process of taking in food and using it for growth,
metabolism, and repair. PHILIPPINE FOOD & NUTRITION PROGRAM
​ Good nutrition is essential for health, productivity and • Directed towards the provision of nutrition services to the DOH's
identified priority vulnerable groups; infants, preschoolers,
the prevention of disease
schoolers, women of child-bearing age (also included are the
pregnant and lactating mothers) and the elderly
Key Agencies:
-​ Department of Health
GOAL
-​ National Nutrition Council - the country's highest
• The improvement of nutritional status, productivity and quality
policy-making and coordinating body on nutrition
of life of the population through the adoption of desirable dietary
practices and healthy lifestyle
Nutrition Situation
●​ Persistent stunting and wasting among children under 5
PROGRAM COMPONENTS
●​ Rising rates of overweight and obesity among adults and
A. Breastfeeding Practices (IYCF)
school-aged children
●​ Micronutrient deficiencies: iron, iodine and vitamin A ​ Exclusive Breastfeeding for the first six months - Infants
deficiency shall be exclusively breastfeed for the first six months of
●​ 23.6% of Filipino children under 5 are stunted (FNRI, lite to achieve optimum growth and development. Only
●​ 2025) breast-milk should be given and no other food or drinks,
●​ 12.9% of Filipino children aged 5-10 are overweight or not even water. Vitamins and medicines are permitted
obese by physicians.
●​ 2 out of 10 Filipino adults were prediabetic ​ Extended breastfeeding up to three years - Although
volume of breast-milk consumed declines as
Philippine Nutrition Program complementary foods are added,, breast-milk contribute
​ Malnutrition remains to be a challenge in the region des significantly as it provides one third to two thirds of
pite of the decline in the under five mortality rate. The d average total energy intake towards the end of first year.
ecline of breastfeeding, compounded by inappropriate
complementary feeding practices, is a cause for alarm b B. Complementary Feeding Practices (IYCF)
ecause of the consequent under nutrition and risk for ​ Appropriate complementary feeding
childhood mortality and morbidity. ​ Infants shall be given appropriate complementary foods
​ One of the Global Nutrition Targets for 2025 is a 40% at age six months in order to meet their evolving
reduction in stunting, thus the Philippines is committed nutritional requirements. This means that it should be
to this target under the Global Scaling-Up Nutrition given: timely, adequate, safe, and properly fed.
Movement (SUN), ensuring optimal nutrition in the First ​ Ensure access to appropriate complementary foods -
1,000 Days of life from a mother's pregnancy up to a through diversified approaches and use of home-and
child's second year of life. community based technologies.
​ The Global Strategy for Intant and Young Child Feeding ​ Use of locally available and culturally acceptable foods
was jointly developed by the World Health Organization ​ Low-cost complementary foods
and UNICEF is the result of a comprehensive
participation process and grounded on the best avallable
Micronutrient Supplementation
scientitic and epidemiological evidence.
Based on the updated Guidelines on Micronutrient
​ The Global Strategy early months and years of lite, and Supplementation, the following are the priority targets for
of the crucial role that appropriate feeding practices play micronutrient supplementation:
in achieving optimal health outcomes. ​ Universal Vitamin A supplementation shall continue to
​ The Strategy identifies interventions with proven be provided to infants and children 6-59 months of age.
positive impact, it emphasizes providing mothers and ​ Vitamin A supplementation shall be given to children at
families the support they need to carry out their crucial
risk, particularly those with measles, persistent
roles, and it explicitly defines the obligations and
diarrhoea, severe pneumonia and severely
responsibilities of the government and other
malnourished children to help re-establish body reserves
organizations and agencies.
of vitamin A and protect against severity of intections
and prevent complications.
OBJECTIVES
General Objective ​ Postpartum women shall be given vitamin A capsule
• The overall objective is to improve the survival of infants and within one month after delivery to increase vitamin A
young children by improving their nutritional status, growth and concentration of her breast-milk as well as vitamin A
development through optimal feeding. status of their breastfed children.
​ Children with signs of xeropthalmia shall be treated with
Specific Objectives vitamin A.
• To raise awareness of the main problems aftecting intant and ​ Children during emergencies shall be given priority for
young child feeding, identify approaches to their solution, and vitamin A supplementation following schedule for high
provide a framework of essential interventions; risk children.
• To create an environment that will enable mothers, families and
other caregivers in all circumstances to make and implement Micronutrient Supplementation:
informed choices about optimal feeding practices for infants and A.​ Iron Supplementation
young children. - shall be provided to pregnant and lactating women and low birth
weight babies and children 6-11 months of age.
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- In addition, anemic and underweight children 1-5 years of age 4.​ Management of Moderated Acute Malnutrition (MAM) -
shall be provided with iron supplements including adolescent girls It targets cases of MAM with supplementary tood, some
enrolled in Grades 7-10. basic medicines, monitoring and nutritional education.

B. lodine supplementation Policies and Laws

- shall be provided to women of reproductive age group, school • PD 491 - Nutrition Act of the Philippines
age children in areas when the Urinary iodine Excretion of less - Declares nutrition as a priority of the gove
than 50 ug/L in more than 20% of the population. rnment
- Priority will be given to all pregnant women who do not have - Creates the National Nutrition Council
access to iodized salt. - Designates July as the Nutrition Month
• RA 832 - Rice Enrichment Law
C. Calcium Supplementation -​ All milled rice will have to be enriched with premixed
- for Pregnant Women shall be provided to reduce the risk of rice
developing gestational hypertensive disorders and associated • RA 8172 - FIDEL Salt
health problems thereby improving maternal and new born health -​ (Fortification for lodine Deficiency Elimination)
and nutrition outcomes through provision of daily calcium • E.O. No. 51
supplementation. -​ Adopting a National Code of marketing of Breast milk
substitutes, Breast milk supplements and related
D. Universal Salt lodization products, penalizing violations thereot, and for other
- Families shall be encourage and educated on the use of iodized purposes
salt in the preparation of foods for older infants and oung children R.A. No. 7600
and even adults to prevent iodine deficiency disorders. -​ An act providing incentives to all government and
private health institutions with Rooming-in and
E. Food Fortification Breastfeeding practices and for other purposes.
- Food fortification of staple foods like oils and flour and salt to • R.A. No. 10028
include processed foods was undertaken to ensure that older -​ An act expanding the promotion of Breastfeeding,
infants and young children receive adequate amounts of Amending for the purpose Republic Act No. 7600,
micronutrients. otherwise known as "An act providing incentives to all
government and private health institutions with
F. Mother Baby Friendly Health Initiative (MBFHI) Rooming-in and Breastfeeding practices and for other
- To promote and support and protect breastfeeding and Infant purposes"
and Young Child Feeding Practices in all health facilities, and the
need to transform these facilities (government and
private-hospitals and Lying-in) rendering maternal and new born
care services into Mother Baby Friendly Health Institution.

G. Philippine Integrated Management of Acute Malnutrition

(PIMAM)
- This aims to support the implementation and expansion of
quality treatment for children suffering from the most severe and
acute form, of under nutrition which is severe acute malnutrition
(SAM). These children with SAM are at most risk of dying as a
result of their under nutrition.

Guiding Principles of PIMAM

1.​ Maximum coverage and access - to achieve the greatest Child Malnutrition in the Philippines
possible coverage by making services. accessible and Stunting, measured as low height-for-age, develops during the
acceptable to the highest possible proportion of a 1,000-day critical window from a child's conception to the first two
population in need; years of life. It results from sustained poor dietary intake or
2.​ Timeliness - early case-tinding and mobilization so that repeated infections or both, and brings long-term, irreversible
most of the cases of SAM can be treated before health and economic consequences.
complications develop;
3.​ Appropriate care - simple and effective Out-patient and Wasting or acute malnutrition, develops as a result of recent rapid
In-patient Therapeutic Care; weight loss or a failure to gain weight. A strong predictor of
4.​ Care when and where it is needed - continuous and mortality, it is measured as low weight-for-height and classified as
appropriate support with other interventions moderate or severe.

Four Components of PIMAM Underweight is a low weight-for-age measurement that reflects

1.​ Outpatient Therapeutic Care (OTC)- management of both stunting and wasting.
non-complicated cases of SAM using ready to use
therapeutic foods (RUTF)at the community level; The status of Filipino Children Under 5:
2.​ Inpatient Therapeutic Care (ITC) - management of • 23.6% stunting rate - this reflects chronic undernutrition -
complicated cases of SAM at the hospital level; children are short for their age
3.​ Community Mobilization - involves engagement with the • 15.1% underweight - this is a measure of weight for age
community to promote a common understanding of • 5.6% wasting - an acute form of malnutrition, children are
acute malnutrition and promote services offered; underweight for their age
• 3.7% overweight

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Double burden of malnutrition - high rates of undernutritio n ●​ Supplementary feeding for pregnant women
(stunting and underweight) and overnutrition (overweight a nd and children; 6-23 months old
obesity) ●​ Functional Infant and Young Child Feeding
(IYCF) support group
GLOBAL BURDEN OF MATERNAL AND CHILD UNDERNUTRITION ●​ Limited early learning and child minding
AND MICRONUTRIENT DEFICIENCY services
• According to more recent estimates, IUGR, stunting and severe C.​ Regulation
wasting are responsible for one third of under-five mortality ●​ Enforcement and compliance to the Milk Code and RA
• About 12% of deaths among under-five children are attributed to 10028 (lactation stations and breastfeeding breaks in the
the deficiency of the four common nutrient workplace)
●​ Salt iodization and food fortification
Major Causes of Maternal Mortality
• Lack of prenatal and postnatal check-ups Early initiation of breastfeeding
• Complications of childbirth (especially height) has been associated with decreased human
• Infections caused by unsterile home deliveries capital, including?:
• Hypertension • Shorter adult height
• Intrapartal/postpartal hemorrhage • Less education
• Below standard nutrition Lower economic productivity
• Lower offspring weight (females only)

Infants with a larger size at birth and at 2 years have an increased

risk of various negative outcomes.:
• High glucose concentration
• High blood pressure
• Harmful lipid levels

DID YOU KNOW

Involvement of fathers in the First 1000 Days of a child's life is vital
to the growth and development of the child.

5 THINGS TO REMEMBER TO SUPPORT YOUR JOURNEY

THROUGH THE FIRST 1000 DAYS
1.​ VITAMIN & MINERAL SUPPLEMENTATION
Services in the First 1,000 Days 2.​ EXCLUSIVE BREASTFEEDING
A.​ Pregnant and lactating women 3.​ INTRODUCING COLORFUL COMPLEMENTARY FOOD
●​ Prenatal care AFTER 6 MONTHS OF LIFE
●​ Iron/folic acid supplementation 4.​ FOLIC ACID FOR THE MOTHER
●​ Immunization 5.​ BALANCED DIET FOR THE MOTHER DURING PREGNANCY
●​ Reproductive health
●​ Salt iodization MALNUTRITION
●​ Lactation stations and breastfeeding breaks • An abnormal condition of the body resulting from the lack or
●​ Infant and Young Child Feeding (IYCF) excess of one or more nutrients like protein, carbohydrates, fats,
counseling vitamins and minerals.
B.​ Infants Primary Cause: Poverty
●​ Promotion of breastfeeding and 1.​ Lack of money to buy food
complementary feeding Majority of the victims of malnutrition comes from
●​ Micronutrient supplementation induding families of farmers, fisherfolk, and laborers who cannot
micronutrient powder afford to buy nutritious foods.
●​ Salt iodization 2.​ Lack of food supply
●​ Immunization 3.​ Lack of information on proper nutrition and food values
C.​ Young children
●​ Growth monitoring and promotion Secondary Causes:
●​ Management of childhood illnesses 1.​ Early weaning of child and improper introduction of
●​ Water sanitation and hygiene supplementary food
●​ Micronutrient powder 2.​ Incomplete immunization of babies and children
●​ Micronutrient supplementation 3.​ Bad eating habits
●​ Early child leaming 4.​ Poor hygiene and environmental sanitation:
a.​ lack of potable water
Gaps to attain potential of First 1,000 Days b.​ lack of sanitary toilet
A.​ Policy c.​ poor waste disposal
●​ Legislation for longer maternity leave (up to 14
weeks) TYPES OF NUTRITIONAL DEFICIENCIES
●​ Scaling up of First 1,000 Days through • Protein-Energy Malnutrition (PEM)
legislation 1.​ Marasmus
B.​ Service delivery - Total caloric deficiency; the child lacks food rich in
●​ Prevention of adolescent pregnancy protein and energy; child is usually less than one year old
when malnutrition started

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Signs: ●​ NOT given in the 1st trimes ter to prevent congenital
-​ Very thin (no fat, there is muscle wasting) problems and to women who are already taking
-​ Very poor weight gain multivitamins with Vitamin A
-​ Old man's face
-​ Enlarged abdomen Postpartum Mothers
-​ Prominent ribs 200,000 IU within four weeks after delivery
-​ Loose and wrinkled skin
-​ Muscle wasting
-​ Anxious
-​ Always hungry
Provision of high-dose Vitamin A Capsule for the Treatment of
2.​ Kwashiorkor Xeropthalmia
- Protein deficiency; disease of the older c hild when the • Infants (6-11 months) with signs and symptoms of VAD, give
next child is born; usually occurs when the child is 1-3 100,000 IU VAC
years old - One capsule today
Signs: - One capsule tomorrow
-​ Very thin, fails to grow - One capsule after 2 weeks
-​ Light colored, weak hair (flag sign) • Preschoolers (12-83 months) with signs and symptoms of VAD,
-​ Moon shaped, unhappy face give 200,000 U VAC
-​ Enlarged abdomen - One capsule today
-​ Swollen or edematous legs, feet, arms & hands - One capsule tomorrow
-​ Apathetic - One capsule after two weeks
-​ Skin sores and skin peeling
-​ Dark spots on skin VITAMIN A SUPPLEMENT
-​ Does not want to eat ●​ Undernourished preschoolers and school age children
with persistent diarrhea, measles and severe pneumonia
TREATMENT: FOOD is the only CURE! give 200,000 IU VAC upon diagnosis.
• Increase protein and energy concentration of the food prepared ●​ Undernourished infants with persistent diarrhea,
• Increase frequency of feeding measles and severe pneumonia, give 100,000 IU VAC
• Increase variety of food offered upon diagnosis
●​ 15-59 month-old-children during National Immunization
Day or Araw ng Sangkap Pinoy
Vitamin A Deficiency (VAD)
-​ A condition in which blood levels of Vitamin A are low SANGKAP PINOY SEAL
and stores in the liver are depleted
- Causes:
• Low intake of vitamin A rich foods
• Low intake of oil and protein
• Illnesses like measles, diarrhea and pneumonia

- Consequences:
• Blindness
Night Blindness - due to decrease in rhodospin
(visual purple)
Nutritional blindness - destruction of cells of
the cornea
• Low resistance to infection

Treatment and Prevention: Vitamin A

Supplementation
Iron-Deficiency Anemia (IDA)
Universal Supplementation of Vitamin A
- A condition in which there is not enough hemoglobin in
the red blood cells because of lack of iron, which is
Infants
necessary in RBC production
(6-11 months)
- Causes:
100,000 เบ
• Low intake of iron-rich foods especially the more
One dose only
absorbable iron from foods of animal origin
• Blood loss which may be due to hookworm infestation,
Preschoolers
menstruation and childbirth
(12-17 months)
• Poor absorption of iron due to lack of iron absorption
200,000 เบ
enhancers or the presence of inhibitors
One capsule every 6 months
• Increased demands during certain stages in life such as
during infancy, preschool and adolescence, pregnancy
Pregnant Women
and lactation
●​ 10,000 IU twice a week starting at the 4th month of
Sources of Iron
pregnancy until delivery
Mustasa - Best animal sources (Heme-iron): liver, internal organs,
meat (pork and chicken blood, fish and shellfish
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Best plant sources (Non-heme iron): green leafy vegetables
(alugbati, kangkong, saluyot, pechay, kamote tops mustasa), dried
beans (bitsuelas, kadyos mongo)

Treatment and Prevention: Iron Supplementation

• Provision of iron (ferrous sulfate) with folic acid for the
treatment and prevention of iron deficiency anemia
• Pregnant women to take 60 mg elemental iron with 400 mcg of
folic acid once a day for 180 days
• Lactating women to take 60 mg elemental iron with 400 mcg of
folic acid once a day for 90 days
• Low birth weight infants and those 6-11 months to be given
ferrous sulfate drops with 15 mg elemental iron/0.6ml​

lodine Deficiency Disorders (IDD)

- Abnormalities that result when the body does not get
enough iodine. These abnormalities range from mild,
such as goiter; to serious, such as stillbirth, congenital
anomalies, growth and mental retardation, and physical
and motor abnormalities
- Causes:
• Low intake of iodine rich foods or low content of
iodine in food
• Goitrogens and other environmental factors
- Consequences:
• Fetus Garantisadong Pambata
- Abortion or miscarriages • A campaign to support various health programs that will reduce
- Congenital abnormalities childhood illnesses and deaths by promoting positive child care
- stillbirth behaviors
• It is a program of the DOH in partnership with the LGUs and
- Infants and preschoolers other government and non-government organizations
• Cretinism (mental retardation, squint, deaf-mutism • Ensures that all children below 5 years old receive health
and paralysis) services needed by them to be healthy
• Delayed walking and other motor activities • Children who missed the routine health services and those living
• Delayed speech and cognitive development in remote areas are given special attention during the
- School children Garantisadong Pambata Week
• Poor scholastic performance
- Adults
• Mental impairment
• Poor working capacity resulting to low productivity

lodine Sources
• 90% from food (best sources are seafood and crops grown on
iodine-rich soil)
• 10% from drinking water

Treatment and Prevention

IODINE SUPPLEMENTATION
• Women 15-45 years old to take one iodized capsule with 200 mg
iodine every year
• School age children to take one iodized capsule with 200 mg
iodine every year
Garantisadong Pambata Services
• Adult males to take one iodized capsule with 200 mg iodine
●​ Giving vitamin A capsule supplement to all 12-59 month
every year
old children
●​ Catch-up immunization (children who missed the
routine immunization such as BCG, DPT, OPV, and
measles)
●​ Distribution of iron supplements to infants and pregnant
women
●​ Promotion of positive caregiving behaviors:
- Exclusive breastfeeding of infants 0-6 months old
- Feeding infants micronutrient-rich complementary
foods starting 6 months old
- Using iodized salt daily
- Buying and eating fortified foods
- Brushing of teeth properly and regularly
- Letting children play safe toys
Not smoking in front of preschoolers
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 ●​ Garantisadong Pambata is done twice a year: one week
in April and one week in October

Garantisadong Pambata improves child survival and safe

motherhood
• Lowers infant and child death
• Protects children from common illnesses, i.e.
pneumonia, diarrhea, measles, etc.
• Lowers the risk of maternal deaths
• Lowers health costs for fewer health complications and
illnesses
• Improves vitamin A status
• Reduces anemia among mothers and infants