PE7.1-8,PE8.1-5 | Infant Feeding — Glossary

A structured method of assessing dietary intake by asking caregivers to report all foods and beverages consumed by the child in the preceding 24 hours; the primary clinical tool for assessing complementary feeding quality.

The WHO framework for evaluating appropriateness of replacement feeding for HIV-positive mothers: Acceptable, Feasible, Affordable, Sustainable, and Safe; if all five criteria are met, formula may be recommended.

A village-level service delivery unit of the ICDS programme providing supplementary nutrition, growth monitoring, immunisation support, and IYCF counselling to children under 6 and pregnant/lactating women.

Complementary foods derived from animals — eggs, fish, poultry, meat, dairy; the highest-priority food group to add after grains/legumes because they provide haem iron, zinc, Vitamin B12, and DHA with the highest bioavailability.

The standard HMB practice in India where donor and recipient identities are not disclosed to each other; protects privacy and addresses most cultural concerns about donor identity, though it does not fully resolve milk-kinship beliefs.

The pigmented circular area surrounding the nipple, overlying the lactiferous sinuses; for effective breastfeeding the infant must take a generous mouthful of both nipple and areola to compress the sinuses and express milk.

A global programme launched by WHO and UNICEF in 1991 to encourage maternity hospitals to adopt the Ten Steps to Successful Breastfeeding; hospitals meeting all criteria receive Baby-Friendly certification.

An enzyme in fresh human milk that initiates fat digestion in the duodenum; largely inactivated by Holder pasteurisation, reducing fat absorption efficiency in preterm infants on donor milk.

A national Indian NGO established in 1991 that advocates for universal BFHI adoption, trains health workers in lactation counselling, and monitors compliance with the IMS Act (India's equivalent of the WHO Code on breast-milk substitutes).

The micellar fraction of milk protein that forms tough, slow-digesting curds; constitutes approximately 80% of cow's milk protein but only 40% of mature human milk protein.

A unit of bacterial culture measurement; pasteurised donor milk must have <10 CFU/mL on post-pasteurisation culture before it can be dispensed.

The initial thick, yellow breast secretion produced from late pregnancy and the first 2–3 days postpartum; rich in secretory IgA, proteins, and growth factors; lower in lactose and fat than mature milk; perfectly calibrated for the newborn gut.

The introduction of solid, semi-solid, or liquid foods in addition to breast milk starting at 6 months of age, when breast milk alone can no longer meet the infant's energy and nutrient needs.

Maintenance of breastfeeding alongside appropriate complementary foods from 6 months through 2 years or beyond; breast milk continues to contribute significant nutrition and immunity in the second year.

A long-chain omega-3 polyunsaturated fatty acid present in human milk, essential for myelination of the developing brain and maturation of retinal photoreceptors; largely absent from cow's milk.

The variety of food groups consumed within a defined time period; a proxy measure for micronutrient adequacy in complementary diets; measured by the WHO minimum dietary diversity indicator (≥4 food groups/24 h).

Putting the newborn to the breast within 1 hour of birth to deliver colostrum, establish the prolactin reflex, and promote skin-to-skin bonding; a key BFHI practice.

The energy content per unit weight of food (kcal/g); WHO recommends a minimum energy density of approximately 0.8 kcal/g for complementary foods in developing-country contexts; thin gruels have ~0.2 kcal/g — inadequate.

Distension of the breast with milk, interstitial fluid, and blood, typically peaking on days 3–5 postpartum when milk 'comes in'; caused by insufficient drainage; managed by increasing feeding frequency and, if areola is too firm to latch, by brief hand expression before feeding.

Feeding the infant only breast milk — no water, other fluids, or solids — for the full first 6 months of life; only medically indicated ORS, vitamins, and medicines are permitted.

The normal tongue-thrust reflex in young infants that pushes solid objects out of the mouth; typically disappears by 4–6 months, coinciding with gut and neuromuscular readiness for solid foods.

The watery, high-lactose, lower-fat milk present at the beginning of a breastfeed; provides hydration but lower calorie density than hindmilk.

A rare inborn error of carbohydrate metabolism in which absence of galactose-1-phosphate uridyltransferase causes toxic galactose accumulation; one of the few absolute contraindications to breastfeeding.

Iron bound in the porphyrin ring of haemoglobin and myoglobin in animal-source foods (meat, fish, poultry, egg); absorbed at 15–35% efficiency regardless of dietary context, far superior to non-haem iron from plant sources (2–20% absorption, influenced by dietary enhancers and inhibitors).

The fat-rich, calorie-dense milk present at the end of a breastfeed; provides the majority of the feed's energy; its delivery depends on complete emptying of the breast.

The standard heat-treatment method used in human milk banks: heating milk to 62.5°C for 30 minutes, followed by rapid cooling; eliminates HIV, CMV, HTLV-1, HBV, HCV, and bacteria while preserving most nutritional and prebiotic components.

A retrovirus transmissible via breast milk that causes adult T-cell leukaemia/lymphoma and HTLV-1-associated myelopathy; all HMB donors must be screened negative for HTLV-1/2.

A facility that collects, screens, processes (pasteurises), stores, and dispenses donor breast milk for infants who cannot receive their own mother's milk, following WHO/NHM guidelines.

Over 200 complex oligosaccharide structures in human milk that act as prebiotics (promoting Bifidobacterium colonisation) and decoy pathogen-adhesion receptors; absent from cow's milk.

Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act — India's national law regulating the marketing of breast-milk substitutes, giving legal force to the WHO International Code.

The WHO/UNICEF framework for optimal feeding practices from birth to 36 months, encompassing breastfeeding and complementary feeding recommendations across the first 1000 days.

A potentially life-threatening illness caused by ingestion of Clostridium botulinum spores (present in honey) that germinate and produce toxin in the infant gut; honey is absolutely contraindicated under 12 months.

A method of care for preterm/LBW infants involving prolonged skin-to-skin contact between mother and infant and exclusive breastfeeding; promotes milk supply establishment and is complementary to HMB services when mother's own milk supply is being built up.

A thin rice-water gruel widely used as a first complementary food in India; typically has an energy density of 0.2–0.3 kcal/g — well below the WHO minimum of 0.8 kcal/g; a common cause of energy-deficit growth faltering in breastfed Indian infants after 6 months.

An India-specific NHM-designated facility that integrates breastfeeding support, lactation counselling, and human milk bank services within a public hospital setting.

A temporary contraceptive method based on the prolactin-induced suppression of ovulation during exclusive breastfeeding; approximately 98% effective if the infant is under 6 months, exclusively breastfed, and menses have not returned.

An iron-binding glycoprotein in breast milk that restricts iron availability to pathogens (bacteriostatic), has direct antimicrobial and antiviral activity, and promotes iron absorption by the infant.

The onset of copious milk secretion (milk 'coming in') triggered by the post-delivery fall in progesterone, which removes the inhibition of prolactin activity at the breast alveoli; typically occurs 48–72 hours after delivery.

The process by which the infant takes the breast into the mouth, forming a seal over nipple and areola tissue; correct latch requires mouth wide open, lower lip everted, more areola visible above than below the mouth, and chin touching the breast.

The milk ejection reflex initiated by oxytocin; myoepithelial cell contraction expels milk from alveoli into lactiferous ducts and toward the nipple.

An enzyme in human milk that disrupts bacterial cell walls (lytic activity against gram-positive organisms); its concentration increases over the first year of lactation, providing ongoing antibacterial protection.

Mother Absolute Affection — India's national programme specifically targeting breastfeeding promotion through health system strengthening, community mobilisation, and mass communication campaigns.

Inflammation of breast tissue, most commonly from milk stasis (incomplete drainage) with or without secondary Staphylococcus aureus infection; managed by continued breastfeeding from the affected side to prevent abscess, with antibiotics only if infective features (fever, systemic illness) are present.

Also called 'let-down': the oxytocin-mediated contraction of myoepithelial cells surrounding breast alveoli that propels synthesised milk into the lactiferous ducts and makes it available at the nipple.

A concept in Islamic jurisprudence in which breastfeeding from an unrelated woman creates a familial bond with implications for marriage permissibility; requires sensitive counselling when donor milk is offered to Muslim families.

A composite WHO IYCF indicator combining both minimum dietary diversity and minimum meal frequency; the proportion of children 6–23 months receiving an overall adequate diet; a summary measure of CF quality.

A WHO IYCF indicator: the proportion of children aged 6–23 months who received foods from at least 4 (out of 8) food groups in the previous 24 hours; only 11.3% of Indian children achieve this per NFHS-5.

A WHO IYCF indicator: the proportion of children 6–23 months receiving foods from at least 4 of 8 defined food groups in the previous 24 hours; achieved by only 11.3% of Indian children per NFHS-5.

A WHO IYCF indicator: the proportion of breastfed or non-breastfed children 6–23 months receiving complementary foods at the minimum recommended frequency (breastfed 6–8 mo: 2×/day; 9–23 mo: 3×/day; non-breastfed: 4×/day).

A WHO IYCF indicator: the age- and breastfeeding-status-appropriate frequency of solid feeds (breastfed 6–8 mo: 2×/day; 9–23 mo: 3×/day; non-breastfed: 4×/day); achieved by 42.7% of Indian children per NFHS-5.

Contractile cells surrounding the alveoli of the lactating breast; contraction driven by oxytocin squeezes milk from the alveolar lumen into the lactiferous ducts during the let-down reflex.

A devastating inflammatory bowel necrosis primarily affecting preterm infants; risk is reduced approximately 4-fold with exclusive breastfeeding compared with formula feeding.

A posterior pituitary hormone released in response to suckling and conditioned stimuli; drives the milk ejection reflex; can be inhibited by pain, stress, or anxiety — explaining why feeding environment affects milk transfer.

India's National Nutrition Mission (2018), targeting reduction of stunting, wasting, anaemia, and low birth weight through convergence of ICDS, NHM, and food security programmes, with IYCF improvement as a core strategy.

Any fluid (honey, glucose water, cow's milk, herbal preparations) given to a newborn before the first breastfeed is established; associated with impaired breastfeeding initiation, infection risk (infant botulism with honey), and reduced passive immunity.

An anterior pituitary hormone released in response to nipple suckling; drives milk synthesis (lactogenesis) in alveolar epithelial cells; operates on a supply-demand principle — more suckling produces more prolactin and more milk.

A cereal grain commonly used in South India; notable for its high calcium content (344 mg/100 g — higher than most cereals), moderate iron, and high fibre; a nutritious base for infant complementary foods when prepared as thick porridge.

The total osmolar burden presented to the kidneys for excretion, primarily composed of nitrogen (from protein) and minerals; cow's milk has 2–3 times the renal solute load of human milk, exceeding the concentrating capacity of the immature neonatal kidney.

A feeding interaction where the caregiver responds to the child's hunger and satiation cues, feeding on demand and avoiding force-feeding; essential for healthy appetite regulation and psychosocial development.

The BFHI practice (Step 9) of keeping the mother and newborn together in the same room for 24 hours a day; enables demand feeding, bonding, and early establishment of breastfeeding, as opposed to a centralised nursery model.

The predominant immunoglobulin in colostrum and mature breast milk; provides mucosal passive immunity by coating the neonatal gut epithelium and preventing pathogen adhesion.

Immediate placement of the dried newborn, prone and naked, on the mother's bare chest after birth (BFHI Step 6); promotes thermoregulation, blood glucose stabilisation, early colonisation with maternal skin flora, oxytocin release, and initiation of breastfeeding.

The rhythmic feeding pattern of a correctly latched infant: a jaw-wide suck extracts milk from the lactiferous sinuses, triggering a swallow (audible as a soft 'kuh' sound), followed by a brief pause to breathe; coordination of this cycle is mature from approximately 34–36 weeks gestation.

The physiological principle governing milk production: the volume of milk synthesised is determined by the volume effectively removed at each feed; reducing feeding frequency (e.g. by supplementing with formula) reduces prolactin release and thereby reduces subsequent milk synthesis.

The WHO-UNICEF framework (revised 2018) for Baby-Friendly certification, comprising four critical management procedures (institutional/policy) and six key clinical practices covering antenatal counselling through postnatal support.

The developmental sequence of complementary food consistency: smooth purée at 6 months → soft lumpy foods at 7–8 months → soft pieces/finger foods at 9–11 months → family foods by 12 months; aligned with jaw and tongue motor development.

A short or anteriorly attached lingual frenulum that restricts tongue elevation and the wave-like peristaltic motion needed for effective milk extraction; a structural cause of recurrent latch failure despite correct positioning — considered only after technique correction has failed.

Breast milk secreted between days 3 and 14 postpartum, representing the compositional shift from colostrum to mature milk, with rising fat and lactose and falling protein content.

Birth weight less than 1500 g; VLBW infants are the primary priority recipients of donor pasteurised human milk from a human milk bank.

The soluble fraction of milk protein (predominantly α-lactalbumin, lactoferrin, sIgA in human milk) that forms soft, easily digestible curds; accounts for approximately 60% of human milk protein.

The period from conception to 24 months of age (the 'first 1000 days') during which nutrition, including optimal IYCF, has the greatest and most lasting impact on growth, brain development, and lifelong health.

An annual global advocacy event observed from 1–7 August, coordinated by WABA in collaboration with WHO and UNICEF; each year has a specific theme; interns are required to participate in institutional WBW activities (PE7.7).