 So, now we are going to be seeing tutorials on essential nutrition action, ENA, these are the actions which can be taken when mother is pregnant and also when baby is under two years of age and we will see that what are these actions, what can be done which will improve children's height as well as children's IQ because when mothers come to us when children are already more than three years, four years of age and even older children mothers sometimes complain that they don't remember, they can't concentrate, they have difficulty with the math, so then it's too late, so here in these two tutorials which are coming up we have discussed that what are those nutrition action that we can ask mothers to take and you will definitely see much better growth in babies till two years of age, thank you. Welcome to the spoken tutorial on essential nutrition actions for pregnant women. In this tutorial we will learn about nutrient requirements during pregnancy, nutrition actions required during pregnancy. Essential nutrition actions are also known as ENA. ENA is an approach to improve the nutritional status of women and children. During pregnancy a woman's body undergoes physical and hormonal changes. Her nutritional needs also increase. Nutrition in this period is important for the health of the mother and child. A baby in the mother's womb is dependent on its mother for nutrition. Time span from conception to the baby's second birthday is the first thousand days. This is the period of rapid growth and mental development. It also determines the present and future health of the baby and its mother. For the mother a nutritious diet provides her relief from nausea and weakness. It helps in brain development of the fetus. It also helps in reducing risk of birth defects in babies and anemia in mothers. Let's discuss the nutrients and nutrition actions required during pregnancy. There are many essential nutrients required during pregnancy. Protein is one of them. To meet the protein requirements it is advised to eat protein rich food. Meat, fish, chicken and eggs are excellent sources of protein. Pulses, beans, nuts, seeds, milk and milk products are other good sources. Essential fatty acids are also vital during pregnancy. These are also called as good fats. For example, DHA and EPA. Fish, nuts and seeds are good sources of these fatty acids. Let's move on to other nutrients required during pregnancy. Folate is essential for DNA synthesis and fetal cell development. It also helps in reducing neural tube defects in infants. Including folate in daily diet during pregnancy is essential. Sprouts, green leafy vegetables and chicken liver are good sources of folate. Along with folate, iron also plays an important role during pregnancy. Iron is required for the production of red blood cells. It helps in carrying oxygen to the entire body. During pregnancy there is a rise in blood volume. Hence women require a large amount of iron. This helps in meeting the requirements of the growing fetus. A reserve of iron is created in the fetus which can be used by them after birth. Deficiency of iron can result in anemia. To prevent anemia the diet should include iron-rich foods. Chicken or goat's liver, brain, heart are good sources of iron. Seafood, eggs and garden crest seeds are other examples. Iron is also present in beans, green leafy vegetables and seeds. Turmeric powder and coriander seeds also have some amounts of iron. Anemia can also be caused due to parasite and worm infections. To prevent this a pregnant woman should take deworming medicine. One dose of deworming medicine is recommended during the second trimester. Remember that tea and coffee should not be consumed along with meals. This will interfere with the iron absorption. Interestingly vitamin C improves the absorption of iron in our body. To do so eat iron-rich food and supplements with vitamin C rich food. Gooseberry, tomatoes, gauva are rich sources of vitamin C. Iron and folate requirements increase during pregnancy. Diet alone does not fulfill these requirements. Thus iron-folic acid supplement is recommended. However a prenatal supplement does not replace a healthy diet. A prenatal supplement is taken before and during pregnancy. Pregnant women should ask for iron-folic acid tablets from health workers. These tablets are provided by Anganwadi centres. The tablet should be taken once a day. Pregnant women should take precautions while taking iron-folic acid tablet. Tablets should be taken two hours after a meal to avoid nausea and discomfort. At times she may pass black stools after consuming these tablets. Lose motion or constipation can also occur. However these symptoms will settle after a few days. Also iron-folic acid tablets should not be taken along with calcium tablets. They should be taken as morning and evening doses. Calcium is another vital nutrient required during pregnancy. Calcium deficiency in pregnant women causes high blood pressure. It leads to swelling of the hand and feet. To avoid deficiency she should include milk and milk products in her daily diet. Seeds, nuts, green leafy vegetables and dried fish also contain calcium. Calcium supplements are also recommended during and after pregnancy. Calcium tablets are provided by ICDS centres and primary healthcare centres. ICDS is an integrated child development service. These tablets are given from 14 weeks of pregnancy up to 6 months after delivery. The tablet has to be taken twice a day. Excess amount of calcium inhibits iron absorption. Hence two calcium tablets should not be consumed together. One tablet should be consumed after breakfast or lunch. The other tablet can be consumed after an evening snack or dinner. Do not consume a calcium tablet on an empty stomach as it will cause gastritis. Gastritis is the inflammation of the stomach lining. Another nutrient that plays a vital role is iodine. Iodine is required for good health throughout all stages of life. Iodine cannot be stored well in the body. Hence small quantities of iodine is required daily. Fish, prawns, milk, cheese and iodized salt are good sources of iodine. To prevent iodine deficiency, iodized salt should be used. Iodized salt is easily available in the local market. While using iodized salt, a few precautions should be taken. It should be added at the end of the cooking. Iodized salt is sensitive to heat and light. Excess exposure to heat and light could destroy the iodine in the salt. Hence store it in a tightly sealed dark container. Other nutrients that play a vital role during pregnancy are choline and zinc. Vitamin B12 and magnesium are also important. Choline, folate and vitamin B12 together reduce neural tube defects. Neural tube defects are birth defects that affect the brain and spinal cord. Choline is also essential for brain development whereas zinc helps in fetal development. More information about these nutrients are explained in other tutorials. Please watch individual tutorials of these nutrients. For example, importance of protein, importance of choline and folate. Also watch the importance of calcium and B12. A healthy diet is critical for both mother and child's health. Mother's diet must include different food groups. The first food group is grains, roots, white tubers and plantains. Pulses are second group and nuts and seeds are third group. Fourth group is dairy. Meat, chicken and fish are the fifth group. The sixth group is eggs. Dark green leafy vegetables are the seventh group. The eighth group is vitamin A rich vegetables. Rest of the vegetables and fruits are ninth and tenth groups. She should include at least six food groups in her daily diet. From these groups, she should include protein rich food groups and good fats. She should make sure to decrease consumption of starchy food. Along with nutrients, water intake is also important. It is recommended to include at least eight glasses of water daily. Processed sugary, salty food and caffeinated drinks should be avoided. Even alcohol and smoking should be strictly avoided. Remember all the nutrition actions mentioned in this tutorial. They are important for a healthy pregnancy and healthy fetal development. This brings us to the end of this tutorial. Thanks for joining. Welcome to the spoken tutorial on essential nutrition actions for children. In this tutorial, we will learn about the best ways to prevent malnutrition. Essential nutrition actions are preventive approach to tackle malnutrition. They are required during the first thousand days. First thousand days start from conception to the second birthday of the baby. Essential nutrition actions are also known as ENA. For a newborn, the first ENA to be done is delaying the clamping of the cord. The umbilical cord should not be cut immediately after delivery. The nurse should first feel the pulsation of the cord. The cord should be cut when it stops pulsating. Delayed cord clamping allows blood flow between placenta and the baby. This may improve the iron store in the baby for first six months. Doing so prevents anemia in babies during these months. After clamping the cord, the baby should be breastfed. To do so, the baby should be placed on the mother's bare abdomen. A baby is born with an instinctive feeding behavior. With this behavior, it can find the mother's breast and initiate breastfeeding. This entire process is called breast crawl. More about breast crawl has been explained in another tutorial. Please visit our website for this tutorial. It is important to start breastfeeding within one hour of birth. The first milk is called colostrum. It is the primary source of nutrients for a newborn. Colostrum has infection fighting elements and good fats. Breast milk is also the first source of vitamin A for the baby. Vitamin A is vital for healthy eyes and immunity. Breast milk is enough to meet the vitamin A requirements for the first six months. After six months, vitamin A rich complementary food should be given. For effective breastfeeding, correct latching is most important. Poor attachment of the baby's mouth to the breast will result in nipple feeding. This will give very little milk to the baby. Baby's mouth should attach to the lower part of the areola. This way, the baby will get sufficient milk. Areola is the dark area around the nipple. Breastfeeding techniques are discussed in other tutorials. On completion of six months, the baby's nutrient requirement increases rapidly. At this stage, exclusive breastfeeding is not enough. Thus, complementary food should be introduced along with breastfeeding. It should start as soon as the baby completes six months of age. Six months of age does not mean the start of the sixth month of a baby's life. It means she has completed six months and has started the seventh month of her life. Also, the quantity and consistency of the food should be changed as per the age. A baby's diet must include different food groups. The first food group is breastfeeding. Grains, roots and tubers are the second group. Legumes, seeds and nuts are the third group. Fourth group is milk products. Meat, fish and chicken are the fifth group. Egg is the sixth group. Vitamin A rich fruits and vegetables are the seventh group. Lastly, eighth group is other fruits and vegetables. Ideally, a baby's diet must include all eight food groups. All these foods provide nutrients that help in the growth of the baby. The details of complementary feeding have been discussed in another tutorial. Let us now look at the supplements that should be given to the babies. To five years, iron folic acid supplements should be given. It has to be given to the babies twice a week by healthcare workers. Vitamin A supplement should be given twice a year. This supplement is given from nine months to five years of age. The supplements should be given under the guidance of a healthcare provider. ENA to treat a baby having diarrhea. Diarrhea is a major cause of malnutrition. It causes water loss and imbalance of sodium and potassium in the body. In severe cases, infant deaths may also happen. Hence, it is very important to treat diarrhea. ORS and zinc supplements help in treating diarrhea. ORS is oral rehydration salts. It replenishes the water and sodium and potassium in the body. It is easily available in the market as powder form in packets. To use it, mix one packet of ORS in one litter of boiled and cooled water. Along with ORS, zinc supplement is necessary too. Zinc reduces the duration, frequency and severity of diarrhea in children. It improves the immunity of the baby. It should be given once a day for fourteen days. Ten milligrams of zinc per day should be given to the babies below six weeks. Twenty milligrams of zinc per day should be given to six months old and above. In a small spoon dissolve zinc tablets in breast milk or ORS. You may also use boiled and cooled water. ORS and zinc tablets should be given after consulting a healthcare provider. Along with ORS and zinc, less than six month old babies should be breastfed. Six to twenty-four month old babies should be breastfed and given complimentary food. Remember, a baby during sickness should be breastfed often. It helps in faster recovery and weight gain. It also comforts the sick baby. With breastfeeding, kangaroo mother care should be provided to every baby. Kangaroo mother care is also recommended for low birth weight babies. More about kangaroo mother care has been discussed in another tutorial. If the baby is older than six months, increase the food to one and a half times. Do this when the baby's appetite comes back during the recovery period. Encourage the baby to eat by offering a variety of foods. Give her type one and type two nutrient rich food as per her hunger cues. More about type one and type two nutrients has been discussed. In severe conditions, the mother should consult a healthcare worker immediately. Healthcare workers should refer the severely malnourished babies to the NRC. NRC is a nutrition rehabilitation centre. It is a unit for restoring the health of severely malnourished children. This centre provides specialized nutrition therapy to babies. It makes them ready for home cooked food if they have completed six months of age. It also educates mothers about breastfeeding, child nutrition and child care. Follow the essential nutrition actions to keep the baby healthy. They also help in preventing malnutrition in babies. This brings us to the end of this tutorial.