Simple Rapid Assessment of Mother and Baby Pair Guide
For infants and young children below 2 years of age
Ask:

How old is the baby - age/months ____________

Are you breastfeeding him/her?

Is the baby getting anything else to eat or drink

Is the baby able to suckle the breast?

Have you any other difficulties with breastfeeding?
Look:

Does the baby look very thin?

Is the baby lethargic, perhaps ill?
Reasons for full assessment:

Baby not breastfed / baby being artificially fed

Breastfeeding but not age appropriate
o Under 6 months, not exclusively breastfed
o Over 6 months and given no complementary foods

Baby not able to suckle the breast

Mother has other difficulties with breastfeeding

Mother requires breastmilk substitutes

Baby looks very thin

Baby is lethargic, perhaps ill
When the baby is not at immediate risk of inadequate feeding the mother only needs praise and supportive care.
 Tell her that she is doing well and point out who she can contact for feeding support and help
If the mother needs extra help do the following assessment:
Step 2
FULL ASSESSMENT OF MOTHER-BABY PAIR GUIDE

Is the baby breastfeeding? – if yes, observe a breastfeed, see below

About how often is the baby breastfed in a day? During the night?
o
Does she keep the baby with her at day and night?
o
If she says demand feeding what does this mean: every time the baby cries?
Before he/she cries? Only if he/she cries a lot? About how often is that?

Is the baby given a pacifier (dummy/soother)?

Is the baby getting other drinks or foods?

What drinks is she/he given?
o
Is it by spoon, cup, hand, feeding bottle, other technique?
o
How many times a day?

(Beliefs and worries) Why are you feeding as you are doing?

How are you yourself (physically and emotionally)?

Would you like to increase your breastmilk? (We can help you to make more)

Would you be interested in breastfeeding this baby? (We can help you to produce
breastmilk again)
IF BABY BEING FED ARTIFICIAL MILK ALSO DO STEP 3
Observing a breastfeed: (Note: For good breastfeeding all answers below should be ‘yes’)
Attachment at breast: Y/N Areola more above
Y/N Mouth wide open
Y/N Lower lip turned out
Y/N Chin close to or touching breast
Y/N No nipple pain or discomfort
Positioning:
Y/N Babies head and body in line (head not twisted)
Suckling:
Y/N Slow, deep sucks, sometimes pausing
Y/N Audible or visible swallowing
Mother confident:
Y/N Enjoyment, relaxation, not shaking breast or baby
Y/N Signs of bonding (stroking, eye contact, close gentle holding)
How the feed ends:
Y/N Baby comes off the breast himself (not taken off)
Y/N Baby looks relaxed and satisfied and looses interest in breast
Y/N Mother keeps breast available, or offers other breast
AT END OF ASSESSMENT DO NOT JUST TELL THE MOTHER WHAT TO DO! BE SUPPORTIVE AND
LISTEN TO THE MOTHER, AGREE A WAY FORWARD AND A TIME PERIOD TO TRY IT IN BEFORE YOU
RETURN.
 DON’T FORGET you may need to talk to other people in the family or community. You need to make
sure that they support the mother in her new actions.
Step 3
IF BEING FED INFANT FORMULA, ASSESSMENT OF PRACTICES GUIDE
Resources - What resources are available? [Note: All these are needed]

Breastmilk substitute
o Suitable for age
o Caregiver has no difficulty in obtaining sufficient formula until the child is at least 6
months of age
o Expiry date clearly marked, and not past
o Instructions written in users own language
o Household member is able to read label’s instructions

Storage
o Safe storage for ingredients
o Water boiled (special clean storage with cover)

Preparation facilities
o Adequate fuel for preparation (and for boiling bottle and teat at each feed, or rinsing
cup if used)
o Adequate drinking water for preparing several feeds per day (at least 1 litre)
o Adequate other water and soap are available for washing utensils and hands
o Clean surface for utensils (and a clean cloth to cover them)
o Means of measuring milk and water (if a feeding bottle, the top is cut off or made in a
large cup with spoon)

Extra caregiver time
o Time to prepare 6-8 fresh feeds per day
Procedures – how does the caretaker manage the feeding?
[Note: Feeding with bottle and teat is dangerous, cup feeding is safer]
 Preparation
o Caregiver washes hands
o Cup (or bottle or teat if used) is covered, in clean place
o Bottle and teat (if used) have been sterilised and are rinsed with clean boiled water
o Water to prepare feed is brought to a rolling boil
o Caregiver measures proportions of milk and water correctly
 Feeding technique
o Infant is fed with cup, and takes most or all of the milk
o Infant is fed with feeding bottle
o Infant is fed with another method  Interaction and the end of the feed
o Infant is held throughout the feed
o Caregiver interacts lovingly with the infant during the feed
o Infant finishes the milk feed
o None of this feed is kept for the infant to take later (milk could be drunk by mother or
older child – don’t use after an hour)
 Adequacy of milk feeds
o Number of feeds given per day appropriate to age and weight
o Amount given at each feed appropriate
 Age-appropriate feeding
o Under 6 months, only milk is given
o Over 6 months, milk and complementary foods are given
AT END OF ASSESSMENT DO NOT JUST TELL THE MOTHER WHAT TO DO! BE SUPPORTIVE AND
LISTEN TO THE MOTHER, AGREE A WAY FORWARD
DON’T FORGET you may need to talk to other people in the family or community. You need to make sure that
they support the mother in her new actions.
Please note that this is a guide, not an assessment template – a template should be developed if you with to
conduct an IYCF assessment