Nutrition Across the Lifespan & Maternal-Child Programs - Cheat Sheet
Your last-minute revision companion for Family Planning & Population at Risk: rapid-fire facts, doses, ages, laws, and definitions covering infant/young child feeding, breastfeeding, micronutrient supplementation, national food guides, and DOH nutrition programs. Every item is exam-critical.
IYCF: Infant and Young Child Feeding — The Three Anchors
Important facts
- Early initiation of breastfeeding: within the first 1 hour of life (part of Unang Yakap/EINC).
- Exclusive breastfeeding for first 6 months—this is non-negotiable for optimal immune development.
- Continued breastfeeding up to 2 years and beyond, with safe and adequate complementary feeding at 6 months.
- Newborn demand-feeding: approximately 8–12 times/day; signs of adequate intake = 6+ wet diapers/day + weight gain.
- Complementary foods must be timely (6 months), adequate (nutrient-dense), safe (hygienic), and properly fed.
- Introducing solids before 6 months risks infection and displaces breastmilk; after 6 months risks growth faltering.
- Breastmilk provides ideal nutrition + passive immunity + reduced SIDS + maternal involution aid + birth spacing (lactational amenorrhea).
- Correct positioning and latch prevent engorgement, sore nipples, and poor milk transfer.
- Breastfeeding provides protection against diarrhea, respiratory infection, otitis media, and allergies.
Key definitions
Exclusive Breastfeeding
Example
Newborn receives only breastmilk from birth to 6 months; no formula, water, or rice cereal.
Breastmilk only for 6 months—no water, other liquids, or solids; medicines and prescribed vitamins/minerals allowed.
Colostrum
Example
Colostrum given within first hour of life protects against diarrhea and respiratory infection.
First milk (thick, yellowish) rich in secretory IgA and immunoglobulins; provides passive immunity and laxative effect.
Complementary Feeding
Example
At 6 months: iron-fortified cereal, mashed vegetables, egg yolk; at 8-12 months: minced meat, beans, fruits.
Introduction of age-appropriate, nutrient-dense foods at 6 months while continuing breastfeeding up to 2 years and beyond.
Diagrams to know
- Timeline: Birth → 1 hour (early initiation) → 6 months (exclusive BF ends) → 24 months+ (continued BF + CF).
- Correct latch diagram: infant's mouth covers entire areola; chin touches breast; no pain for mother.
Breastfeeding Laws & Milk Code — RA 10028, RA 7600, EO 51
Important facts
- RA 10028 = Expanded Breastfeeding Promotion Act (2009); amended RA 7600 (Rooming-In & Breastfeeding Act, 1992).
- Lactation period under RA 10028: ≥40 minutes per 8-hour working period, not less, and paid break time.
- EO 51 (Milk Code) does NOT ban breastmilk substitutes but prohibits promotion, free samples, and marketing in health facilities.
- Nurse role: enforce rooming-in, support working mothers, protect breastfeeding, never promote/accept formula marketing.
- Breastfeeding-friendly workplaces = increased maternal compliance, improved infant health outcomes, reduced healthcare costs.
- Formula marketing in health facilities = illegal under EO 51; report violations to DOH.
- Lactation stations must be private, clean, comfortable, with refrigeration for milk storage and expression.
Key definitions
RA 10028 — Expanded Breastfeeding Promotion Act (2009)
Example
A nurse working an 8-hour shift is entitled to ≥40 minutes total lactation break time, paid and protected.
Amended RA 7600; mandates lactation stations in workplaces/public places, lactation periods (≥40 min per 8-hour shift, paid), and breastfeeding-friendly environments; reinforces rooming-in.
RA 7600 — Rooming-In and Breast-feeding Act (1992)
Example
Mother and newborn stay in same room immediately after delivery for bonding and early BF initiation.
Mandates rooming-in (keeping mother and newborn together in health facilities) and promotes breastfeeding as the norm.
Executive Order 51 — The Milk Code (1986)
Example
Health facilities cannot display free formula samples or accept promotional materials from formula manufacturers.
National Code of Marketing of Breastmilk Substitutes; regulates and restricts promotion of formula/bottles/teats; does NOT ban formula but prohibits aggressive marketing.
Lactation Station
Example
Hospital must provide a lactation room with chair, refrigerator for milk storage, and privacy.
Designated private, clean space in workplaces/public places where nursing mothers can express/feed in comfort; required by RA 10028.
Diagrams to know
- Regulatory hierarchy: RA 7600 (1992) → RA 10028 (2009 amendment) + EO 51 (1986, ongoing enforcement).
Garantisadong Pambata (GP) — Biannual Child-Health Package
Important facts
- Garantisadong Pambata = biannual rounds, typically April and October (twice per year).
- GP package includes: vitamin A supplementation, deworming, immunization catch-up, nutrition counseling, growth monitoring, breastfeeding/CF promotion, micronutrient supplementation, health education.
- Delivered through: health centers, barangay health stations, schools, and outreach (community-based).
- Nurse role: organise rounds, ensure cold-chain/supply readiness, record coverage, educate caregivers, monitor outcomes.
- Recording feeds into FHSIS (Family Health and Safety Information System) and National Nutrition Council monitoring.
- Priority targets: preschool (0–5 years) and school-age children (6–12 years); vulnerable groups flagged for follow-up.
- Community-based approach ensures equity and accessibility, especially in rural/remote barangays.
- Inter-agency coordination: BNS (Barangay Nutrition Scholar), BHFS (Barangay Health Facilities), LHU (Local Health Unit), barangay officials.
Key definitions
Garantisadong Pambata (GP)
Example
April and October mass health campaigns at barangay health stations where all children receive vitamin A, deworming, and immunization.
DOH strategy for delivering a package of child-health services twice a year (biannual rounds, traditionally ~April and October); evolved from 'Araw ng Sangkap Pinoy.'
Araw ng Sangkap Pinoy
Example
Historically delivered nutrition education and micronutrients; now integrated into GP biannual rounds.
Former DOH nutrition program superseded by Garantisadong Pambata; emphasized nutritious food and supplementation.
Diagrams to know
- GP cycle: Plan (Jan–March/Jul–Sept) → Execute (April/October) → Monitor/Record (same month) → Evaluate/Report (by May/Nov).
Micronutrient Supplementation — Ages & Doses (CRITICAL MEMORIZATION)
Common values
Value
100,000 IU
Symbol
Single dose
Quantity
Vitamin A, infants 6–11 months
Value
200,000 IU
Symbol
Every 6 months (biannual)
Quantity
Vitamin A, children 12–59 months
Value
200,000 IU
Symbol
Within 4 weeks (1 month)
Quantity
Vitamin A, postpartum
Value
60 mg elemental + 400 µg folic acid
Symbol
Daily through pregnancy + 3 months postpartum
Quantity
Iron in pregnancy
Value
10 mg/day
Symbol
10–14 days with ORS
Quantity
Zinc for diarrhea, <6 months
Value
20 mg/day
Symbol
10–14 days with ORS
Quantity
Zinc for diarrhea, ≥6 months
Important facts
- VITAMIN A — Prevents xerophthalmia (leading preventable childhood blindness); reduces mortality from measles and diarrhea.
- Vitamin A, 6–11 months: 100,000 IU, one dose (during GP or routine consultation).
- Vitamin A, 12–59 months (1–5 years): 200,000 IU every 6 months (twice a year via GP rounds).
- Vitamin A, postpartum women: 200,000 IU within 4 weeks (1 month) after delivery, single dose; improves breastmilk vitamin A content.
- Vitamin A NOT given in pregnancy (teratogenic—causes birth defects); given postpartum only.
- Vitamin A, therapeutic dosing (measles, xerophthalmia, SAM): age-appropriate dose on day 1, day 2, and day 15.
- IRON + FOLIC ACID IN PREGNANCY: 60 mg elemental iron + 400 µg folic acid daily throughout pregnancy and up to 3 months postpartum.
- Iron, low-birth-weight infants: supplementation from 2 months of age (monitor for anemia).
- Iron, infants 6–11 months (term, normal BW): supplementation to prevent infant anemia; continue if at risk.
- Iron, adolescent girls & women of reproductive age: weekly iron-folic acid supplementation (secondary prevention of anemia).
- ZINC FOR DIARRHEA: Shortens episodes and reduces recurrence; given with ORS for 10–14 days.
- Zinc, <6 months: 10 mg/day for diarrhea.
- Zinc, ≥6 months: 20 mg/day for diarrhea (10–14 days).
- IODINE: RA 8172 (ASIN Law) mandates salt iodization; prevents goiter, cretinism, cognitive impairment.
- RA 8976 — Philippine Food Fortification Act: mandates fortification of rice, wheat flour, cooking oil, refined sugar; voluntary fortification = Sangkap Pinoy Seal.
Key definitions
Micronutrient Deficiency (Hidden Hunger)
Example
A child eating enough rice but lacking iron develops anemia and cognitive delay; vitamin A deficiency causes xerophthalmia.
Lack of vitamin A, iron, or iodine despite adequate energy intake; leads to stunting, anemia, goiter, blindness, and reduced immunity.
Micronutrient Powder (MNP) / Sprinkles
Example
One sachet of MNP added to baby's porridge daily provides iron, zinc, and vitamins in one dose.
Sachets of multiple micronutrients (iron, zinc, vitamin C, etc.) mixed into complementary food; used for children 6–23 months.
Diagrams to know
- Micronutrient supplementation flowchart by age: Birth → 6 months (no supplementation, EBF) → 6–11 months (Vit A 100,000 IU + MNP) → 12–59 months (Vit A 200,000 IU q6mo + deworming) → School age (deworming continuation).
Growth Monitoring, Malnutrition Classification & Operation Timbang
Common values
Value
<115 mm
Symbol
Mid-upper arm circumference, children 6–60 months
Quantity
MUAC cutoff for SAM
Value
<70% of standard
Symbol
Severe acute malnutrition
Quantity
Weight-for-height cutoff (SAM)
Important facts
- First 1,000 Days = conception to age 24 months; critical window for brain development and prevention of irreversible stunting.
- Growth monitoring and promotion uses weight-for-age, height/length-for-age, weight-for-height/length plotted on child growth standards.
- Stunting = chronic undernutrition; priority indicator for First 1,000 Days framework; irreversible if not corrected early.
- Wasting = acute malnutrition; reversible with prompt intervention; SAM = severe acute malnutrition (weight-for-height <70% of standard or MUAC <115 mm).
- Operation Timbang (OPT Plus) = annual mass weighing to locate malnourished children in barangay; community-wide, participatory approach.
- CMAM with ready-to-use therapeutic food addresses SAM in outpatient settings, improving access and compliance.
- Malnutrition nursing diagnosis: Unbalanced Nutrition: Less Than Body Requirements (NANDA); priority intervention = assess/refer for supplementation.
- Growth faltering in infancy/toddlerhood = alarm sign; investigate breastfeeding adequacy, CF timing/quality, infections, hygiene, caregiver knowledge.
Key definitions
Stunting
Example
A 24-month-old child with height below the 3rd percentile for age; often due to prolonged inadequate nutrition or repeated infections.
Low height-for-age; indicator of chronic undernutrition; associated with irreversible cognitive loss if occurring in First 1,000 Days.
Wasting
Example
A previously well-nourished child suddenly loses weight due to acute diarrhea or recent food shortage.
Low weight-for-height; indicator of acute (recent) malnutrition; reversible with intervention; severe acute malnutrition (SAM) requires therapeutic feeding.
Underweight
Example
A child whose weight is below expected for age could have stunting, wasting, or both.
Low weight-for-age; composite indicator reflecting both chronic and acute malnutrition.
Operation Timbang (OPT Plus)
Example
Every year, barangay health workers weigh and measure all preschoolers at school/health station; malnourished ones referred for CMAM.
Annual mass weighing and measuring of preschool children (0–5 years) to identify and locate malnourished children in barangay.
CMAM — Community-Based Management of Acute Malnutrition
Example
A child with SAM (MUAC <115 mm, without complications) receives RUTF sachets and caregiver counseling instead of hospitalization.
Treatment of SAM using ready-to-use therapeutic food (RUTF) in outpatient settings; includes counseling on nutrition and feeding.
First 1,000 Days Framework
Example
Adequate nutrition from pregnancy through age 24 months prevents stunting and optimizes brain development and lifetime learning capacity.
Critical window from conception to child's 2nd birthday; undernutrition in this period causes irreversible stunting and cognitive loss.
Diagrams to know
- Child growth standards reference: WHO growth charts (weight-for-age, height-for-age, weight-for-height); classification thresholds (stunted, wasted, underweight).
- OPT Plus cycle: Prepare → Conduct mass weighing/measuring → Identify malnourished → Refer/monitor → Reassess after 3–6 months.
National Food Guides — Pinggang Pinoy & Nutritional Guidelines for Filipinos (NGF)
Important facts
- Pinggang Pinoy = single-meal plate guide; shows proportions, not absolute amounts; age-specific versions (children, adolescents, adults, older persons, pregnant/lactating).
- Go (energy-giving): rice, bread, cereal = ~1/3 of plate; provides carbohydrates and energy.
- Grow (body-building): fish, shellfish, poultry, meat, eggs, dried beans, nuts, milk = smaller portion; builds/repairs body tissues.
- Glow (body-regulating): vegetables, fruits = largest portion of plate (vegetables the biggest, plus fruit); regulates body functions, prevents disease.
- Accompanying Pinggang Pinoy: glass of water (not sugary drinks) and reminder to be physically active.
- Nutritional Guidelines for Filipinos (NGF) = Ten Kumainments: variety, breastfeeding, vegetables/fruits/fish consumption, limit salty/sweet/fatty, safe food/water, active lifestyle, healthy weight.
- NGF answers "what and how much overall?" (dietary principles); Pinggang Pinoy answers "how much per meal?" (proportions).
- RA 8172 — ASIN Law: mandates salt iodization to prevent iodine-deficiency disorders.
- RA 8976 — Food Fortification Act: mandates fortification of staples (rice, wheat flour, cooking oil, refined sugar); voluntary fortification = Sangkap Pinoy Seal.
- Nurse teaches using both Pinggang Pinoy (practical plate tool) and NGF (principles) for patient-centered nutrition counseling.
Key definitions
Pinggang Pinoy
Example
One meal plate: ~1/3 rice (Go), small portion fish/egg (Grow), large portion vegetables/fruit (Glow) + glass of water.
DOST-FNRI single-meal plate guide showing proportions of Go, Grow, Glow food groups on a plate; practical tool for portion sizes.
Go–Grow–Glow Classification
Example
Go: rice, bread; Grow: fish, meat, eggs, legumes, milk; Glow: leafy greens, orange/red vegetables, citrus fruits.
Go = energy-giving (grains); Grow = body-building (protein); Glow = body-regulating (vegetables/fruits/minerals).
Nutritional Guidelines for Filipinos (NGF) — Ten Kumainments
Example
Eat a variety of foods daily; breastfeed infants exclusively for 6 months; consume vegetables/fruits/fish; limit salty/sweet/fatty foods; maintain healthy weight.
FNRI-DOST evidence-based dietary messages for whole population; complement Pinggang Pinoy by giving overall dietary principles (not portions).
Sangkap Pinoy Seal
Example
Bread, milk, juice, or noodles with Sangkap Pinoy Seal contain added iron, vitamins A, D, B1, B2, B3.
Label on food products indicating voluntary fortification with vitamins/minerals per RA 8976 (Philippine Food Fortification Act).
Diagrams to know
- Pinggang Pinoy plate diagram: Divide plate into thirds; ~1/3 Go (top), ~1/4 Grow (side), ~1/2 Glow (side/bottom) + glass of water.
- Ten Kumainments as a list or mnemonic: Variety → Breastfeeding → Vegetables/Fruits → Limited salty/sweet/fatty → Safe food/water → Activity → Healthy weight.
Nutrition in Pregnancy & Postpartum
Common values
Value
60 mg elemental iron + 400 µg folic acid
Symbol
Daily through pregnancy + 3 months postpartum
Quantity
Iron in pregnancy
Value
1000–1200 mg
Symbol
Per day (preeclampsia prevention)
Quantity
Calcium in pregnancy
Value
600 µg
Symbol
Daily (neural tube defect prevention)
Quantity
Folic acid in pregnancy
Important facts
- Pregnancy increased nutritional needs: energy (~300 kcal/day 2nd/3rd trimester), protein (~70 g/day), iron (~27 mg/day), folate (600 µg/day), calcium (~1000 mg/day), iodine.
- Iron-folic acid supplementation in pregnancy: 60 mg elemental iron + 400 µg folic acid daily throughout pregnancy and up to 3 months postpartum.
- Folate (folic acid) prevents neural tube defects (spina bifida, anencephaly); supplementation ideally 3 months preconception + throughout pregnancy.
- Iron supplementation prevents maternal anemia, low birth weight, preterm delivery, and postpartum hemorrhage.
- Calcium (1000–1200 mg/day) in pregnancy reduces preeclampsia/hypertension risk and supports fetal skeletal development.
- Vitamin A NOT supplemented in pregnancy (teratogenic); adequate dietary intake from non-fortified sources; supplementation postpartum only (200,000 IU within 1 month).
- Adequate weight gain in pregnancy: underweight (12–18 kg), normal (11–16 kg), overweight (7–11 kg), obese (≥7 kg); poor weight gain = low birth weight risk.
- Postpartum vitamin A supplementation (200,000 IU within 4 weeks) improves breastmilk vitamin A content and supports infant immunity.
- Lactating women have increased energy (~500 kcal/day), protein, calcium, iron, and micronutrient needs; nutrition counseling essential.
Key definitions
Maternal Anemia in Pregnancy
Example
A pregnant woman with Hb 9 g/dL (anemia) has higher risk of postpartum hemorrhage and delivering a low-birth-weight infant.
Hemoglobin <11 g/dL in 1st/3rd trimester or <10.5 g/dL in 2nd trimester; increases risk of maternal hemorrhage, low birth weight, preterm delivery.
Preeclampsia Risk & Micronutrients
Example
Adequate calcium intake (1000–1200 mg/day) in pregnancy is associated with lower preeclampsia incidence.
Adequate calcium, vitamin D, and antioxidants (vitamin C, E) in pregnancy may reduce preeclampsia risk; iron supplementation prevents anemia-related complications.
Diagrams to know
- Timeline: Preconception (folic acid counseling) → Pregnancy (iron-folic acid daily, monitor weight gain) → Delivery → Postpartum ≤4 weeks (vitamin A 200,000 IU) → Lactation (sustained supplementation).
Nutrition in Childhood & Adolescence
Common values
Value
15 mg/day
Symbol
Due to menstruation
Quantity
Iron in adolescent girls
Value
8 mg/day
Symbol
No menstruation
Quantity
Iron in adolescent boys
Value
1000–1300 mg/day
Symbol
Peak bone mass accrual
Quantity
Calcium in adolescence
Important facts
- Complementary feeding at 6 months: introduce iron-rich foods (fortified cereal, egg yolk, meat, beans) to prevent anemia.
- CF introduction timing: too early (before 6 months) = infection risk, breastmilk displacement; too late (after 6 months) = growth faltering.
- Deworming in childhood: preschool (1–5 years) and school-age (6–12 years) receive deworming during Garantisadong Pambata biannual rounds (April/October).
- Adolescent iron needs: boys 11–18 years = 8 mg/day, girls 11–18 years = 15 mg/day (due to menstruation); weekly iron-folic acid supplementation for girls.
- Adolescence = second growth spurt: rapid weight/height gain; increased energy (~2000–2600 kcal/day depending on sex/activity), protein, calcium (bone accrual), iron.
- Calcium in adolescence (1000–1300 mg/day) crucial for peak bone mass accrual; prevents osteoporosis in adulthood.
- Eating habits established in adolescence track into adulthood; nutrition education crucial for prevention of obesity, cardiovascular disease, diabetes.
- Growth monitoring in school age: tracks weight and height; compares to standards; flags stunting or overweight for intervention.
Key definitions
Complementary Feeding Window
Example
From 6 months: iron-fortified cereal, soft vegetables, mashed fruits, egg yolk; 8–12 months: minced meat, cooked beans; 12–24 months: family foods with texture.
Age 6–24 months when breastmilk is supplemented with foods; foods must be timely, adequate, safe, properly fed.
School-Age Nutrition
Example
School-age child receives deworming twice yearly (GP), vitamin A supplementation, and health education on balanced diet.
Sustained energy, protein, and micronutrient intake for growth and cognitive development; deworming and micronutrient supplementation via Garantisadong Pambata.
Adolescent Growth Spurt
Example
A 13-year-old girl enters menarche; her iron needs rise to 15 mg/day; counseling on dietary iron sources and weekly supplementation.
Second major growth phase (pubertal); increased energy, protein, iron (especially menstruating girls), calcium, and zinc needs.
Diagrams to know
- CF introduction: 6 months (iron-rich softs) → 7–9 months (texture increase, variety) → 10–12 months (minced/shredded) → 12+ months (chopped family foods).
- Micronutrient needs across childhood: Infants (iron-rich CF, Vit A) → Preschool (Vit A q6mo, deworming, MNP) → School-age (deworming biannual, growth monitoring) → Adolescence (iron supplementation for girls, bone health).
Nutrition in Older Adults
Common values
Value
1.0–1.2 g/kg/day
Symbol
Sarcopenia prevention
Quantity
Protein in older adults
Important facts
- Older adult nutritional needs: lower energy (due to reduced activity) but sustained/higher protein (sarcopenia prevention), micronutrients.
- Protein in older adults: 1.0–1.2 g/kg/day (higher than younger adults) to maintain muscle mass and function.
- Risk of undernutrition: reduced appetite (medications, taste changes, satiety), dental problems, swallowing difficulties, polypharmacy (drug-nutrient interactions), social isolation, limited income.
- Micronutrient risks: vitamin B12 deficiency (intrinsic factor loss, pernicious anemia), folate, vitamin D (osteoporosis, falls), iron (anemia, fatigue).
- Hydration: older adults have reduced thirst sense; risk of dehydration, constipation, urinary tract infections; encourage 6–8 glasses water/day.
- Falls prevention: adequate vitamin D, calcium, protein, strength training reduce fall/fracture risk.
- Nutrition screening (MUST): assess appetite, intake, weight changes, dental status, medication side effects, functional ability, social support.
- Pinggang Pinoy for older persons: adapted portions; emphasize nutrient-density, ease of chewing, safe swallowing, hydration.
- Nurse role: assess, counsel on nutrient-dense foods, encourage meals with social support, monitor for malnutrition signs, refer for dysphagia/dental intervention if needed.
Key definitions
Sarcopenia in Older Adults
Example
An older adult losing muscle mass and strength benefits from increased protein (1.0–1.2 g/kg/day) and strength training.
Age-related loss of skeletal muscle mass and strength; increases fall risk, functional decline, frailty; reversed by adequate protein and resistance activity.
Undernutrition in Older Adults
Example
An isolated older adult living alone on a fixed income may skip meals or rely on cheap, nutrient-poor foods; at risk for anemia, frailty, cognitive decline.
Risk of deficiency due to reduced appetite, dental problems, swallowing difficulties, polypharmacy, social isolation, fixed income.
Diagrams to know
- Older adult nutrition assessment flowchart: Screen (appetite, weight, intake) → Assess (dental, swallowing, medications, social) → Diagnose (undernutrition, risk) → Intervene (counseling, supplementation, referral).
Nurse's Role & Community Nutrition Programs
Important facts
- Nurse's core nutrition role (aligned with RA 9173): assess, counsel, administer/record supplements, monitor growth, enforce laws, educate, coordinate.
- Assessment: nutritional status, breastfeeding technique, complementary feeding practices, malnutrition risks, family food security, hygiene.
- Counseling: IYCF anchors, Pinggang Pinoy portions, NGF principles, micronutrient importance, safe food handling; use local languages/food examples.
- Administration & Recording: exact doses of Vit A, iron, zinc, deworming; record in FHSIS + facility records (not recording = not done).
- Growth Monitoring & Promotion (GMP): weigh/measure children, plot on standards, classify (stunted/wasted/underweight), counsel, refer for CMAM if needed.
- Law Enforcement: protect rooming-in, support lactating mothers, report breastmilk-substitute marketing violations (EO 51), enforce food safety.
- Community Coordination: work with BNS, BHFS, LHU, barangay nutrition committee, municipal health officer for program delivery.
- Guarantisadong Pambata Organization: plan logistics (supplies, personnel, venue), conduct rounds (April/October), ensure cold-chain, record coverage, evaluate, report.
- Health Teaching: bedside/group education using Pinggang Pinoy, NGF, visual aids; assess comprehension, provide referrals.
- Documentation (CRITICAL): all nutrition interventions recorded in FHSIS; ensures accountability and population-level monitoring.
- Referral: malnourished children → barangay nutrition program/CMAM; dysphagia → health facility; food-insecure families → social services.
Key definitions
Health Counseling (NANDA: Deficient Knowledge)
Example
Nurse teaches a mother the three IYCF anchors using her local foods; observes return demonstration of correct latch.
Nurse educates on nutrition using simple language, local food examples, and behavior-change techniques; documents knowledge gain.
Nursing Diagnosis: Unbalanced Nutrition (NANDA)
Example
A malnourished child with NANDA diagnosis "Unbalanced Nutrition: Less Than Body Requirements" receives micronutrient supplementation, CF counseling, and growth monitoring.
Indication that actual/risk of inadequate nutrient intake relative to metabolic needs; prioritized by Maslow's hierarchy (safety/health maintenance).
Barangay Nutrition Scholar (BNS)
Example
BNS coordinates with nurse to organize April/October vitamin A and deworming rounds, identifies malnourished children, provides basic nutrition education.
Community nutrition volunteer trained by DOH to promote nutrition, lead Garantisadong Pambata rounds, counsel caregivers; nurse's partner in barangay.
FHSIS — Family Health and Safety Information System
Example
Nurse records vitamin A supplementation coverage in FHSIS; data aggregated at LHU/municipal level for DOH reporting.
DOH national database for recording health facility outputs (deliveries, immunizations, nutrition services, supplements); feeds DOH monitoring/evaluation.
Diagrams to know
- Nurse's nutrition intervention cycle: Assess → Plan (Vit A/iron/deworming schedule, counseling topics) → Implement (administer, counsel, educate) → Record (FHSIS) → Monitor/Evaluate (growth, coverage, compliance) → Report.
Philippine Legal & Policy Framework (RA 9173, RA 10028, EO 51, RA 8172, RA 8976)
Important facts
- RA 9173 (Philippine Nursing Act): defines nurse scope (includes nutrition assessment, counseling, supplementation administration), accountability, continuing education.
- RA 10028 (Expanded Breastfeeding Promotion Act 2009): amends RA 7600; mandates lactation stations, lactation periods (≥40 min/8 hr, paid), breastfeeding-friendly workplaces.
- RA 7600 (Rooming-In & Breast-feeding Act 1992): mandates rooming-in of mother and newborn in health facilities; norm-setting law.
- EO 51 (Milk Code 1986): National Code of Marketing of Breastmilk Substitutes; restricts (not bans) formula marketing; prohibits free samples/promotion in facilities.
- RA 8172 (ASIN Law): mandates salt iodization nationwide; prevents iodine-deficiency disorders.
- RA 8976 (Food Fortification Act): mandates staple fortification (rice, wheat flour, cooking oil, sugar); Sangkap Pinoy Seal = voluntary fortification compliance.
- Nurse accountability: enforce laws (rooming-in, EO 51), counsel based on evidence (IYCF, NGF), administer exact supplement doses, record accurately, report violations.
- DOH nutrition programs (aligned with laws): Garantisadong Pambata (GP), growth monitoring, CMAM, health education.
- Penalties for non-compliance: formula marketing in facilities = fine/closure (EO 51); salt non-iodization = fine (RA 8172).
Key definitions
RA 9173 — Philippine Nursing Act of 2002
Example
RA 9173 grants nurses authority to administer/counsel nutrition interventions (Vit A, iron, deworming) within barangay health programs.
Professional regulation law defining nurse scope of practice, standards, and accountability; establishes PRC Board of Nursing and NLE.
Diagrams to know
- Philippine nutrition policy timeline: RA 7600 (1992 rooming-in) → EO 51 (1986 milk code, ongoing) → RA 8172 (1991 salt iodization) → RA 8976 (1999 food fortification) → RA 10028 (2009 expanded breastfeeding).
Must remember
IYCF Three Anchors: (1) Early initiation within 1 hour of life, (2) Exclusive breastfeeding for 6 months, (3) Continued breastfeeding up to 2 years and beyond with timely complementary feeding at 6 months. This is the foundation of all infant feeding counseling.
Vitamin A Supplementation Ages & Doses (EXACT MEMORIZATION): 6–11 months = 100,000 IU (once); 12–59 months = 200,000 IU q6mo (biannual GP); postpartum = 200,000 IU within 1 month. NOT in pregnancy (teratogenic). Wrong dose = patient harm.
Iron-Folic Acid in Pregnancy: 60 mg elemental iron + 400 µg folic acid daily throughout pregnancy + 3 months postpartum. Prevents maternal anemia, neural tube defects, low birth weight. One of the highest-yield facts.
Garantisadong Pambata (GP) = Biannual Package: Delivered twice per year (April & October) at barangay level; includes Vit A, deworming, immunization, nutrition counseling, growth monitoring. Nurse must organize, execute, record, and report coverage to FHSIS.
RA 10028 vs. RA 7600 vs. EO 51: (1) RA 7600 (1992) = rooming-in + breastfeeding norm; (2) RA 10028 (2009) = amended RA 7600, adds lactation stations + ≥40 min lactation period/8 hr (paid); (3) EO 51 (1986) = Milk Code, restricts (not bans) formula marketing, prohibits free samples in health facilities. NLE will test distinctions.
First 1,000 Days Framework (Conception → 24 months): Critical window; undernutrition causes irreversible stunting and cognitive loss. Stunting = chronic; wasting = acute; underweight = composite. Stunting is the priority indicator for this period.
Colostrum is the Infant's First Immunization: Rich in secretory IgA (mucosal immunity); NEVER discard. First milk in first hours/days. Key teaching point with all mothers.
Complementary Feeding at 6 Months: Start with iron-rich foods (fortified cereal, egg yolk, meat, beans) to prevent infant anemia as breastmilk iron depletes. Textures progress: soft → minced → chopped. Timely, adequate, safe, properly fed.
Zinc for Diarrhea Dosing: <6 months = 10 mg/day; ≥6 months = 20 mg/day, given with ORS for 10–14 days. This is testable; wrong dose = error.
Pinggang Pinoy & Nutritional Guidelines for Filipinos (NGF): Pinggang Pinoy = single-meal plate guide showing proportions (Go ~1/3, Grow smaller, Glow largest + water); NGF (Ten Kumainments) = overall dietary principles (variety, breastfeeding, vegetables/fruits/fish, limit salty/sweet/fatty, safe food/water, activity, healthy weight). Use both for patient teaching.
Last minute tips
Dose Precision is Critical: Vitamin A and zinc doses are exact and testable; a single incorrect digit can be a wrong answer on NLE. Write them down, memorize them verbatim, and triple-check before administering or answering exam questions. Treat every numerical value as exam-critical.
Laws Are Distinct: Don't confuse RA 7600, RA 10028, and EO 51. RA 7600 = rooming-in (1992); RA 10028 = lactation stations/periods (2009 amendment); EO 51 = Milk Code (1986, regulates marketing). NLE commonly asks which law applies to a scenario—read each option carefully.
Garantisadong Pambata Timing: The exact months (April & October) are testable. If an exam question says "May" or "September," that's a red flag—GP is specifically biannual in April and October. Also know that GP is twice per year, not annually.
IYCF Anchors Are Non-Negotiable: The three anchors (early initiation within 1 hour, exclusive 6 months, continued to 2 years with CF) are evidence-based DOH policy. Questions often test whether a scenario aligns with these anchors. A mother introducing water at 3 months = not following IYCF; an infant receiving formula at 2 months = not exclusive BF. Spot these in exam scenarios.
Growth Monitoring Language: Know the difference between stunting (height-for-age, chronic), wasting (weight-for-height, acute), and underweight (weight-for-age, composite). Also know Operation Timbang = annual mass weighing to identify malnourished preschoolers. NLE may ask "which malnutrition type and how to identify?"—use precise definitions.
Comparison tables
Vitamin A Supplementation — Age, Dose, Timing
| Age Group | Dose | Frequency | Timing / Notes |
|---|---|---|---|
| Infants 6–11 months | 100,000 IU | Single dose | Once (during GP or routine) |
| Children 12–59 months (1–5 yrs) | 200,000 IU | Every 6 months | Biannual (April & October GP) |
| Postpartum women | 200,000 IU | Single dose | Within 4 weeks (1 month) postpartum |
| Pregnant women | NOT given | Not applicable | Teratogenic; counsel adequate dietary intake |
| Therapeutic (measles/SAM/xerophthalmia) | Age-appropriate dose | Days 1, 2, and 15 | Standard therapeutic protocol |
Malnutrition Classification — Stunting vs. Wasting vs. Underweight
| Type | Definition | Indicator | Timing | Reversibility |
|---|---|---|---|---|
| Stunting | Low height-for-age; chronic undernutrition | Height-for-age <3rd percentile (or -2 SD) | Long-term inadequate nutrition/repeated infections | Irreversible if in First 1,000 Days |
| Wasting | Low weight-for-height; acute malnutrition | Weight-for-height <3rd percentile (SAM: <70% standard or MUAC <115 mm) | Recent/sudden food shortage or acute illness | Reversible with prompt intervention |
| Underweight | Low weight-for-age; composite (chronic + acute) | Weight-for-age <3rd percentile | Can reflect either chronic, acute, or both | Reversibility depends on cause (chronic vs. acute) |
IYCF: Exclusive Breastfeeding vs. Complementary Feeding
| Aspect | Exclusive Breastfeeding (0–6 months) | Complementary Feeding (6–24+ months) |
|---|---|---|
| Definition | Breastmilk only; no water, other liquids, or solids (medicines/vitamins allowed) | Breastmilk plus age-appropriate foods; continues up to 2 years and beyond |
| Feeding frequency | On demand, ~8–12 times/day | Increases with age: 2–3 meals (6–8 months) → 3 meals + 1–2 snacks (9–24 months) |
| Signs of adequacy | 6+ wet diapers/day, weight gain, infant contentment | Continued weight/height gain, appropriate texture intake, continued breastfeeding |
| Key benefit | Optimal nutrition + immunity (especially colostrum/IgA) + protection against infections + bonding | Meets increased energy/micronutrient needs (Vit A, iron, zinc) as breastmilk alone insufficient at 6+ months |
| Common mistakes | Introducing water/other fluids (displaces breastmilk, infection risk); withholding colostrum; incorrect latch → poor milk transfer | Starting solids too early (infection risk) or too late (growth faltering); foods not iron-rich; poor hygiene → diarrhea |
Supplementation Doses — Iron, Folic Acid, Zinc by Population
| Population | Iron Dose | Folic Acid Dose | Zinc Dose | Duration / Timing |
|---|---|---|---|---|
| Pregnant women | 60 mg elemental | 400 µg | Not standard | Daily throughout pregnancy + 3 months postpartum |
| Adolescent girls (non-pregnant) | Iron-folic acid weekly | Included in formulation | Not standard | Weekly (secondary prevention of anemia) |
| Infants <6 months with diarrhea | Not standard | Not standard | 10 mg/day | 10–14 days with ORS |
| Infants/children ≥6 months with diarrhea | Not standard | Not standard | 20 mg/day | 10–14 days with ORS |
| Low-birth-weight infants | Iron supplementation from 2 months | Not standard | Not standard | Monitor for anemia; duration depends on infant status |
Breastfeeding Laws & Policies — Summary
| Law / Policy | Year | Key Mandate | Nurse Enforcement |
|---|---|---|---|
| RA 7600 — Rooming-In & Breast-feeding Act | 1992 | Rooming-in of mother and newborn; breastfeeding as norm in health facilities | Enforce rooming-in immediately postpartum; counsel on early initiation/positioning |
| RA 10028 — Expanded Breastfeeding Promotion Act | 2009 (amended RA 7600) | Lactation stations + lactation periods (≥40 min/8 hr shift, paid) in workplaces/public places; breastfeeding-friendly environment | Advocate for lactation facilities; support working nursing mothers; educate employers on law |
| EO 51 — The Milk Code | 1986 | Regulate/restrict marketing of breastmilk substitutes, bottles, teats; does NOT ban formula; prohibits free samples/promotion in facilities | Never promote formula; reject free samples/marketing materials; counsel on EBF benefits; report violations to DOH |
Food Classification: Go–Grow–Glow
| Classification | Function | Examples | Proportion (Pinggang Pinoy) |
|---|---|---|---|
| Go (Energy-giving) | Provide energy (carbohydrates, some fats) | Rice, bread, cereal, pasta, potatoes, corn | ~1/3 of plate |
| Grow (Body-building) | Build/repair body tissues (protein, minerals) | Fish, shellfish, poultry, meat, eggs, legumes, nuts, milk, cheese | Smaller portion (side of plate) |
| Glow (Body-regulating) | Regulate body functions, prevent disease (vitamins, minerals, fiber) | Leafy greens (spinach, malunggay), orange/red vegetables (carrots, tomatoes), citrus fruits, banana, papaya, mango | Largest portion (vegetables biggest, plus fruit) |
Diagrams
Nutrition Across the Lifespan — Complete Overview
Mind map showing nutritional priorities across each life stage from pregnancy through older adulthood, highlighting key ages, nutrients, and interventions for quick reference.
IYCF Timeline & Decision Tree (Birth to 24+ Months)
Flowchart detailing the IYCF timeline from birth through 24+ months, showing decision points (exclusive vs. CF), common mistakes (introducing water/solids too early, stopping BF early), and signs of adequacy. Essential for understanding the entire feeding progression.
Vitamin A Supplementation Protocol by Age
Flowchart for vitamin A dosing by age group, including decision points for pregnant vs. postpartum women and therapeutic indications. Ensures correct dose administration and recording.
Philippine Nutrition Laws & Policy Timeline
Timeline showing the sequence of Philippine nutrition and breastfeeding laws from 1986–present, helping students understand the regulatory evolution and context for each law.
Malnutrition Classification States & Transitions
State diagram showing transitions between well-nourished, underweight, wasting, and stunting states, emphasizing the reversibility of acute malnutrition and the irreversibility of stunting in the First 1,000 Days if not corrected early.
Garantisadong Pambata Biannual Rounds Organization & Execution
Flowchart detailing the complete Garantisadong Pambata biannual round cycle from planning through post-campaign follow-up, emphasizing the nurse's coordinating role, FHSIS documentation, and identification of children needing further intervention.