NKRA, LIH: Orang Asli/ Pribumi Improving & Sustaining Nutritional Status of Interior Orang Asli/ Pribumi Children COMMUNITY FEEDING PROGRAMME NUTRITION DIVISION, MOH
NKRA, LIH: Orang Asli/ Pribumi
Improving & Sustaining Nutritional
Status of Interior Orang Asli/
Pribumi Children
COMMUNITY FEEDING
PROGRAMME
NUTRITION DIVISION, MOH
Community Feeding Programme (PCF) is an initiativeunder Government Transformation Programme(GTP) 2.0 (2013-2015) for Low Income Households.
In October 2012, Pilot Project for Community FeedingProgramme was carried out among interior Orang Asliin Hulu Perak and Jerantut.
Community Feeding Programme has been implementedsince 2013 in the interior Perak (Hulu Perak), Pahang(Jerantut, Lipis and Cameron Highland), Kelantan (GuaMusang) and Sarawak (Long Keluan).
Background
Childhood malnutrition amongst Orang Asli
•Several studies had revealed that underweight and stunting Orang Asli children were found in one-third to three quarters of the population groups (Khor, 1985; Ismail, 1988, Zalillah & Tham, 2002, Hesham et al, 2005, Shasikala et al, 2005).
•Thus, prevalence of child malnutrition was higher among interior Orang Asli community in Malaysia.
Based on report, 3 states (Kelantan, Perak, Pahang) had the highest cases of malnourished children in the interior. Cases were higher in hard core poor families (JHEOA, 2006).
Gerik
CameronHighlands Lipis
Gua Musang
Areas identified are Gua Musang, Gerik, Cameron Highlands, Lipis
Contributing factors leading to malnutrition among OA children
poverty
shortage of Food
inadequate dietary intake
infectious diseases
incomplete vaccination
socio-economic
status
cultural poor health care
access to agricultural resourcesaffordability
of foodfood
security
safe water
women status
health services sanitation
environment
caring capacity
education
Conceptual Framework of Childhood Malnutrition
Childhood malnutrition
Inadequate dietary intake
Insufficient access to food
Inadequate maternal and child
care
Poor water/sanitation and
inadequate health services
Quantity and quality of actual resources – human economic and
organizational and the way they are controlled
Potential resources, environment, technology,
people
Disease
Outcomes
Immediate causes
Underlying causes at household/ family levels
Basic causes at societal level
Inadequate and/or inappropriate
knowledge and discriminatory
attitudes limit household access
to actual resources
Political, cultural, religious,
economic and social systems,
including women’s status, limit
the utilisation of potential
resources
Adapted: UNICEF
1. To ensure at least 95% of malnourished Orang Asli/
Pribumi children enrolled in the Community
Feeding Programme.
2. To rehabilitate > 25% of malnourished Orang Asli/
Pribumi children after 6 months in the Community
Feeding Programme.
3. To sustain the normal nutritional status of Orang
Asli/ Pribumi children in the Community Feeding
Programme.
Objectives
7
Distribution of Community Feeding Centres (2013-2015)
Gua Musang = 5 PCF
Perak
Kelantan
Pahang
36 Community Feeding Centres2013 = 26 2014 = 7 2015 = 3
Cameron Highlands = 1 PCF
Kuala Lipis = 2 PCF
Jerantut = 3 PCF
Rompin = 1 PCF
Hulu Perak = 18 PCF
Batang Padang = 2 PCF
Kuala Kangsar = 2 PCF
Long Keluan, Miri = 1 PCF
Long Urun, Kapit = 1 PCF
Sarawak
2013 2014 2015
District PCF District PCF District PCF
Hulu Perak 1. Kg. Banun2. Kg. Bal Ragak3. Kg. Bal Salor4. Kg. Bal Chemelak5. Kg. Bal Chareh6. Kg. Bal Changkes7. Kg. Bal Stol8. Kg. Akei9. Kg. Katong 110. Kg. Katong 211. Kg. Senangit12. Kg. Senangit Dalam13. Kg. Lediau14. Kg. Rantau 1a15. Kg. Rantau 1b16. Kg. Rantau 217. Kg. Lerlar
Kuala Kangsar 27. Kg. Piah28. Kg. Kembok
Hulu Perak 34. Kg. Sg Tiang
Jerantut 18. Kg. Sungai Tiang19. Kg. Sungai Koi20. Kg. Sungai Mai
Batang Padang 29. Kg. Jernang30. Kg. Bersih
Gua Musang 35. Kg. Sugi36. Kg. Ayong
Kuala Lipis 21. Kg. Lenjang22. Kg. Pagar
Rompin 31. Kg. Sawah Batu
Cameron Highland
23. Kg. Lemoi Gua Musang32. Kg Pasik
Gua Musang 24. Kg. Jias25. Kg. Langsat
Kapit 33. Long Urun
Miri 26. Long Keluan
Distribution of Community Feeding Centre (PCF 2013-2015)
COMMUNITY FEEDING CENTRE
PCF IN HULU PERAK
PCF Sg Tiang
PCF Rantau 1b
PCF Lediau
PCF Sg Lerlar
PCF Rantau 2
PCF Rantau 1a
PCF Senangit Dalam
PCF Senangit Baru
PCF Akei
PCF IN HULU PERAK
PCF Katong 1 PCF Katong 2
PCF Bal Chemelak
PCF Bal Ragak
PCF Bal StolPCF Bal Changkes
PCF Pos Jernang, Sungkai
PCF Pos Bersih, Slim River
PCF IN BATANG PADANG
PCF IN KUALA KANGSAR
PCF Kg Kembok
PCF Kg Piah
PCF IN JERANTUT
PCF Sg Koi
PCF Sg Tiang
PCF Sg Mai
PCF IN KUALA LIPIS
PCF Kg Lenjang
PCF Kg Pagar
PCF IN CAMERON HIGHLAND
PCF IN ROMPIN
PCF Kg. Sugi, Pos Pasik
PCF Kg. Ayong,Pos Pasik
PCF Kg. Pasik, Pos Pasik
PCF Kg. Jias,Kuala Betis
Bangunan PascabanjirPCF Kg. Langsat, Kuala
Betis
PCF IN GUA MUSANG
PCF IN SARAWAK
PCF Long Urun
PCF Long Keluan
Two initiatives have been identified to reduce malnutrition amongst interior OA children by 50% in 2015 throughCommunity Feeding Programme
20
Food Basket Community Feeding
Community Feeding Programme
Focused initiatives through Community Feeding Programme
21
Rehabilitation Programme
Food Basket (Option 13)
Community Feeding
Ready to Use Therapeutic Food (RUTF)
Supplementary Feeding Programme
Community EmpowermentProgramme
• Special milk and multivitamin•Given to malnourished OrangAsli/ Pribumi children aged 6 months to 6 years from hardcore poor family until rehabilitated
• To support food basket initiative and avoid sharing of food baskets among family members.•Consists of 3 main programmes ie RUTF, supplementary feeding programme and community empowerment programme•Runs parallel with food basket until identified malnourished children in targeted community is rehabilitated.
•Target group: All malnourished Orang Asli/ Pribumi children aged 6 months to 6 years old in selected community •Made of peanut, sugar, milk powder, oil and etc• RUTF is given until the children get rehabilitated (3times/week)
•Target group: All children aged 6 months to 6 years old in selected community • Local volunteers feed the children with:i. a glass of milkii. fish oil or/and multivitaminiii. carbohydrate food based
(biscuits, cereal, etc) iv. protein food based (fish,
chicken and etc)for 5 times/ week.
•Objective: Sharing of information on nutrition/health care through community activities ie health talk, health screening, cooking classes for mothers, gotong royong•Empower local volunteer/leaders on health issues
Implementing Food Basket (Option 13) to interior OA malnourished children from hard core poor families
• To provide special milk powder and multivitamin for the malnourished
children monthly.
• Only for underweight children from 6 months to 6 years old from poor and
hardcore poor family was selected into the programme.
• Considered as a priority case and need to be monitored closely.
• Food baskets is given until rehabilitated.
• To reduce 50% of malnourished children by year 2015
• Improve health status of targeted children.
• Milk is a nutrient dense food and easily consumed .
• Targeted to children, thus, reducing the possibility of food sharing within
family members and OA communities.
• Targeted children with improved weight gain .
• Procurement of milk and multivitamin.
What is the
initiative?
Why is it
Important?
What is the
deliverable?
Where /How to
obtain resources?
Type of food Opt.1 Opt.2 Opt.3 Opt.4
Opt.5 Opt.6 Opt.7 Opt.8 Opt.9 Opt. 10
Opt. 11
Opt. 12
Opt. 13
Rice (5 kg) √ √ √ √ √ √
Beehon (2.8 - 3 kg ) √ √ √ √ √ √
Full Cream Milk(1.8 - 2 kg)
√ √ √ √ √ √ √ √ √ √ √ √
Breakfast Cereal (0.9-1 kg)
√ √ √ √ √ √ √ √ √ √ √ √
Biscuit (1.8-2 kg) √ √ √ √ √ √ √ √ √ √ √ √
Egg (30s) √ √ √ √
Sardine (7 tin:155g/tin )
√ √ √ √
Anchovies (500 g) √ √ √ √
Margarine (240-250 g) √ √ √ √ √ √
Cooking Oil (1 kg) √ √ √ √ √ √
Malt Choc powder (1 kg) √ √ √ √ √ √ √ √ √ √ √ √
Multivitamin (30/ 60 tablets or 50-120ml)
√ √ √ √ √ √ √ √ √ √ √ √ √
Special milk or formula milk (1.6-2 kg)
√
Food Basket Options
Ready to Use Therapeutic Food (RUTF)
• To give the children RUTF until rehabilated (3times/ week).
• Criteria for selection: i. High prevalence of underweight amongst
children under 6 years ii. Hard core poor families iii. Accessibility to
community feeding centre.
• To reduce malnutrition amongst children by at least 30%.
• To improve and sustain nutritional status of children.
• To assist children attain optimal growth.
• Establishment of feeding centre, elimination of food sharing and
community empowerment to health care.
• OA children from 6 months to 6 years old for fast improved weight
gain.
• OAs are more responsible for their children nutritional status.
• RUTF (specially prepared).
• Local village health volunteer.
• Utensils for preparation/cooking.
What are the
initiatives?
Why is it
Important?
What is the
deliverable?
What are the
resources?
RUTF IN 2013 & 2014
At the beginning of the programme,RUTF was locally prepared andsupplied by the respective districtusing the same basic ingredientsconsisted of peanut, sugar, fullcream milk and oil.
RUTF IN 2015
Since 2015, centralized preparation/formulation and supply of RUTFcoordinated by the Nutrition Division.RUTF is made of peanut butter, butter,glucose syrup, glucose, shredded driedcoconut, cereal, full cream milk powderand ground nut.
Nutritional value
Per 100g Per serving (23g)
Energy 605Kcal 139.15Kcal
Protein 8g 1.84g
Total fat 49.8g 11.45g
Carbohydrate 31.2 7.18g
Moisture 9.2g 2.12g
Ash 1.8g 0.41g
Supplementary Feeding Programme
• To provide a glass (~250 ml) of milk, carbohydrate based food
(biscuits/ breakfast cereals and etc), protein based food
(fish/chicken & etc) and multivitamin or/ and fish oil 5x times/week.
• Milk
• Multivitamin or/and fish oil
• Carbohydrate based food
• Protein based food
What are the
initiatives?
Why is it
Important?
What is the
deliverable?
What are the
resources?
• Direct consumption by the child with strict local village health
volunteer supervision.
• Recommended daily important nutrient intake through
supplemented foods given to the child.
• Improved growth.
• Inculcation of milk drinking habit to meet the
recommendation based on the Malaysian Food
Pyramid.
Menu 1:
1 glass of milk
1 tbsp Scott Emulsion
1 tablet Multivitamin
5 piece of biscuit with cream
Menu 2:
1 glass of milk
1 tbsp Scott Emulsion
Rice + sardine
Mix Vegetables
Menu 3:
1 glass of milk
1 tbs Multivitamin
Nasi lemak/ mee goreng/ nasi
ayam
Menu 4:
1 glass of milk
1 tbsp Scott Emulsion
1 tablet multivitamin
1 bowl of bubur keledek
Menu 5:
1 glass of milk
1 tbsp Scott Emulsion
1 tablet of multivitamin
1 piece of lempeng
pisang
1 hard boiled egg
Examples of Supplementary Feeding Menu
Supplementary Feeding
• Carry out activities to create awareness
and improve their knowledge and practices through:-
- Nutrition & health talks
- Health screening & interventions
- Cooking classes
- Gotong royong
• Conducted at least 3 times/week.
• To empower the community/local leaders in the
implementation of health and nutrition
programmes.
• Empowered/ mobilised community leaders and its
community on health and nutrition.
• Improved knowledge and practices on proper
food preparation, handling and storage as well
as feeding principles.
• Collaboration between MOH, JAKOA and OA
community .
Community Empowerment Programme
What are the
initiatives?
Why is it
Important?
What is the
deliverable?
What are the
resources?
No. District No. of PCF No. of volunteers
1. Hulu Perak 18 56
2. Kuala Kangsar 2 6
3. Batang Padang 2 6
4. Jerantut 3 6
5. Kuala Lipis 2 6
6. Cameron Highland 1 2
7. Rompin 1 2
8. Gua Musang 5 14
9. Miri 1 1
10. Kapit 1 5
Total 36 104
Distribution of Orang Asli/ Pribumi Volunteers
Incentive for local volunteers: RM150/ month
Roles of Orang Asli/ Pribumi Volunteer
1. To prepare and feed supplementary foods 5 times/week to allchildren age 6 months to 6 years.
2. To feed RUTF to malnourished children age 6 months to 6 yearsfor 3 times/week.
3. To record daily attendance of children in the Log Book.
4. To ensure all children attend the Community Feeding Centre to gettheir supplementary feeding.
5. To help the health staff to monitor children’s weight and height bytaking anthropometric measurement every month.
6. To help teach the local community on how to prepare nutritiousfood/meals for their children using their own native language.
7. Help to give health education to the local community using theirown language.
Community Empowerment
COMMUNITY EMPOWERMENT PROGRAMME IN JERANTUT
COMMUNITY EMPOWERMENT PROGRAMME IN ROMPIN
HEALTH COMMUNITY PROGRAMME RPS KEMAR
COMMUNITY EMPOWERMENT PROGRAMME IN GUA MUSANG
Cooking Demonstration
Health and hygiene education
COMMUNITY EMPOWERMENT PROGRAMME IN GUA MUSANG
Supplementary Feeding
39
COMMUNITY EMPOWERMENT PROGRAMME
IN SARAWAK
Roadmap and targets by 2015
40
Reduce 25% from baseline
(in 2012) of malnourished OA
children
Implementation
plan
50% reduction of
malnourished OA
children
• Train local village
health volunteer
• Programme
implementation
2015
2014
2013
2012
Malnourished children enrolled in the Community Feeding Programme (2013- Jan-June 2015)
State
2013 20142015
(Jan-June)
No. of
cases <6
years
No. of malnourished cases
% of malnourished cases
No. of cases
<6years
No. of malnour
ished cases
% of malnourished cases
No. of cases
<6years
No. of malnouri
shed cases
% of malnourished
cases
Perak 644 262 40.6 803 289 36.0 793 209 26.4
Pahang 159 123 77.4 300 101 33.7 269 66 24.5
Kelantan 79 63 79.7 224 65 29.0 204 61 29.9
Sarawak 26 14 53.8 155 43 27.7 90 4 4.4
TOTAL 908 459 50.6 1482 498 33.6 1356 262 19.3
Status of malnourished children rehabilitated in the Community Feeding Programme (2013- Jan-June 2015)
State
2013 20142015
(Jan-June)
No. of malnour-
ishedcases
No. of cases
rehabili-tated
% of cases
rehabili-tated
No. of malnour-
ishedcases
No of cases
rehabili-tated
% of cases
rehabili-tated
No. of malnour-
ished cases
No of cases
rehabilita-ted
% of cases rehabilita-
ted
Perak 262 157 59.9 289 63 21.8 209 54 25.8
Pahang 55 34 61.8 101 36 35.6 60 11 18.3
Kelantan 43 22 51.1 65 14 21.5 61 15 24.6
Sarawak 14 9 64.3 43 34 79.1 4 3 75.0
TOTAL 374 222 59.4 498 147 29.5 334 83 24.9
KPITarget
2013-2015
Achievemen
t 2013
Achievemen
t 2014
Achievement
2015 (Jan-June)
1. % of malnourished children enrolled in the Community Feeding Programme
> 95% 95.5% 99.5% 99.7%
2. % of malnourished children recovered after 6 months in the Community FeedingProgramme
25% 59.4% 29.5% 24.9%
Key Performance Indicators (2013-2015)
93.9
96.9
100 100100.0
97.5
100.0 100.0100
98.5
100 100.0
90
91
92
93
94
95
96
97
98
99
100
101
Perak Pahang Kelantan Sarawak
% o
f m
aln
ou
rish
ed c
hild
ren
en
rolle
d in
th
e p
rogr
am
State
Percentage of malnourished children enrolled in Community Feeding Programme (2013- Jan- June 2015)
2013 2014 2015
0
10
20
30
40
50
60
70
80
Perak Pahang Kelantan Sarawak
59.9 61.8
51.1
64.3
21.8
35.6
21.5
79.1
25.8
18.3
24.6
75.0
% o
f m
aln
ou
rish
ed
ch
ildre
n r
eh
abili
tate
d
State
Percentage of malnourished children rehabilitated in Community Feeding Programme 2013- Jan-June 2015
2013 2014 2015
Initiatives
Budget (RM)
2013 2014 2015
Community Feeding (RUTF, Supplementary Feeding Programme and Community empowerment Programme)
2,256,000 1,817,240 1,151,500
Food Basket (Option 13) 1,200,000 1,213,920 848,500
TOTAL (RM) 3,456,000 3,031,160.00 2,000,000
Budget for PCF Implementation: 2013 - 2015
Grand total: RM 8,987,160.00
Other issues
• Food availability/ food insecurity among Orang Asli .
• Parasitic Infection
• Fostering Good Hygiene Practice
• Nomadic- hard to monitor the children
• Transportation (the availability of 4WD and boats)
• Turnover staff – frequent staff transfer/ exchange
The Challenges• Food taboos/ beliefs, they don’t eat what they rear. (ie livestock's only for the purpose of earning money)• Difficulty in introducing/ altering their taste bud.• Don’t eat certain food, limit the variation of food consumption (picky eater).
•Communication barrier (languages) between health personnel/worker and Orang Asli community.
Way Forward
Short Term
• Community Feeding Programme will continued in 2016•To expand Community Feeding Programme to other Orang Asli/Pribumi settlement.• To ensure the malnourished children in existing Community Feeding Programme rehabilitated and able to sustain their nutritional status.
Long Term
• To enable the Orang Asli/Pribumi Community to inculcate elements emphasized in the community empowerment into their daily life.
To achieve this, multi-pronged strategy by multi agencies to improve economic status, educational level, food security (food availability and food utilization) are warranted.
CADANGAN POLISI PEMBERIAN SUSU FORMULA KEPADA BAYI BERUMUR <6 BULAN YANG MENGALAMI
MASALAH KEKURANGAN ZAT MAKANAN MELALUI
PRESKRIPSI KLINIKAL
Bahagian PemakananKementerian Kesihatan Malaysia
1. Objective
• To prevent and reduce infant morbidity andmortality due to malnutrition.
• To promote optimal infant growth anddevelopment.
2. Prerequisite
• Counseling on infants feeding
• Despite adequate counseling on breastfeeding
2. Suggested Criteria For Formula Milk Supplementation To Children Under 6 Months
1.Infant’s criteria
2.Mother’s criteria
3.Socio economic status – poverty
Must fulfill all the 3 criteria
3. Entry Criteriaa) Infant’s Criteria
• Low weight for age ( below -2SD) OR
• Low weight for length ( below -2SD) OR
• Failure to thrive with weight crossing 2 major percentiles which includes inadequate calories, inadequate caloric absorption or excessive caloric expenditure. OR
• Clinical Kwashiorkor (edema of both feet)
3. Entry Criteriab) Mother’s criteria
• Not breast feeding because of maternal illness(HIV, medications, mental disorder and etc. Refer Listof contraindication for breastfeeding), foster care andadopted child. OR
• Not able to establish or re-establish effectiveexclusive breastfeeding by the mother after adequatecounseling and support. OR
• Inadequate volume of expressed breast milk (EBM)for infants who are not directly feeding at the breast.
3. Entry Criteria: c) Socio economic status
• Hard core poor, poor and easily poor
4. Discharge Criteria
• Discharge from the supplementation programwhen the infant reach 6 months of age.
• If the condition persists (the infant stillmalnourished), continue with the existingrehabilitation programme for malnourishedchildren.
5. Management
• Continuous infant feeding assessment
• Monitoring infant growth
• Counseling to mothers/ caretakers
• AFASS (Acceptable, feasible, affordable, sustainable and safe) component
• Continue breastfeeding while giving milk supplementation for mothers without contraindication
• The supplementation should be started if there is no improvement after 2 weeks of intervention (assessment, counseling and support)
Recommended Type of Infants Formula Milk
• Normal term baby- Prescribe Normal infant formula milk
• Pre term baby- post discharge formula milk
Formula Milk Supplementation by Prescription
• Prescription by Pediatricians
FMS
• In rural clinics with no immediate access to FMS/ Pediatricians
CADANGAN MEKANISME PEMBERIAN SUSU FORMULA KEPADA BAYI BERUMUR <6 BULAN YANG MENGALAMI MASALAH KEKURANGAN ZAT
MAKANAN MELALUI PRESKRIPSI KLINIKAL
ii. Kuantiti Pemberian Susu Formula
• Dikira mengikut cadangan anggaran pemberian susu yang diperlukan oleh bayidalam sehari, Garis Panduan Pemberian Makanan Bayi dan Kanak-kanak Kecil,2009.
Umurbayi
Bil. penyusuan sehari
Amaun susupada setiappenyusuan
Jumlahsusu /Hari
Amaun Susu Dalam
Gram/ Hari
(1scoop=4.4g)
Amaun Susu/
BulanJumlah Tin/ Bulan
(1 tin = 900 g)
Dari lahir - 1 bulan
8 60 ml 480 ml2 scoop x 4.4g x 8 kali
= 70.4 g
70.4 g x 30 hari
= 2,112 g 3
1 - 2 bulan
7 90 ml 630 ml3 scoop x 4.4g x 7 kali
= 92.4 g
92.4 g x 30 hari
= 2,772 g 3
2 - 4 bulan
6 120 ml 720 ml4 scoop x 4.4g x 6 kali
= 105.6 g
105.6 g x 30 hari
= 3,168 g 4
4 - 6 bulan
6 150 ml 900 ml5 scoop x 4.4g x 6 kali
= 132 g
132 g x 30 hari
=3,960 g 4
Terima Kes Bayi <6 Bulan
Saringan Pertama oleh Jururawat
i) Antropometri (berat dan tinggi) ii) Pemeriksaan fizikal dan klinikal
Menentukan status kes:
Normal (-2SD-<+2SD KZM Sederhana (-3SD-<-2SD) dan
Susut (BMI-untuk-umur < -2SD)
KZM Teruk (<-3SD)
Bayi Menyusu Susu Ibu Bayi Tidak Menyusu Susu Ibu Bayi Menyusu Susu Ibu dan Susu
Formula (mix feeding)
Layak Mengikut Kriteria
Ditetapkan (akan ditetapkan)
*Bantuan Susu Formula mengikut kuantiti yang
ditetapkan diberi (Rujuk Pegawai Sains
Pemakanan)
Temujanji Susulan (mengikut TCA) oleh Pakar
Kanak-Kanak/ Pakar Perubatan Keluarga/ Pakar
Perubatan
Rujuk kepada Pakar Kanak-
Kanak/ Pakar Perubatan
Keluarga/ Pakar Perubatan
untuk pemeriksaan lanjut dan
pengesahan kes. (eg: FTT)
Nasihat pemakanan dan
lain-lain berkaitan
CARTA ALIR
PENGESAN
AN DAN
PENDAFTA
RAN KES
KZM BAGI
BAYI
BERUMUR
<6 BULAN
Penilaian dan
Kaunseling
Penyusuan Susu Ibu
-Ada checklist:
Verified by Matron/
PSP
Kawal Pemberian
Susu:
SPESIFIKASI SUSU RUMUSAN BAYI (NORMAL)
Bil Syarikat Nama Kategori Berat Tenaga/ hidangan (kcal)
Protein/100g
(g)
Lemak/ 100g (g)
Karb/ 100g (g)
Harga (RM)
1. Wyeth
S-26 Gold SMA
Rumusan Bayi (0-12 bulan)
900g 513 10.0 28.0 54.0 113.80
S-26 SMARumusan
Bayi (0-12 bulan)
1.2kg 529 11.0 28.0 57.0 88.60
2. Nestle
LactogenRumusan
Bayi (0-12 bulan)
1.8kg 508 10.5 26.0 58.0 57.80
NAN Pro® 1Rumusan
Bayi (0-12 bulan)
1.3kg 519 9.6 27.7 57.8 129.60
3. FonterraAnmum Infacare
Langkah 1
RumusanBayi (0-12 bulan)
900g 507 13.1 25.9 55.2 85.70
4. Abbott Similac 1Rumusan
Bayi (0-12 bulan)
900g 512 10.6 28.1 52.9 112.90
SPESIFIKASI SUSU RUMUSAN BAYI (NORMAL)
Bil Syarikat Nama Kategori Berat Tenaga/ hidangan (kcal)
Protein/100g
(g)
Lemak/ 100g (g)
Karb/ 100g (g)
Harga (RM)
5. Dumex
Dupro 1Rumusan Bayi (0-12 bulan)
900g 487 10.2 23.8 56.3 27.30
Mamex Cherish
Rumusan Bayi (0-12 bulan)
1.5kg 497 10.5 26.1 52.0 158.80
Babelac Langkah 1
Rumusan Bayi (0-12 bulan)
800g 487 10.5 23.9 56.2 47.80
6.Dutch Lady
Frisolac 1 Rumusan Bayi (0-12 bulan)
900g 505 10.8 27.0 53.6 81.50
Dutch Baby Langkah 1
Rumusan Bayi (0-6 bulan)
1.3kg 505 10.6 27.0 54.5 34.95
7.Mead
Johnson
Enfalac A+ Rumusan Bayi (0-12 bulan)
1.3kg 510 10.7 27.0 57.0 154.60
Enfalac Langkah 1
Rumusan Bayi (0-12 bulan)
650g 520 11.0 30.0 53.0 51.60
SPESIFIKASI SUSU RUMUSAN BAYI (PRA-MATANG)
Bil Syarikat Nama Kategori Berat Tenaga/ hidangan (kcal)
Protein/100g
(g)
Lemak/ 100g (g)
Karb/ 100g (g)
Harga(RM)
1. Nestle PreNAN ® Rumusan Khas
400g 498 14.4 25.9 53.2 28.90
2. DumexMamex Premature
Rumusan Khas
400g 477 15.6 22.9 49.8 33.10
3.Mead Johnson
Enfalac A+ Pramatang
Rumusan Khas
400g 480 14.7 25.0 54.0 47.80
SPESIFIKASI SUSU RUMUSAN BAYI (POST-DISCHARGE)
Bil Syarikat Nama Kategori Berat
Tenaga/
hidangan
(kcal)
Protein/100g
(g)
Lemak/ 100g
(g)
Karb/ 100g (g)
Harga(RM)
1. AbbottSimilac
Neosure Rumusan
Khas900g 513 13.3 28.2 52.8 69.90
2.Mead
Johnson
Enfalac A+ Post
Discharge
Rumusan Khas
900g 500 13.5 27.0 52.0123.2
0
PEMATUHAN TERHADAP TATA ETIKA PEMASARAN PEMAKANAN BAYI DAN PRODUK BERKAITAN
• Sebelum preskripsi klinikal dibuat, Pakar Pediatrik/ PakarPerubatan Keluarga/ Pegawai Perubatan harus melakukankaunseling/ penilaian berkenaan penyusuan susu ibuterhadap ibu penerima untuk memastikan jika ibu mengalamimasalah penyusuan.
• Selain itu, tatacara pemberian dan pembelian susu formulamesti mengikut Tata Etika Pemasaran Pemakanan Bayi danProduk Berkaitan. Perlu juga memastikan pendidikan diberikepada ibu tentang Prinsip AFASS (Acceptable, Feasible,Affordable, Sustainable, Safe) kerana golongan penerimakebanyakannya tidak berkemampuan dan dalam kalanganOrang Asli.
Sekian, Terima Kasih