Nutrition and Child Growth

More than half of all child deaths are associated with malnutrition,which weakens the body’s resistance to illness. Poor diet, frequent illness, and inadequate or inattentive care of young children can lead to malnutrition.

If a woman is malnourished during pregnancy, or if her child is malnourished during the first two years of life, the child’s physical and mental growth and development may be slowed. This cannot be made up when the child is older – it will affect the child for the rest of his or her life.

Children have the right to a caring, protective environment and to nutritious food and basic health care to protect them from illness and promote growth and development.

1. A young child should grow well and gain weight rapidly. From birth to age two, children should be weighed every month. If a child has not gained weight for about two months, something is wrong.
2. Breastmilk alone is the only food and drink an infant needs until the age of six months. After six months, the child needs a variety of other foods in addition to breastmilk.
3. From the age of six months to two years, children need to be fed five times a day, in addition to sustained breastfeeding.
4. Children need vitamin A to resist illness and prevent visual impairments. Vitamin A can be found in many fruits and vegetables, oils, eggs, dairy products, fortified foods, breastmilk, or vitamin A supplements.
5. Children need iron-rich foods to protect their physical and mental abilities. The best sources of iron are liver, lean meats, fish, eggs and iron-fortified foods or iron supplements.
6. Iodized salt is essential to prevent learning disabilities and delayed development in children.
7. During an illness, children need to continue to eat regu- larly. After an illness, children need at least one extra meal every day for at least a week.

Importance of weight gain in a child

A young child should grow well and gain weight rapidly. From birth to age two, children should be weighed every month. If a child has not gained weight for about two months, something is wrong.

Regular weight gain is the most important sign that a child is growing and developing well. The child should be weighed during every visit to a health centre.

A child who is given only breastmilk for about the first six months usually grows well during this time.Breastfeeding helps protect babies from common illnesses and ensures good physical and mental growth and development. Infants who are not breastfed may not learn as easily as breastfed infants.

If a child does not gain weight for two months, he or she may need larger servings or more nutritious food,may be sick or may need more attention and care.Parents and health workers need to act quickly to dis-cover the cause of the problem.

Each young child should have a growth chart. The child’s weight should be marked with a dot on the growth chart each time he or she is weighed, and the dots should be connected after each weighing. This will produce a line that shows how well the child is growing. If the line goes up, the child is doing well. A line that stays flat or goes down indicates cause for concern.

If a child is not regularly gaining weight or growing well, there are some important questions to ask:

• Is the child eating often enough?A child needs to eat three to five times a day. A child with disabilities may require extra help and time for feeding.
• Is the child receiving enough food?If the child finishes his or her food and wants more, the child needs to be offered more.
• Do the child’s meals have too little ‘growth’ or ‘energy’ foods? Foods that help the child grow are meat, fish, eggs, beans, nuts, grains and pulses. A small amount of oil will add energy. Red palm oil or other vitamin-enriched edible oils are good sources of energy.
• Is the child refusing to eat? If the child does not seem to like the taste of a particular food, other foods should be offered. New foods should be introduced gradually.
• Is the child sick? A sick child needs encourage- ment to eat small, frequent meals. After an illness,the child needs an extra meal every day for a week.Young children need extra breastmilk for at least a week. If the child is frequently ill, he or she should be checked by a trained health worker.
• Is the child getting enough foods with vitamin A to Prevent illness? Breastmilk is rich in vitamin A. Other foods with vitamin A are liver, eggs, dairy products, red palm oil, yellow and orange fruits and vegetables, and many green leafy vegetables. If these foods are not available in adequate amounts, as is the case in many developing countries, a child needs a vitamin A capsule twice a year.
• Is the child being given breastmilk substitutes by bottle? If the child is younger than six months,exclusive breastfeeding is best. From 6 to 24 months breastmilk continues to be the best milk as it is an important source of many nutrients. If other milk is given, it should be fed from a clean, open cup,rather than from a bottle.
• Are food and water kept clean? If not, the child will often be ill. Raw food should be washed or cooked. Cooked food should be eaten without delay.Leftover food should be thoroughly reheated.
  Water should come from a safe source and be kept clean. Clean drinking water can be obtained from a regularly maintained, controlled and chlorinated piped supply. Clean water can also be obtained from a tubewell, handpump, protected spring or well. If water is drawn from ponds, streams, springs, wells or tanks, it can be made safer by boiling.
• Are faeces being put in a latrine or toilet or buried? If not, the child may frequently get worms and other sicknesses. A child with worms needs deworming medicine from a health worker.
• Is the young child left alone much of the time or in the care of an older child? If so, the young child may need more attention from adults and more stimulation, especially during meals.

Importance of Breastmilk

Breastmilk alone is the only food and drink an infant needs until the age of six months. After six months, the child needs a variety of other foods in addition to breastmilk.

In the early months, when the baby is most at risk, exclusive breastfeeding helps to protect against diar-rhoea and other common infections. By about six months, a child needs other types of foods and drinks.Breastfeeding should continue into the second year.

If an infant under six months of age is not gaining weight, he or she may need to breastfeed more frequently.

• A breastfed infant under six months needs no other fluids, not even water.
• A breastfed infant who is not gaining weight may be ill, or may not be getting enough breastmilk. A health worker can check the infant’s health and counsel the mother on how to increase the infant’s intake of breastmilk.

Starting at about six months of age, infants need other foods, called complementary foods, in addition to breast-milk. The child’s diet should include peeled, cooked and mashed vegetables, grains, pulses and fruit, some oil,as well as fish, eggs, chicken, meat or dairy products to provide vitamins and minerals. The greater the variety of foods, the better.

• Babies aged 6 to 12 months should be breastfed frequently and before being given other foods.
• After six months of age, the risk of infection increases as the child begins to eat other foods and starts to crawl. Both the child’s hands and the child’s food should be kept clean.
• Children aged 12 to 24 months should continue to breastfeed after meals and whenever they wish.

Feeding a child during the age - 6 months - 2 years

From the age of six months to two years, children need to be fed five times a day, in addition to sustained breastfeeding.

• Poor nutrition in the first two years can slow a child’s physical and mental development for the rest of her or his life.
• In order to grow and stay healthy, young children need a variety of nutritious foods such as meat, fish, pulses, grains, eggs, fruits and vegetables, as well as breastmilk.
• A child’s stomach is smaller than an adult’s, so a child cannot eat as much at one meal. But children’s energy and body-building needs are great. So it is important that children eat frequently to provide for all their needs.
• Foods such as mashed vegetables, a little chopped meat, eggs or fish should be added to the child’s food as often as possible. A small amount of oil may be added, preferably red palm oil or another vitamin-enriched oil.
• If meals are served in a common dish, younger children may not get enough food. Young children should have their own plate or bowl of food to ensure they can eat what they need and so the parent or caregiver can see how much they have eaten.
• Young children may need encouragement to eat and may need help in handling food or utensils. A child with a disability may need extra help eating and drinking.

Importance of Vitamin A

Children need vitamin A to resist illness and prevent visual impairments.Vitamin A can be found in many fruits and vegetables,oils, eggs, dairy products, fortified foods, breastmilk, or vitamin A supplements.

• Until children are six months of age, breastmilk provides them with all the vitamin A they need, provided the mother has enough vitamin A from her diet or supplements. Children six months and older need to get vitamin A from other foods or supplements.
• Vitamin A can be found in liver, eggs, dairy products, fatty fish liver oil, ripe mangoes and papayas, yellow sweet potatoes, dark green leafy vegetables and carrots.
• When children do not have enough vitamin A, they are at risk of night blindness. If the child has difficulty seeing in the early evening and at night, more vitamin A is probably needed. The child should be taken to a health worker for a vitamin A capsule.
• In some countries, vitamin A has been added to oil and other foods. Vitamin A is also available in capsule or liquid form. In many countries vitamin A capsules are distributed once or twice a year to all children between six months and five years of age.
• Diarrhoea and measles deplete vitamin A from the child’s body. Vitamin A can be replaced by more frequent breastfeeding and, for children older than six months,by feeding the child more fruits and vegetables, eggs,liver and dairy products. Children with diarrhoea that lasts for more than 14 days and children with measles should be given a vitamin A capsule obtained from a health worker.

Importance of iron-rich foods

Children need iron-rich foods to protect their physical and mental abilities.The best sources of iron are liver,lean meats, fish,eggs and iron-fortified foods or iron supplements.

Anaemia – a lack of iron – can impair physical and mental development. Symptoms of anaemia include paleness of the tongue, the palms of the hands and the inside of the lips, tiredness and breathlessness.Anaemia is the most common nutritional disorder in the world.

• Even mild anaemia in infants and young children can impair intellectual development.
• Anaemia in children under two years of age may cause problems with coordination and balance, and the child may appear withdrawn and hesitant. This can limit the child’s ability to interact and may hinder intellectual development.

Anaemia in pregnancy increases the severity of haemorrhage and the risk of infection during birth and is therefore a significant cause of maternal mortality.Infants born to anaemic mothers often suffer from low birth weight and anaemia. Iron supplements for preg-nant women protect both women and their babies.

Iron is found in liver, lean meats, eggs and Pulses.Fortifying foods with iron also prevents anaemia.Malaria and hookworm can cause or worsen anaemia.

• Malaria can be prevented by sleeping under a mosquito net that has been treated with a recommended insecticide.
• Children living in areas where worms are highly endemic should be treated two to three times a year with a recommended antihelminthic medication.Good hygiene practices prevent worms. Children should not play near the latrine, should wash their hands often and should wear shoes to prevent worm infestations.

Importance of use of Iodised salt

Iodized salt is essential to prevent learning disabilities and delayed development in children.

• Small amounts of iodine are essential for children’s growth and development. If a child does not get enough iodine, or if his or her mother is iodine-deficient during pregnancy, the child is likely to be born with a mental,hearing or speech disability, or may have delayed physical or mental development.
• Goitre, a swelling of the neck, is one sign of a shortage of iodine in the diet. A pregnant woman with goitre is at high risk of miscarriage, stillbirth or of giving birth to a child with brain damage.
• Using iodized salt instead of ordinary salt provides pregnant women and children with as much iodine as they need. If iodized salt is not available, women and children should receive iodine supplements from a health worker.

Feeding a child during and after an illness

During an illness,children need to continue to eat regularly. After an illness, children need at least one extra meal every day for at least a week.

• When children are sick, especially when they have diarrhoea or measles, their appetite decreases and their body uses the food they eat less effectively. If this happens several times a year, the child’s growth will slow or stop.
• It is essential to encourage a sick child to eat. This can be difficult, as children who are ill may have no appetite. It is important to keep offering foods the child likes, a little at a time and as often as possible. Extra breastfeeding is especially important.
• It is essential to encourage a sick child to drink as often as possible. Dehydration is a serious problem for children with diarrhoea. Drinking plenty of liquids will help prevent dehydration.
• If illness and poor appetite persist for more than a few days, the child needs to be taken to a health worker.The child is not fully recovered from an illness until he or she weighs about as much as when the illness began.

Source: Portal Content Development Team