Nutrition and Growth

Supporting Information

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 discover 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 encouragement 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.