•Searching for undernourished, underweight children among poorer socio economic groups and families.
•Monitoring their growth.
•Underweight, undernourished children to receive measles vaccine at 6-8 months.
•Provide another dose after completion of 9 months of age.
•Asses nutritional status of children infected with Measles.
•Counsel the parents about nutritional inputs, Measles complications, growth monitoring and growth faltering.
•Take follow up visits and ensure protection and proper growth of these children.
Average Height and Weight at different Ages (ICMR (Boys) ).
Biology of under nutrition
•Under nutrition is widely prevalent among socially and economically deprived population groups around the world. Cluster of factors responsible:
-Inadequate income level
-Diets quantitatively and qualitatively deficient
-Poor environment, poor access to safe water
and poor sanitation
-Poor access to health care
-High levels of female illiteracy.
•Nutritional status depends on nutrition's availability at cellular level. Diets providing essential nutrients, Absorptions, utilisation and activity level and environmental factors like infections and stress situations.
•Under 5 constitutes the most sensitive segment of the population from the point of view of nutritional vulnerability.
Growth Retardation
•The minimal role of genetic factor.
•The differences in growth patterns are mostly attributable to differences in their socioeconomic status and not to genetic differences.
•The genetic potential for growth and development is nearly similar among most peoples of the world.
•There is often a linear relationship between the degree of growth retardation and the degree of physical and mental functional impairment.
•In Japan between 1957 and 1977 average mature height increased by 4.3 cm in males and 2.7cm in females. Practically all the height increase was due to increase in leg length, not in sitting height, with the result that within 20 years of economic advancement the entire body proportions of the Japanese had changed.
Child survival
• Regular nutritional assessment of mothers and under 5 is a must on the part of MCH workers.
• If under nourished status of a child is not corrected within 5 years, the child will get stunted.
• It can never be intervened and corrected beyond that age.
• MCH supervisors must become skilled in nutritional assessment and counseling so that they train their workers in the field.
• Child survival will be ensured only when you care to provide all the inputs:
Immunisation
Nutritional inputs
Health care
Female literacy
But where do we stand now?
