Nutrition norms issued to tackle severe acute malnutrition

• The National Technical Board on Nutrition (NTBN) has approved guidelines proposed by WCD Ministry for severe acute malnutrition.
• The measures are part of the community-based health management of children suffering from SAM.

Important guidelines:

• The guidelines outline the role of anganwadi workers and auxillary nurse midwives (ANMs) in identifying severely wasted children, segregating those with oedema or medical complications and sending them to the nearest health facility or nutrition rehabilitation centres.
• The remaining children are enrolled into “community based management”, which includes provision of nutrition, continuous monitoring of growth, administration of antibiotics and micro-nutrients as well as counselling sessions and imparting of nutrition and health education.
• Anganwadi workers have to provide modified morning snacks, hot cooked meals and take home ration for SAM children.
• The morning snacks and hot-cooked meals, which are served at anganwadis to children between the age of three to six years, should be “prepared freshly and served at the centralised kitchen/ anganwadi centres. Locally available cereals, pulses, green leafy vegetables and tubers, vitamin C rich fruits, as well as fresh milk and 3-4 eggs every week” have also been prescribed.
• It is also suggested that local self-help groups, mothers or village committees be engaged for the preparation of these meals.
• Similarly, the take home ration, which is given to children between the ages of six months and three years, has to be prepared from “locally available and culturally appropriate food ingredients”. Use of extra oil/ ghee in these food items is also suggested in order to ensure these are “energy dense”.
• The emphasis on freshly prepared food as well as locally procured ingredients clears the air on differences within the government on what form of food should be given at anganwadis
• The government has also revised the method to be used to measure wasting and advised calculating weight based on the height of children instead of the mid-upper arm circumference.

What is severe acute malnutrition?

• Severe acute malnutrition is the most extreme and visible form of undernutrition. Its face is a child – frail and skeletal – who requires urgent treatment to survive.
• Children with severe acute malnutrition have very low weight for their height and severe muscle wasting. They may also have nutritional oedema – characterized by swollen feet, face and limbs. About two thirds of these children live in Asia and almost one third live in Africa.
• Severe acute malnutrition is a major cause of death in children under 5, and its prevention and treatment are critical to child survival and development.

By: Vishal