Health and Nutrition
Balanced diet for the early years
Energy from cereals and fats, body-building protein from pulses, milk, egg and flesh foods, and protective vitamins and minerals from coloured fruits and vegetables. Small frequent meals suit small stomachs; avoid choking hazards and excess sugar, salt and packaged snacks.
ICDS supplementary nutrition norms
- Children 6–72 months: about 500 kcal and 12–15 g protein per day.
- Severely underweight children: about 800 kcal and 20–25 g protein.
- Pregnant and lactating women: about 600 kcal and 18–20 g protein.
Micronutrients
- Vitamin A prophylaxis: 100,000 IU at 9 months, then 200,000 IU every six months up to five years.
- Anaemia Mukt Bharat: IFA syrup twice weekly for 6–59 months; deworming with albendazole 400 mg on National Deworming Day (10 February and 10 August) for children above one year.
- Iodised salt prevents goitre and cretinism; vitamin D and sunlight prevent rickets.
Protein-energy malnutrition
Marasmus: severe wasting, 'old man' face, no oedema, appetite often preserved. Kwashiorkor: oedema, moon face, fatty liver, flaky-paint skin, apathy, poor appetite. Treatment is gradual, medically supervised feeding - not a sudden heavy diet.
Growth monitoring
The weight-for-age chart ('road to health' card) is the front-line screening tool; a flat or falling line signals faltering growth and needs referral.
Worked example
A two-year-old with swollen feet, a moon face and peeling skin has low protein intake. Reasoning: oedema plus skin changes point to kwashiorkor, not marasmus, because marasmus shows wasting without oedema.
Traps
Swapping the marasmus and kwashiorkor pictures; misquoting the vitamin A doses; treating the growth chart as a one-time record.