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28 nutrition

  1. 1. 28-1NUTRITION
  2. 2. 28-2 NUTRITIONWhat should we eat to remain healthy? The amount of food may differ from person to person –depending upon age, sex , activity, likes and dislikes and a person’s ability to buy. The diet alsovaries from community to community. Any diet can help us to keep healthy as long as it is aBalanced Diet.A Balanced Diet has a right mix of different types of foods that are needed to grow properly,work actively and to avoid illnesses. It should be able to provide us energy to keep our organsactive and strong. It must also help to build, maintain, repair and defend different parts of thebody. There can be four types of food - Energy Giving Food, High Energy Giving Food, BodyBuilding Foods and Protective Foods. A balanced mix of these is what makes a Balanced Diet.1. Main food (Energy Giving Food)Usually, every family eats a “main food” that it eatsin large quantities and is cheap, like rice, wheat flour,maize, potatoes and bread. They help our body keepwarm and help the different parts of our body to work– just like the wood burns to give us fire and heat.Examples of Energy Giving Food are: Rice, Wheat, Maize ( or corn) , Millets Potatoes, sweet potatoes, Tapioca, Banana2. High Energy or Helper FoodThese foods also provide energy but in more quantity. Fats and sugars are examples. If we eat toomuch of Energy Giving or High Energy Giving Foods, they turn into fat in the body. On the otherhand, when more energy is needed, fats stored under the skin (mainly) are broken down to sugar.Fats give three times more energy than energy giving foods. Examples of High Energy Foods are:Fats : Oil, Ghee, Butter, Vanaspati Ghee(‘Dalda’)Fat rich foods : Nuts, Oil seeds, Soyabeans,PorkSugar : Sugar, Jaggery (Gur), Honey3. Body Building Foods (Proteins)Proteins build muscles and the structures of most other parts of the body including the brain.They also form other parts of the body including the blood and are important to fight germs anddiseases.Main foods like rice and wheat also have protein butdo not have enough for the body’s daily needs. Ide-ally, at least one of the Body Building Foods must formpart of the diet.Animal sources : Milk, eggs, fish, cheese, mutton, pork, beef, dogmeat, etc.Plant sources : Soybeans (‘Nutrella’ or ‘NutriNuggets’), Groundnuts, peas, nuts, etc.How much Protein do we need? What has how much proteins?We need about 1 gram of protein everyday for While milk has 3.5% protein (8.5 grams in every 250 mlevery kilo of our body weight after we grow or glass full), rice has only 7% of protein, wheat and attaup. As a child we need about 2 grams of pro- have only 10 % and Daals have 16 to 18%. Meat also hasteins everyday and when adolescent, we need about 18 to 20%, while Soybeans has 40.0 %. Meat pro-about 1.5 grams every day. An average adult tein is absorbed more easily into our body. Soybeans chunksneeds 60 and an average woman will need 50 ( brand name of ‘Mealmaker’/’Nutrella,’ and ‘Nutri-Nug-grams of protein every day. gets’ have about 55%!
  3. 3. 28-34. Protective Foods(Vitamins and Minerals)Vitamins Where Vitamins Are FoundThey are protective foods that help to make our or-gans work properly. We may get sick because of lessVitamins in our diet. There are different kinds of Vi-tamins. Vitamin A, Vitamin D and Vitamin E can getstored in the body and it may be harmful to take toomuch of these when there is no need. Vitamin B andVitamin C can get washed away with the urine. It isa waste of money to give more Vitamin B Complexand Vitamin C than is needed. * Vitamin A is found in spin-Minerals ach, dark leafy vegetables, pumpkin,Minerals are important to make tomatoes, carrots, etc.healthy bones and blood and teeth. * Vitamin B Complex isIron, Calcium, and Iodine are some found in leafy vegetables, milk, eggs,minerals needed for the body. meat, fruit and some within our* Iron is needed for Blood and bodymuscles. It is found in green leafy veg- * Vitamin C isetables, liver, Jaggery and tamarind, etc. found in guava* Iodine is needed for growth and is found in soil, (amrood or peda),water and fruits/vegetables. gooseberry, lemons, oranges, etc.* Calcium is needed for strong bones and teeth and isfound in milk, meat and green leaves. * Vitamin D is made by ex- posing the skin to sunlight just 15 minutes a day. It can also be found in liver (codliver oil) A Balanced Diet would have 4 parts of Main Food, 4 parts of Body Building foods, 2 parts of fat and enough minerals & Vitamins Lean meat has a lot of protein. When eating meat, make sure that you eat more lean meat than the fat. Tips for a Healthy Diet Eat fresh raw vegetables Keep fresh vegetables in a cool place so that the nutreints are not lost Wash before peeling & chopping. Avoid washing chopped vegetables to save the some minerals and vitamins which gets washed away with water. Peel vegetables as thinly as possible we waste a lot of vitamins & minerals which are in the peels. Cook food with lid or better still, in pressure cookers. Avoid overcooking and reheating the vegetables.
  4. 4. 28-4 Low Cost Foods: Cheaper ways to be healthy1. Breast Milk – At no cost to the baby or the mother, breast milk is a complete food for the baby up to 6 months of her age.2. Fish/Snails/Crabs – If cheap or caught by oneself, these are good sources of protein. Be sure of washing them very well.3. Eggs - Eggs can be one of the most cheap and good forms of proteins. They may be given to small children who cannot get milk. Eggshells can be cleaned, crushed well and mixed with food as a good source of Calcium for babies and mothers.4. Liver, heart, kidney, meat (pork/beef/mutton) - They are high in protein, vitamins and minerals like iron. If cheaply available, they are good for protein. 5. Rice and wheat – As most of our village people are farmers, they try to eat lots of rice in their diet to get even their daily needs of proteins from rice and wheat. However, for women and children who do not eat as much quantities, the diet does not give enough protein for a balanced diet. Different cereals (rice, wheat etc are called cereals) must be mixed. One should rotate the diet by alternating rice with wheat. 6. Daal/ lentils – Usually they are cheap sources of protein as compared to meat which has an equal concentration of protein. Peas, Moong, Masur, Urad , Arhar and other daals are almost as good as meat in quality but mush cheaper. If allowed to sprout, they give lots of vitamins also.7. Dark green leafy vegetables – They have Iron and lots of Vitamin A. Spinach, leaves of beans, peas and mustard are good sources of Iron and Vitamin A. ( Light green leafy vegetables like cabbage are poor nutritionally). Even daals and green leafy vegetables should be rotated to get the different varieties of necessary foods.8. Fruits – Sour fruits like Amla (gooseberry), and oranges, lemons, etc have a good amount of Vitamin C. Yellow and red fruits like Mangoes and Papayas have large amounts of Vitamin A. All fresh and dry fruits give vitamins and minerals. Sour fruits help to im- prove the absorption of Iron into the body. Iron is added to the food when it is cooked in Iron vessels. Jaggery also gets its Iron this way. When you have money, buy food It is cheaper and better to buy fruits, eggs and other nutritious foods than to take pills, cap- sules, tonics or injections.
  5. 5. 28-5 SPECIAL DIET FOR PREGNANT WOMEN AND BREASTFEEDING WOMENWould-be mothers and breastfeeding mothers need to take special care of their diets because theyare responsible for the nutrition of another person, their child. Fathers need to encourage them. Nutrition For Pregnant And Breastfeeding Mothers Their diet must have a combination of energy foods like rice, wheat, etc., proteins or body building foods like daal,beans, soyabeans, eggs or meat, etc and green leafy vegetables with oil or sugar for extra energy. The extra energy that women get from such a diet during pregnancy gets stored as fat and can be used to make milk for the baby. Roughly, a preg- nant woman needs one and a half times her normal diet and a breastfeeding woman needs about two and a half times that of a normal woman. See Page 28-14 for details on extra diet of women who are preg- nant or breastfeeding. Am nm yd h a yw r ,b taw m nw r sl n e a a o ev ok u oa ok ogr h u s T e w r e u l ya dn e e u la o n so f o . or. hy ok qal n ed qa mut f od
  6. 6. 28-6 Nutrition for ChildrenFirst four monthsFor the first four months, NOTHING If child cannot be breast-fedbut mother’s milk should be given. If it is needed to give the child some milk, use goat, cow or buffalo milk. It will have to be prepared for the smallÖ Anything given to a newborn child in the manner as given below:– like honey, sugar, tea, etc. – will sat-isfy her hunger. This will make herlazy enough not to suck strongly atthe mother’s breast. This leads tolesser milk coming out from themother’s breast. The more the child Do Not use Milk Bottlessucks, the more the milk in the breast. It is better to use a spoon and cup to feed the child.Ö If there is no money to buy DO NOT USE BOTTLESmilk, or no milk is available, you may and nipples – they need torequest another mother to feed a be boiled EVERYTIME tochild. It is an age-old practice in be cleaned properly or elsemany communities. She may be they can lead to diarrhoeasgiven food and help for her services. that can kill the baby.Ö You may also help the mother to cook rice, daal, some vegetables, (a bit of egg if no daal)together. Mash together and add boiled water to give as a liquid.4 months to a year All food that an adult needs (as discussed elsewhere in this session) can be mashed and given as semi-solid food. Remember that small children have a small stomach. Feed her often and give as much as she can take five to six times every day. Continue giving the breast milk. Boil the water that the baby drinks. Keep the babies and their surroundings clean Complete their immunisation so that their nutrition does not suffer a setback.1 year and aboveEvery food item that anadult eats may be givento a child also.
  7. 7. 28-7DISEASES OF NUTRITIONWhat you will learn in this chapter 1. Mild Malnutrition 28-8 2. Dry Malnutrition 28-9 3. Wet Malnutrition 28-9 4. Goitre 28-10 5. Vitamin A Deficiency 28-10 6. Anaemia 28-11 7. Rickets 28-11 8. B Complex Deficiency 28-11 9. Measuring Children 28-12 10. Height-Weight Table 28-13 10. Balanced Indian Diet 28-14
  8. 8. 28-8 MALNUTRITIONIf a person does not eat enough items of different parts of a BALANCED diet, she is likely to getdisease. When nutrition suffers, one calls it Malnutrition.A person who is very fat is also suffering from as much malnutrition as one who has too littleweight. Yet, it is malnutrition of the second kind that we are more bothered about. It kills childrenby exposing them to other illnesses. A malnourished child may not be able to fight diseases well.Besides she may take far longer to get well than other children. To avoid malnutrition, we need tomake people aware of the need to eat enough and to eat a balanced diet if possible. (Refer to thesession on Nutrition on Page 28-2)General Malnutrition What will happen if a child does not get enough nourish-When the amount of energy or ment?proteins is not enough in the diet, Malnutrition because of getting less amounts of specifica person is likely to get general foods or components of diet can also lead to different dis-malnutrition. It may be different eases. For example, Iron deficiency Anaemia, Goitre due toif only one or two minerals or Vi- less Iodine and Rickets because of less Vitamin D. Thesetamins are less in the diet. Before have been discussed elsewhere in the session.we discuss illnesses due to thelack of some specific items in thefood, let us discuss general mal-nutrition, also called Protein – Why do we get Malnutrition?Energy – Malnutrition or P.E.M. Many children - and adults too – get malnutrition because they do not get enough to eat compared to what their body requires. Either they work too hard and get too little wages to buy enough food, or have too large a family to feed or they live in such unhealthy conditions that they keep fall- ing ill and the body can never cope with the demands of illness. Malnutrition Of Children Mild malnutrition More than half of all children in India are found to have malnutrition, in other words their height or weight is below the average normal of their age ( Refer to the table on Average height and weight for age for Indian children on Page 28- 13). Mild malnutrition means that the child simply does not grow or gain weight as a normal child. She may not be ‘sick’ but cannot fight disease as well as others and takes time to return to normal once illness has struck. Such children suffer commonly from coughs, colds and diarrhoeas. They are prone to pneumonia and serious illnesses like Measles, TB and others too. That is why we need to identify such children at the earliest, ensure that they are immunized and give them better diets that will bring them back to normal. Regular weighing of children or measuring the middle upper arm is a good way of checking for malnutrition
  9. 9. 28-9 Severe malnutritionSevere malnutrition occurs commonly in those babies who do not get enough high energy foodsoften, or those who stopped breastfeeding too early. The severe malnutrition starts when achild has a prolonged diarrhoea, cough or measles, etc. Even without measurements, we canidentify such babies who may have either Dry Malnutrition or Wet Malnutrition. 1. Dry Malnutrition 2. Wet malnutrition (Marasmus) (Kwashiorkar)This is due to the child not getting enough to This is due to the child not getting enough pro-eat. The child is always hungry, has the face of teins in foods like daal, eggs, meat and milk toan old woman, has a potbelly, and the arms eat. The malnutrition is called “Wet” because theand legs are very thin. On weighing the weight feet and hands along with theof the child is not even 60% of the weight for face are swollen.age of the child (refer Table). Just bones and skin, such chil-Usually such chil- dren are usually between 6dren start getting months and 2 years and aremalnutrition be- seen in very poor families.tween the ages ofages of 1 and 4 years. The child is unhappy, cries and has no interest in eating.The child is alert, her The skin is pale and may havehair is thin but nor- patches. The hair is also pale,mal and she shows brownish and thin enough togreat interest in eat- break off.ing.TO TREAT SEVERE MALNUTRITION 1. The child must eat 5 to 6 times every day. 2. Give ALBENDAZOLE to get rid of worms in the child. 3. A mixture of energy foods and growth foods must be given. 4. Food must be well cooked and mashed to help digestion. Add a little oil or fat to it. Khichdi or daal & rice cooked together with some oil in it is good for health. 5. If possible give eggs to the person. 6. Refer the child to a doctor : · those who do not eat at all. · Those who do not gain weight even after giving ALBENDAZOLE. · Those with repeated infection like diarrhoea, pneumonia, etc. · Those with eye damage due to Vitamin A being less. 7. Complete their immunization for age at the earliest. 8. You will learn to make home-made food that can bring back mal- nourished children back to health. Please teach women to make this special food at home. After 1 year of age, any child whose upper arm is less than 13.5 cms around is malnourished. If it is less than 12.5 cms, she is severely malnourished.
  10. 10. 28-10Malnutrition due to specific items being less in the dietThe most important of these would be : Goitre if Iodine is less in diet Eyes and skin problems if Vitamin A is less Anaemia due to less Iron or Proteins in diet Rickets if Vitamin D is less Neck swells Skin and other problems with Vitamin B Complex being less. in Goitre1. GoitreGoitre is a swelling on the throat that results from an abnormal growth of the thyroid gland.Usually it happens because of less Iodine in the diet. It is common in mountainous areas or foot-hills because the soil and the water have very little Iodine in it. Eating too much of tapioca orcabbage can also make a person get Goitre.If a mother has less Iodine (sometime she may not even show a goitre on her neck) her babies maydie or be born with mental problems or deafness.Iodised salt must be taken in all such areas where Iodine is less or where Goitre is commonly seen.Eating crabs may also help avoid goitre. Iodised salt maybe costlier but it may be able to savechildren from mental illnesses.2. Vitamin A deficiencyVitamin A deficiency is very common amongst youngchildren. The reason mainly is that the diet lacks foodswith Vitamin A like dark green leafy vegetables, car-rots, pumpkins, beetroot, papaya, mango, liver, eggs, etc. Foods rich in Vitamin ASigns of less Vitamin A are:Eyes SkinThe child may not be able to see well The skin dries up, cracks and the outer layer mayin the dark – called night blindness. peel off. Skin infections and wounds may be seen.She may not be able to see in the darkas well as other people. Other signs of Less Vitamin ALater, the white part of the eyes dries Infections of other parts of the body also becomeup. It loses its shine and wrinkles may common when stores of Vitamin A in the body arebe seen on it. Small bubbles may also finished. The body’s protective powers are lost.be seen (called Bitot’s spots). With Diarrhoeas get commoner while infections of themore deficiency of Vitamin A, even lungs may lead to repeated Bronchitis andthe cornea may dry, become soft and Pneumonias. Vitamin A deficiency is known to causeburst! Measles and TB. To AVOID Vitamin A deficiency Give more green leafy vegetables, carrots, papaya, pumpkin, liver and eggs etc.. Give 2,00,000 (2 lakh) Units of Vitamin A every six months (one 2 ml spoon or one capsule) to every child above one year age and 1,00,000 (1 lakh) units every six months to those be- low 1 year age. To TREAT Vitamin A deficiency2,00,000 units for two consecutive days may be given to cure a personwho already shows eye, skin or other signs of Vitamin A deficiency. Excess of Vitamin A may lead to fits and rarely to death. Check the doses and your spoon size before giving the Vitamin A.
  11. 11. 28-113. AnaemiaAnaemia has already been discussed inManual II Page 19-11. Usually, it is dueto less of Iron in the blood.Iron rich foods must be eaten.4. RicketsRickets is quite common in Khasis in Meghalaya and in othermountainous areas amongst babies who do not get enough Vita-min D. Rarely it may also be due to some problems since birth.Rickets means the bowing of the legs and developing other abnor-malities of bones in children who usually do not get milk or sun-light.Giving enough milk from the mother and exposing the child’sbody to sunlight even for 10 minutes daily is enough to preventVitamin D deficiency and improve Rickets.To treat severe rickets, refer to a doctor.5. B Complex deficiencyVitamin B Complex vitamin has many types. Some of the Vitamins of this group are namedand numbered, like Vitamin B1, B2, B3, B6, B12, etc.Signs of less B ComplexA dry cracked skin, swollen bellies, sores in the corners of the mouth, red sore tongue, weakness andanaemia, etc are signs of Vitamin B Complex deficiency.Food with B Complex Vitamins Vitamin B12 is a type of B Com-Vitamin B can be got from vegeta- plex Vitamin and is very importantbles, fruit, milk and sprouted daals/ to make blood. It is found only fromgram, meat, eggs, etc. animal sources. Hence for thoseInstead of taking medicines for this, who are vegetarian, it is importanteat beans, daal, groundnuts or fish, to take milk or milk products likeeggs and meat to cure or avoid this curds or cheese, etc. Less Vitamintype of malnutrition. B12 can lead to serious Anaemia and problems of the nerve system.
  12. 12. 28-12 Learning to Measure Children 1. Measuring the Upper Arm After 1 year of age, any child whose up- 0 cm per arm is less than 13.5 cms around is malnourished. If it is between 12.5 to 13.5 cm is mildly malnourished. If the arm of any child is less than 12.5 cms, she is severely malnourished. Thin arms of childrenTOO THIN tell of malnutrition. 2. Weight and Height Measure the upper The weight and height of children can arm of children with also be measured to know if they are de- a special tape. The veloping well. exact size of the tape is given alongside. Compare the height and weight with the normal chart given. The chart can be put up on the walls of your house or in the school and the height of children can be measured. If you do not have the facility for weigh- 12 ½ cm ing children, then some arrangement can be made with the local health cen- tre who may come and weigh children once every three months. 13 ½ cm Growing Well
  13. 13. 28-13 HEIGHT-WEIGHT TABLE FOR INDIAN CHILDREN Age Girls Boys Height (in Weight Height Weight cm) (in kg) (in cm) (in kg) At birth 48.00 2.76 47.95 2.98 1 month 53.20 3.82 53.85 3.92 2 months 55.60 4.30 56.75 4.65 3 months 58.80 5.25 59.90 5.63 6 months 63.90 6.83 65.10 7.14 9 months 68.40 7.37 68.95 8.05 1 year 72.80 8.45 72.90 8.90 1 & half years 79.10 9.55 79.00 10.05 2 years 82.40 10.30 84.10 11.53 2 & half years 86.80 10.92 86.65 11.80 3 years 87.80 11.90 90.80 12.50 3 & half years 91.50 13.26 91.70 13.15 4 years 96.60 15.10 95.00 14.60 4 & half years 99.15 16.20 100.40 15.22 5 years 103.00 17.00 104.00 17.60 6 years 111.60 18.50 114.10 18.90• Each Foot 7 years 118.40 20.50 119.20 21.00has 30 cms: so 8 years 124.80 22.80 124.50 23.90150 cms is 9 years 127.00 24.00 130.00 25.50equal to 5 feet. 10 years 135.30 27.50 134.00 27.50 11 years 139.50 31.00 140.00 31.00• Each inch 12 years 146.00 34.80 144.00 34.30has 2.5 cms: so 13 years 152.80 42.50 153.50 41.5010 cms is equal 14 years 153.00 46.00 156.30 44.00to 4 inches 15 years 156.50 46.30 164.80 48.40 ¨ These are averages only. Heights and weights within a range of 10% percent less or more or these aver- ages can be said to be NORMAL. For figures beyond the ten percent, we must look for a reason or seek medical help. ¨ If someone’s weight is found to be between 75 and 90% of the normal weight as above, it would be called MILD MALNUTRITION. ¨ If someone’s weight is found to be between 60% and 75 % of the normal weight as above, it would be called MODERATE MALNUTRITION. ¨ If someone’s weight is found to be less than 60% of the normal weight as above, it would be called SEVERE MALNUTRITION.
  14. 14. DAILY INDIAN BALANCED DIET ( All weights are in grams) S. Food Item ADULT MAN ADULT WOMAN CHILDREN BOYS GIRL N (In years) S o Light Mode-rate Heavy Light Mode-rate Heavy 1-3 y 4-6 y 6-12 y 6-12 y work work work work work work 1. Rice, wheat, Atta, 460 520 570 410 440 575 175 270 420 380 maize, etc 2. Daal, gram, rajma, 40 50 60 40 45 50 30 35 45 45 beans, etc (or Meat/ fish) 3. Green leafy 40 40 40 50 50 50 40 50 50 50 vegetables 4. Other vegetables 60 70 80 40 70 100 20 30 50 50 5. Potatoes, Tapioca, 50 60 80 50 50 60 10 20 30 30 other tubers 28-14 6. Milk 150 200 250 100 150 200 300 250 250 250 7. Ghee, oil, Vanaspati 40 45 65 20 25 40 15 25 40 35 (‘Dalda’), butter, etc 8. Sugar, jaggery, etc 30 35 55 20 20 40 30 40 45 45Extra diet for pregnant women and breastfeedingwomen (apart from the amount given in table above) Note FOOD ITEM Pregnant During * Meat eating people can substitute 50 gms of Daal with 50 gms of woman breastfeeding Meat or fish or 2 eggs. In such diets, 10 gms of oil may be lessened.Rice, wheat, Atta, Maize, etc 35 gms 60 gmsDaal (lentils like Moong, 15 gms 30 gms 1 ml = 15 dropsMasur, Urad, Chana, etc.) Roughly 1 teaspoon = 5 ml or 5 gmsMilk 100 ml 100 mlGhee/ Oil - 10 gms Roughly 3 tablespoon (or dinner spoons) = 15 ml or 15 gmsSugar/ Jaggery 10 gms 10 gms 1 cup = 200 ml or 200 gms 1 glass= 250 ml or 250 gms
  15. 15. 28-15 Know the Answers Nutrition & Nutrition DiseasesI. Please fill in the blanks: 1. The four types of foods needed to make a Balanced Diet are: a) ______________________ b)___________________________ c)_______________________ d)___________________________ 2. The difference between Energy Giving foods and High Energy giving foods is that the first type is _______________ and people eat them in large amounts. The second type has __________ or ____________ in them. 3. Proteins can be found in ________________, ___________________, ______________, _______________ and ________________. 4. _____________ and _____________ have the same amount of proteins, but _______ is much cheaper to get. 5. Vitamins can be found in ____________ and minerals like __________, __________ and __________ that are needed in small amounts every day are found in ___________________, ____________________ and ________________. 6. Pregnant women need _______________ times their normal diet and breas feeding women need roughly ______________ times their normal diet. 7. Goitre in the mother can lead to her child born with __________ and _________. 8. Iron can be got from ________ , _____________ and ___________ in our diet. 9. The difference between Dry and Wet Malnutrition is that we must give more of _______ and _______in the Dry type, while children with Wet Malnutrition can get better simply with extra _____________. Please mark right or wrong: 1. Children until the age of eight months should be given only mother’s milk. 2. Children need to eat five to six times a day. 3. If the weight of children is even lesser than 60% below the normal weight for their age as seen in the table, it means that they have mild malnutrition. 4. Severe malnutrition can be measured and treated only by a doctor. 5. Less of Vitamin A in our diets can lead to anaemia and we must take a Vitamin capsule every day to avoid it.
  16. 16. 28-15a “Special Mixture” for the MalnourishedMore than 50 percent of all children in India are found to have malnutrition. It is usually found inchildren living in villages, in urban slums and in children living on the streets in cities. As manyof these are children from poor backgrounds and illiterate parents, it is important to teach moth-ers – fathers also – how to bring children back to their normal weight.Feed one child or feed the full family?Although one expects parents to try and give special foodto their malnourished children, it is far from easy. Wecannot expect the parents to give special foods – whetherit fish or meat - only to one child in the family thoughthat child might need those extra proteins. Parents thenend up buying the ‘good’ food for everyone in the house.It gets so costly that even the patient does not get it. It becomes difficult to feed “good” food only to some children not to others. Making “special mixture” at homeOne way out of this would be to make some sort of cheap and yet protein-filled food that can begiven like a “medicine” especially to the malnourished child. This would ensure that the familycan afford it and the child gets the required proteins.Using the “Special Mixture?”This homemade “special mixture” can be made and stored. Special dishes can be made for thechild. Some ideas for making the foods are given below, you can make up new ones accordingto the taste of the child. Or else, the “special mixture” can be added to other foods that the childeats. Making the “Special Mixture” Rice (or rice) - 1kg (4 parts) Lentils (moong/urad/ masoor, etc) - 500 gms. (2 parts) Groundnuts - 250 gms (1 part) 1. Roast all three items separately. Pound or grind all of them separately (or else the oil from the groundnuts will make it difficult to grind the rice). 2. Mix all the three powders. Let the mixture cool down and then store it in a dry tin or bottle. This is the “SPECIAL MIXTURE” (SM) for the malnourished. It can be given in different forms to bring back the child to good health. Note: While making SM, rice may be substituted by wheat or maize/corn. Any lentil (daal) that is locally grown may be used for roasting. As groundnuts may be costly to buy, only the other two items – rice and daal – may be roasted and ground. At the time of cooking, some oil or fat must be added.
  17. 17. 28-15bHow many times a day to give SM?SM must be given to the child in different forms five to six times aday. It is better that the child eats as much SM as possible. Give itaccording to the taste of the child. If the food with SM is madewell, the child will eat more. Recipe 1 Recipe 2 SM Sweet: Heat some clear non SM Porridge: Take a smelling oil. Heat Add equal small bowl of SM and amount of SM and stir until mild brown. Add equal quantity of mix it with hot milk Sugar and water. Keep stirring and two teaspoonfuls until the water dries up. of sugar. Recipe 4 Recipe 3 SM Horlix : Roast the SM once again SM Pooree / Roti : Mix along with half the amount of sugar. sufficient water and a Keep stirring. Cool and store. This pinch of salt in the SM to can be served dry as a sweet pow- knead some dough. Make der. Be careful in giving dry powder small balls and spread out to very small children as it might with a rolling pin. You choke them. Some hot water can be may fry this to make added to it and the child can have it pooree or bake it like any like a hot drink. other chapati or roti.
  18. 18. 28-16My Notes