Nutritional Interventions for Children with MR

Rationale
While providing early intervention services to children with mental retardation (MR), MNC observed that children with mental retardation are affected by additional disabilities like cerebral palsy, autism, attention deficit hyperactive disorder, Down syndrome and epilepsy. The compounding nature of the disability in the children affects their sucking, biting, chewing and swallowing of food resulting in reduced food intake, insufficient absorption of food thereby affecting their overall growth and development.

About 70 % of the families of the children attending the Centre are from the lower socio-economic background with poor unhygienic living conditions. Coupled with this situation is their level of ignorance, due to poverty or illiteracy additionally affecting the nutrition status of the child.

Under nourishment is most damaging when it occurs in the first two years of life, its effect on the brain, physical development and vulnerability to disease is often irreversible.

It is therefore inevitable and imminent that the nutritional requirement of the children be planned and implemented forthwith, due importance also to be given to regular medical check ups for following up the progress in each child.

This nutrition plan will also prevent secondary disabilities from setting in.

Article 21 of the Constitution declares that right to food is a fundamental requirement that falls under the right to life. Ironically, India has about half the world's under-nourished children and a general decline in consumption (per capita calorie) in the last few decades. A holistic life cycle approach that begins with food security for pregnant women and ending with old or disabled persons should be a priority.

Nutritional Interventions for Children with MR

PILOT PROJECT
MNC has been a front runner in providing nutritional intervention for children and mothers attending the Centre.

Annapoorna is the Hindu deity of wholesome nourishment. ‘Anna’, means food and grains. ‘Purna’, means full, complete and perfect. The importance of, and the need for, nutritional and health intervention among these children and the parents led to the Annapoorna Project, initiated in June 2004.

Currently all children socio-economically disadvantanged background are assessed by an interdisciplinary team of experts including a paediatrician, nutritionist, special educator and physiotherapist. Periodic clinical investigations include blood test- haemoglobin, and recording of height and weight. Thirty children with pronounced deficiencies are identified for nutritional interventions, based on the specific feeding challenges and other clinical conditions in the child.

Nutritional Interventions
MNC provides the children and their mothers with a supplementary drink of ‘Sathu Mavu Kanji’ (energy drink based on a time tested recipe) in the afternoon. In the mornings a plantain is given along with ‘Sathu Mavu Powder’. Vegetable soup is given once a week. It is visualized that the supplementary nutritive food being given will prevent secondary disabilities from setting in.

Beneficiaries
The immediate beneficiaries of the programme are children attending MNC and their mothers. This has already been extended to the state Resource cum Training Centre, Chennai and all Early Intervention Centres run by the Government of Tamil Nadu, (mentored and monitored by MNC Chennai) all over the state.

Why was porridge the preferred diet?

• very satisfying, as the taste can be varied with the addition of salt, sugar or jaggery( a form of unrefined sugar, rich in iron)
• easily digested
• used as a nutrition supplement since centuries
• The main ingredients are wholesome cereals, grains and nuts grown in almost all regions of the country, even by small and marginal farmers
• available perennially
• affordable by even the poor
• easy to prepare, takes minimum time
• consistency can be varied according to the child’s needs, from semi-solid to more liquid, without compromising the quality

Annapoorna has been a one-of-a-kind micro project, conducted in-house over a sample of 30 children covered by the programme. Efforts of MNC in the field of Early Intervention in Mental Retardation have been recognized in the form of awards by the Government of India and Tamil Nadu state government.

Future Plans

MNC plans to replicate this programme to other special schools mentored by MNC in Chennai and other districts of Tamil Nadu. It is estimated that about two per cent of India’s child population suffers from mental retardation. Among the population, children from birth to six years account for 6%. Annapoorna can be scaled up to cover this population.