As we prepare for another Thanksgiving feast with family and friends, Holt’s nutrition initiatives coordinator shares what she has learned over the past year about the unique nutritional challenges children face when they grow up in institutional care — and how Holt’s orphan nutrition program is working to ensure all children receive the proper nutrition they need to grow and thrive.
It’s that time of year. Pumpkin-spiced everything, leaves falling everywhere, turkey, stuffing and graaaavy creeping into my daydreams. Thanksgiving is upon us.
Thanksgiving has always been my favorite holiday because I truly do have so much to be grateful for. And as I reflect on the last year — a year in which I traveled around the world meeting and serving children through Holt’s Orphan Nutrition Program (ONP) — I feel an even greater sense of gratitude.
Two years ago, Holt received a four-year grant to pilot a program that gives orphanages a system to monitor their children’s growth and anemia prevalence as well as training on how to properly nourish and feed children.
Before I began working with the ONP, I didn’t understand nutrition’s multifaceted importance. After all, we all eat every day. It’s easy and automatic and often mindless. Surely, I thought, the situation in the orphanages we partner with is not significant — just something we can improve upon.
Unfortunately, I was very wrong.
It is easy and automatic for me because I had parents who fed me properly from the beginning. I learned, like we all do, how to eat. It’s second nature for most of us, but if you slow down, you realize how complex it is. Go put some food in your mouth and chew it right now! Pay attention to what is happening in your mouth — your jaw movements, teeth, tongue… There is A LOT going on there! Developing those fine motor skills takes time, patience and individualized attention. Sadly, attention is one thing that children growing up in institutions do not get a lot of. Thus, orphaned and abandoned children often have a significantly different experience with food than those of us who grew up with parents who mindfully guided us.
Holt’s ONP is currently implemented in three countries and we are in the planning stages to expand to two additional countries next year. In the eight orphanages we are currently partnering with, we identified a pattern of feeding children in ways that lead to choking and aspiration — especially among infants and children with special needs who are unable to communicate when they are in pain or just simply need a break from food to breathe. Improper feeding practices lead to serious health complications such as constant respiratory infections, ear infections, malnutrition, psychological and physical trauma and even death. Infants usually have poorly developed — even severely delayed — motor skills because of being kept on the bottle without the introduction of complementary foods. The same is true for children with special needs.
Caregivers are not doing this to children maliciously. They have simply never received any training or guidance on how to feed children properly. Nor has anyone ever explained to them why proper feeding practices are so critical. This is where Holt comes in. We, in partnership with the nonprofit orphan nutrition organization SPOON Foundation, provide training and guidance that shows caregivers how to drastically improve the quality of life for the children they serve. One spoon or bottle at a time, three meals a day.
This year, we visited orphanages in Vietnam, China and India that are partnering with Holt to strengthen nutrition growth monitoring and feeding techniques of children in their care. Everywhere we went, we not only saw how improper feeding was causing serious, life-threatening issues among the children, but also how what they were being fed was causing nutritional deficiencies. Due to staff time constraints, budget constraints and a lack of detailed training, children in orphan care often receive a very poor and imbalanced diet. Children do not get to explore food and flavor varieties. They often have macro- and micro-nutrient deficiencies along with overall under-nutrition or malnutrition.
Another major issue with what they eat is how it is prepared. Globally, approximately 1.5 million children die each year from diarrhea, mostly due to poor hygiene and sanitation — another critical aspect of child health and nutrition addressed through Holt’s ONP program.
According to a report issued by UNICEF, over 50% of all deaths of children under age 5 have poor nutrition as an underlying cause. Yet, despite all of this research, there is not any reliable information about how many orphaned and abandoned children are undernourished worldwide. The orphans of the world are being left out of this discussion. In fact, in UNICEF’s 62-page document laying out their plan to end child hunger, the word “orphan” is mentioned only once — stating that feeding programs and services will likely need to be adapted for them. In terms of nutrition, hunger and feeding, the world has ignored its 132 million+ orphaned and abandoned children.
Orphans need to be a part of this discussion. As the challenges facing children who are raised outside of a family setting are unique, so solutions for them will also be different from those for children in family-based care. Holt has heard the call and is fighting to correct this oversight. Holt’s orphan nutrition program was designed as a direct response to this gap in care. We are dedicated to making sure these children are no longer overlooked.
The fact is that poor feeding practices and lack of a balanced and nutritious diet have serious long-term consequences. Not addressing malnutrition in a child can actually cause long-term disabilities. Developmental delays, growth stunting, malnutrition, wasting, low immunity and frequent illnesses and infections are commonplace in child care centers around the world — again, because of lack of understanding, training and time.
Not being fed properly robs children of so much, including critical cognitive development. Mealtime is an opportunity for a child and caregiver to connect, interact, learn and to have fun. Sadly, that is overwhelmingly not the case for children living in orphanage settings. Meals are served on tight schedules and sometimes truly scary and traumatic experiences. Making mealtime something to look forward to and something that nourishes and strengthens them is one of the big ways we are working to improve children’s lives while they are in care — and helping them to reach their full, thriving potential.
We take our food for granted in this country. It is so easy to get the quantity and variety of anything we want or need. We eat for pleasure, for boredom, for emotional satisfaction, even occasionally for hunger, and we forget what a luxury it truly is to have and to be able to consume.
Thursday is Thanksgiving, a day where families come together, cook food, eat food, play board games and football… A day we set aside to relish in our most basic and yet most important and profound gift we have in this world — our family. Whether it is our immediate kin, our closest friends, or in-between, it is a day to be together and reflect on our blessings.
So as we all prepare for our Thanksgiving feasts, I encourage you to reflect and be mindful. Think about your meal, your access to it, your ability to enjoy it, digest it… How it nourishes you and your soul. Reflect on how fortunate your family is to have these gifts and what significant gifts they truly are.
I am also thankful for so much. However, I plan to share with my family what has impacted me most this year: that my eyes have been opened to such a significant problem facing millions of the world’s most disenfranchised children and that I am empowered to help large numbers of them by working for an organization dedicated to doing something to address their nutrition and feeding needs.
Here at Holt International, we all participate in improving the lives of orphaned, abandoned and vulnerable children. Holt’s orphan nutrition program is a key tool for change — something to be truly grateful for.
Aloura DiGiallonardo | Nutrition Initiatives Coordinator
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