More Than Nutrition: Holt’s CNP Team Helps One Girl With FASD

It’s always heartbreaking when children have been exposed to drugs or alcohol. But Holt’s child nutrition program can help improve the health and nutrition of these children. And for one little girl with FASD in Mongolia, the program has had a huge impact on her life.   

Altansarnai entered into care at of one of Holt’s partnering care centers in Mongolia shortly after being born. Nothing was known about her family or prenatal circumstances. She was small and very sick. Although the staff provided care for her sickness and appropriate formula for her age, they still noted that over time her development seemed to be slow and delayed. She seemed behind her peers in physical growth, was often fussy, and had difficulty calming herself down.

Children like Altsarnai are the reason why Holt’s child nutrition program (CNP) is so important.

The CNP helps care centers and community sites ensure they are providing optimal care through proper nutrition, safe feeding practices, improved hygiene and sanitation practices with a key focus on all the areas most critical to ensuring that children’s brains and bodies have, and are able to utilize, all the nutrients that they need to grow and develop to their full potential.

The CNP also helps identify why children are not reaching their potential.

Concerned about Altansarnai, staff at the infant sanitorium, our partner in Mongolia, brought her to the attention of one of our CNP specialists, Tracy Kaplan. Tracy, who is an infant mental health specialist, speech language pathologist, certified lactation consultant and feeding expert, had sadly seen many similar children before. Through working and discussing with Tracy, it became evident that this little girl had probably been prenatally exposed to alcohol and now had Fetal Alcohol Spectrum Disorder (FASD). Our feeding specialist worked to explain all the challenges that children with alcohol exposure can experience and what the caregivers can do to best support her growth and development.

It’s a heartbreaking reality that many children who come into care in Mongolia have been exposed to drugs or alcohol. The effects of alcohol exposure can be irreversible and difficult to address. Many children will experience poor growth, other birth defects like vision or hearing loss, seizures, delayed development, difficulty sleeping, poor fine motor skills, impaired social skills, learning difficulties and behavioral problems like poor attention, fussiness, anxiety or hyperactivity.

Altansarnai needed extra attention and love, especially during mealtimes, to ensure that she was getting enough nutrition for her body to grow. Our specialist practiced numerous tips and techniques and left the caregivers with additional resources. Our amazing in-country staff and occupational therapists provided continued follow-up training for staff and caregivers on topics related to health, feeding and nutrition.

Inspired by what they learned and all the obstacles in life that this little girl had faced, the caregivers worked diligently with Altansarnai to ensure all of her special needs were being addressed and accounted for.

In many ways, Altansarnai’s story illustrates how Holt’s CNP team works with care centers around the world to improve the health and nutrition of children. We empower caregivers with the tools and training they need, and they in turn apply the skills they’ve learned to new children coming into care. Not only that, they also pass on what they’ve learned to other caregivers.

CNP focuses on addressing the unique nutrition and feeding needs of children who are most at risk of malnutrition through a Training of Trainers (ToT) approach to empower sites to provide optimal care to children. CNP’s training, tools, resources and support provides sites with targeted interventions to help address and prevent the causes of malnutrition, especially in children ages 0-5 and children with disabilities.

Around the world, a model like Holt’s children nutrition program could not be more needed.

Malnutrition and hunger-related diseases continue to be the main cause of mortality among children under the age of 5 in the developing world and some of the most vulnerable children are orphaned and abandoned children. Approximately 2.7 million children live in residential care globally and these children are especially at high risk of malnutrition. For many children, even though family-based care is the ideal environment, it is not always possible.

“In many ways, Altansarnai’s story illustrates how Holt’s CNP team works with care centers around the world to improve the health and nutrition of children.”

Often children enter into institutionalized care having faced numerous adversities prior to admission while many also enter with pre-existing nutritional, developmental, medical and neurological needs. Some have disabilities or were born prematurely or with low birth weight and many have had exposure to drugs or alcohol, HIV, stress or a range of other issues. All of these factors can impact their health. But no matter what challenges they have faced prior to coming into care, they deserve the love and proper care to ensure that they grow to their fullest potential.

CNP provides partnering sites individualized resources and tools to support behavioral and organizational change through a variety of methods consisting of training and hands-on practicum. Through CNP’s standardized training, long-term supported implementation and rigorous evaluation, the program is able to implement a sustainable and scalable model.

And for one little girl in Mongolia, the program has had a huge impact on the rest of her life.

When the CNP team returned in 2019, they saw a bright and energetic little girl who was able to feed herself. Altansarnai was engaged with her friends and loved mealtimes. She was especially excited for play time on the carpet with her caregivers and the other children in her classroom. Because of the special care she received, her condition was not worsening. Instead, she was healthier than she ever had been before!

Since the beginning of the program in 2013, the Holt International Child Nutrition Program has:

• Expanded to six different countries and scaled to 42 sites, including institutional care, community care and foster care programs. Countries include: China, India, Mongolia, the Philippines, Ethiopia, Uganda, Haiti and Vietnam.
• Conducted more than 20,000 health and nutrition screenings, impacting more than 3,700 children while allowing for optimal health monitoring and intervention.

Of the children whose lives have been impacted by the program, over 30% have a disability or special need and 70.2% of the children started the program with one or more malnutrition indicators — i.e., stunting, wasting, underweight or anemia. Since 2013, more than 1,000 caregivers have participated in CNP training, and the program has seen significant reductions in rates of stunting, wasting, underweight and anemia and improved the overall health of participating children.