After a successful pilot project, Holt and SPOON Foundation secure a four-year grant to implement a nutrition and feeding program for orphaned and abandoned children in five more countries — starting this year in China and Vietnam.
It’s lunchtime at an orphanage in southern Vietnam. Children eat their meals in separate rooms— grouped together by age and degree of special need — and caregivers help feed the youngest and most disabled children. In one room, a caregiver is feeding a boy on a stretcher. He is about 8 years old and has severe spastic cerebral palsy. Many of the other children in this room have cognitive or behavioral delays, and you can hear them screaming or clapping in the background. Some are waiting their turn to be fed. One sits on the floor, feeding herself.
The caregiver is a young woman who wears her hair in a neat bun and little pearls in her ears. She smiles as she spoons congee into the mouth of the boy with CP, who is laying flat on his back with a towel spread across his chest and his arms up around his head. Congee is a watery rice soup common in Vietnam and other parts of East and SE Asia, but it’s especially difficult for a child with CP to swallow. The boy keeps shaking and coughing — sometimes gagging — after each spoonful. Unsure what to do, the caregiver continues feeding him — rubbing his chest as he coughs. Thinking he might have an easier time if flatter on his back, she lowers the stretcher. This only makes it harder for him to swallow, and he shakes as he tries not to choke on his food.
Two years ago, Holt teamed up with SPOON Foundation, a Portland, Oregon nonprofit and truly the first organization worldwide to take a special focus on improving nutrition and feeding for orphaned, fostered and adopted children. After identifying two pilot sites among Holt’s partner organizations overseas, SPOON implemented a nutrition screening system and trained caregivers and staff to properly track the growth and nutrition of children in care. Looking at the diet and feeding practices at each care center, SPOON also suggested small changes that could dramatically reduce malnutrition and improve the overall health and wellbeing of the children.
In India, these changes included introducing cow milk to infants at 6 months instead of 3-4 months; delaying the introduction of cereal to infants to when they are 4-6 months instead of 2-3 months; providing iron supplements with Vitamin C to increase absorption and adjusting the dosage depending on whether the child is anemic; and giving iron at mealtimes but not with milk, which lowers absorption. Although some nutritional measurements such as stunting and head size will take longer to show impact, one outcome was immediate. Just six months after SPOON implemented these changes, anemia prevalence among the children dropped from 45 percent… to nine. At one site, anemia was completely eliminated.
“Anemia is the big issue children face in orphanage care,” says Dan Lauer, Holt’s VP of Africa programs. Dan helped forge Holt’s partnership with SPOON. “If 75 percent of children are anemic, we have a real issue.”
Most commonly caused by a deficiency of iron, anemia can have very severe consequences for a growing child. As Zeina Makhoul, SPOON’s nutrition scientist, explains, “Iron is a very important mineral for brain development. For a child between 0 and 5-years-old — especially between 0 and 2 — this is when their brain is developing at an accelerated rate. So having a deficiency in iron at that time is really going to impact their brain development.” Long-term studies of anemic children have shown that they have lower IQs and perform more poorly in school. Iron is also very important in disease prevention and immunity. As Zeina explains, “Those who are iron-deficient tend to get sick more easily and for longer periods of time and then those who are sick have poor appetite, and poor appetite means not enough nutrients. Not enough nutrients mean iron- and other deficiencies. It’s an ongoing cycle.” Continue reading “A Nourishing Start”