Objectives of growth monitoring
Growth monitoring and promotion have the following objectives:
- To measure individual health and to instigate effective action in response to growth faltering (slowing down)
- Teach mothers, families and health professionals how diet and illness can affect child growth and thereby stimulate individual initiative and improved nutrition and healthcare practices
- To provide regular contact with primary health services.
Poor linear growth (underweight and stunting) usually occurs in the first 24 months of life. If the child is not optimally fed during this time, they could lose 11cm from the potential height that they would have reached as an adult. Once stunting has happened, it is very difficult to catch up. By the time a child is two or three years old, catch-up growth is less likely to occur; such children have probably failed to grow and are potentially stunted for the rest of their lives.
Main determinants of child malnutrition during the first five years
| Age of malnourished child | Determinant factors |
|---|---|
| Birth | Maternal factors (including nutrition), gestational age |
| Four-six months | Infant feeding practices, maternal ability to care for the child |
| Six months to two years | Complementary feeding practices, exposure to infections, disease and poor household food as the child gets older |
| Two-five years | Inadequate access to household food; infections and social deprivation |
If you determine that the child is malnourished (underweight), you should be able to analyse the causes, identify resources, suggest alternative solutions and arrive at decisions together with the mother or caregiver as to what should be done about the child. This process of assessment analysis and action is known as the 'triple A' cycle which is described below.