Dietary Considerations for Management of Infections

From our earlier discussion you  would have got a clear idea of how malnutrition and infections like diarrhoea and measles affect growth and development of children. Looking at the synergism between malnutrition and infections, it is important to remember that the preventive measures must necessarily take both  conditions into account. How to prevent malnutrition  has already been discussed earlier in this block. The dietary considerations for the management of two of the most common childhood infections-diarrhoea  and measles-are  however discussed in the next subsection. We begin with dietary management of measles. 

Dietary Management of Measles 

You have just learnt about the serious and deleterious  effects of  measles on the nutritional status of the children. You should, in such cases, take steps to ensure that the child gets proper nutrition.  Generally, it is believed by the village mothers that nothing should be given to a child with measles. This is a wrong belief and you should educate and convince the mothers that without proper diet the child may develop severe malnutrition. Few dietary considerations to be advocated are: 

1. If the child is breast fed, advice the mother to continue breastfeeding the baby. 
2. Give to the child liquids like milk or semi-solid preparations like Kanjee, soft khichri; nutritious pouidges which have been thinned by the addition of ARF. ARF ,is nothing but a few grams of germinated wheat powder which has the ability to instantly break down the thickness of gruels and to make them much easier for a sick child to swallow.
3. If the child also has diarrhoea, the mother should be advised to give the'child oral rehydration solution to prevent dehydration. What is oral rehydration solution? Refer to sub-section for the preparation of oral rehydration  solution. 
4. All children  with measles should get a large dose of vitamin A (200,000 IU) orally by mouth. 
5. Ensure proper feeding of the child suffering from measles. If the child is properly fed you would notice that the reduction in body weight will be much less.

Dietary  Management of Diarrhoea 

You are aware that, like in measles, mothers often withhold food during diarrhoea due to the fear that the disease ;nay become more severe. This belief is wrong. You should educate the mothers, in such cases, to properly feed the children. The dietary considerations include : 

1. Advice the mothers to continue breastfeeding specially if the child is breast fed or alternatively give milk feeds mixed with equal amount of boiled, clean water. 
2. Serve soft, well-mashed, non-spicy foods to the child which are easy to digest. For example, soft well-cooked rice with dal preparation or khichri, soups, eggs, fish etc. can be given to the child. As stated earlier nutritious cereal-pulse-oil porridges suitably 'thinned'  with ARF, can also be given. 
3. Give the child foods rich in potassium such as fruit juices, mashed bananas, potatoes, carrots, well-cooked whole grain cereals. 
4. Give the child food as much as he wants and at least 5-7 times a day. 
5. As soon as diarrhoea starts, give the child more fluids than usual for example, rice water(kanjee),fruit juice, coconut water, butter milk (lassi), dal soup, diluted milk, tea, nimbu-pani (fresh lime in water),barley water or any other fluid available at home and acceptable to the child. 
6. Give oral rehydration solution (ORS) to the child. What is ORS? ORS  is a solution made from sugar and salt dissolved in water. This solution helps replace the fluids and electrolytes lost in the stools during diarrhoea. You may be aware that in the market several electrolyte mixtures are available. This mixture should be added to one liter of clean water (preferably boiled and cooled) and the child should be fed this solution as frequently as possible and after every loose stool. We can prepare this solution at home as well in the following manner: 

Take one liter of clean water, add three finger pinch of common salt and four finger scoop of sugar and mix well. This mixture is as good as the electrolyte mixtures available in the market. It is now known that salt (as stated above) added to one liter of thin rice kanjee or barley water will also serve as well. LOW income mothers prefer this as they very often may not have sugar or jaggery at home, but all homes will have some cereal or the other to make a kanjee solution.  The child should be given this solution as frequently as possible. 

The education of the mother is the sheet anchor in the management of diarrhoea. Tell  the mother she can prevent diarrhoea, if: she gives her child fresh, clean and well-cooked food and clean drinking water and she practices good hygiene.