چگونه مي توان رشد كودك را بهبود بخشيد ؟
دكتر ناهيد عزالدين زنجاني-متخصص اطفال و مدير عامل انجمن ترويج تغذيه با شيرمادر
خلاصه مقاله : تخمين زده مي شود 70% كودكان كوتاه قد دنيا در آسيا زندگي مي كنند . كوتاه قدي در دوران كودكي ريسك فاكتوري است براي افزايش مرگ و مير ، نقصان تكامل حركتي و شناختي و ساير مشكلات عملكردي . اين پديده معمولا" پايدار مانده و سبب مي شود كه در بزرگسالي نيز جثه فرد كوچك و قدرت فعاليت او محدود باشد .
تاكنون مداخلات تغذيه اي فراواني انجام شده كه موارد زير را تأييد مي نمايد :
- تغذيه انحصاري با شير مادر در 6 ماه اول زندگي قوياً تاكيد مي شود .
پس ازشروع غذاي كمكي ، تغذيه با شيرمادر بايد هم چنان ادامه يابد ( كيفيت غذاهاي كمكي در مقايسه با شيرمادر ، ناچيز است ).
How to improve child Growth
An estimated 70% of the world’s stunted children live in Asia .
Growth Stunting in childhood is a risk factor for increased mortality , Poor congnitive and motor development and other impairments in function. It usually persists , causing smaller size and poorer performance in adulthood.Nutrition intervention trials support the following recommendations.
Exclusive breastfeeding is strongly recommended for the first 6 months of life .
Breast feeding should be continued when other foods are added to the infants diet. In general the quality of complemenary foods is poor compared to breast feeding .
The energy density of many gruels , soups, broths and other watery foods fed to infants is often below the recommended 0/6 Kcal/g. Energy intake can be increased by reducing the water added to foods where possible.
Adding extra energy in the form of oil or suger can adversely affect the density of protein and micronutrients in the diet.
Randomized controlled trials of the effects of processed complementary foods have shown a mixed impact on growth . most of the trails included infants 6 to 12 months . In three, the supplement increased weight and length; in two only weight was improved and in another four there was no effect on growth.
In most developing countries the micronutrient content of unfortified complementary foods is inadequate to meet infant’s requirements . It is particularly difficult for infants to consume enough iron , Zn ,or calcium ,and vitamine A , riboflavin ,thiamine and vitamin B6 intakes are often low.
Intervention with single micronutrient have shown benefits for children with low intakes : vitamin A prevents eye loseions , causes a substantial reduction in mortality from measles and diarrhea, and increases Hb synthesis ; iron improves cognitive and motor development of anaemic infants and children; Zn improves growth of children who are stunted or have low plasma Zn ; iodine reduces infant mortality and goitre prevalence and improves motor and mental function ; vitamine B12 improves growth and cognitive function .
Because multiple micronutrient deficiency tends to occur simultaneously , there is interest in the benefits of providing supplements that contain multiple micronutrients , multiple micronutrients caused some improvement in height growth rate in stunted Vietnamese children and in Mexicas infants aged < 12 months, but had no impact on growth in Peru or Guatemala .
Novel approaches to providing micronutrients include a fatbased spread which improved growth and Hb in one trial in stunted children , and encapsulated ” sprinkles “ which are undergoing further trial.
Micronutriens intake can also be improved by targeting animal products to young children . The consumption of higher amount of animal products was associated with better growth and micronutrient status in several studies. Increasing meat intake improved Hb in Danish infants. Meat as chicken liver could be rich micronutrient sources for infants and children ;
Micronutrient fortification of cereal staples is especially important where there are major constituents of complementary foods .
