This is the process of providing education and support to a child and or caregiver in order to enable them gain understanding and make informed decision on the nutritional requirements. Emphasis is placed on macro and micronutrient deficiencies that affect wellness in child growth and development.
Aims
· Establish wellness/restore health
· Detect and manage nutritional deficiencies
· Prevent nutritional related complications
· Support follow ups
· Prevent misconceptions about food
Types
· Periodic
· Routine
Requirements
· Pen
· Paper/electronic health chart
· Food guide/Pyramid
· Measuring tape
· Stadiometer/height measure/Infantometer
· Weighing scale (Age appropriate)
· MUAC Tape
· Growth chart (child health record)
· Flip chart
· Food samples
· Audio visual materials (Age appropriate)
Steps
1. Receive child/caregiver into a comfortable seat
2. Perform five (5) moments of hand hygiene as and when necessary
3. Establish rapport (refer steps)
4. Introduce self to child/caregiver
5. Explain procedure to child/caregiver (refer steps )
6. Incorporate developmentally appropriate strategies in dealing with the child
7. Provide privacy
8. Support child/caregiver to understand that nutrition counselling is a two-way process in which the child/caregiver must be involved in describing the child’s nutritional problems and analysing the causes and solutions
9. Ask child/caregiver about nutritional allergies and intervene as necessary
10. Use the child growth record chart to determine the rate and direction of growth of the child for appropriate intervention to be planned and delivered
11. Assist/ask caregiver to undress child to be examined exposing only one part at a time (keep child warm during the assessment)
12. Perform Anthropometric measurement/assessment (include weight, height, abdominal girth, head circumference and MUAC)
13. Assess child from head to toe for any signs of nutritional deficiencies
14. Document anthropometric measurements and findings on head to toe assessment on child’s medical records/growth chart
15. Ask about the last time child was dewormed
16. Communicate findings of assessment to the child/caregiver
17. Encourage child/caregiver questioning and provide appropriate responses
18. Discuss child’s favourite meals using Food Guide/Pyramid/Rainbow Chart and other appropriate nutritional teaching aids as a counselling resource on healthy cooking and eating
19. Use audio-visual materials to discuss Acceptable, Feasible, Affordable, Sustainable and Safe food sources for child (AFASS Principles)
20. Ask child/caregiver questions on frequency of food fortification (e.g. iron, iodone, Vit A, Vit D., etc.)
21. Discuss food supplementation with multivitamin syrups/tablets, as appropriate
22. Build awareness on available and cost-effective food sources of high nutritional value for the child
23. Assess for mal-distribution of food at home and other negative cultural and religious practices/beliefs that affect child feeding and counsel appropriately
24. Address issues relating to food faddism/unhealthy eating and food prejudices using a non-judgmental approach
25. Demonstrate how to prepare balanced diet using appropriate food samples from the Four Star Diet:
· Animal protein (eg. meat, chicken, fish, liver, eggs, and milk products)
· Legumes and seeds (eg. beans, groundnut, lentils
· Vitamin A-rich fruits and vegetables (pawpaw, mangoes and dark green leaves)
· Staple foods (e.g. grains such as maize, wheat, sorghum, millet; and tubers such as yam, sweet potatoes and cocoyam)
26. Ask mother to do a return demonstration
27. Express appreciation to child/caregiver for their cooperation
28. Encourage follow up/refer if necessary/arrange for home visits as appropriate
29. Document procedure in nurses note and child health record book
30. Report abnormal findings to Nurse Manager/In-Charge or Dietician for appropriate interventions
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