NTBN Approves Nutrition Norms

• 25 Sep 2018

India’s top nutrition panel, the National Technical Board on Nutrition (NTBN) has recommended that severely malnourished children must be fed freshly cooked food prepared from locally available cereals, pulses and vegetables, and distributed by anganwadi centres.

• This is the country’s first-ever guidelines for nutritional management of children suffering from severe acute malnutrition (SAM).
• The measures are part of the community-based health management of children suffering from SAM.
  • Severe acute malnutrition is defined by a very low weight for height (below -3z scores of the median WHO growth standards), by visible severe wasting, or by the presence of nutritional oedema. Decreasing child mortality and improving maternal health depend heavily on reducing malnutrition, which is responsible, directly or indirectly, for 35% of deaths among children under five.

National Technical Board on Nutrition (NTBN)

• The NTBN was constituted in 2017 under Ministry of Women & Child Development to make technical recommendations on policy relevant issues on nutrition.
• The board meets once in three months and its recommendations are advisory in nature.

• The government had, in 2011 put in place only the guidelines for the hospitalisation of severely wasted children who develop medical complications and not anything related to nutrition.
• Under the new guidelines, the morning snacks and hot-cooked meals, which are served at anganwadis to children between the age of three to six years, should be “prepared freshly and served at the centralised kitchen/ anganwadi centres.
  • Locally available cereals, pulses, green leafy vegetables and tubers, vitamin C rich fruits, as well as fresh milk and 3-4 eggs every week have also been prescribed.
• The anganwadi workers and auxillary nurse midwives (ANMs) will identify severely wasted children, segregate those with oedema or medical complications and send them to the nearest health facility or nutrition rehabilitation centres.
  • The remaining children (those not with medical complications) are enrolled into “community based management”, which includes provision of nutrition, continuous monitoring of growth, administration of antibiotics and micro-nutrients as well as counselling sessions and imparting of nutrition and health education.

Oedema

• Oedema is a build-up of fluid in the body which causes the affected tissue to become swollen.
• It's normal to have some swelling in legs at the end of the day, particularly in state of sitting or standing for long periods.
• Oedema is often temporary and clears up by itself.
• It can occur as a result of malnutrition as well.

• Recently, the government has also revised the method to be used to measure wasting. Now, weight is calculated based on the height of children instead of the mid-upper arm circumference.