Growth Monitoring in Under-Three Children Using the Mother Child Protection Card

Right from its inception, ICDS programme envisaged monthly weighing and monitoring of growth in under-three children for early detection of under-nutrition. Currently accurate portable digital balances are available in anganwadi and Mother Child Production Card (MCPC) with child growth charts has been provided to children. A community based mixed longitudinal study was taken up in under-three children from urban low middle income families to assess feasibility and impact of growth monitoring and appropriate nutrition education using MCPC. Monthly weighing of children and plotting the weight-for-age in the MCPC was carried out by the research staff. A total of 5708 children were enrolled and followed up over 32879 visits between 2015 and 2019. Plotting the weight-for-age of the child in growth chart enabled identification of underweight children at the time of the visit so that appropriate nutrition and health education and care can be provided. Monthly weighing and plotting weight-for-age in growth chart enabled identification of small children growing along their own trajectory and prevented them from being mislabelled as under-nourished. Children showing deterioration in Weight for age Z score (WAZ) as compared to earlier visit(s) were readily identified and given needed advice. Personalised nutrition and health education provided at each visit taking into account current nutritional status, morbidity and Infant and Young Child Feeding Practices (IYCF) helped in preventing rise in underweight rates in the first 18 months and brought about some improvement in nutritional status of moderate and severely underweight children. It is feasible to operationalize growth monitoring as envisaged in Poshan Abhiyaan and accelerate the pace of reduction in under-nutrition in under three children.