Saving a Severely Malnourished Child

Ajay was born on August 20, 2011 in a village outside of Kolkata. Sadly, his mother died shortly after childbirth, and he was sent to be raised by an aunt, also in the village, who had two other children. Over time, Ajay grew malnourished and his aunt was unable to provide proper care for him. In late 2011, he was sent to live with another aunt named Pramila in Fakir Bagan, where we work. Pramila has been married for many years, but has never had any children of her own.

Ajay and Pramila in late January, 2012

Pramila learned about Calcutta Kids and on Friday, January 20, she brought Ajay in for his first immunizations at five months old. Our triage nurse was quickly alarmed; his distended stomach, loosely hanging skin, bulging eyes, skinny limbs, and lethargy made her nervous about the inoculation. Weighing in at 3.79kg (~8.4lbs), he had a weight-for-age Z-score (WAZ) of -5.392, which was off the growth charts in the severely malnourished category. Bringing him to the attention of our health workers and doctor, Ajay received a thorough examination and a counseling and nutrition plan began. Ajay’s dirty bottle and diluted cow’s milk were replaced with clean bottles and newborn formula. Thankfully, he was hungry and eager to recover.

Starting the following Monday, Pramila brought Ajay to the Swastha Kendra (health center) daily for supervised feeding of Ajay. CK mothers are always encouraged to exclusively breastfeed, but in this case, without a lactating mother and with the severity of Ajay’s malnutrition, formula became the only viable option. Thanks to generous donors, CK supplies Ajay with all of his formula, which is expensive but critical to his growth. Almost immediately, we also started complementing his formula feeding with kicheri (lentils, rice and vegetables), which he ate well. Our community health workers conducted regular home visits to make sure that feedings were successful in the home. By February 1, Ajay weighed 4.5kg (~9.9lbs), and had a WAZ of -4.49. Making great progress, he was looking healthier and had more energy.

Ajay in late February, 2012

Pramila was also taken in by our mother’s support group. They were eager to help her, and invited her to attend their meetings. At one meeting, they taught Pramila various ways to make household ingredients into baby food. As a first-time mother of a very fragile child, the women in the support group also took the initiative to visit her and make sure she had what she needed. On March 1 he weighed 5.7kg (~12.6lbs) and had a WAZ of -3.633. His cheeks and limbs were starting to fill out, he was able to roll over on his own, and his smile could light up a room.

Ajay and Pramila in late March, 2012

Ajay and Pramila have continued coming to Swastha Kendra 2-3 days per week for counseling and food. On March 20, two months after Ajay’s first visit to Calcutta Kids, he weighed 5.97kg (~13.2 lbs) with a WAZ of -2.95, and was officially out of the “severely malnourished” category. Throughout the whole process, Pramila has worked very hard, heeding the counsel of Calcutta Kids, and has expressed her gratitude for our programs.

Ajay and Pramila in late March, 2012

Sitting in Swastha Kendra, I am fortunate to be able to see Ajay and Pramila regularly, observing the feeding, assessing his progress, and enjoying their company. The transformation in this sweet child over these 2+ months has been remarkable to witness. Thanks to the great work of Calcutta Kids, he continues to grow well, and is reaching both physical and developmental milestones. – Margy Elliott, Fellow, American India Foundation

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