Altrusa's Nutrition Support Program

U.S. trainers show Chinese staff how to use the mobile app and how to measure children using the donated equipment they brought.


Since regionalization, our nutrition support has switched from supplementing individual malnourished children's diets to supporting the staff at the orphanages to learn about nutrition and feeding practices and implement them.


We've done this primarily with a program called SPOON. Our volunteer professionals take a training from the SPOON Foundation in Portland, Oregon ( This prepares them to present a five-day training to Chinese staff that covers the best positioning and feeding practices for  disabled children. 


The training includes a mobile app called Count Me In. We train the Chinese staff to measure and weigh the children each month and enter the data, along with hemoglobin test results, into the app. The app prepares a report for each child, comparing their growth to normal children and making recommendations.


When the orphanages report to us later, they are delighted to see definite improvement in their practices and results. Orphanage staff say the caregivers’ attitudes towards the children has changed. They get down at eye level with the children at mealtime and talk and laugh with the children, which they didn’t previously do. Caregivers let each child, if they are able, eat by themselves and develop skills in holding their own spoons, etc. 


They follow recommendations learned in training and suggested by the app, like supporting the correct posture of the child while they are eating as well as correct feeding techniques. Some children had their anemia improve or resolve.  Others learned to feed themselves (an age-appropriate skill they’d never been given time to try before).  A simple idea, like feeding a small mouth with a small spoon or positioning children so they don’t silently aspirate food, can be life-saving.


There is also a module on anemia and iron deficiency which can affect growth and development, including brain development, and contribute to learning difficulties.  The orphanage doctor and/or nursing staff is given a Hemocue machine and supplies and can check for anemia with just a finger prick blood test.  For those children who are anemic a trial of iron and vitamin supplements is given and if the anemia responds these are continued for several more months.