India continues to show lack of progress in child nutrition

Health Care, Heart Care Foundation of India, Medicine Comments Off

Identifying focus areas and a targeted approach are need of the hour

New Delhi, 9 March 2019: Despite the National Family Health Survey-4 (NFHS-4) showing an encouraging improvement in child nutrition, India continues to fare poorly in world rankings on child nutrition. What needs to be done, where, how and by whom are the questions we need answers to. The focus must be on the pregnant, breastfeeding mother and the child, especially in the first two years of the child’s life, which is the crucial phase for physical, mental and cognitive development.

Given the size of the problem (38% of children under five years of age are stunted, according to UNICEF) and budgetary constraints, a targeted approach is needed. With the wealth of district-level data made available by NFHS-4, the focus districts can easily be identified. These include Uttar Pradesh, Bihar, Madhya Pradesh and Jharkhand apart from Karnataka, Maharashtra, Rajasthan and Gujarat.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Wasting is also called as acute malnutrition and as low weight-for-height. A healthy child is normally expected to gain 2 to 3 kg of body weight every year. Wasting occurs when the weight-for-height measurement in a child is less than two standard deviations from the globally accepted reference cut-off point. Severe wasting happens when a child’s weight-for-height measurement is less than three standard deviations from the globally accepted norm. Wasting and stunting are often two separate forms of malnutrition requiring different interventions for prevention and/or treatment. However, they are closely related and often occur together in the same populations and often in the same children.”

Some signs and symptoms of malnutrition include loss of fat, breathing difficulties, abnormally low body temperature, weakened immunity, higher susceptibility to feeling cold, longer healing time for wounds, reduced muscle mass, tiredness and fatigue, and irritability.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Children with severe malnutrition experience slow behavioral and intellectual development, leading to intellectual disabilities later in life. Even when they are treated, under nutrition can have long-term effects in children including impairments in mental function and digestive problems, which can last for their whole life.”

Prevention of malnutrition entails eating a healthy balanced diet. There are four major food groups that should form a part of a child’s diet plan. These include:

  • Bread, rice, potatoes, and other starchy foods. This forms the largest portion of the diet and provides calories for energy and carbohydrates that are converted to sugars which provide energy.
  • Milk and dairy foods – Vital sources of fats and simple sugars like lactose as well as minerals like Calcium
  • Fruit and vegetables – Vital sources of vitamins and minerals as well as fiber and roughage for better digestive health
  • Meat, poultry, fish, eggs, beans and other non-dairy sources of protein – These form the building blocks of the body and help in numerous body and enzyme functions.
  • Other factors to be considered include adequate nutrition of the mother during pregnancy and promoting the practice of exclusive breastfeeding.