Prevention of child malnutrition and good parenting skills

Malnutrition is a global threat to children, and babies' health can result in short- and long-term, irreversible adverse health effects.

According to WHO, it is responsible for around 54% of child mortality in the world. The Global Nutrition Report 2018 finds that about 1/3rd of children worldwide suffer from some form of malnutrition. Malnutrition is a major public health concern worldwide.

The time between the baby's conception and the two years is crucial for the children's overall development. The children undergo brain development, growth, and neuron pruning in these early two years. The loving relationship with caregivers, usually parents, is crucial for social, emotional, and cognitive development in the first two years. 

Causes of Malnutrition in Children

Child malnutrition varies according to family wealth, mother's education, mother's age at first baby birth, birth history, and other socio-economic and physical environments.

Good Parenting and family environment

Why are parenting skills necessary? According to the studies, 90% of the brain develops in the first three years. So, in this crucial period, good nutritional health of both mothers and infants required, and good parenting is essential for the child's emotional and social development. 

Children with good parenting are likely to be happier, independent, and disease resilient. The experiences with caregivers or parents make new millions and millions of new connections in the brain.

On the other side, caregivers' negligence can make children more vulnerable to anxiety, depression, and learning and memory impairments.

Unfortunately, due to the joint family system's breaking and parents' busy schedule, children do not receive much-needed love, time, and support.

For centuries, the joint family system also provided the right kind of atmosphere to get parenthood skills from older people and other siblings.
 
The lack of parenting skills and practical experiences also impacts the rate of breastfeeding and the kids' overall well-being.

 

Healthy mothers and prenatal care

Why diet during pregnancy matter? During pregnancy, the body needs extra nutrients, vitamins, and minerals to meet the growing fetus's needs. 

To meet the body requirements during pregnancy, around 350 extra calories are needed. A healthy and balanced diet can help in reducing birth complications like nausea and constipation. The low diet and excessive weight gain may increase the risk of gestational diabetes.

Although everyone needs folic acid, it is crucial for childbearing women. Lack of folic acid(Vitamin B9) can cause congenital disabilities like the brain and spinal disorders. Vitamin B9 helps in forming red and white blood cells. It is helpful in the first 28 days after the conception when most of the neural tube defects occur. These congenital disabilities occur in the first few weeks of pregnancy.

 

But most of the time, many women don't know that they are pregnant before 28 days. Therefore, folic acid should be taken before conception and during pregnancy. It also helps in preventing miscarriage. The childbearing women need around 400 micrograms folic acid each day.

A balanced diet is right for both mother and child. It should be rich in vitamins, calcium, iron, fats, and carbohydrates. The nutritious diet helps healthy birth weight, reduces the risk of anemia in mother and many serious birth fetus complications, and boosts the child's immunity.

 

A healthy diet may include protein, Vitamin C, Vitamin A, Calcium, grains, dairy products, eggs, legumes, fruits, and vegetables.
 

Food quality and quantity

Food security means quality food is available, accessible, and affordable, but due to poverty and many socio-economic causes, there is food insecurity in various nations.

So what is malnutrition? The imbalance in the nutrients required by the body and consumed from the food leads to malnutrition.

Sub-Saharan African countries like Congo, Chad, and Niger are worst hit by poverty and hunger. Nearly 50% of people living in extreme poverty are 18 years old or younger. Due to extreme poverty, hunger kills 21000 people each day worldwide. 
 

Unsafe Drinking Water   

Unsafe water and sanitation have a direct impact on infectious diseases. Generally, when we talk about good nutrition, the food comes in our mind, but clean water is also an essential part of a healthy, nutritious diet.

 

The contaminated water can lead to many water-borne diseases like diarrhea, cholera, typhoid, trachoma, etc. The dirty water, along with poor sanitation and hygiene, can cause stunting among children.

 

The children miss the school due to frequent diarrhea and sickness caused by dirty drinking water.

 

Due to a lack of tapped water, many children are forced to drink stagnant water from ponds, wells, and dirty streams. 

 

According to Thirsting for a future report, around 36 countries are facing an acute shortage of water.

Lack of sanitation

The poor hygienic conditions and poor sanitation invite the parasites and germs. The open defection also contributes to the pollution of drinking water. 

The open defection is responsible for chronic infections via the intestines. It is also responsible for the reduced intestine's absorbing capacity. As a result, the nutrients in the food are not absorbed in the body. 

According to UNICEF, around 1, 17,000 children died from diarrhea every year. Sanitation is the main reason behind the high level of child malnutrition in India.

The children exposed to open defection suffer from chronic inflammation of gastrointestinal tracks, which can cause stunting. 
 

Social inequality

In a patriarchal society, preferences are given to boy child; hence the girl children are more likely to be malnourished than boys. Children belonging to low strata of society may be more malnourished than high strata. 

In many countries, economic decisions are made by men due to which both the quality and quantity of food are not available for women and girl children.
 

Diseases and infections

According to WHO, one of the dangerous consequences of malnutrition is the inability to resist diseases. In the absence of proper nutrients, the immune system becomes weak.

Malnutrition in children is more dangerous in developing countries because of the prevalence of many infectious diseases like Cholera, Malaria, and Tuberculosis, etc.

The high frequency of diarrhea can cause acute malnutrition. Developing countries are also more prone to secondary malnutrition. For example, if a child is suffering from diarrhea, the body cannot correctly process minerals and nutrients available in the food.

Since developing and underdeveloped nations suffer from the lack of potable water, poor sanitation, and hygienic conditions, diarrhea is common among children.
 

Fast food culture and overeating

Malnutrition is not caused only due to a lack of sufficient diet and energy but also due to excessive intake.

 

Children's obesity is generally caused due to unhealthy lifestyle habits. Due to easy access and less time required to cook, fast food consumption is increasing at an alarming rate across the world. 

 

The fast-food lack in iron and has too much fat and added sugar. Fast and junk food is generally linked to obesity, but it can also impact the children's learning abilities according to new research

 

Therefore consumption of readymade food affects mental and physical development.

 

Overeating leads to weight gain and obesity. Obsessed children are at greater risk of developing severe health problems in their later life, such as heart diseases, diabetes, sleep apnea, etc.

 

But why children eat more? The possible causes of overeating can be emotional eating and binge eating disorder. It would help if you encouraged them for healthy eating habits. It will help if you become a role model for them by establishing good eating habits for yourself.

Maternal Malnutrition

Immunity of children up to 5 years of age depends on the nutrition level of the mothers. Therefore, compromising healthy food and the intake of nutrients during pregnancy can seriously affect the newborn baby and mother's health.

Maternal malnutrition can increase the risk of gestational anemia, hypertension, and death of mother and baby. The newborn outcomes are strongly connected to maternal malnutrition. The bad lifestyles like eating junk foods, smoking, tobacco, and drinking (alcohol) can harm both mother and baby.

 

There can be placental problems, heart and lung tissue complications. It is essential to have a healthy weight before getting pregnant. 

 

Underweight and overweight both can cause problems. Avoid eating raw meats and fish or undercooked food to keep yourself safe from harmful microorganisms. The pregnant women and their unborn children are at greater risk of developing Listeriosis (A foodborne disease).

Measurement

The WHO prepared a growth chart, and nations use this chart as a reference to measure the level of malnutrition. There are three commonly used methods to determine malnutrition in children.

Stunting

The WHO prepared a growth chart, and nations use this chart as a reference to measure the level of malnutrition. There are three commonly used methods to determine malnutrition in children.

It is estimated that stunting is 3 times more in poor children than the wealthy one. This is because wealthy families can better invest in nutritious food and can maintain hygienic conditions and can drink clean water and invest in better health care.

Wasting

A child is wasted if his weight is low for the height. It is an indicator of acute undernutrition and is the result of more recent food deprivation or illness. It can lead to diseases like Kwashiorkor and Marasmus.

Underweight

A child having low weight for age or less than 2.5 Kg at the birth is said to be underweight. Underweight is used as a standard indicator to reflect both acute and chronic nutrition.

Mid-upper-arm-circumference (MUAC)

Each country has many ethnic communities. In some communities, people are of short stature, but that doesn't mean they are malnourished.

There can be many discrepancies if the WHO growth chart is used for measurement. To avoid such errors, MUAC of WHO is another method. A child whose MUAC is less than 115mm is said to be severely malnourished. Children with 115-125mm MUAC are moderately acute malnourished and those having MUAC above 125 are considered normal.

Signs and Symptoms

Sometimes the physical measurements like height, weight, and MUAC are insufficient to identify malnutrition in babies. It is not always that scarcity of nutrients, or lack of food causes malnutrition, but there may be other reasons like a chronic illness. 

 

Due to diarrhea, the child cannot absorb the nutrients available in the food. 

 

If you find the below behaviors among children, then consult with your pediatrician for further diagnosis and treatment.

-Children lose interest in eating and get full too quickly. This bad eating may further complicate the situation.

-Tiredness, fatigue, irritation, anxiety, lack of attention, and too much crying are common with malnourished babies.

-Children with malnutrition are inactive and don't show interest in playing. Due to the weakness of muscles, body strength is reduced to carry out daily activities.

-They may not grow as expected in terms of weight, height, or both.

-They feel cold most of the time.

-They can suffer from frequent vomiting. 

-They lack immunity against infections and diseases. Slow recovery from diseases and injuries.

-The skin becomes dry and scaly, and hair may turn dry and fall.

-A bloated stomach can be developed due to the lack of strength of the muscles of the abdomen. Legs are swollen due to edema.

-Malnourished children have poor cognitive and learning abilities.

Prevention of malnutrition

You can avoid malnutrition in your children by addressing the various physical, social, emotional, and nutritious food needs. It should be a vital component of the comprehensive care of the child.

 Working closely with the pediatrician, health workers, and Anganwadi (school) workers, you can address the problem of malnutrition before it gets too dangerous for your baby's health.

Ensure that your child eats nutritious food, rich fibers, fruits, low-fat dairy products, vegetables, and whole grains. Help your child to develop a healthy eating diet at regular intervals (after 3-4 hours).

Children must pick up good eating habits at childhood to benefit when they are adults. Teach them how to select healthy food choices and leave junk and fast food choices. Encourage your child to eat slowly and to chew food properly before swallowing.

Developing and underdeveloped countries need to improve the necessary facilities for safe water and toilets. They should promote proper handwashing by using soaps among children.

The poor sanitation and hygienic conditions are roadblocks for a healthy population. These nations are going through demographic dividends, and they must provide adequate necessary facilities to reap the benefits of the demographic dividend and avoid disaster.
 
According to WHO, Breast milk promotes sensory and cognitive development and protects the infant from chronic diseases.

According to WHO, infants should be exclusively breastfed for the first six months, followed by complementary foods while continuing breastfeeding up to 2 years or beyond.

Breastfeeding is essential for child growth. Pregnant women should be educated about the benefits of breastfeeding. Allow the mother and newborn baby to live together 24 hours a day. The health care providers who interact with pregnant women in a prenatal period play an essential role in encouraging breastfeeding. And also improve feeding practices.
 
Proper waste disposal mechanisms should be in place to stop the contamination of environmental resources and keep ourselves safe from infectious diseases and infections.
 
Women and communities should be educated about healthy foods and lifestyles. By increasing the birth spacing and reducing teenage pregnancy can reduce low birth weight problem. Delaying early marriages and pregnancy can help in curbing both maternal and infant mortality.

Consequences of malnutrition

Iron deficiency

Lack of Iron can develop iron deficiency anemia, a common nutritional deficiency in children. Iron helps red blood cells carry oxygen to the body. Children lacking in iron may not develop adequate red blood cells.

Iron deficiency can impact the learning and behavioral aspects of the child. The teenage boys may develop an iron deficiency in their puberty.

Iron deficiency is common in teenage girls because of the loss of iron during menstruation. Around 27% of adolescent girls in developing countries are iron deficient. According to WHO, anemia is responsible for 20% of all maternal deaths.

The newborn baby gets iron from the mother by breastfeeding, but once they start eating other foods, they should get enough iron for better muscles and brain development. The symptoms of iron deficiency may include tiredness, weakness, pale skin, rapid heartbeat, etc.

 

Iodine deficiency

Nearly 1/3rd of children are at risk of iodine deficiency worldwide. It is a trace mineral required to produce thyroid hormone. It helps in regulating growth, metabolism, heart rate, and other vital body functions.

Iodine deficiency may result in goiter, hypothyroidism, miscarriage, stillbirth, congenital disabilities, infant mortality, and impaired growth. Lack of iodine may result in fatigue, weight gain, constipation, hair, and cold feeling.

An adequate thyroid hormone is essential for normal growth and neurodevelopment in fetal life. The risk of developing complications is more significant in the first three years of a child's life.
Vitamin A deficiency

Vitamin A deficiency

According to WHO, around 190 million preschool-age suffer from Vitamin A deficiency.

It can cause visual impairment (night blindness) and may increase the risk of diseases and death. Vitamin A helps in the growth of tissues in nail, skin, and hair. It helps in bone growth and protects from infections.

Impaired growth and development

It can impair brain development, cognitive abilities, and physical development and can lead to reduced growth. Beyond the age of 2-3 years, the effects of chronic malnutrition are irreversible. Malnourished children from an early age can have a low ability to learn.

Economic loss

Malnutrition perpetuates the cycle of poverty. Low-income families don't have enough resources for a healthy diet and better health care for the children. Most of the malnourished children belong to poor households, and they earn less due to less productivity than better-nourished co-workers.

The country's long-term human capital is severely affected if the large population of children suffers from malnutrition. Due to unhealthy human resources, there will be a negative impact on the country's GDP and overall economic development.

High risk of infections and Mortality

Around 19000 children die each day worldwide from illnesses that could have been easily prevented. The newborn babies with low weight are at greater risk of morbidity. They are at risk due to both communicable and non-communicable diseases. They can easily suffer from malaria, respiratory illnesses, and diarrhea, diabetes, and hypertension problems.

Low performance in Schools

The malnutrition in children can lead to an increase in absenteeism and poor performance in the schools. Millions of malnourished children who manage to reach schools fail to learn the basics and lack of skills to earn their livelihood.

How to reverse malnutrition?

The treatment depends on the severity of malnutrition and complications. If you see any signs of malnutrition in your child, you should consult with appropriate health workers to carry out tests like blood tests, MUAC, etc.

Many of the complications can be reversed if treatment is taken on time. The delay in the treatment can cause permanent damage to your child's health and development. The pediatrician and dietitian will recommend an appropriate diet and supplements.
 

Children are the future of the world. Therefore, their health care and overall development cannot be ignored. The rights of children should be protected in letter and spirit.

The food should have adequate macro and micronutrients for healthy development.  They should have access to safe drinking water, toilets, a better health care system, and family support. Governments across the world need to curb extreme poverty and hunger. They need to formulate plans and execute them in letter and spirit by working with other nations and NGOs. The prevention of malnutrition in children is the way forward.

Disclaimer - This article is only informative in nature.Consult certified or skilled health worker for child's nutritional diet,treatment and requirements. 

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