Addressing burden of malnutrition among children

The United Nations Children's Fund (UNICEF), says malnutrition is a direct or underlying cause of 45 per cent of all deaths of under-five children, which mostly occur in low and middle income countries.

It also says that Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 per cent of children under-five.

In Nigeria, an estimated two million children suffer from severe acute malnutrition (SAM), but only two out of every 10 children affected receive treatment.

Hunger and poor health infringe on the rights of children, that is why Sustainable Development Goals (SDGs) Two and Three, aim at zero hunger and good health and well-being as well as quality education for children.

This grim picture of malnutrition suggests that Nigeria is not on track towards the realisation of the SDGs and that the rights of children are being infringed upon.

Ms Nkeiruka Enwelum, Nutrition Officer, UNICEF Nigeria Country Office, said that Nigeria ranked number one in Africa and number two in the world in terms of malnourished children

Quoting from Nigeria Demographic Health Survey (NDHS) statistics of 2018, she said that 35 million children under the age of five, were malnourished, 14 million were stunted, while three million were wasted and 24 million were anaemic.

Enwelum listed the consequences of malnutrition as impaired brain development and lower Intelligence Quotient (IQ), low birth weight, weakened immune system, leading to increase in infectious diseases and premature death.

She added that failure to prevent and treat malnutrition could result in long term cognitive and growth impacts and loss of income for households and up to 15 per cent Gross Domestic Product (GDP) loss for Nigeria.

According to Enwelum, benefits of good nutrition includes increase in school participation by one year, reduce stunting and increase in adult wages by five to 50 per cent, among others.

Enwelum added that the burden of malnutrition was extremely high in the North-West and North-East.

She said that in spite the coverage of all the high-impact interventions in the country, they were less than the recommended 80 per cent coverage.

These interventions include iron-folic acid supplementation, early initiation of breastfeeding, minimum dietary diversity, Vitamin A supplementation, among others.

She said that it costs N6,000 to prevent malnutrition through the delivery of high impact nutrition interventions, while treating malnutrition through Integrated Management of Acute Malnutrition costs N60,000, which was 10 times the cost of prevention.

Unarguably, to reverse the trend in children requires giving them good, healthy and balanced foods and other supplements.

Uju Onuorah, a nutritionist, said that the major factors responsible for malnutrition in Nigeria are poverty and rising cost of living, illiteracy, globalisation and exposure of children to some preventable illnesses such as malaria and tuberculosis.

She submits that the way forward in addressing the crises is "introduction of feeding programmes (infant feeding) in health facilities and community levels and counselling on dietary intake in health centres by trained health workers.

"Integrating health education in primary health care schemes. Here, health education should be given by nutritionists and community health workers to mothers to adequately breastfeed their children up to two years.

"This is because breastfeeding contains all food nutrients in the right proportions and is affordable and accessible."

She maintains that all community health care centres should have nutrition units, where mothers will be given food demonstration lessons on adequate diet with locally available foods and provide hygiene education on food preparation

Other interventions include increased support for rural farmers, distribution of Vitamin A and iron supplements in rural health centres and encouraging production of low cost weaning diets.

Experts stressed that parents have great responsibility in shaping the nutrition of their children.

Adequate nutrition starts from pregnancy, when the baby takes nutrients from the mother and in their first year, it is expected that infants triple their birth weight.

To achieve this, they need all the energy and nutrients to facilitate their growth as recommended by the World Health Organisation, but breast milk is still the best source of nutrition for babies during the first six months.

However, at six months, while breast milk continues to be a vital source of nutrition, complementary foods need to be rich in energy and nutrients.

"In addition to grains and potatoes, infants should also eat vegetables and fruits, legumes and seeds, a little energy-rich oil or fat, especially animal foods (dairy, eggs, meat, fish and poultry) every day.

"Parents should make it an utmost priority to provide their children with a variety of foods every day that gives them the best chance of getting all the nutrients they need", Onuorah added.

She dispelled the existence of any vaccine that boosts growth in children, adding that available vaccines were to prevent their susceptibility to certain diseases.

According to Ms Oluwaferanmi Oyewale, also a nutritionist, adequate information on best eating habits for children especially when they are being weaned is very important.

" For a child that is just being weaned, the complementary food does not have to be very expensive.

"It can just be rice and vegetables, mashed potatoes with eggs and these are things that are easy to get because the truth is that good food does not really have to be expensive.''

She emphasised that foods that should be given to children should be in varieties and in their right classes.

According to the nutritionist, all foods should be given to children but in the right proportion and there should be presence of lots of fruit and vegetables.

"Fruit salads with milk or yoghurt, they can be given smoothies, different kinds of vegetables.

"Children should be taught not to be picky because some children don't like vegetables or fruit, rather they should be encouraged. They should be made to eat all those foods and be told why they should eat them so that they can be healthy.

"When children eat a variety of healthy foods in the right proportion, it makes them grow well, it increases their immunity and they will not get sick anyhow.

"If a child consumes food that is rich in calcium, the bones, the teeth, everything is going to be strong and this will help prevent malnutrition," Oyewale added.

She said that there were lots of modern foods now, due to globalization, such as junks and fizzy drinks.

She cautioned parents to avoid them as much as possible, but if they must, it should be little and once in a while.