Bridging the Nourishment Divide: Tackling Infant Malnutrition Head-On

By Harshini Patel, Jia Patel, and Ria Patel, GRC 2023 Global Essay Competition Top 30

In the small village of Chikungunya, a haunting silence that speaks volumes about the devastating impact of malnourishment replaces the laughter of children that once echoed through the air.1 This stark reality illuminates the urgent need to address the global crisis of malnutrition. Over several decades, the understated problem of infant malnutrition has escalated, influenced by various aspects contributing to suboptimal feeding. Factors such as misinformation, insufficient resources, and a lack of support play significant roles in exacerbating this issue. Ensuring the well-being of upcoming generations becomes imperative as inadequate infant nutrition prolongs a crisis that urgently requires intervention.

Insufficient Nutrition for Infants: Highlighting the Nutritional Deficit

The pressing issue of infant malnutrition persists to cast a significant shadow over the surging mortality rates among young children. Doctors emphasize the importance of prompt breastfeeding postpartum, as it provides vital energy and nutrients required for development.2 Yet, numerous mothers fail to adhere to these guidelines, causing infant weight loss, growth stunting, and heightened mortality risk. Reportedly, non-breastfed and partially breastfed infants have a three times higher risk of death in the first six months of life.2 The complementary feeding stage, which incorporates healthy foods after exclusive breastfeeding for six months, is crucial for ensuring the newborn absorbs the essential nutrients required for robust physical and mental growth. However, during this phase, infants are susceptible to receiving inadequate food, leading to undernutrition. Prelacteal feeding, wherein newborns are given prohibited substances before breastfeeding initiation, may trigger infection exposure due to inadequate protection.3 Ultimately, improper breastfeeding and improper feeding practices during an infant's early months are highly probable to result in a shortage of essential nutrients and vitamins necessary for healthy development.

Unveiling Stereotypes in Infant Feeding Practices

In this labyrinth of malnutrition among infants, the primary nurturers, mothers, often find themselves bereft of knowledge regarding nutritional standards. A study completed by BioMed Central (BMC), among a cohort of new mothers in Gambia, unfolded an array of stereotypes regarding infant feeding. For instance, many women believed drinking water was indispensable for survival or in nurturing men’s physical strength early in infancy.4 To fill in these informational gaps and instigate change, three pillars are introduced.

Pillar I: Cultivating Awareness for Optimal Infant Nutrition

The first pillar, awareness, entails the circulation of information on infant nutrition. In areas prone to higher infant mortality due to malnutrition, comprehensive campaigns, seminars, and community outreach should be introduced to dismantle misconceptions and empower individuals with nuanced perspectives on optimal infant nutrition.

Pillar II: Universal Education for Postpartum Infant Care

The imperative of education extends beyond mere local initiatives; however, it calls for the establishment of global standards that must be universally met. Women must be equipped with comprehensive knowledge concerning post-partum care, including a profound understanding of nutritional guidelines. In a study reviewing 29 different assessment tools, it was concluded that assessment tools for malnourished infants from organizations such as UNICEF and WHO can be improved by adding questions from other resources.5 As such, through global cooperation, resources to educate women on proper nutritional requirements should be facilitated.

Pillar III: Government Commitment to Infant Nutrition

The third pillar focuses on active involvement and commitment from governmental bodies. Governments should prioritize the development and enforcement of policies that promote infant nutrition. This includes initiatives to regulate the marketing of infant formula, ensure the availability of nutritious foods, and provide support for breastfeeding mothers. Additionally, establishing financial resources for nutritional programs, awareness campaigns, and accessible healthcare services can bolster government involvement.

Revitalizing Malnutrition In Infants and Relinquishing Improper Feeding Practices

When the prerequisites fail to meet the necessary needs, effective remedies must be provided and compromised. Complementary meals are made available at the critical 6-month milestone to satisfy the nutrient-energy requirements of developing children, yet they usually fall short of adequacy. Food composition, variety, and fulfilling caloric expectations are all aspects of enhancing a child's supplemental diet: 200 kcal for 6-8 months, 300 kcal for 9-11 months, and 550 kcal for 12-23 months.6 In their calorie diets, infants should avoid additional sugars, which frequently appear in fruit juice.7 Fruit juice can replace a baby's thirst for breast milk, posing life-threatening risks such as poor weight gain. Cow milk should also be avoided since it is difficult to digest and lacks key minerals (iron and vitamin E).7 For positive effects, supply breast milk with infant oats or grain8. Hence, abiding by these guidelines is a fundamental step in eradicating inappropriate infant feeding practices.

Breaking the Chains of Silence: A Triumphant Call to Action Against Infant Malnutrition

In conclusion, the intricate fabric of infant malnutrition demands immediate and decisive action. The multifaceted challenge arises from inadequate infant nutrition, perpetuated by misinformation and deeply ingrained stereotypes. To unravel the tapestry of malnourishment, a three-pillar approach to change was proposed: cultivating awareness, universal education for postpartum care, and government commitment to infant nutrition. The prioritization of the essential pillars can assimilate the cycle of improper feeding practices and unearth a healthier future for infants worldwide. The grim silence that had befallen the village of Chikungunya urges for a change — a change of mind and action.

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Bibliography

1. Weger-Lucarelli, James, Lucia Carrau, Laura I Levi, Veronica Rezelj, Thomas Vallet, Hervé Blanc, Jérémy Boussier, et al. “Host Nutritional Status Affects Alphavirus Virulence, Transmission, and Evolution.” PLoS Pathogens, November 11, 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6872174/.

2. WHO. “Infant and Young Child Feeding.” World Health Organization, June 9, 2021. https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding.

3. Degefa, Nega. “Suboptimal Child Feeding and Its Determinants.” IntechOpen, November 7, 2023. https://www.intechopen.com/online-first/88534.

4. Sosseh, Sering A. L., Amadou Barrow, and Zxyyann Jane Lu. “Cultural Beliefs, Attitudes and Perceptions of Lactating Mothers on Exclusive Breastfeeding in The Gambia: An Ethnographic Study.” BioMed Central, January 13, 2023. https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02163-z/tables/2.

5. Brugaletta, Concetta, Karine Le Roch, Jennifer Saxton, Cécile Bizouerne, Marie McGrath, and Marko Kerac. “Breastfeeding Assessment Tools for At-Risk and Malnourished Infants Aged under 6 Months Old: A Systematic Review.” National Center for Biotechnology Information, November 10, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898355/.

6. Harrison, Leila, Zahra Padhani, Rehana Salam, Christina Oh, Komal Rahim, Maria Maqsood, Anna Ali, et al. 2023. “Dietary Strategies for Complementary Feeding between 6 and 24 Months of Age: The Evidence.” Nutrients 15 (13): 3041. https://doi.org/10.3390/nu15133041.

7. “8 Foods You Should Avoid Feeding Your Baby.” n.d. What to Expect. https://www.whattoexpect.com/first-year/baby-feeding/foods-babies-shouldnt-eat.

8. “The Best First Foods for Babies 6 to 9 Months.” n.d. Happiest Baby. https://www.happiestbaby.com/blogs/baby/best-baby-foods-6-to-9-months.

Bibliography

“8 Foods You Should Avoid Feeding Your Baby.” n.d. What to Expect. https://www.whattoexpect.com/first-year/baby-feeding/foods-babies-shouldnt-eat.

Bachmann, Max O. “Cost Effectiveness of Community-Based Therapeutic Care for Children with Severe Acute Malnutrition in Zambia: Decision Tree Model - Cost Effectiveness and Resource Allocation.” BioMed Central, January 15, 2009. https://resource-allocation.biomedcentral.com/articles/10.1186/1478-7547-7-2.

Brugaletta, Concetta, Karine Le Roch, Jennifer Saxton, Cécile Bizouerne, Marie McGrath, and Marko Kerac. “Breastfeeding Assessment Tools for At-Risk and Malnourished Infants Aged under 6 Months Old: A Systematic Review.” National Center for Biotechnology Information, November 10, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898355/.

Degefa, Nega. “Suboptimal Child Feeding and Its Determinants.” IntechOpen, November 7, 2023. https://www.intechopen.com/online-first/88534.

Harrison, Leila, Zahra Padhani, Rehana Salam, Christina Oh, Komal Rahim, Maria Maqsood, Anna Ali, et al. 2023. “Dietary Strategies for Complementary Feeding between 6 and 24 Months of Age: The Evidence.” Nutrients 15 (13): 3041. https://doi.org/10.3390/nu15133041.

Sosseh, Sering A. L., Amadou Barrow, and Zxyyann Jane Lu. “Cultural Beliefs, Attitudes and Perceptions of Lactating Mothers on Exclusive Breastfeeding in The Gambia: An Ethnographic Study.” BioMed Central, January 13, 2023. https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02163-z/tables/2.

“The Best First Foods for Babies 6 to 9 Months.” n.d. Happiest Baby. https://www.happiestbaby.com/blogs/baby/best-baby-foods-6-to-9-months.

Weger-Lucarelli, James, Lucia Carrau, Laura I Levi, Veronica Rezelj, Thomas Vallet, Hervé Blanc, Jérémy Boussier, et al. “Host Nutritional Status Affects Alphavirus Virulence, Transmission, and Evolution.” PLoS Pathogens, November 11, 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6872174/.

WHO. “Infant and Young Child Feeding.” World Health Organization, June 9, 2021. https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding.

Yilak, Gizachew, Woiynshet Gebretsadik, Hiwot Tadesse, Megbaru Debalkie, and Agegnehu Bante. “Prevalence of Ineffective Breastfeeding Technique and Associated Factors among Lactating Mothers Attending Public Health Facilities of South Ari District, Southern Ethiopia.” PloS one, February 11, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012449/#:~:text=nipple%20%5B11%5D.-,Improper %20positioning%2C%20attachment%2C%20and%20suckling%20are%20constructs%20for%20ineff ective%20breastfeeding,immunity%20%5B10%2C%2012%5D.