|© UNICEF/ HQ00-0175/ Pirozzi|
|Lecencia, a 15-month-old girl whose hair has turned red, a symptom of severe malnutrition, is spoon-fed by her mother, in the province of Gaza, Mozambique.|
Just as the damaging effects of malnutrition can pass from one generation to the next, so can the benefits of good nutrition. Giving a child a solid nutritional start has an impact for life on her or his physical, mental and social development.
Malnutrition weakens the immune system, making a child susceptible to disease, increasing severity of illness and impeding recovery. A sick child, in turn, can quickly become malnourished. Age-appropriate breastfeeding and nourishing complementary foods, along with adequate health care, can break this vicious cycle.
A child’s nutritional future begins before conception with the mother’s nutritional status prior to pregnancy. A chronically-undernourished mother is likely to give birth to an underweight baby, who may be stunted as a child and in turn give birth to malnourished baby. A well-nourished woman over the age of 18 has a much greater chance of surviving pregnancy and her child of growing up healthy.
Eliminating malnutrition in mothers can reduce disabilities in their infants by almost one third. It is also important that expectant mothers eat a variety of foods, receive essential micronutrients and have adequate rest. During fetal growth is when most of the child’s organs and tissues, blood, brain and bones are formed, and his or her potential is shaped. Lack of maternal nutrition and nutritional stores can create irreversible harm.
First three years: Infant and young child feeding
The period from birth to the age of three is a time of rapid growth and represents a singular opportunity to provide a child with a strong nutritional and immunological foundation. Intellectual and physical growth is the most rapid, with doubling of brain size and quadrupling of body weight. If a child is malnourished during these early years, much of the damage is irreversible – the answer lies in prevention.
If every baby immediately put skin-to-skin at the breast, hypothermia would be prevented, saving about 200,00 lives annually, If every baby were exclusively breastfed for six months, an estimated 1.3 million additional lives would be saved every year, and millions more would benefit in terms of health, intelligence and productivity. Breastmilk is the perfect food – it contains all the nutrients and micronutrients an infant needs for normal growth during the first six months of life.
Breastfeeding stimulates an infant’s immune system and response to vaccinations, and is continually changing to meet the babies needs. Breastmilk contains hundreds of health-enhancing cells, proteins, fats, hormones, enzymes and other factors found nowhere else but in mother's milk.
Breastfed babies have at least six times greater chance of survival in the first months because breastmilk has factors that protect the mucous membranes of gastrointestinal and respiratory tracts, and cells and immune factors that actively fight infections, shielding babies from diarrhoeal diseases and upper respiratory infections. (SOWC, 1998) Exclusive breastfeeding increases the chance of survival many times more, and may also lower the chances of an HIV-positive mother passing on the virus via breastfeeding.
After six months, the infant should continue her frequency of breastfeeding while begining responsive complementary feeding with nutrient- and iron-dense foods that provide additional vitamins, minerals, proteins and carbohydrates to meet her or his growing needs. Complementary feeding should start gradually, but the 6-8 month old child should receive.
Tiny doses of minerals, vitamins and trace elements can mean a difference between life and death for mothers and children. Micronutrients – particularly iron, vitamin A, iodine and folate – play a vital role in the mother’s survival in pregnancy and childbirth, and in the child’s development.
Vitamin A is essential for the functioning of the immune system. Vitamin A deficiency (VAD) causes blindness and renders children susceptible to common childhood killers: measles, diarrhoea, malaria and pneumonia. Increasing the vitamin A intake of populations with VAD can decrease childhood deaths from such illnesses by 25 per cent. Vitamin A also helps prevent maternal mortality and may reduce mother-to-child transmission of HIV.
Iodine is a critical nutrient for the proper functioning of the thyroid gland which regulates growth and metabolism. Iodine deficiency is the primary cause of preventable learning disabilities and brain damage, having the most devastating impact on the brain of the developing foetus. One teaspoon of iodine – consumed in tiny amounts on a regular basis over a lifetime – is sufficient to prevent the conditions known collectively as iodine deficiency disorders (IDD).
The body needs iron to manufacture haemoglobin – the protein in red blood cells that carries oxygen around the body – and several enzymes necessary for muscle, brain and the immune system. The body’s iron requirements increase during menstruation, pregnancy, breastfeeding and high-growth periods. Iron-folate supplements during pregnancy help prevent anaemia, which increases the risk of haemorrhage and sepsis (overwhelming bacterial infection) during childbirth and is implicated in 20 per cent of maternal deaths. Folate, a B vitamin, is needed for the formation of red blood cells and also the development of nerve cells in the embryo and feotus stages of development.