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The big picture

“The world produces enough food to feed every man, woman and child on earth. Hunger and malnutrition therefore are not due to lack of food alone, but are also the consequences of poverty, inequality and misplaced priorities.” – UNICEF Deputy Executive Director, Kul C. Gautam [Executive speech, To the World Food Summit: Five Years Later, 11/6/02]
© UNICEF/ HQ98-0529/ Pirozzi
A child, suffering from severe malnutrition, looks up and holds her mothers hand at a feeding centre run by the NGO Action contre la Faim. Sierra Leone.
Malnutrition is called an “invisible” emergency because, much like an iceberg, its deadly menace lies mostly hidden from view. Each year malnutrition is implicated in about 40% of the 11 million deaths of children under five in developing countries, and lack of immediate and exclusive breastfeeding in infancy causes an additional 1.5 million of these deaths. However, contrary to popular belief, only a fraction of these children die from starvation in catastrophic circumstances such as famine or war. In the majority of cases, the lethal hand of malnutrition and poor breastfeeding practices is far more subtle: they cripple children’s growth, render them susceptible to disease, dull their intellects, diminish their motivation, and sap their productivity.

What is malnutrition?

Malnutrition – the state of being poorly nourished – is not merely a result of too little food, but of a combination of factors: insufficient protein, energy and micronutrients, frequent infections or disease, poor care and feeding practices, inadequate health services and unsafe water and sanitation.

Malnutrition’s most devastating impact is in the womb – when the foetus can fail to develop properly – and during the first years of a child’s life, when it can hamper her or his physical and mental development. Malnutrition takes different forms and a child can be affected in several ways simultaneously. Almost one-third of children in developing countries are malnourished – 150 million are underweight for their age. Another 175 million are stunted in height due to chronic illness and poor diet. And more than 60% of all children are not exclusively breastfed for the vital first 6 months.

Millions of children suffer from micronutrient malnutrition – when the body lacks essential minerals – iodine, iron and zinc – and vitamins – vitamin A, folate. The body needs micronutrients in minute doses to manufacture enzymes, hormones and other substances required to regulate growth, development and the functioning of the immune and reproductive systems. Deficiencies in iodine can lead to severe mental or physical impairment, in iron to life-threatening anaemia or lowered productivity, in vitamin A to blindness or to a weakened immune system and in folate to low birth weight or birth defects such as spina bifida (a fault in the spinal column in which one or more vertebrae fail to form properly, leaving a gap or split, causing damage to the central nervous system).

Breastfeeding is the initial source of vital micronutrients, as well as providing overall sound nutrition and good health. The immune factors, growth factors, and other protective factors in mother’s milk cannot be found anywhere else in nature. Lack of breastfeeding exposes infants to an increased risk of death and disease in childhood, and increase the risk of chronic diseases such as diabetes and childhood cancer.

Key tools in the effort to defeat malnutrition include: an adequate diet, which includes immediate and exclusive breastfeeding for the first six months, and continued breastfeeding with age-appropriate complementary foods, micronutrients, prevention and treatment of disease and proper care and feeding practices.

Also critical is the need to protect the rights of women and girls. Wherever women are discriminated against, there is greater malnutrition. Children born to mothers with no education are twice as likely to die in infancy as those born to mothers with even four years of schooling. [UNICEF]  Reproductive health, including birth spacing for at least three years, also reduces stunting and death.

The 1989 Convention on the Rights of the Child recognizes the right of all children to the highest attainable standard of health, and specifically the right to good nutrition. Governments have the legal responsibility to protect that right and it is in the best interest of all that they fulfill this obligation. Malnutrition is both a consequence and cause of poverty. Children’s nutrition and well being are the foundation of a healthy, productive society.



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