Healthy Living: Causes of malnutrition in children
Last week healthy Living dealt with the advantages of breastfeeding and in this week segment, we look at substitutes. And as we learn from the experts, the rising costs of milk formula can lead to an increase in cases of malnutrition.
Dr Egbert Grinage, Pediatrician/Pediatric Internist
“Its prevalence is widespread. It’s starting to be one of the leading causes of mortality and morbidity in under five children all over the world particularly in developing countries.”
Marleni Cuellar, Reporting
Malnutrition is a global issue. And as we have learned recently it is not an unfamiliar situation here in Belize. Pediatrician Dr. Egbert Grinage speaks of the situation here at home.
Dr Egbert Grinage
“In Belize there have been some recent studies done. Between 2000 and 2006 it’s thought that 7 % of babies under five were underweight moderate and severe. Particularly in the southern district we found that in 18 to 39 % of children school age between, six and nine, were chronically malnourished. We knew that because from that study it was showing that their height for age was lower than expected or ‘stunted’.”
“Malnutrition is when there is an imbalance at the level of the cells between what the body requires and what is being provided in terms of energy units and essential nutrients for the body to grow, maintain and perform specific functions. There are the two types of malnutrition, a protein energy malnutrition kwashiorkor which is the child is getting some calories but not enough protein those babies tend to develop water under the skin and in the belly which is called edema and ascities they look a little different they are unhealthy but they are puffy their skin may not have the correct texture, color. Their hair may fall out rapidly they have a skin that breaking down due to not only the protein energy malnutrition but also this associated with iron , zinc, and what we call micronutrient deficiency.”
“And then there is Marasmus. This is the baby that looks like a little old man, total loss of fat. This baby is taken off the breast far too early, getting total calorie depletion and not getting enough calories. The baby doesn’t have the water under the skin or the fading of the skin like kwashiorkor. The baby is just totally very small not active, not moving, changes in the skin etcetera.”
There are several underlying reasons for malnutrition in children but one unfamiliar cause is linked to the improper use of bottle feeding with baby formula.
Dr. Egbert Grinage
“In these harder economic times you may see more and more children coming in with malnutrition because formula costs.”
Marleni Cuellar
“Baby formula is a zero rated item which means it has no GST included in its cost. With the prices ranging here from about fourteen to seventeen dollars we can understand why formula is such a pricey commodity. But even more than the cost parents and mothers need to pay attention to how they are making the formula.”
Dr. Egbert Grinage
“Technically, they might think it’s easier cause it’s just mixing milk and water but its actually more difficult because you have to make sure you’re doing it in a hygienic manner so it doesn’t not cause the baby infection. You have to wash your hands, boil the nipples, boil the bottle prepare the milk in a sterile manner. And often in some of the homes that some of these children are growing up, they may things walking around at night and the bottles may not be stored properly etcetera. They may not only dilute the formula, but they may be diluting it because they don’t know how to mix it properly or they may be diluting it because it may last longer. It’s economically driven due to economic hardship. So even if they stop breastfeeding they may be giving formula that is watered down. The baby won’t bee getting the calories that it needs to get for the brain to functions.”
Another warning from the pediatrician is regarding the common remedy of feeding babies sugar and water.
Dr. Egbert Grinage
“It may be a thing that is passed from generation to generation that sugar and water makes the baby sleep better at night and nothing could be further from the truth that there is no nutrients in glucose water. So that is vicious cycle that is very prevalent in Belize. It may start out as one bottle but when times get hard that may become the only source of calories if you will for the baby and it just doesn’t cut it. Invariably when we diagnose malnutrition in the hospital there is a history of sugar and water; sometimes that is the only thing they’ve been given.”
“Chronic malnutrition can cause a decrease in their ability to learn so they won’t become fully productive members of society. Even in its mild form, they find that children who are mildly malnourished on a chronic basis are apathetic; they won’t show a lot of affection. They’re irritable, they cause a lot of school problems in that they have attention deficit disorder and they’re not functioning well. A child who comes to us late with severe or moderate case of malnutrition may actually be irreversibly subjected to a life where he or she doesn’t learn well in school and can’t become the person he or she would have become had they had that good nutrition.”
With the lasting effects of malnutrition, there is a great need for parents to be able to focus on providing for their children the best start possible.
Dr. Egbert Grinage
“Children are the most valuable resource you have. When things get hard and there are floods and there are deaths in the family—both the d-e-a-t-h-s and the d-e-b-t-s—shortage of money etcetera and things get hard, just look at your children, provide for them and make sure that they grow up to be healthy. A famous person once said that you can make mistakes with everything in the world but don’t make a mistake in how you raise your child.”
