What parents can do to prevent child malnutrition: preparing before pregnancy

Chronic child malnutrition (DIC) It is one of the biggest public health problems in Ecuador, as stated by Unicef, since it affects 27.2% of children under 2 years of age.

The curve for this condition has not moved since 1993, despite various government health programs. Between 2014 and 2018 it increased from 24.8% to 27.2% in children under 2 years of age and to one in four under 5 years of age in Ecuador, and it remains so.

DIC has a long-term impact, declares Unicef. His signs are the low weight, peeling skin, hair loss. “We see a child who is not very active, with a tendency to drowsinessperhaps paleness, with recurring viral or bacterial infections”, indicates the pediatrician nutritionist Vladimir Vélez.

Just as there is loss in muscle size, there is damage to the teeth. “The teeth of these patients begin to crack, and take on a different coloration: yellowish, orange, reddish”, describes doctor Vélez.

Unicef ​​indicates that the path to rectify DIC in Ecuador goes through public policies that guarantee an environment of care and affection, stimulation for development, access to drinking water and sanitation, breastfeeding, medical follow-up from pregnancy, compliance with the plan vaccination and, of course, food.

A child can reach this state for a number of reasons, in addition to poverty.

• Lack of parental training. “Quality food begins in the first days of life or even more, before being parents. The information that you handle is very important: from 0 to 6 months it should be exclusive breastfeeding, this means not introducing nutrients that the child does not provide, such as oatmeal or water with milk. From 6 months, continues the pediatrician, children begin to eat fruits and vegetables, and ensures that there is no reason to fear this transition. “Your child already needs more protein, fat and carbohydrates. He suggests giving the child a variety of fruits, so that he can choose and start solid foods. “We will do very well with Baby Led Weaning (in which the baby selects his food and begins to detach himself from breastfeeding). When the baby achieves the ability to ruminate and swallow, it gives us the opportunity to progress with other foods, so much so that at one year of age we will have him as one more member of the household table”.

• Lack of promotion of quality food. Vélez explains that there is a lot of fear of choking, but this will dissipate as the child acquires skills. “Because, From the first minute of life, the child must be assessed by a professional to find out if their weight, height and body mass are in accordance with their age, month by month.”. A quality diet, from 6 months, introduces white meat (chicken, fish). At 8 he could try red meat, depending on his development. Offer variety, but know that the way you present the food also matters: pureed foods, smoothies, juices, and soups are fine, as long as they don’t prevent your child from eating solid food.

Prepare the living conditions of the child before becoming parents

Pediatrician and child nutrition researcher Mercedes Gordillo A. also emphasizes prevention, which does not begin at birth or during pregnancy, but before. The woman who plans to get pregnant must go through this process with proper nutrition.

The doctor recommends a balanced diet and the use of folic acid before and during this stage. “Because when the child is already malnourished, we will face many problems,” including poor cognitive performance, since this is the stage in which the brain is developing. Or as Unicef ​​Ecuador maintains: “Once stunting is diagnosed, there is no going back”.

“The first five years of the child are sacred,” says Gordillo, because The ability to learn and the final size will depend a lot on the diet at this stage, indicates the pediatrician, author of the Theoretical and practical treatise on child nutritionpublished by the University of Guayaquil.

Children benefit from breast milk, which for Gordillo is the unrivaled option up to 6 months, when it will become part of complementary feeding until the first year; From then on, the little ones will be able to integrate into the family diet, and acquire protein from foods such as whole milk (the latter up to 6 years).

It is important to make sure that the child reaches the stage of puberty with an adequate weight and height, because then it will enter the final growth phase, which will be until the age of 21, approximately. “In adolescence there are also nutritional requirements”, proteins of animal and vegetable origin (grains)”.

Do children need supplementation? Gordillo says yes, and has a simple and inexpensive recommendation: the B complexfor the development of the nervous system.

The two sides of child malnutrition in Ecuador

Vélez notes that in urban areas there are many more cases of overweight children. “Obesity rates have increased, while in patients from rural areas the rate of malnourished children has risen. That is why not having information makes it difficult to nurture our children.”

While children in cities consume a large amount of ultra-processed foods, with high caloric intake. “A suitable lunch box for your baby cannot have the calories of a lunch, with yogurt, cereals, chocolate and cookies. You should only take a piece of fruit and a bottle of water; It’s supposed to be an appetizer, nothing more, or the kid will go home full and not want to eat lunch.”

On the other hand, children from rural areas do not have close proximity to quality food, they are subject to many carbohydrates, and they lack protein. In Velez’s opinion, Educating future parents is the way to start changing the DIC rate. “It’s not that you can’t eat well in the countryside, it’s that there isn’t adequate information, there isn’t good health promotion.”

When the malnourished baby is not caught in time with the weight, height and body mass tests, the doctor reaffirms, he can reach school age with cognitive deficit. (YO)