Questions and Answers on Nutrition and Healthy Living in Children

What is Nutrition

Nutrition simply means the study of nutrients in food, how the body uses them, and the relationship between diet, health, and disease.

What is Malnutrition
Malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization.

A child can be “undernourished or over-nourished”. Most times, the over-nourishment part gets overlooked, Over-nourishment brings about obesity, overweight and diabetes while the Undernourishment brings about wasting, stunning and micronutrient deficiencies. Stunting and wasting are sometimes confused but majorly, stunting is chronic (develops over a long period of time) while wasting is more acute (develops over a shorter period of time.

Stunting in children can be measured using the height-for-age nutritional index. Stunting is often associated with cognitive impairments such as delayed motor development, impaired brain function and poor school performance, as it often causes these negative impacts.

This is when some mothers start saying “my child isn’t just tall, it’s his/her nature” sometimes, it might be true but some other times, forget that the, baby was never fed well.

Wasting is often seen in children who are thin for their height because of acute food shortages or disease also known as ‘acute malnutrition’, wasting is characterized by a rapid deterioration in nutritional status over a short period of time in children under five years of age. Wasted children are at higher risk of dying.

Quick Fact: “According to WHO, 45% of child death yearly is associated with malnutrition”.

The Micronutrient Deficiencies:

Iron, zinc, vitamin A, folate, vitamin B12 and iodine are often involved as they are the most difficult to satisfy without diverse diets. There are still other diseases like kwashiokor, marasmus and sometimes, a combination of both which occur with protein energy malnutrition.

Overnutrition

This child is actually “well fed” but the nutrients were never in the right proportion, they were way too much especially the carbohydrates and added sugars. This brings about obesity, being overweight and in some cases – diabetes in children (yea, you read right, diabetes!)

FREQUENTLY ASKED QUESTIONS AND ANSWERS:

Question 1: highlight the kind of foods to be given to a one and half years old child?

For a one and half year-old child, it is expected that the child should still be breastfed though not exclusively anymore. In actual fact, exclusive breastfeeding for a child like this will bring about severest forms of malnutrition. So, in essence, give breastmilk alongside other household diets. Be careful to try the household diets out one after the other thought to know if the child is allergic to any. Instead of pap, you might want to give tom brown, a combination of corn, soyabeans, groundnut and crayfish. Also, ensure you give milk, eggs and fish well.

Question 2: How do I know a child is having diabetes?

More often than not, the child might start urinating excessively, start asking for water more, extreme hunger but weight loss and blurred vision are early signs.

Not all are linked to diet though, the one linked to diet is more of type 2 (this wasn’t common in children initially but now, we are having it in children). Some children also have type 1 diabetes which is more linked to hereditary.

Question 3: Can we have categories of food and their ages? I mean from 7 month upward?

There isn’t a particular category as such. Just give all classes of food in the right proportion – carbohydrates, proteins, minerals, vitamins, water fats and oil (sparingly). All these should be alongside breastmilk though from 6 months to 2 years.

Question 4: What do we do to a child that refuses to eat? But likes to take Golden morn all through the day?

This is another main cause of malnutrition. Children nowadays prefer noodles, biscuits and cereals like cornflakes, golden morn and the likes. It is advisable to be careful of bringing a child up with those food items. Try making meal times more child-friendly.  This is a lot of work but it helps; you might want to serve the child with a fancy plate, cut the food into fancy shapes to make them more appetizing and also give a small reward to the child at the end. More importantly, do away with those food items the child is stuck on.

Question 5: What do you suggest to be the percentage of classes of food in each diet of children between 8 &10?

This diagram below will serve as a guide when dishing out food to children and even adults.

Question 6: What kind of food can be given to a child that has been undernourished to boost the immune system?

It isn’t just about boosting the immune system here, the target is all about adequate nutrition for the child, the immune system will be boosted through that. If it is really severe, kindly go to an hospital for better management, if mild, ensure you give meals that cut across all food classes with milk and eggs fully present. “Big fish and eggs aren’t just for Daddy; the kids need them more”.

Question 7: In Nigeria, the prevalence of malnutrition has progressively deteriorated over the last ten years. Stunning, wasting and underweight were 53.1%, 9.0% and 36% respectively according to (NDHS). Therefore, how do we deal with nutritional disorders management and factors responsible for poor nutrition among Nigeria children?

For nutritional disorders, having a health system with free/subsidized services for under 5s would have helped but unfortunately, we don’t have that here. Diseases also contribute to malnourishment in children. Disease that cause malnutrition in children are mainly parasitic worms, hence regular deworming is important Also, enlightenment of mothers during antenatal visits is also a good one including compliance with nutrition clinics. This problem is multidimensional. Poverty is the leading culprit here followed by ignorance, some have money but still under or over feed, all thanks to noodles and cereals. So, it requires multi-sectoral collaboration ranging from the government to schools to private institutions and all other concerned bodies. There is a need for enlightenment especially as regards family planning and concept of adequate nutrition. School feeding would be nice too.

Question 8: what can be done to a child of a year old that is over nourished that has result to obesity?

For obesity, carbohydrates are the main culprit, as much as it should form the bulk of the meal, kindly cut down the child’s intake in a way, add more of vegetables and fruits to the child’s diet as well as water. Also, support the child in exercising- jogging, skipping, brisk walking (mild exercises) should help. Weigh the child frequently and give rewards for weight loss. Also, avoid body shaming the child Ensure you keep fatty meals out of the child’s reach and explain the importance of weight loss to the child using appropriate communication for age.

Question 9: Can malnutrition be related to inability to spell correctly in an age 6. If so, what can be done to correct it?

The child’s brain is constantly developing and the brain depends on minute to minute intake of glucose from the blood stream. This isn’t the only reason why there might be that problem but it is very possible. Feed with nourishing meals, avoid junks at all costs and you might want to get a child-friendly teacher for the child if it is really bad. Peak 456 is also good for this age because it contains DHA (Docosahexaenoic acid) which helps in brain development. Eggs, milk, crayfish (if not allergic to seafood), fish, fruits cannot be overemphasized here too.

Question 10: Can we allow the child to take cheese balls, cereals, ribena, biscuits, etcetera along household diets?

Yes, but sparingly, never allow your child get stuck on them and never let them form a meal – breakfast, lunch or dinner, before one knows it, they might get so attached to them. Make them get attached to fruits more.

Question 11: What is the right timing to give children their food?

For the right timing, breakfast should be taken between 7-9 (depending on the family time), brunch should be between 10-12 (brunch here might be fruits, fruit salad, vegetable salad or biscuits, ribena etc. (these two should never be given frequently please). For dinner, 6-7 is fine depending on their sleeping time, just ensure they don’t go to bed immediately after eating. Don’t serve dinner late into the night please or get to the point of having to wake them up later at night to eat (this contributes to fat accumulation and might cause obesity in at risk children and even adults.

Question 12: Which of this meal in important, breakfast, lunch, dinner?

All of the Above, but do ensure they take breakfast at home or if impossible, ensure they get fed breakfast in school with the help of their school teachers.

 

Presented by Abimbola Adebayo

 

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