Paediatricians’ body to tackle nutritional deficiencies in infants

Though the State has made significant gains on the breastfeeding front going by the NFHS-6 data, Kerala falls far short when it comes to meeting the nutritional requirements of infants and young children.

The Indian Academy of Paediatrics (IAP) has noted with concern the NFHS-6 data that just 26% of infants in the 6-23 months age group in the State meet the “adequate” diet criteria of WHO and has seriously taken up the task of improving the nutritional content of infant diet in Kerala, by partnering with parents.

“About 70-80% of the brain development in infants happens in the first 1,000 days (including the intra-uterine period) and this is the time that we need to focus on nutrition. However, we noticed that paediatricians often do not get an opportunity to see the infant at the sixth month and counsel parents about the nutritional content of complementary feeds. This is because, after the initial immunisation visits, the infant is seen by the paediatricians only in the ninth month when the next vaccination is due,” says M.K. Nandakumar, president, Indian Academy of Paediatrics, Kerala.

ICYF guidelines

Nutritional adequacy of complementary feeds is determined by the WHO’s core indicators in infant and young child feeding (ICYF). ICYF guidelines say that a diet lacking in diversity can increase the risk of micronutrient deficiencies, which may have a damaging effect on children’s physical and cognitive development.

Infants exposed to foods which are high in added sugar, unhealthy fats, salt and refined carbohydrates with little nutritional value at an early age may be inclined towards these food in their childhood and adolescence and making them prone to chronic non-communicable diseases. This is something that the State cannot overlook because 20% of the infants in Kerala have stunting, which is directly linked to micronutrient deficiencies

“Infants should not be given any food with added sugars before the age of one year but we find that these days junk food -- biscuits in particular -- are becoming a part of the infant diet. There are also several food-related misconceptions among parents. We need to counsel parents on how to start nutritious complementary feeds, its frequency and quantity. Hence, we are trying to introduce an infant wellness clinic concept and encourage parents to visit us when the infant is six months old,” says Dr.Nandakumar.

Nutritional counselling

Hospitals will thus celebrate “half birthdays” of infants on the sixth of every month when parents are asked to bring their six-month-olds to the hospital so that the parents can be given nutrition counselling.

Paediatricians counsel parents on how they can give nutritious, balanced feeds to their infants, keeping in mind the availability of regional and seasonal foods and how it should be incorporated into the infant’s diet.

This also becomes an opportunity for paediatricians to give advice on vaccinations and for the cognitive and development assessment of infants so that interventions can be made early. Infants are assessed for physical growth parameters as well as their movement, speech and social interactions

IAP is also extending the wellness clinic concept to anganwadis so that the nutritional counselling and developmental assessment can be extended to infants in rural areas also. IAP has 19 branches across the State, and will adopt one or two anganwadis where these initiatives will be taken up on a regular basis.