Photo by Feed My Starving Children (FMSC) on Flickr (CC BY 2.0).
Seeing your child’s first smile, watching their initial wobbly steps, and hearing their child begin to form words are all precious milestones that gladdens the heart. This growth comes from nutrients in foods children eat.
Children’s food should be rich in essential nutrients delivered in the right balance. When this balance is not maintained or achieved, it can lead to malnutrition which affects the child’s well-being in several ways.
Here are some key facts about malnutrition in Nigerian children:
- Approximately 37% of children (6 million) experience stunting (a condition whereby the child is too short for the age)
- 18% of children are affected by wasting (indicating low weight for height)
- 29% of children are underweight (which includes both acute and chronic malnutrition)
What is malnutrition?
Malnutrition is an abnormality in nutrition. It occurs when there’s an imbalance in a child’s nutrient intake, either because the child takes too much or too little calories, carbohydrates, vitamins, proteins, or minerals. Malnutrition includes both undernutrition and overnutrition, which are consequences of either deficiencies or excesses of vital nutrients.
Why are some children malnourished?
Children are more likely to have shortages of both macronutrients and micronutrients due to their increased nutritional needs during growth. When they don’t get adequate food or don’t eat as they should, they may become malnourished.
The consequences of malnutrition in children under five can include being underweight, stunted, or wasted, with or without edema (previously referred to as marasmus and kwashiorkor, respectively), and in severe cases, it can lead to death.
Malnutrition represents a critical outcome of food insecurity among children in this age group. Acute malnutrition can result in illness, death, and long-term disabilities, as well as hinder cognitive and physical development, while also increasing the likelihood of concurrent infections.
Each year, around 50 million children globally experience acute malnutrition. Despite the availability of treatment, accessing it can be difficult.
Types of Malnutrition
Malnutrition can be categorised primarily into two groups:
- Overnutrition
- Undernutrition
Overnutrition
Overnutrition occurs when your child consumes more nutrients than their bodies need, resulting in excess body fat and related health risks.
Children who are classified as overweight or obese face increased risks for a variety of health issues later in life, including:
- Heart disease
- Diabetes
- Certain types of cancer
The occurrence of overnutrition is rising globally, with reports from unicef indicating that 5.7% of children under five were classified as overweight in 2020, an increase from 5.4% in 2000.
Undernutrition
Photo by Cate Turton / Department for International Development on Flickr(CC BY 2.0).
Undernutrition is when a child is not eating enough food or the right foods to meet their body's needs for energy and good health.
Undernutrition poses a serious threat to the health and development of children. It can result in severe outcomes like protein-energy malnutrition, including a greater vulnerability to infections, hindered cognitive and physical growth, and, in extreme cases, death.
Undernutrition can be further classified into four categories:
- Wasting (defined as low weight-for-height)
- Stunting (defined as low height-for-age)
- Underweight (defined as low weight-for-age)
- Deficiencies in essential vitamins and minerals
Each of these conditions can have a profound impact on a child's health and development.
Why are children unable to access nutritious food?
Dietary practices
Unlike adults that can choose what they want to eat, children often take what they are fed. For the first months of life, most children are on breastmilk. Family food such as pap, rice, and “swallows” like eba, amala, and pounded yam, come much later.
However, children may be left malnourished due to practices that undermine adequate nutrition. For instance, some mothers think that breastmilk alone is insufficient for their baby's growth and feel compelled to introduce other traditional foods too early.
Additionally, there are misconceptions that colostrum—the first milk produced after childbirth—is not healthy for children, and may even be harmful, which leads some mothers to discard it.
Breastmilk, especially colostrum, is one of the most nutritious foods a child can take. It is rich in nutrients and easy to digest. It also contains proteins that protect the child from diseases, plus growth factors to support the child’s maturation.
Caregiver ignorance
Caregivers, especially first-time mothers are sometimes unaware of how frequently a child needs to be fed. Children’s meals do not follow adult timetables. They need to eat as soon as they are hungry, which is often many times.
Young children grow rapidly in the first years of life, and this consumes their energy. Their energy comes from food. So they use more nutrients than adults, necessitating frequent meals that are balanced
However, many first-time mothers mistakenly adhere to the adult routine of three square meals a day, which can result in the child not receiving the necessary nutrients.
Illness
Frequent or severe illnesses can cause a child to become malnourished. For instance, malaria, pneumonia, and measles causes the child to lose energy, or increase their energy demand, leading to malnutrition.
An ill child may have poor appetite such that they don’t eat even when food is available. Such child may vomit their food, or lose all their nutrients through to diarrhoea. Some children with short gut may also not be able to absorb the foods they eat, whether the food is adequate or not.
Besides, when their parents are ill and there’s other caregiver to take care of the child, the child may suffer malnutrition. This is often true for children of mothers with chronic illnesses, or mothers that had surgery or complications during delivery.
Cost of quality meal
The high cost of nutritious meals is a major reason why many children under five in Nigeria suffer from malnutrition. Families, especially those in poorer areas, often can't afford the balanced diets that young children need.
This issue is particularly severe in low income communities where many families don’t have a stable source of income, or the income is too low to provide enough food for the family.
Moreover, factors like inflation, climate change, and economic instability are driving up food prices, making it even more difficult for low-income families to secure essential nutrients for their children.
Conflict and drought
In northeastern Nigeria, the combination of drought and conflict has led to significant food shortages. Displacement of families means that parents often struggle to secure food, as they no longer have a reliable supply. When livelihoods are compromised, food insecurity becomes a pressing issue.
According to a June 2024 report by UNICEF on food insecurity in Nigeria, around 11 million children, or one in every three children under five years of age, in Nigeria are experiencing severe child food poverty, making them up to 50 per cent more likely to experience wasting, a life-threatening form of malnutrition.
Signs and symptoms of malnutrition
Signs of malnutrition can vary but often include:
- Unintentional weight loss
- Reduced appetite or disinterest in food
- Fatigue and irritability
- Difficulty concentrating
- Dry, pale skin
- Easy bruising or rashes
- Changes in hair texture and growth
- Swollen or cracked tongue
- Increased sensitivity to cold
- Prolonged wounds healing
- Higher likelihood of infections
- Night blindness or sensitivity to light
Sometimes, a child is given the right amount of food, but essential micronutrients like Zinc, Vitamin D etc are lacking, which would result in a term known as hidden hunger.
How can you prevent malnutrition
The key to preventing malnutrition is to maintain a balanced diet that includes a variety of foods from all major food groups. This should include:
- An abundance of fruits and vegetables, like oranges, watermelon, pumpkin leaves
- Sufficient starchy foods such as bread, rice, yam flour, wheat flour, cassava flour (aka, garri) and pasta
- Adequate dairy or dairy alternatives
- Protein sources like meat, fish, crayfish, eggs, and legumes
If you don’t know what a balance diet looks like in your local diet, discuss with a dietitians or a paediatrician to guide you.
How malnutrition is treated
Malnutrition is a medical condition that requires care of specialists like dietitians and paediatricians. Treatment strategies will differ based on the severity of the condition and any underlying health issues. Approaches may include:
- Correcting life-threatening deficiencies
- Stablizing the child’s body temperature and fluid levels
- Continuous monitoring and assessment
- Developing a dietary plan that may include nutritional supplements
- Addressing specific symptoms, such as vomiting and diarrhoea
- Treating any existing infections
- Evaluating and managing swallowing difficulties
- Following up on the child’s recovery
In severe cases where a child cannot eat through the mouth, tolerate enough food, or absorb nutrients on their own, the physician may resort to feeding the child through intravenous (parenteral) or tube (enteral) methods to ensure adequate nutrient delivery.
Conclusion
The complexities surrounding malnutrition are significant, with its most common causes linked to poor dietary quality, inadequate caregiving practices, and recurrent infections among children.
The repercussions of malnutrition can lead to both immediate and long-term health challenges, including slower recovery from illnesses and an increased risk of infections.
Therefore, it is vital for parents to prioritise prevention strategies and recognize the signs of malnutrition to enable timely interventions and restore health in affected children.
