Severe acute malnutrition can sniff out life from a child

Severe acute malnutrition can sniff out life from a child

• by Dr. Sanjay Choudhary, Senior Consultant Pediatrics, Fortis Escorts Hospital, Jaipur

Severe acute malnutrition (SAM) may read like a flowery figure of speech, but the reality it presents can alter your life. It is the most extreme and visible form of undernutrition and the affected children look frail and skeletal – they require urgent treatment to survive. Other characteristics of severe acute malnutrition is very low weight for the height and severe muscle wasting. They may also have nutritional oedema – characterized by swollen feet, face, and limbs. Severe acute malnutrition is a major cause of death in children under 5 years, and its prevention and treatment are critical to child survival and development. Plagued by chronic poverty, lack of education, poor hygiene, and limited access to food and poor diets, nutrition faces significant barriers to bring sustainable development in countries like ours.

Why is SAM our concern?

Malnutrition is a major health concern in Indian children, not only in rural areas, but in urban slums too. About two thirds of these children live in Asia and every third malnourished child in the world lives in India[1]. In Rajasthan, the government figures show 20 per cent of the children are either in the underweight or severely underweight category[2]. Now, picture this. Over the last 20 years, total food grain production in India increased from 198 million tonnes to 269 million tonnes but, as it turns out, the share of expenditure on cereal and cereal substitutes has declined between 1972-73 and 2011-12, from 57 per cent to 25 per cent in rural areas and from 36 per cent to 19 per cent in urban areas. This indicates that energy and protein intake from cereals has decreased in both rural and urban India, largely because of increased consumption of other food items such as milk and dairy products, oils and fat and relatively unhealthy food such as fast food, processed food, and sugary beverages. The consumption of unhealthy energy and protein sources is much higher in urban areas. All these together compound the malnutrition problem in India where despite increase in food production, the rate of malnutrition remains very high.

In India, people who have money but they do not spend it right when it comes to food. They do not have complete information about the food they are consuming nor are aware of practices such as reading food labels.

Prevention and treatment of SAM

Ending acute malnutrition is a complex social and political challenge as it involves improving equitable access to health services and nutritious foods, promoting breastfeeding and optimal infant and young child feeding practices, improving water and sanitation, and planning for cyclic food shortages and emergencies. In the short term, children with severe acute malnutrition need urgent life-saving treatment to survive. With the ready-to-use therapeutic food (RUTF), this task is made easy. The RUTF is a group of high-energy, micronutrient-enhanced paste used to treat children under age 5 who are affected by severe acute malnutrition. It does not need to be cooked or prepared before consumption, and hence makes it a practical solution. RUTF has a long shelf life and is safe for use even in the absence of clean drinking water. These days, intake of fast food has increased in comparison of homemade food. In such cases, maternal and family education plays a very important role. While feeding your child, keep them away from TV, mobile phones and laptops as it affects the duration of the meal intake. Also, trust your child’s opinion – if s/he says they are full, do not force them to eat more.

[1] https://www.indianpediatrics.net/apr2019/apr-287-293.htm

[2] https://www.hindustantimes.com/jaipur/one-in-five-children-underweight-shows-rajasthan-government-data/story-78UsAn9B1MLqBtECXhSU2M.html