Angela Onwuzoo
Nutrition and child health experts have identified early initiation of breastfeeding within 30 minutes of birth as one of the most cost-effective interventions to reduce stunting in children under the age of five in Nigeria.
The experts affirmed that nutritional intervention carried out for infants and toddlers to prevent stunting is exclusive breastfeeding for six months and continued until the age of two years.
Exclusive breastfeeding, they noted is expected to help children obtain proper nutrition and reduce the risk of stunting.
They stated that breastfeeding gives an infant significant protection against pneumonia and diarrhoea, which are two major causes of death in children in poor countries.
The Federal Ministry of Agriculture and Rural Development says no fewer than 12 million Nigerian children are suffering from stunted growth.
According to the United Nations Children’s Fund, Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 per cent of children under five.
UNICEF also states that an estimated two million children in Nigeria suffer from severe acute malnutrition but only two out of every 10 children affected is currently reached with treatment.
Speaking in separate interviews with PUNCH Healthwise, the experts said widely accepted and evidence-based interventions, including exclusive breastfeeding for the first six months of life beginning with early Initiation, reduce the risk of stunting in children.
A Registered Dietician-Nutritionist at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nwabumma Asouzu, disclosed that stunting affects children’s health by making them more susceptible to diseases and infections.
According to the dietician, stunted children who experience rapid weight gain after the age of two years have an increased risk of becoming overweight or obese later in life, revealing that such weight gain is also associated with a higher risk of coronary heart disease, stroke, hypertension, and type 2 diabetes.
Asouzu identified stunting as a major contributor to child morbidity and mortality.
Quoting the 2018 Nigeria Demographic and Health Survey, she said, “37 per cent of Nigerian children aged between six and 59 months are stunted (short for their age); seven per cent are wasted (thin for their height); 22 per cent are underweight (thin for their age); and two per cent are overweight (heavy for their height).”
Giving insight into stunting and its causes, Asouzu said “Stunting is said to be growth and development impairment which normally occurs in children as a result of; poor or inadequate nutrition to meet up with their rapidly growing demand.
‘Stunting, or being too short for one’s age, is defined as a height for age and length of –two SD of the World Health Organisation Child Growth Standards median.
“What causes stunting in children can be categorized into direct and indirect causative factors.
“The direct factors which are also preventable include but are not limited to; inadequate nutrition (not eating enough or eating foods that lack growth-promoting nutrients), recurrent infections or chronic diseases which cause poor nutrient intake, absorption or utilization.
“This leads to a lack of care and stimulation for development because the body is lacking the basic nutrients needed for growth purposes.
“Poor nutrition and a lack of access to diverse and safe foods, poor sanitation and no access to clean drinking water.”
She explained that lack of proper healthcare for children and maternal nutritional and health status before, during, and after pregnancy was also responsible for stunting in children.
“This influences a child’s early growth and development, beginning in the womb. For example, intrauterine growth restriction due to maternal undernutrition (estimated by rates of low birth weight) accounts for about 20 per cent of childhood stunting.
“If a mother is malnourished, it’s more likely that her baby will be born underweight. This set off a cycle of stunting”, she affirmed.
On indirect causes of stunting in children, the dietician listed poverty, low status of women, and unsanitary health conditions, among others.
The dietician, however, said stunting in children could be prevented while calling on the government to make it a priority.
Asouzu said focusing on the critical 1000-day window from a woman’s pregnancy to her child’s second birthday was critically important.
“Action can be taken across multiple areas to reduce rates of stunting. First, improving optimal breastfeeding practices is key to ensuring a child’s healthy growth and development.
“Early initiation and exclusive breastfeeding for six months provides protection against gastrointestinal infections, which can lead to severe nutrient depletion and therefore stunting.
“Second, among the most effective interventions for preventing stunting during the complementary feeding period is improving the quality of children’s diet.”Evidence suggests that greater dietary d
iversity and the consumption of foods from animal sources are associated with improved linear growth”, she said.
A Consultant Paediatric Haematologist and Oncologist at the Lagos University Teaching Hospital, Idi-Araba Prof. Edamisan Temiye, urged mothers to breastfeed their newborns within the first 30 minutes to one hour after delivery.
“Stunting not only affects a child’s health, making them more susceptible to disease and infection but also impairs their mental and physical development – meaning children who suffer from stunting are less likely to achieve their full height and cognitive potentials as adults.
“Stunting is often intergenerational: Children who are stunted are also more likely as adults to have stunted children.”
“A stunted child is also more prone to becoming overweight as an adult, posing more health risks.
“Stunting has long-term effects on individuals and societies, including diminished cognitive and physical development, reduced productive capacity and poor health, and an increased risk of degenerative diseases such as diabetes and other non-communicable diseases”, he noted.
He, however, noted that exclusive breastfeeding from an early age had been proven to prevent or reduce the risk of stunting in toddlers because breast milk contains sufficient micro and macronutrients such as colostrum to provide immunity to infants.
“At the same time, lactose, iron, and other minerals are helpful for infant brain development”, the paediatrician added.
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