Child undernutrition, tropical enteropathy, toilets, and handwashing
The Lancet, Volume 374, Issue 9694, Pages 1032 - 1035, 19 September 2009 doi:10.1016/S0140-6736(09)60950-8
Research evidence points to a more insidious cause of stunting in
children due to chronic ingestion of feacal matter during the critical
growth years between 0-2 years of age. The conventional justification
for sanitation programmes has usually been based upon diarrhoeal disease
reduction. This new research suggests that rather than diarrhoea
episodes being responsible for growth stunting it seems that a
phenomenon known as Tropical Enteropathy is a more likely candidate.
Essentially this is caused by chronic fecal matter ingestion and
associated damage to the small intestines which are responsible for
severe nutrient uptake inhibition - leading to stunting.
Nutrition education improves growth in rural China
An article in the April 2010 issue of Public Health Nutrition
presents findings from a randomized controlled trail of an
education intervention designed to improve complementary feeding
practices in China. Children in villages that received the
intervention gained significantly more weight and length and
experienced faster growth velocity compared to a control group.
These results offer further evidence that educational messages
alone can improve linear growth in food-secure low-income groups.
Read more.
Local micronutrient fortification of school meals improves nutrition
The
June 2010 issue of The Journal of Nutrition revealed
results from a trial in India that tested the nutritional impact
of giving school meals fortified with micronutrients onsite. The
treatment group experienced significant improvements in total
body iron, serum retinol, and folate compared to the control
group. The authors concluded that point-of-use fortification of
school meals using existing infrastructure is a cost-effective,
locally acceptable, and sustainable way to implement
micronutrient fortification programs.
Read more.
Can low-phytate maize or zinc supplements enhance
growth?
An
article published in the May 2010 issue of The Journal of
Nutrition presents the results of a trial that measured the
effect of giving low-phytate maize, zinc supplements, or both on
linear growth velocity among Guatemalan infants aged 6 to 12
months. Low-phytate maize did not show any effect, but the zinc
supplements increased serum zinc concentration. Even so, the
authors found no impact on child growth, leaving the cause of
early stunting in Guatemala still unexplained.
Read more.
Why does exclusive breastfeeding reduce HIV transmision
from mother to child?
An
article in the March 2010 issue of Clinical Infectious
Diseases
explores the hypothesis that lower levels of mastitis among
women who exclusively breastfeed is the mechanism by which
exclusive breastfeeding protects against mother-to-child
transmission of HIV ((MTCT). Results showed no association
between mixed feeding and mastitis. Mastitis was predictive of
MTCT, but only when maternal plasma HIV load was high.
Read more.
Nigeria: Responding to the 2009 World Health Organization
recommendations
In a
Q&A, the t’s Wasiu “Prince” Afolabi shares the latest
on his country’s interpretation of the November 2009 World
Health Organization recommendations on infant feeding and HIV.
After
much debate and examination, national nutrition and prevention
of mother-to-child transmission of HIV stakeholders reached a
consensus to adopt the new guidelines. The decision, he says, is
a major step toward increasing HIV-free survival of children.
Prince will present this experience at the XVIII
International AIDS Conference. Read
the Q&A with Prince.
Zambia: Provincial training teams increase nutrition support for
HIV-positive moms
Offering better nutrition support to keep HIV-exposed children
healthy in Zambia’s Eastern Province was a problem that Sydney
Kambobe, a provincial nutrition specialist, had grappled with
for several years. In Zambia, poor feeding practices put
children of HIV-positive mothers at high risk of HIV
transmission. With the support of the IYCN Project, Sydney is
now part of a local team that is training health workers to
support HIV-positive moms to practice safer feeding.
Learn more.
Update from the
field: Côte d’Ivoire
Venance Kouakou, IYCN technical advisor in Côte d’Ivoire, joined
US President’s Emergency Plan for AIDS Relief and government
officials on May 18 for a ceremony marking the launch of efforts
to support social centers in improving nutrition for orphans and
vulnerable children (OVC).
At
the event, IYCN presented directors of 21 social centers from
across the country with anthropometric tools to identify
malnourished OVC and equipment for cooking demonstrations.
Investing in nutrition is key to feeding the future
In
May, the US Government launched the Feed the Future Guide,
describing its strategy to address global hunger and food
security. The strategy emphasizes that investments in addressing
the root causes of undernutrition can improve the lives of
mothers and their children. The guide highlights the role IYCN
is playing in
preventing malnutrition in Haiti.
View the guide.
Educating US policymakers on maternal and child health
IYCN’s Altrena Mukuria joined policymakers, congressional staff,
and global health colleagues to discuss the role of health
systems in improving maternal and child health during a May 25
Capitol Hill briefing in Washington, DC. Dr. Mukuria highlighted
the vital work that IYCN does to improve health systems and
increase the capacity of health workers, as well as how health
systems are integral to improving the health of women and
children throughout the world.
Learn more.
UNICEF: Fighting malnutrition in Benin 14 April 2010
ALIBORI DEPARTMENT, Benin More than one in three Beninese children under the age of five show
signs of chronic malnutrition. In the drier, northernmost part of the
country, most families harvest crops for both income and their own
consumption, feeding their children whatever is available from this yield.
The main cause of malnutrition is ignorance, said Linata Gbadamassi, a
nurse working in the Gomparou Health Clinic in Benins northern Alibori
Department.There is not a shortage of food but, rather, mothers dont use
the right ingredients, she added. They tend to always give the child
plain porridge made of just maize or millet instead of enriching it with
soya or other nutritious foods.
Reaching parents in Benin a country of about 9 million people and some
50 languages has proven to be a challenge. To connect with parents,
UNICEF is working with Benins Ministry of Health on an innovative,
community-based programme to prevent child illnesses related to malnutrition.
UNICEF: Improving chances for malnourished children in Côte d'Ivoire 1 April 2010
ABIDJAN, Côte dIvoire
Since her ninth child was born, Silué Kewa Tchewas breasts have not
produced a drop of milk. As a result, her six-week-old, Fatoumata, is underweight.
But the baby recently gained nearly 200 grams in just a few days when
she was brought to a UNICEF supported Red Cross therapeutic nutritional centre.
When the child is malnourished, its growth is slowed down. The parents
dont like this and blame evil spirits, said Red Cross nutritional centre
manager Salimata Coulibaly. Some abandon their child. Our first task is
to explain why the child is sick, the causes, and how they can get better.
In this rural area, cotton was once the main crop. The economic crisis
combined with a political crisis in Côte dIvoire has weakened many
families. Farmers are forced to sell all their vegetables to make ends
meet, without keeping part of their crop for their own consumption.
In the villages, the incidence of malnutrition is very high. UNICEF
works with the public authorities and NGOs to reach out to these
communities and improve their understanding of nutrition issues.
Community health workers conduct local follow-up outreach visits.
UNICEF: Food shortages in Chad lead to malnutrition in children 24 March 2010
MAO, Chad
Malnutrition rates are increasing in western Chad's Kanem Region, as the
region is gripped by severe food shortages due to a lack of rain. The
situation is exacerbated by local communities' very limited access to
basic health care and safe drinking water.
"Without the therapeutic feeding centre here, there would be a lot more
deaths and an even bigger catastrophe," says Chief District Medical
Officer Dr. Mekonyo Kolmain Gedeon. "We can see the change in health
with children admitted. After only a few weeks ... they are able to go home.
"These feeding centres are a critical lifeline for children living in
this region. We need more of these centres in order to save more lives," he adds.
In 2009, around 8,000 children were treated at 32 feeding centres in the
Kanem region. The centres were established by the Chadian Ministry of
Health and receive support from UNICEF to provide therapeutic food and medical treatment.
"At the moment, we have 2,800 children benefitting from the programme,"
says UNICEF Representative in Chad Marzio Babille. "While severe acute
malnutrition is an emergency, a rapid response with appropriate medical
care and technology can save lives."
Evidence supports coupling prevention with treatment of acute malnutrition February 2010 Following the Niger food crisis of 2004-2005, programs for
community-based treatment of acute malnutrition found that the
prevalence of acute malnutrition remained high. In an
anthropological study published in the January 2009 issue of
Disasters, researchers investigated social factors that may
predispose children to acute malnutrition and contribute to its high
prevalence. The authors found several harmful infant and young child
feeding practices. They recommended that treatment-based nutrition
programs should include integrated, long-term approaches to improve
infant and young child feeding.
Read more.
Can water safety interventions reduce diarrhea during weaning? February 2010 In a study published in the Journal of Infectious Diseases in
September 2009, investigators implemented a set of household water
safety interventions to determine whether preventing exposure to
waterborne pathogens would reduce diarrhea during weaning among
HIV-exposed infants. During the weaning period, the frequency of
diarrhea was the same in both the intervention and non-intervention
groups. The authors concluded that diarrhea during the weaning
period may be attributable to factors other than waterborne pathogens.
Read more.
Continued breastfeeding lowers the risk of serious gastroenteritis for HIV-exposed kids February 2010 The January 2010 issue of the Journal of Acquired Immune Deficiency
Syndromes features several articles on gastroenteritis and early
cessation of breastfeeding. One study analyzed the risk of serious
gastroenteritis in HIV-exposed infants who participated in two
different trials in the same hospital in Uganda during different
time periods. In one trial, mothers stopped breastfeeding their
babies before 6 months of age, while mothers in the other trial
stopped after 6 months. Stopping before 6 months of age led to
higher rates of serious gastroenteritis through 18 months, and higher cumulative mortality.
Read more.
Country spotlight: Kenya
Take a photo tour of our community-based activities February 2010
View our new photo slideshow featuring dedicated community
volunteers who help HIV-positive mothers boost nutrition for
their children in Kenya. Since April 2009, IYCN has collaborated
with the Society for Women and AIDS in Kenya and PATH to train
more than 400 volunteer counselors on improving infant feeding
practices in Western Province. See how the volunteers are
spreading the infant feeding message to mothers and families
through home visits, support groups, and discussions at health centers.
View the slideshow.
IYCN project news
Haiti update February 2010 Our thoughts are with the victims and families affected by the
Haiti earthquake. Over the past few weeks, we have been very
concerned about the safety and well-being of our IYCN team in
Haiti. We are relieved to report that we have been in contact
with all three of our staff members, who are employed by IYCN’s
partner CARE: Rose Mireille Exume, Jennifer LaTortue, and
Natacha Pierre-Pierre. Our sympathies are with them as they cope
with losses of family members and homes. IYCN Country
Coordinator, Rose Mireille Exume, is helping coordinate
emergency nutrition activities as a member of the Nutrition
Cluster team led by the United Nations Children's Fund (UNICEF).
Check the IYCN website for future updates on the situation.
Please view and share the following important statements on appropriate infant and young child feeding during the Haiti emergency.
February 2010
Introducing new programs in Bangladesh, Ethiopia, and Malawi February 2010 IYCN will expand its work to three new countries to reach mothers and children with nutrition interventions.
In Bangladesh, IYCN is working with CARE to provide families
with micronutrient powders to mix with their children’s food to
combat anemia and motivate beneficial feeding practices.
Learn more.
In Ethiopia, the team is working with partners to provide
training and support for improving nutrition practices for
HIV-positive mothers and HIV-exposed children.
Learn more.
In Malawi, the project will support the Office of the
President and Cabinet to build capacity for community-based nutrition and HIV services.
Learn more.
Making a difference in Lesotho February 2010
The project will wrap up activities in Lesotho this month. For
the past two years, IYCN supported the Ministry of Health and
Social Welfare to improve infant feeding practices by enhancing
national policies, training more than 1,100 community-based
workers to counsel mothers, improving linkages between health
facilities and communities, and more. Program highlights include
the recent launch of the
National Infant and Young Child Feeding Training Curriculum for health workers.
Read the stories of
Mamorena and
Tsepo to learn about the impact of IYCN’s efforts in Lesotho.
View a new video featuring Lesotho’s launch of demonstration
gardens to improve complementary feeding, during World Breastfeeding Week in August 2009.
Looking for the latest research on infant feeding and HIV? February 2010 Next month, the IYCN Project will launch a series of technical
briefs to assist program implementers in understanding the evidence behind the
new World Health Organization guidelines on HIV and infant
feeding.
A ward committee meets in Nigel, South Africa to discuss
integrating nutrition interventions into development programs.
Summaries of research on exclusive breastfeeding, formula
feeding, and continued breastfeeding beyond six months will help
nutrition and prevention of mother-to-child transmission of HIV
program implementers and providers sort through the risks and
benefits of promoting different feeding options to HIV-positive
mothers. Look for the new materials soon.
Update from the field:
South Africa Training community volunteers February 2010 In October 2009, consultant Benny Sikhakhane helped IYCN start
up a pilot project to integrate nutrition interventions into economic and educational development programs in South Africa’s
Nigel District. Through a unique partnership with J&J Development Projects Trust, a private investment and management
company, IYCN is introducing nutrition activities for mothers and children into community development plans. Read Benny’s
message to learn about his experiences training community volunteers on infant feeding, reaching new mothers in the Nigel
community, and educating community leaders on nutrition.
India's children bearing brunt of costly food 19 May 2008 - Delhi: More than 1.5 m children in India are at risk of becoming malnourished because of rising global food prices, the UN children's charity, UNICEF, says.
It warns that food inflation could be devastating for vulnerable women and children right across South Asia.
The region already has the largest number of malnourished children in the world and levels could get even worse.
Even before the current crisis almost half of all Indian children showed signs of stunted growth, UNICEF says.
51% of Indian children stunted by undernutrition - Child undernutrition, micronutrient deficiencies in India among highest in the world 15 May 2008 - New Delhi: The Lancet has warned that children would suffer irreversible damage in adult life unless proper nutritional interventions are delivered before
the age of two. Launching a five-part series of research papers on maternal and child undernutrition, the international medical journal said the prevalence of child
undernutrition and micronutrient deficiencies in India was among the highest in the world.
A suffering Bharat vs shining India 25 April 2008 - It seems that the policies made in Parliament have gone just one way, away from the poor.
The latest reminder is a survey by the National Sample Survey Organisation, which is asking a question - What can you do with just Rs 12 a day?
Twenty per cent people in rural India have only Rs 12 a day, of which each person spends just Rs 7 on food.
In Orissa and Chhattisgarh, 44% people live this life. Ever wondered why people migrate from villages to cities?
The survey says life is a shade better in urban India where 22% people spend Rs 19 daily. In urban Bihar, 56% live on this amount.
Most of
world's stunted children live in India, says Lancet 24 April 2008 - A recent The Lancet study shows that among the 20 countries where four-fifths of all undernourished children live, India is home to the largest number.
The reputed international journal says these 20 countries lack the political will to put nutrition on their list of priorities – and keep it there.
The study, however, commends the work being done in southern Indian states of Kerala and Tamil Nadu.
The Lancet Series on Maternal and Child Undernutrition – a global, scientific report by a team of public health scientists – underlines the importance of the "golden
interval of intervention" that ranges from pregnancy to two years of age. After the age of two, under-nutrition would have caused irreversible damage to the child's development.
"India, with a large population, is also home to the most stunted children. There are 61 million stunted children in India, which is over half (51%) of all Indian children
under the age of five years, and 34% of all stunted children worldwide," says the study.
Hunger has an even bigger impact on children's health than was thought 24 Jan 2008 - BADAAM lives in the Indian province of Rajasthan. Tetanus killed one of her children in infancy; another is weak from diarrhoea, caused probably by the
custom of keeping mother and baby isolated for a month after birth. Yet she is one of the lucky ones: a charity, Save the Children, has been keeping her family alive with
food and nutritional advice.
UNICEF, the United Nations' children's agency, said this week that fewer than 10m children died before their fifth birthday in 2006–probably the lowest rate ever, and
certainly the smallest number since records began in 1960, when twice as many under-fives died, out of a world population half today's level.
New Lancet Series Urges Action on Maternal and Child Undernutrition January 17, 2008 - The Lancet launched a new series on Maternal and Child Undernutrition, which draws in part on nutrition and health data from Demographic and
Health Surveys and from DHS research. The series provides new evidence about the widespread impact of poor nutrition on many low- and middle-income countries.
The authors concluded that more than a third of child deaths and 10 percent of the global disease burden are due to child and maternal undernutrition. Further, more than
3.5 million mothers and children under five die each year as a result of undernutrition. Most undernourished children live in just 20 countries across four regions -
Africa, Asia, western Pacific, and the middle East.
To download a free copy of the The Lancet series as well as accompanying materials, go to
globalnutritionseries.org.
Malnutrition rampant, may trigger crisis 2 April 2007 - New Delhi (WFS) - India may well be 'shining' to the world at large but when it comes to its children's health the picture is far from glossy. The
recently released National Family Health Survey (NFHS-3), the third pan-India survey conducted since 1992 (covering 200,000 people from 15-54 years), highlights some
sobering facts on this front.
"India should be worried." Experts reiterate that child malnutrition is not only responsible for 22 per cent of India's disease burden - and for 50 per cent of the 2.3
million child deaths in India -- but is also a serious economic hazard. Neeta Lal reports.
