Feed Right To Fight Childhood Pneumonia

Malnutrition or bad nourishment is a major health problem, especially in developing countries. Along with inadequate sanitation and poor hygiene, it plays a vital role in predisposing children to pneumonia and other diseases. Pneumonia is the leading killer of children under 5, claiming 1.5 million young lives every year. An estimated 98% of the children who die of pneumonia live in developing countries. We can reduce these deaths by two-thirds, just by feeding our children with the right foods in right amounts and at the right time, in clean surroundings.

Malnutrition takes into its purview undernourishment as related to poverty, and over nutrition that leads to obesity in children. Clinically, malnutrition is characterized by inadequate or excess intake of protein, energy, and micronutrients such as vitamins, and the ensuing frequent infections and disorders. Malnourished children, with a weakened defence system, are prone to multiple infections which increases the chances of mortality and morbidity. Malnutrition, low birth weight, measles, Vitamin A deficiency, tuberculosis etc. increase susceptibility to pneumonia and pneumonia makes a child more prone to other respiratory disorders like asthma.

Good nutrition is indispensable to building a child’s immunity which not only reduces the chances of infection but also increases the ability to fight and recover from a disease. Dr. Neelam Singh, Consultant Obstetrician and Gynaecologist, and Chief Functionary of Vatsalya Resource Centre on Health, asserts, “Good nutrition in infants is highly important because it is that period of life when their nutritional requirements are very high due to very fast growth of brain and body. Hence we need to know “which” foods and “how much” of them are required by a developing child, as the nutritional requirements of different age groups of children are different. We must also remember that malnourished mothers often give birth to low birth weight babies. So, the nutrition of mothers should also be good, right from their adolescence, in order to bring healthy babies in the world. 

Dr. S. K. Sehta, Consultant Paediatrician and Neonatologist, Lucknow, says, “These days, in big metropolitan cities, children are getting fast food, readymade meals, excessively oily and salty foods, all of which are making them more obese and increasing their risk of diabetes and cardiovascular heart diseases in future.”

 Dr. Neelam Singh also opines, “Malnourishment is the reason for a high number of deaths due to pneumonia and diarrhoea in our country. In my state of Uttar Pradesh, approximately 46% children under 5 suffer from malnourishment. In one of our recent surveys we came across many new born infants who were being given tea and even cold-drinks. Babies are also given “ghutti” (gripe water), and their top feed/formula milk is heavily diluted with water, either to increase the quantity, (and thus reduce expenses) or due to the misconception that the child cannot digest pure milk. The child may not be given high energy food for similar reasons. Very often, food is prepared keeping in mind the likes of elders and not according to the requirements of a growing child.”

Adding to the list of myths related to bad nutrition, Dr. S. N. Rastogi, a leading private paediatrician of the city, comments that, “There is a myth that the baby should not be given pure breast milk or cow milk, but it should be diluted with equal amounts of water, else it will cause diarrhoea. Under feeding in most children results from dilution of milk. Supplements which have high protein content should be given to low birth weight babies.”

Dr. Neelam Singh clarifies that, “Good nutrition does not mean expensive food. Very often, expensive things lack sufficient nutrition or have the same nutrition as present in cheap, homemade food prepared from locally available resources. As an important example I would like to mention that although now the advertisement of Cerelac is not being broadcast on television, it remains a very popular food supplement. So much so, that even the household maids feed their children with it, in a bid to imitate their wealthy employers. Ceralac provides the same nutrition to the child as rawa/suji kheer (semolina), mashed daliya (porridge) and mashed dal (lentils) prepared at home. It is not only the illiterate masses of rural areas, but children of affluent and well-educated urban mothers also suffer from malnutrition.”

Inadequate access to clean water and good sanitation also encourage the incidence of pneumonia. To emphasize the role of hygiene in controlling diseases we have a World Hand Washing Day. Dr. S. K. Sehta says, “Hygiene is very important for containing the occurrence of any disease especially gastrointestinal Infections. Even in the case of pneumonia handwashing before touching a child reduces transfer of infection to the child.”

Dr. Neelam Singh emphasizes, “The carers of the child should be very cautious about hygiene and cleanliness. Hands should be washed properly with water and soap every time the child is cleaned after urinating/ passing stools, and also before and after feeding the child. The child should be given clean water to drink, and fresh and clean food to eat. The food should be kept covered and prevented from contamination. The child’s surroundings should be kept clean and hygienic, water should not be allowed to collect, and the child should be bathed everyday and dressed with clean clothes. These simple hygiene practices play a crucial role in preventing infectious diseases, especially pneumonia and diarrhoea.”

Dr. S.N. Rastogi emphasizes on regular cleaning of the breasts before feeding the infant. His advice is that, if it is absolutely necessary to bottle feed the baby, a minimum of four bottles and 4-5 nipples should be used. They should be boiled properly before use. Babies should be made to wear clean clothes. Normally babies are dressed in old worn out clothes for first few months due to some tradition.  This is not right.”

Apart from international interventions, like reducing poverty, to cope with the problem of malnutrition, there is also a need to mobilize people about the importance of good nutrition. Dr. Neelam Singh suggests, “The different nutritional requirements of children of different age groups should be discussed with the common public. These discussions must be carried out not only in national and international conferences with professionals, but the message needs to be spread to the rural masses-- to the last family of the last village.”

Somya Arora - CNS
(The author is doing her post-graduation in microbiology from Lucknow University and writes on social justice issues for CNS: www.citizen-news.org)