Fortifying our future

Early childhood development and growth is a significant element of human life. The emotional, social and physical development of young children has profound effects on their adult personalities and health.

It is, therefore, imperative to understand the importance of this period and to invest in children to maximise their future wellbeing. The saying ‘you are what you eat’ aptly describes the key ingredient involved in child development. The quality of food and its nutritional status plays a pivot role in this regard.

Breast milk can produce immunity in an infant till he or she is six months old. After this point, babies start developing their own immune system that ought to be strong enough to protect them from illnesses – especially if they are not breast-fed. This is termed as the weaning stage, when babies become more active and independent of their mothers and start eating solid foods. There is a need to examine their nutritional needs during this phase, as they are more prone to get infections from the environment.

According to WHO, solids should be introduced for all babies when they are six months old and not before they are 17 weeks old. Solids must be provided in addition to breast milk. As children grow, their nutritional requirements also change. Weaning, which involves the introduction of solid food, is a sensitive phase of child development because if the food doesn’t meet their nutrition requirements, they may suffer deficiencies in normal growth and will become more vulnerable to diseases like diarrhoea. Consequently, frequent exposure to these infections in a child’s formative years may result in severe micronutrient deficiencies that could later lead to stunting and wasting.

A weaning diet should have a sufficient amount of macro and micro nutrients like vitamins and minerals. The lack of nutrients, for example irons or calcium, can make child feel tired and sluggish. Children under the age of two who suffer from iron deficiencies often develop anaemia that results in cognitive, intellectual, and social-emotional impairments in their adult years. Similarly, a limited quantity of iodine in a child’s diet can result in impaired mental growth. Vitamins should also be an integral part of a child’s diet.

According to WHO, between 250,000 and 500,000 children with Vitamin A deficiencies become blind every year across the globe and half of them die within 12 months of losing their sight. The provision of fortified food during the weaning period has proved to be one of the best global remedies to address the issue of malnutrition among children. In various countries, the fortification of their staple food – like wheat, rice and fortified milk – has helped to upgrade the nutritional status of children because of its easy availability, accessibility, and cost-effectiveness. The fortification of salt with iodine has emerged as a global success story.

WHO has revealed that the number of countries where an iodine deficiency was prevalent in children has gone down by 50 percent. Similarly, countries like Bolivia and Guatemala are able to improve their children’s nutrition indicators by fortifying sugar with Vitamin A. Meanwhile, wheat flour and cereal-based foods targeting young children have been fortified in developed countries and have proved to be successful in addressing iron deficiencies and anaemia.

Pakistan shows some alarming indicators regarding malnutrition in children under the age of five. According to the National Nutrition Survey, almost 35 percent of children die due to poor nutrition – directly or indirectly. Stunting and iron deficiency are also highly prevalent – at a rate of 43.7 percent and 62 percent, respectively. In this context, there is an urgent need to focus on this particular age group and prioritise interventions to address macro- and micro-nutrient requirements during a child’s formative years. The most simple and cost-effective preventive measure is food fortification. It can lead to relatively rapid improvements in the nutritional status of a population, especially if targeted at the right age.

Ensuring adequate nutrition, specifically during the formative years of a child’s life, sets the foundation for a healthy and productive resource in their later years and performance. As famous words by Ban Ki-Moon, the former secretary-general of the UN: “The Sustainable Development Goals recognise that early childhood development can help drive the transformation we hope to achieve over the next 15 years”. Pakistan also needs to invest in nutrition and the health of children to produce a productive nation.

The writer is a public health consultant.

Email: fauziawaqar_28@hotmail.com