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Published on: August 19, 2020
Undernutrition in children & critical windows of opportunity in Indian context
R Hemalatha1, K V Radhakrishna2, B Naveen Kumar3
1ICMR-National Institute of Nutrition, Hyderabad, India.
Insights
Most child wasting in India begins at birth, highlighting the need to improve fetal growth. Focusing on critical nutritional phases, especially before pregnancy, is key to enhancing child health outcomes.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Childhood wasting is a significant public health issue in India.
- National Family Health Survey 4 (NFHS-4) data indicates high rates of wasting at birth (31.9%).
- Prevalence of wasting decreases to 17.7% in children under five, suggesting fetal growth as a critical factor.
Purpose of the Study:
- To analyze the prevalence and origins of childhood wasting in India.
- To identify critical nutritional phases influencing child health indicators.
- To emphasize the importance of maternal nutrition before pregnancy.
Main Methods:
- Analysis of National Family Health Survey 4 (NFHS-4) data.
- Overview of nutritional status in children under five.
- Examination of antecedents and critical phases affecting child nutrition.
Main Results:
- A substantial proportion of childhood wasting in India is present at birth.
- Improvement in fetal growth is crucial for reducing overall wasting.
- Children with severe wasting and stunting (<1%) require targeted interventions.
Conclusions:
- Reducing childhood wasting necessitates a focus on improving fetal growth.
- Maternal nutritional status before pregnancy is a critical determinant of child nutrition.
- Targeted interventions during critical nutritional phases are essential for program effectiveness.
Abstract:
It is intriguing to note that majority of the wasting among the under 5 yr in India is present at birth. The National Family Health Survey 4 (NFHS-4) data analysis shows 31.9 per cent wasting at birth, which is decreasing to 17.7 per cent in the under five children; clearly suggesting that any reduction in wasting should come from improvement in foetal growth. In addition, children with both severe wasting and severe stunting, in whom the risk of mortality increases many folds, are <1 per cent in almost all the States; and these are the children in whom special care is required under the community-based management of severe acute malnutrition. This article presents an overview of nutrition status in children, their antecedents, and the critical phases; especially, nutrition status before pregnancy that plays a crucial role in all the nutrition status indicators of children. More attention on the critical phases is crucial to maximize the benefits from national programmes.
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