Friday, 7 August 2020

CHILDHOOD FEEDING PROBLEMS





Feeding problems such as refusal to eat, disruptive meal time behavior and pickiness are common and part of the normal development of infants and toddlers. These feeding problems can lead to family stress with long-term negative consequences of children’s nutrition (under nutrition or over nutrition), behavior and growth. 
Early in life, children learn that refusal to eat is a powerful strategy that attracts the mother’s or caregiver’s attention and may lead to increased access to favorite fruits and snacks. Picky eating is usually just another method they use to express their strong desire for independence. Nagging, forcing, or bribing children to eat reinforces picky-eating behaviours because of the extra attention. Bribing children to eat a new food may achieve the parent’s immediate goal, but it often has negative results in the long run. In subsequent meals when the reward is removed, children eat less of the hurdle food. Bribing children to eat also teaches them that food is an appropriate reward.  

Feeding Guidelines

The nurturing of a young child involves more than nutrition, but also a safe, loving, secure environment in which the children may grow and develop.

  • Discourage unacceptable behaviour (such as standing at the table or throwing food). Be consistent and firm, not punitive.
  • Let young children explore and enjoy food. This may mean eating with fingers for a while. Learning to use a spoon will come in time. Children who are allowed to touch, mash, and smell their food while exploring it are more likely to accept it.
  • Meal presentation should be attractive: Color their plates with all kinds of great-tasting vegetables. Meals should include a variety of foods from each food group—in amounts suited to their appetites and needs.
  • Don’t force food on children. Rejecting new foods is normal, and acceptance is more likely as children become familiar with new foods through repeated opportunities to taste them.
  • Provide nutritious foods, and let children choose which ones, and how much, they will eat. Gradually, they will acquire a taste for different foods.
  • Limit sweets. Infants and young children have little room for empty calorie foods in their daily energy allowance. Do not use sweets as a reward for eating meals.
  • Don’t turn the dining table into a battleground. Make mealtimes enjoyable. Teach healthy food choices and eating habits in a pleasant environment. Mealtimes are not the time to fight, argue, or scold.


If a child fails to eat enough to support healthy growth and development, consult a registered dietitian-nutritionist.

Wednesday, 5 August 2020

WORLD BREASTFEEDING WEEK 2020





First week of August each year, the world celebrate World Breastfeeding Week (WBW). The team for the WBW 2020 is: Breastfeeding; the Foundation of Life. They so aim is  to give the people every knowledge about the positive effects of breastfeeding on the infants when they get a mother's milk.  Breastmilk is very important and necessary as it provides optimum nutrition for the infant and also has many non nutritional benefits for both mother and child. World Health Organization (WHO) and Paediatrics Society recommend that one should aim for exclusive breastfeeding for the first 4-6 months of life. WHO also recommends breastfeeding up to 2 years of life especially in countries/populations with high rates of infectious diseases as this will help in reducing morbidity and mortality rates.

Benefits of exclusive breastfeeding to the child includes;

  • It reduces the risk of developing non communicable diseases later in life. 
  • It positively influences the child’s immune system against infectious diseases such as diarrhea and respiratory tract infections.
  • It reduced a child chances of having immune related diseases such as diabetes, asthma, and inflammatory bowel diseases.
  • The relatively low protein content of breast milk compared to cow’s milk meets the infant’s needs without overloading the immature kidneys with nitrogen.
  • Minerals in breast milk are largely protein-bound and balanced to enhance their availability and meet infant needs with minimal demand on maternal reserves.
  • Breastfeeding influences the infantile growth especially during the few months of life.
  • Breastfed infants gain weight during the first months of life and grow leaner during the first year of life than formula fed infants. This explains the reason for lower risk of noncommunicable diseases such as obesity later in life.

Steps to a successful breastfeeding
  • Initiate breastfeeding within the first hour of birth.
  • Encourage breastfeeding on demand.
  • Breastfeed and maintain lactation even if you’re separated from your baby.
  • Give no teats or pacifier to breastfeeding infant.
  • Practice rooming in-that is, you and your infant should remain together 24 hours a day.


Promote, protect and support breastfeeding for a healthier planet.

Saturday, 22 February 2020

Colostrum.. Baby's First Milk



Colostrum isa milk-like liquid produced by the mammary glands of mammals immediately following delivery of the newborn. It looks thicker and more yellow than mature milk. It contains antibodies to protect the newborn against disease, but it is small in quantity . It’s very nutritious and contains high levels of antibodies, which are proteins that fight infections and bacteria. It’s an important source of nutrients that promotes growth and fights disease in infants. Newborns have very immature and small digestive systems, and colostrum delivers its nutrients in a very concentrated low-volume form. It has a mild laxative effect, encouraging the passing of the baby's first stool, which is called meconium. This clears excess bilirubin, a waste-product of dead red blood cells, which is produced in large quantities at birth due to blood volume reduction from the infant's body and helps prevent jaundice. Colostrum is known to contain immune cells (as lymphocytes) and many antibodies.
How long does colostrum last?
Colostrum secreted in the first few days (2-5days) after birth. After 2-3 days, mature breast milk called transitional milk starts to replace colostrum. During the next 10-14 days, the transitional milk increases in quantity and changes in appearance and composition to meet the increasing requirements of the baby. By day 10, the baby’s stomach grows to about 2 ounces. Mature milk being produced by this time; looks thinner than colostrum but is still full of nutrients for the baby. Mature milk will continue to change with your baby’s needs and tummy.

Quantity of colostrum a newborn needs

The amount of colostrum/breast milk produced varies, this is because, after delivery one can produce roughly 60-80ml of colostrum on the first day. The next day it is estimated that around 120ml and on the third day 180ml will be produced respectively. This amount is enough for the baby since the volume of a new born's stomach capacity is not much, and hence needs about 5-10mls of breastmilk per feed on a frequency of 8-12 times per day.

Importance of Colostrum

1.Colostrum fights infection:  Up to two-thirds of the cells in colostrum are white blood cells that guard against infections, as well as helping the baby start fighting infections for himself.

2. It supports the baby’s gut function: Colostrum is also rich in other immunologic components and growth factors that stimulate growth of protective mucus membranes in your baby’s intestines. And while that’s happening, the prebiotics in colostrum feed and build up the ‘good’ bacteria in the baby’s gut.

3. Your colostrum is especially rich in a crucial antibody called sIgA. This protects the baby against disease, not by passing into his bloodstream, but by lining his gastrointestinal tract. Antibodies and cells help in the immune mechanism which can last up to 6 months.

4. Prevents jaundice: This clears excess bilirubin, a waste product of dead red blood cells which is produced in large quantities at birth due to blood volume reduction, from the infant's body and helps prevent jaundice.

5. It contains complete nutrition (protein, salts, fats, carbohydrates, and vitamins) that the baby’s stomach can easily digest, and gives the baby’s brain, eyes and heart the right blend of nutrients and vitamins to grow.

6. Delivers its nutrients in a very concentrated low-volume form, suitable for newborn immature, small digestive system. Furthermore, learning to ‘suck and swallow’ is easier in small amounts.

Saturday, 8 February 2020

Overnutrition Malnutrition




While hunger is a tremendous global health concern that cannot be minimized, overnutrition should similarly be addressed as a top priority. Overnutrition is the form of malnutrition that happens when you take in more of a nutrient or nutrients than you need every day. It can develop into obesity, which increases the risk of serious health conditions, including cardiovascular disease, hypertension, cancer, and type-2 diabetes.
    Developing countries are facing a double burden caused by coexisting under- and over-nutrition, which causes a change in the disease profile from infectious diseases to a chronic degenerative pattern. The population moves from a traditional diet high in carbohydrates and fiber and low in fat and sugar, to a typical Westernized diet, characterized by a higher intake in energy, saturated fat, sodium, sugar, and low in fiber, and associated with physical inactivity and other unhealthy lifestyle behaviors (e.g., smoking), which increase the risk of obesity, hypertension, stroke, type 2 diabetes, and ischemic heart disease (IHD). According to the World Health Organization (WHO), Non-Communicable Disease (NCD)-related deaths are projected to increase by 15% globally until 2030, with most increases taking place in Africa.
    According to World Health Organization in 2014, more than 1.9 billion 18 years and older adults worldwide were overweight and more than 600 million adults were obese, while 42 million children under the age of five were overweight or obese.  In 2018, the WHO noted that childhood obesity is one of the most serious public health challenges, affecting people in every country in the world.

    Types Of Overnutrition
  • Overnutrition of energy nutrients: It happens when excess energy is consumed more than the body's daily requirements. Over time, it causes weight gain unless daily physical activity is increased. It doesn’t matter if those extra calories come from fat, carbohydrates or proteins, because the body can take whatever it doesn’t need and store it as fat leading to obesity and the many life-threatening conditions associated with it.
  • Overnutrition of micronutrients: It is possible to get too much of most vitamins or minerals, but usually, this happens when mega doses of dietary supplements are taken. Getting too much of micronutrients from food is rare. Micronutrients overnutrition can cause acute poising, like taking too many iron pills at once. The Institute of Medicine has established tolerable upper limits for most micronutrients, but the best way to avoid this type of overnutrition is to stay away from mega doses of dietary supplements unless directed by your healthcare provider.

Factors Contributing to Overnutrition

While many factors including genetics, drugs, and other medical conditions may contribute to obesity, behavior is perhaps the most common contributor. Individual level healthy weight is associated with a healthy diet and regular physical activity. 

Ways of Maintaining Optimum Nutrition

There is no best weight-loss diet. Choose one that includes healthy foods that you feel will work for you. Dietary changes to treat obesity include:
  • Cutting calories. The key to weight loss is reducing how many calories you take in. The first step is to review your typical eating and drinking habits to see how many calories you normally consume and where you can cut back. A typical amount is 1,500 to 1,800 calories for women and 2,000 to 2,400 for men. At the same time, increase physical activity and avoid junk foods, which are foods that are high in calories but have little nutritional value.
  • Dietary changes: Reducing calories and practicing healthier eating habits are vital to overcoming obesity. Although you may lose weight quickly at first, steady weight loss over the long term is considered the safest way to lose weight and the best way to keep it off permanently.
NB: Avoid drastic and unrealistic diet changes, such as crash diets, because they're unlikely to help you keep excess weight off for the long term.
  • Feeling full on less: Some foods —fruits and vegetables provide a larger portion size with fewer calories while foods like desserts, candies, fats and processed foods — contain a large amount of calories for a small portion.  By eating larger portions of foods that have fewer calories, you reduce hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall.
NB: Drinking sugar-sweetened beverages is a sure way to consume more calories than you intended, and limiting these drinks or eliminating them altogether is a good place to start cutting calorMake
  • Make healthier choices. To make overall diet healthier, eat more plant-based foods, such as vegetables, fruits, legumes, and whole-grain carbohydrates. Also emphasize lean sources of protein — meat, skimmed milk, soy milk, fish etc. Limit salt and added sugar. Eat small amounts of fats, and make sure they come from heart-healthy sources, such as safflower oil,  olive oil, soy oil, canola and nut oils etc.





Tuesday, 4 February 2020

Undernutrition among under Five children


 

Undernutrition and food insecurity are critical problems among under-five children in many developing countries. Acute malnutrition among children at the globe level is still a critical problem; its effects are long lasting and go beyond childhood; it has both short and long term consequences. The first 1,000 days of a child's life offer a unique window of opportunity for preventing undernutrition. The nutritional status of under five children is a sensitive indicator of a country`s health status as well as economic condition. Undernutrition generates economic losses associated with impaired brain development, poor school performance, and impaired productivity.
     Undernutrition is usually the result of a combination of inadequate dietary intake, poor access to food, inequitable distribution of food within the household,  improper food preparation and storage methods, dietary taboos and infections with pathogens. It is a third most risk factor for death of under-five children in the world. It occurs when a child does not have enough to eat and the second is when a child develops an illness or infection. In most cases, these factors combined to cause a rapid and significant loss of weight and - if things deteriorate and the child is not treated – death occurs.
    An estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM), with her being the second highest burden of stunted children in the world, having a national prevalence rate of 32 percent of children under five. Prevalence of under-nutrition is assessed by weight for age, height for age, BMI for age, and wasting (weight for height irrespective of age). Of these, weight for age is the most widely used indicator for assessment of nutritional status because of ease of measurement. Children can be under-weight because they are stunted, or wasted or stunted and wasted.

Ways of preventing and control undernutrition

1.  Encourage exclusive breast feeding of infants for first 4 to 6 months

2. Additional nutritive supplements introduce from 6 months of age

3. Offer as much milk, egg, fish, meat or food of high biological value that the family can afford

4. Provision of good health care system that provides immunization, oral rehydration, periodic deworming, early diagnosis and proper treatment of common illnesses.

5. Improved water supply, sanitation and hygiene

6. Health education to mothers about good nutrition and hygiene for a healthy diet










Friday, 31 January 2020

Malnutrition In Children





Malnutrition  can  be  caused  by  deficiencies,  excesses, or imbalances  in an  individual’s  consumption  of  nutrients. It addresses 3 broad groups of conditions: 

  • Undernutrition(stunting, wasting and underweight);
  • Hidden hunger caused by a lack of essential nutrients;
  • Overweight among children under the age of five.

    As children begin transitioning to soft or solid foods around the six-month mark, too many are introduced to the wrong kind of diet. As they grow older, their exposure to unhealthy food becomes alarming, driven largely by inappropriate marketing and advertising, the abundance of ultra-processed foods in cities but also in remote areas, and increasing access to fast food and highly sweetened beverages. 
There is basically three major 

Causes Off Malnutrition

  • Basic causes which include poverty,  insecurity  and  lack  of  access  to  clean  water.
  • Underlying Causes This  is  usually  found  at  the  community  level  as  a  result  of  failure  of an  individual  and:  household  to  obtain  proper  nutrition  due  to  food insecurity,  inequitable  distribution  of  wealth  and  poor  housing.
  • Immediate Cause include Inadequate  intake  or  poor  absorption  due  to diseases  and  infections  including  malarial,  acute  diarrheal  disease, measles,  HIV-AIDS  and  tuberculosis especially  if  a  delay  occurs  in  seeking  professional  health care.
 
Consequences of malnutrition in the society

The consequences of malnutrition includes increased risk of infection, death, and delayed cognitive development, leading to low adult incomes, poor economic growth and intergenerational transmission of poverty. Children with malnutrition have reduced ability to fight infection and are more likely to die from common diseases such as malaria, respiratory infections and diarrhoeal diseases 

   Globally, malnutrition is regarded as the most important risk factor for illness and death and it is associated with 52.5 % of all deaths in young children. According to UNICEF, WHO and the World Bank, out of the 161 million under-fives estimated to be stunted globally in 2013, over a third resided in Africa. In Nigeria, malnutrition remains a major public health and development concern:49 percent of children under five years of age are not growing well (they are either stunted, wasted or overweight). This is partly because 34 percent of children between six months and two years of age are fed food that is not rich and diversified enough to ensure optimal growth. This puts them at risk of poor brain development, weak learning, low immunity, increased infections and, in many cases, death.

Conclusion

High levels of malnutrition have multidimensional consequences for children which will impact resilience and long-term development of households and children, including intergenerational effects. Addressing malnutrition is not only lifesaving but it is also essential to strengthen the resilience of communities and systems, to support long term development goals and improve human capital,

Thursday, 30 January 2020

Reasons For Low Supply of Breast Milk

 

How does milk production work?

By the end of the second trimester, the body is capable of breastfeeding. As early as the third month of pregnancy, the breasts start to prepare for breastfeeding, developing the glandular tissue needed to produce milk and increasing the number of milk ducts in thr breasts.  Once a baby is born, a hormone called prolactin cues milk production, and another hormone, oxytocin, causes tiny muscle cells in the breasts to contract, pushing milk out. As the baby nurses, the prolactin levels increase and more milk is produced, in a continuing cycle of supply and demand: Baby drains milk from your breasts (demand), breasts respond by producing more milk (supply).

Potential causes of low milk supply

Often, mothers think that their milk supply is low when it really isn’t. If your baby is gaining weight well on breastmilk alone, then you do not have a problem with milk supply. But if you’re not quite sure about baby’s current weight gain, if baby is having an inadequate number of wet and dirty diapers then the following reasons may be why you have a low milk supply:

1. The Baby Isn't Latching on Correctly: 



The most common cause of low breast milk supply is a poor latch. If your baby is not latching on to your breast the right way, he can't get the milk out of your breasts very well. The removal of your breast milk from your breasts is what tells your body to make more breast milk. So, if your baby isn't latching on correctly, your milk supply will suffer. If you aren't sure if your baby is latching on well, have someone evaluate your breastfeeding technique.

2. Supplementing. Nursing is a two-way process; supply & demand process. Milk is produced as your baby nurses, and the amount that she nurses lets your body know how much milk is required. Every bottle (of formula, juice or water) that your baby gets means that your body gets the signal to produce that much less milk.

3. You Aren't Breastfeeding Often Enough: Just like a poor latch, not breastfeeding often enough is another common reason mothers develop a low milk supply. Newborns need to breastfeed at least every 2 to 3 hours throughout the day and night. The more you put your baby to the breast, the more you will be stimulating your body to make a healthy supply of breast milk

4. Allowing Others to Influence You: Sometimes the people in your life who didn't breastfeed, or who don't understand breastfeeding, can make you question yourself. They may say that your breasts are too small to make enough breast milk, or that the baby is breastfeeding too often so you must not have enough milk. As long as your child is growing at a consistent healthy rate, there's no need to worry or to listen to the doubts and negative comments of others. 

5. Cutting short the length of nursings. Stopping a feeding before your baby  ends the feeding herself can interfere with the supply-demand cycle. Also, your milk increases in fat content later into a feeding, which helps baby gain weight and last longer between feedings.