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.

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.

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