According to a report, one-third of all children are underweight and almost one-third of these children have iron deficiency and anaemia. These rates have hardly changed over two decades according to the findings of a maternal and child nutrition study group published by Lancet. The reason is very simple; around the age of 6 months, what an infant gets from breastfeeding is not enough to meet the required need for energy and nutrients so complementary foods are necessary to meet those needs. According to paediatricians, an infant of this age is also developmentally ready for other foods and, as such, if complementary foods are not introduced around the age of 6 months, or if they are given inappropriately, an infant's growth may falter.
So, the most dominant factor for child under-nutrition in Pakistan and in other countries in this part of the world is obviously widespread poverty and food insecurity. Though complementary food for infants is available all over Pakistan, not many parents can afford it. On the other hand, a brute majority of parents belonging to the lower middle class are not fully aware of the fact that after crossing six months children need something more than simple breastfeeding. There is therefore, a need to educate parents about the nutritious requirements of children and ensure availability of children's complementary food at a generally affordable price.
Paediatricians unanimously agree that after the first six months of a child's life, appropriate complementary feeding of nutritious and safe foods is an absolute must for the healthy growth of a child. In fact, the general lack of knowledge of universally approved feeding practices and other social taboos and misconceptions (such as the concept of 'hot and cold foods') or inappropriateness of some foods for children, such as meats and fruits, is affecting the health of children adversely.
The National Maternal and Child Health Programme is fully aware of the situation and admits that the improvement in the maternal and child health status is crucial. Health indicators regarding maternal, new-born and children illustrate that an immense effort is needed to improve the health status of these indicators and therefore, poverty reduction is a part of all policy documents of the Government of Pakistan. Pakistan is also a signatory to the Millennium Development Goals. Goal 4 and 5 particularly focus on maternal and child health.
Additionally, a major contributor to childhood malnutrition is the fact that despite the established benefits of early and exclusive breastfeeding, most parents, probably because of work pressures, start administering alternative fluids such as tea and even animal milk.
The national regulatory and support system also does not provide paid maternity leave or breastfeeding support mechanisms for working women to continue exclusive breastfeeding, a factor that has been shown in other countries to be a major barrier to appropriate feeding practices. Data from the Pakistan Demographic and Health Survey (2012-2013) suggests that immediate breastfeeding is initiated in 18 per cent of all births, whereas exclusive breastfeeding is carried out for only 38 per cent of infants younger than six months.
To improve child nutrition, it is also important to focus on some other factors including maternal nutrition and antenatal care, especially the nutrition of adolescent girls and young mothers. Immediate and easy access to healthcare facilities and arrangements for timely vaccination are also absolutely necessary.
A starting point would be educating mothers about the importance of food fortification. In fact, fortification as part of a country's nutrition strategy is supported by global organizations such as UNICEF, the World Health Organization (WHO), and the U.S. Centers for Disease Control and Prevention (CDC), the Global Alliance for Improved Nutrition (GAIN) and Nutrition International. Through its global partnership, FFI provides advocacy support and technical assistance to help parents plan, implement and monitor high-quality fortification practices. The government must seek assistance from these organisations to educate the mothers about food fortification.
Pakistan's nutrition indicators and rates of childhood nutrition progress have fallen way behind other nations in the region. This is related to lack of focus on implementing quality programmes and addressing disparities and there is urgent need for introducing food supplements for infants at an affordable price. The government and those involved in producing such fortified food for children must cooperate with each other to build a strong nation.