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Malnutrition: Prompt treatment of wasted children could save lives –Expert

A Nutrition Specialist has called on the Lagos State Government to increase the screening of children to pave way for the identification and prompt treatment of children that are stunted and wasted in communities. Ada Ezeogu Ezeogu, who is the United Nations Children Fund (UNICEF) nutrition specialist, said there was need to identify these children from the communities first.

Similarly, she urged the Lagos State Government to increase the number of health workers who have the skill to screen children so they can be referred to facilities that would tackle their stunting and wasted conditions. She spoke at a 2-day Advocacy Meeting with Media on the First 1000 days of a Child and COVAX Uptake in Lagos State organised by the United Nations Child’s Fund (UNICEF), in collaboration with the National Orientation Agency (NOA). Lagos State accounts for about 2,000 children with stunted growth as a result of malnutrition. According to her, though the percentage of wasting in Lagos is 6.4 per cent if translated into absolute numbers more than 200,000 children in Lagos are wasted, a statistics which is higher than the global target of less than five per cent.

For wasting, the nutrition specialist said, “If these children are not treated on time, we may lose them.” Stunting is one of the leading measures used to assess childhood malnutrition. It indicates that a child has failed to reach their growth potential as a result of disease, poor health and malnutrition.

A child is defined as ‘stunted’ if they are too short for their age. Child wasting refers to a child who is too thin for his or her height and is the result of recent rapid weight loss or the failure to gain weight. A child who is moderately or severely wasted has an increased risk of death, but treatment is possible. The most direct causes of stunted growth are inadequate nutrition (not eating enough or eating foods that lack growth-promoting nutrients) and recurrent infections or chronic or diseases which cause poor nutrient intake, absorption or utilisation. On its part, wasting of a child is caused by inadequate calorie intake, malabsorption of nutrients, an altered metabolic rate, and hormone deficiency. Physicians need to monitor body composition of people with HIV to prevent and reverse the loss of lean body mass.

“On the duration of treatment for both a stunted and wasted child, the nutrition specialist said, “Immediately the child is screened and you find out that the child is severely malnourished, they should be referred to the health centre.” Ezeogu said that it was imperative to ensure that the high numbers of stunted and wasted children did not continue to increase because stunting has dire consequences on physical growth and cognitive development. “Do we want this number to continue because we know that stunting does not just affect physical growth but also cognitive development?” Ezeogu asked. Speaking further, she said once the effect of stunting has set in it is irreversible.

“That means when a child is stunted you cannot change that.” Painting a picture of the physique of a stunted child, the UNICEF nutrition specialist said such a child would grow taller to a certain height but can’t exceed it. “He would grow eventually to a certain height but he can’t exceed it. Already that child is compromised both in terms of height and physical cognitive development.

“So you do not get the best from that child. That child will not achieve his full potential in life and that has implications.” Speaking further, Ezeogu said there are implications for the onset of adult non-communicable diseases like diabetes. “There is a tendency that people will still have that as they grow later in life as a result of this stunting or being malnourished as a child.

She said stunting has an implication that goes beyond childhood even unto adulthood. “So we want to prevent that,” she added, saying, “Once there’s malnutrition, the child easily falls ill; the immune system is also compromised because of that health, cost increases because the child will be taken more often to the hospital and would be treated.” So, she reasoned that there are health cost implications. That child may not be good in school as one that is fully nourished; there’s an implication. There might be repetition of classes. All of that has an economic impact on the economy and the school system,” stressed Ezeogu.

She said, “If you have a child repeating a class or not paying attention fully — their attention span is reduced as a result of malnutrition then stunting has implications for education and the health system.” However, the nutrition specialist said fortunately, the Lagos State Government is already doing some management of Severe Acute Malnutrition (SAM) which involves giving malnourished children ready therapeutic food and if there are underly-ing conditions, they would be treated as well. She said, “We encourage mothers to take these children immediately to health facilities for treatment.

“I’m aware that Marcy Children’s Hospital had a ward; I don’t know if it’s still there, where they were treating children with severe acute malnutrition. They are trained and there are some designated facilities. Even if you take them to a facility and they’re no trained personnel they would refer you back to the facility that has trained personnel and in the absence of that you could also call the state nutrition officer. She would be able to give you specific hospitals where they have trained staff to manage such conditions in children.” The Director of the National Orientation Agency, Lagos State, Waheed Ishola said the essence of the workshop was to bring media practitioners to scale up their knowledge on the COVAX vaccine mandate and hesitancy and to increase the uptake of the COVID-19 vaccine.

“We found out that the majority of our people are thinking that COVID- 19 is a done deal but it’s not from evidence across the world.” On the contrary, he said it has come to stay. “So, we need to protect ourselves by practicing those non-pharmaceutical interventions which are washing of hands regularly, covering the nose when you’re sneezing, and all of that, keeping safe distance and using of nose masks not only when you are out in public but also in an enclosed space because you don’t know who may have contracted the disease.” Also, he said this media advocacy is meant for encouraging women to do immunisation. “We know the first 1000 days of a child’s life determines how that child will grow and what that child will be in future.

However, he noted: Majority of our mothers especially in rural areas do not know that it is important to complete all the doses of child immunisation. “Mothers do not know the importance of nutrition in a child’s life. We are encouraging our mothers through the media practitioners because when you write stories around all of these, people will begin to understand the importance of all of these COVID-19 vaccines; they will begin to accept the fact that those that have not taken would see the need to take it and complete the second dose as well.”

In addition, he stressed that mothers must ensure that they exclusively breast feed their children, attend antenatal care because when you do you are told the state of your health and that of the child in your womb. Once you give birth, do complete the immunisation process for the child because it guarantees the survival of the child and gives the child enough nutrients through exclusive breastfeeding for the child.

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