Feeding Lessons

Optimal feeding of infants is fundamental to tackling the burden of malnutrition.

- Arun Gupta

THE RELEASE OF THE COMPREHENSIVE National Nutrition Survey (CNNS 2016-2018) has renewed interest in tackling malnutrition in India. The conceptual framework for child undernutrition, developed by UNICEF, recognizes breastfeeding, good complementary feeding, caring and health care to minimize disease burden as immediate underlying factors that determine malnutrition in all its forms.

According to the CNNS, 35 per cent of the children under five were stunted (HAZ <-2 SD), 17 per cent were wasted (WHZ <-2 SD), and 33 per cent were underweight (WAZ <-2 SD). India has set ambitious targets to annually reduce stunting to 25 per cent by 2022. In the past decade, the focus of dealing with malnutrition has been tilting in favor of treating severe malnutrition with ready-to-use therapeutic foods (RUTF), projected as a magic solution for saving babies. However, a recent study from eastern India concluded: “Given that the risk of mortality is lower than expected among children older than 6 months and that many deaths occur because of prematurity or low birth weight during the neonatal period, outpatient treatment for SAM [severe acute malnutrition] using RUTF for children over 6 months may be too late to avert a substantial number of deaths from undernutrition in Indian children. This further strengthens the case for prioritizing prevention through known health, nutrition, and multisectoral interventions in the first 1,000 days of life.”

Nutrition action in India needs a rethink and reassessment. Some fundamental corrections are needed to change the focus from treatment to prevention.