Nutritionists bemoan certain household practices that make infants vulnerable to illness and infection
Nutrition experts are worried that infants in the country may be silently suffering from reduced nutrient content in their milk due to common household practices. Many of these lead to malnutrition, health imbalances and high rate of mortality.
The National Institute of Nutrition points out that supplementing cow's milk with water, premature introduction of diluted cow's milk to infants, and heating or removing fat content from cow's milk improperly are affecting the health of infants.
“There seems to be a significant compromise being made on infant’s health as mother’s milk is being substituted for a variety of reasons in the first year itself, when the child is most vulnerable to infections,” note experts.
This trend is mirrored even in the National Family Health Survey III, which states that only 69 per cent of infants below two months get exclusive breastfeeding; and between two and three months, exclusive breastfeeding falls to 51 per cent; and declines further to 28 per cent between four and five months of age. The decline occurs because mothers supplement milk with plain water initially, and later with bovine milk (cow or buffalo). Says Dr. B. Sesikeran, director, National Institute of Nutrition: “Although feeding cow’s milk to infants is more than a thousand-year-old tradition in India, it’s an unsafe practice in the modern context, where antibiotics and pesticides are detected in high levels in bovine milk. Cow’s milk is nutritionally inadequate for fast-developing babies.’’
Several studies, including a 2012 report published in Indian Journal of Public Health, have found water, mostly contaminated, to be the most common adulterant in milk as it lowers the nutritional quality and poses serious health hazards. The study points out that household practices such as boiling causes loss of vitamins, and adding water further decreases the vitamin content. Likewise, removing the layer of fat or milk cream strips milk of its essential nutrients. Boiling also impacts heat-sensitive vitamins and folic acid intake negatively.
Research shows that boiling milk once to increase its shelf life reduces the concentration of fat-soluble vitamin A by 21 per cent, while 15 minutes boiling can result in a 24 per cent loss of vitamin B12. Likewise, microwave heating causes 30 to 40 per cent loss of vitamins. Besides, the addition of water before first boiling the milk further lowers its nutrient content. Adding 150 ml of water per litre of milk decreases the concentration of all vitamins and minerals, with boiling reducing this even more. Hence, usage of cow’s milk could be contributing to 50 per cent of children in the country being severely malnourished as whole cow's milk does not contain sufficient Vitamin E or essential fatty acids. Worse, pesticide residues, heavy metals and even detergents have been detected in cow’s milk. All these factors are leading to low delivery of nutrients, causing malnutrition during the tender years.
Mothers, for their part, seem to be oblivious that infants should be exclusively breastfed for the first six months at least and preferably on demand till the age of two, as recommended by WHO, UNICEF and the national guidelines. This is because the formative months and years are critical for the baby’s healthy growth and rapid development, including weight gain.
According to Sachi Sohal, Dietician, BLK Super Specialty Hospital, “Mother’s milk is sterile and considered best for the baby. It contains exact amount of nutrients like lactose, proteins, iron, calcium, Ig A, Ig B, etc. needed by the baby for healthy growth, brain development and digestion. Breast milk contains antibodies and macrophages that kill bacteria, fungi and viruses. It provides protection from many diseases like bronchitis, botulism, German measles, etc. On the other hand, cow's milk has proteins that are difficult for the baby to digest; and also higher contents of protein, sodium and potassium, which puts strain on the kidneys. It provides no immunity as compared to mother's milk.”
Experts feel if this confusion and misunderstanding continues about infant milk, it could lead to a numerous health deformities in children. Already, 38.4 per cent of children under age three are stunted, and 46 per cent are underweight; wasting affects 19 per cent of children under three years, and 79.2 per cent of children under three years are anaemic.
Given the high levels of malnutrition prevalent among Indian infants, the infant mortality rate stands at one of the highest levels globally — 47 per 1,000 live births or, computed annually, 1.25 million infant deaths. Dr. Sesikeran agrees that the number of women breastfeeding infants, is unsatisfactory. He says reversing the unhealthy numbers will go a long way in reducing malnutrition deaths, by boosting infant well-being and its future quality of life. “In the first six months, it is preferable to nurse the infant exclusively on mother’s milk since this boosts resistance to disease. For mothers unable to nurse because of health reasons, it’s best to consult the family physician about a safe alternative, rather than feeding cow’s milk,’’ he notes.