The poor quality of nutrition during the ante-natal period and improper feeding practices followed for infants and young children have been leading to alarming rates of malnutrition among pre-school children. Even among the high income category, one-third of children in the under-five years group are malnourished, paediatricians have pointed out.

The inadequate dietary intake in pre-school children (under-five years children) or the gap between Recommended Dietary Allowance (RDA) and the actual intake is about 500 calories in pre-school children. This is not due to poverty but solely because of poor feeding practices, Head of the Department of Paediatrics, SAT Hospital, Lalita Kailas, said.

Malnutrition starts in the womb itself and about 14-16 per cent of babies have been found to be underweight within the first six months itself.

The growth period from six months to two years is very critical for the child's development, yet almost 50 per cent infants suffer from protein energy malnutrition (PEM) by the age of two years.

Unavailability of protein and nutrition components in the weaning foods, traditional feeding practices and poor awareness among mothers are some factors which lead to PEM in infants.

“Most of the traditional weaning foods are cereal-based and lacks in protein. There is also a general reluctance to give protein foods to infants because of some misconception that proteins are hard for the babies to digest. Another wrong practice that all mothers follow is restricting food intake when the infant falls sick,” Dr. Kailas said.

Growth during infancy depends on the birth weight of the child, nutrition adequacy and the absence of infections and other infestations. In Kerala, most of the families feed the children predominantly with adult food, with little or no attention to nutrition, she added

Early termination of exclusive breastfeeding and early complementary feeding of babies, often with foods which has low levels of nutrients is another problem contributing to malnutrition of infants. Though exclusive breastfeeding has been recommended for infants up to six months, the percentage of infants exclusively breastfed till the recommended period is only 46.4 per cent in the State.

Paediatricians recommend that the complementary foods fed to infants from the age of one year be enriched with ghee or oil and that fruits and vegetables should be necessarily included in the daily diet. From the age of two years, children should be given three main meals as well as two snacks during the day, which should be fruits, curd or biscuits.

Deficiency of iron and Vitamin A was another major problem commonly found in pre-school children.

Doctors recommended that the Integrated Child Development Scheme, the only government programme aimed at the nutrition of pre-schoolers, be revived and strengthened and that immediate steps be taken to address malnutrition in the 0 to 3 years group.

Keywords: healthmalnutrition

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