Early introduction of solid food a recipe for severe child malnutrition

By MOSES NAMPALA

As part of its annual series, Ugandans Making a Difference, New Vision will, until October 3, publish articles on individuals and organisations that have dedicated their efforts to fighting malnutrition in the country. The articles will highlight the causes, discuss solutions and recognise the efforts of those working to avert the problem that affects up to 54% of children under the age of 18 years in Uganda.

At three years, Alice Kayinza is just learning to walk. She can hardly take two steps without tripping. Her limbs are weak and rather wobbly.

But her mother, Esther Nambozo, and the health staff at the Mbale Regional Referral Hospital Nutrition Wing are delighted that the little girl is steadily responding to the health care she is getting.

“Those who saw Kayinza a month ago knew the little girl would drop dead the next minute,” Nambozo recalls.

A keen look at her now confirms how terrible her state was. The girl, who should naturally be light-skinned, looks pale.

Her body is still slightly swollen, a condition the health workers have referred to as oedema.

Her hair is scanty, with a golden-brownish tint, her eyes dazed and cheeks swollen.

Siraji Kijogo, a nutritionist at Mbale hospital, says Kayinza is recovering from acute malnutrition.

“She could not sit, stand or walk, and had no appetite when she was first brought here. Her body was severely swollen,” Kijogo narrates.

However, the drastic improvement in her health can be attributed to the intensive care at the nutrition unit.

Kayinza is one of the 40 children the nutrition wing admits every month. The wing serves more than 18 districts in the eastern region.

Samuel Omodoi, 14 months, is another case of acute malnutrition. Unlike Kayinza who bears some bit of flesh, Omodoi is considerably thin and frail.

Kijogo defines malnutrition as an abnormal health condition that the body develops when it does not get enough amounts of body nutrients.

According to Kijogo, about 80% of the malnutrition cases are a result of early complementary feeding, a deplorable phenomenon that mothers have adopted.

Complementary feeding is feeding an infant on other foodstuff such as cow or goat gastrointestinal system but would also render it difficult to effectively perform its key functions of processing nutrients and energy for the body. The strain in processing of complementary feeds results into the body receiving less nutrients and energy.

“In the long run, a child may develop common symptoms, among them loss of weight,” Nakanwagi explains.


Kayinza was only two months old when her mother used to leave her behind as she went to work in the market. The mother of five says at that time, the family was in financially strained.

“I had to work to make ends meet,” Nambozo says.

The health condition of the child who would be fed on milk and porridge gradually started to deteriorate until last month when she was admitted.

Kijogo says early complementary feeding, has inevitably prevailed due calamities in which an infant loses her mother or parents at a very tender age.

In Uganda, 16 mothers die every day due to pregnancy and child-birth related complications and according to The Uganda Women’s Health Initiative, 25% of the deaths occur as a result of excessive bleeding.

Kijogo says, to a great extent, early motherhood compels infant to be put on early complementary feeding.

Poverty, early marriages, early initiation of sex and lack of information, are said to be the leading drivers of adolescent pregnancy.

Uganda is ranked ninth on the list of countries with the highest teenage pregnancy rate in Africa, with 152 teenage pregnancies per 1,000 girls.

In some wealthier families, girls who drop out of school as a result of pregnancy are given another chance at education leaving the responsibility of taking care of the baby to the girls’ parents.

“Usually when a girl is taken back to school, the baby is left under the custody of its grandmother who has no any other feeding option but complementary feeding,’’ Kijogo explains.

However, Kijoko notes that besides early complementary feeding, there other factors responsible for malnutrition include diseases, poor sanitation and poor dietary intake.

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Kayinza cries for milk

According to Kijogo, the centre admits only children that are severely malnourished.

“Because very often the infants admitted here are in very critical condition, we put them on intravenous fluids and formula diet F 75,” Kijogo explains.

As their condition improves, they are put on another formula foodstuff F 100. “It’s only in extreme cases like that of Kayinza that a child would stay at the nutrition wing for more than two weeks,” explains Kijogo.
Apart from the medical attention given to the wasted infants, mothers are subjected to a practical induction session from a nearby demonstration garden. “Here the mothers are taught about the nutritious foods for the infants, among other thing,” Kijoko explains.

He further says the nutrition wing receives supplies from the health ministry and United Nations Children’s Fund. It is also supported by local partners in the private sector, among them Cure International, which provides fresh milk to both the patients and their care givers. Others local partners are Jenga and Kisito.

But the nutrition wing, like any other public utility, faces a number of challenges.

“The roof-tops are still covered with asbestos material,” he says.

According to the World Health Organisation, exposure to asbestos causes arrange of diseases such as lung cancer, mesothelioma, asbestosis (fibrosis of the lungs), among other health complications.

The wing of the hospital constructed 70 years ago, has a capacity to accommodate only 20 in-patients. However, with the 28 districts it serves, the number of patients almost doubled.

“We need more beds and mattresses because currently some of the patients sleep on the floor,” Kijogo says.
 

Do you know any individual or organisation focusing efforts on improving nutrition in communities? Write to the Features Editor, P.O. Box 9815 Kampala or e-mail features@newvision.co.ug giving name, telephone contact of nominee and reasons for nomination. Type food, the nominee’s name and SMS to 8338