Undernutrition of young children severely undermines their potential for good. Arjan de Wagt, chief of nutrition, Unicef, India, and former global coordinator on orphans and vulnerable children, spoke to Bappa Majumdar on the importance of breastfeeding in addressing nutrition challenges for kids:

Why is undernutrition so vital to address during the Covid-19 pandemic?

Two-thirds of deaths among children under five in India are attributed to undernutrition, which manifests as underweight, stunting and wasting. It is a ‘silent killer’ that results in compromised physical and mental development, poor performance at school, reduced intellectual capacity, and later even impacts adult income generation. It cuts across all people and socio-economic groups, but women, infants, children and adolescents are at particular risk of undernutrition. And people who are poor are more likely to be affected by different forms of malnutrition. The costs of inaction are immense, resulting in losses to individuals, states and the Indian economy from millions more undernourished and poorly educated children.

Has Covid-19 made things worse on the nutrition front for children?

The Covid-19 pandemic is undermining nutrition with the worst consequences being borne by young children. In India, despite the commendable change in improved child nutrition indicators, an estimated 20 million children under five years of age are suffering from wasting, over 40 million children are chronically malnourished and more than half of Indian women aged 14-49 years are anaemic. The pandemic has further exposed the fragility of children, less by the virus itself but much more by the indirect and long-term fallout.

What has been the impact of Covid-19 on India’s plans to combat malnutrition?

The secondary impacts of the Covid-19 crisis are aggravating the challenges faced by many families, especially in terms of access to affordable and nutritious food. Schools, which provide much needed nutrition to children across India by way of midday meals, are also closed for now. Decades of progress on children’s health and nutrition and other priorities risk being wiped out, unless we take immediate action and arrest the critical child-related issues exposed by Covid-19.

How can we arrest undernutrition and its associated risks in children?

Optimal nutrition in the first two years of life is critical to a child’s survival and development. And breastfeeding, within the first hour of life, is recognised as the most important intervention for infant survival.

Optimal breastfeeding and complementary feeding practices together can prevent almost one-fifth of deaths in children under five years of age. Exclusively breastfed infants are at a lower risk of diseases like diarrhoea and pneumonia, major causes of death among children under five years.

Can Covid-19 be passed on through breastfeeding?

Evidence is overwhelmingly in support of breastfeeding even in Covid times. Skin-to-skin contact and early, exclusive breastfeeding helps your baby thrive, and there is no reason to discontinue in the wake of this virus. To date, transmission of active Covid-19 through breast milk and breastfeeding has not been detected.

If a mother is confirmed or suspected to have Covid-19, can she continue breastfeeding?

Yes, she may continue breastfeeding with appropriate precautions. These include wearing a mask, washing hands with soap and water or with an alcohol-based hand rub before and after touching your baby, and routinely cleaning and disinfecting surfaces.

If the mother is feeling too sick to nurse, there are other ways to safely provide the child with breast milk, like expressing milk and giving to the child via a clean cup or spoon, or providing donor human milk if culturally acceptable. One just needs to make sure to follow basic Covid safety and sanitation guidelines – wash breast milk pumps, milk storage containers and feeding utensils after every use as usual.

How important is breastfeeding to combat Covid-19?  

It is very important to continue breastfeeding your child if she becomes ill. Whether the little one contracts Covid-19 or another illness, it is important to continue nourishing her with breast milk. Breastfeeding boosts the baby’s immune system, and the mother’s antibodies will pass to her through breastmilk, helping her fight infections.

What role is Unicef playing in Telangana and Andhra Pradesh to combat undernutrition?

Unicef is implementing the Government of India’s flagship nutrition programme – Poshan Abhiyaan. In Telangana and Andhra, Unicef has actively supported advocacy and orientation of staff nurses and doctors to continue infant and young child feeding practices effectively during Covid-19.

Unicef, in association with World Food Programme, has also orientated ICDS officials in Andhra, Telangana and Karnataka on streamlining and strengthening the food supply chain systems during emergency. In present context, where Anganwadi Centres are closed, the home delivery of supplementary nutrition has ensured that women and children continue receiving appropriate nutrition.

DISCLAIMER : Views expressed above are the author’s own.

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