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by Aryadasa Ratnasinghe

"More than 100 million children, both in under developed and developing countries, suffer from malnutrition, mostly due to inadequate intake of essential ingredients in the diet, which leads to growth retardation, physical weakness and health hazards due to poor resistance to infections". - (WHO)

Majority of children who suffer from malnutrition are between the age group from 3 to 10 years, but even infants are liable to suffer from it, when mothers are unable to breast feed them due to agalactia (failure of milk supply).

This condition leads to loss of wight, physical weakness, pallor languidness and other indictions which are the hallmarks of under nourishment. In Sri Lanka, about 67% of children suffer from malnutrition, or are susceptible to it, chiefly among the poor families of the rural sector.

As a result of poverty and destitution, some parents are unable to nourish their children with nutritional foods. Some are even unable to supplement their diet with powdered milk, as they cannot meet the high cost, due to financial difficulties.

A full cream packet of 400g milk good is sold for Rs. 135. A litre of fresh cow milk costs Rs. 50. Milk is a wholesome food of nutritional value and best suited for growing children.

A packet of standard powdered milk with full cream contains proteins, carbohydrates, fat, vitamin A (retinol), vitamin C (ascorbic acid), vitamin D (calciferol), vitamin B6 (pyridoxine), vitamin B (riboflavin), vitamin B12 (cyanocobalamin), foliate, phosphorous, magnesium, zinc, iodine, sodium and potassium and these combined diet of nutritional value, provides good nourishment to the child.

Milk foods in their natural form viz: cow milk, goat milk, ewe milk, buffalo milk, camel milk (kefir) mare milk (koumiss) are drunk for nourishment. Milk products viz: butter, cheese, ghee, curd, yoghurt etc. also provide good nourishment, specially for children to keep them healthy and active.

There is also sterilised milk (Kal kiri) brought to ultra high temperature (132 deg. Centigrade), which can be preserved without refrigeration. In the old days, there were only three brands of milk powder, namely Lactogen, Cow & Gate and Ostermilk. Horlicks and Nestomalt were also there as an invigorating nutritious drink.

Above all, breast milk is the most supreme for infants because it is the natural food of humans. It comes to the child at the proper temperature, completely sterile and contains bactericidal properties which make the milk pure and harmless and free from micro organisms.

Breast milk contains 88% water, 4.8% lactose, 3.2% protein and 3.9% fat. This composition agrees with all babies and it is the only food that is capable of saving the lives of premature babies, when mothers after childbirth run dry.

During pregnancy, the breasts discharge a serous fluid and immediately after confinement, it becomes added with a yellowish liquid known as 'colostrum' (the first milk after parturition).

Agalactia takes place when a mother is under nourished due to her physical debility, sickness and lack of natural affection towards her offspring.

It is an emotional force deleterious to the production of milk. On the other hand, some mothers suffer from 'galactorrhoea' (involuntary overflow of milk).

The global situation of malnutrition is not due to any famine, war or other catastrophe, but due to poor dietary intake of nutritional foods rich with nutrients. Malnutrition is a silent enemy, but its hazards are quite positive in the long run, because it mainly affects the proper functioning of the body system.

In 1990, the World Summit on Child Health Care singled out three important food items which are essential for a child to lead a healthy life. They are iron, protein and vitamins.

Iron is a part of haemoglobin (a widely occurring red coloured protein) in the body. Vitamins are organic substances, normally present in small and variable amounts in different foods and their absence or partial deficiency in the diet leads to various diseases and body functions.

It was in 1915 that vitamins were considered essential to maintain good health. Vitamins have been divided into two groups. One is water soluble (e.g. yeast, rice polishing and wheat germs) and the other is fat soluble (e.g. egg yolk, butter, cheese, fish liver oil etc).

Proteins are also organic substances containing carbon, hydrogen, oxygen and nitrogen and constitute an important part of living cells. The most common examples are albumin in eggs, casein in milk, haemoglobin in blood and ossein in bone.

Iodine is a halogen (any member of the group of elements, such as chlorine, bromine, fluorine that form metal compounds like sodiumchloride (common salt). It is not freely found in nature but as sodium nitrate deposits in seaweeds). Iodine was discovered by the Irish physician Robert James Graves in 1845.

Iodine is an essential element and any deficiency in the body gives rise to goitre (a swelling in the neck resulting from enlargement of the thyroid gland). The gland secretes hormones and calcitonin, the principal ones being thyroxine and trilodothyroxine which control metabolism of the body. By type of vitamin and its deficiency syndrome is as under.

Vitamins are essential for youthfulness, longevity, efficiency of the digestive system and excretory and respiratory tracts for promotion of healthy action of the cilia (hair like appendages in the respiratory membranes) for glandular health, good hearing and vision and for conditioning the mucous membrane.

In women, they are essential to regulate the rhythm of the menstrual cycle. Vitamins also add to conjugal harmony between men and women which is vital for procreation.

Vitamin A (Retinol) - Poor vision, unhealthy skin, poor resistance to infection, night blindness, thyroid disorders, ENT problems etc.

Vitamin B1 (Thiamine) - Lack of appetite, oedema, constipation, dizziness, nausea, insomnia, acute headache, weak muscles, anaemia, premature senility etc.

Vitamin B2 (Riboflavin) - Eye disorders, cracked skin, pellagra (marked by wasted body and insanity), wrinkles at the young age, migraine, spinal ache, forgetfulness etc.

Vitamin B3 (Pantothenic acid) - Poor resistance to infection, early greying of hair and schizophrenia (loss of feelings between thought and action) etc.

Vitamin B6 (Pyridoxine) - Hypertension, atherosclerosis (thickening of the arteries) anaemia etc.

Vitamin B8 (Para-amino benzoic acid) - Retards glandular efficiency, lack of libido, impotence, no interest in sex, greying of hair etc.

Vitamin B12 (Cyanocobalamin) - Pernicious anaemia, poor vision, liver diseases, clumsiness of the legs, reduction in the formation of erythrocytes (red blood cells) etc.

Vitamin C (Ascorbic acid) - Eye diseases, slow in healing wounds, impairment of muscles, gland tissues and sex organs, poor resistance to fever, loss of strength, susceptibility to colds, mouth, gum and throat diseases etc.

Vitamin D (Calciferol) - Muscle weakness, short sightendness, pot belly, tooth decay, racket in children, osteomalacia (bone diseases) in adults etc.

Vitamin E (Alpha Tocopherol) - Impairment of essential functions of the body, emphysema, heart strain, anoxia, gangrene in diabetics, slow male virility, phlebitis, thrombosis, muscular dystrophy, stunted growth, varicosity etc.

Natural Vitamin E is extracted from vegetable oils, nuts and wheat germ oils, while synthetic Vitamin E is derived from petrochemicals.

Vitamin F (Linoleic acid) - Coronary and apoplectic attacks due to cholesterol, acidosis, biliousness, heart and liver troubles, duodenal ulcers, psoriasis (skin disease) etc.

Vitamin K (Menadione) - Prevents clotting of blood after injury. Effective against jaundice, miscarriage in women, and widely used as an anti-carcinogen, and in case of nose bleeding.

Vitamin P (Hesperidin) - Cirrhosis of the liver, exzema, glaucoma or dimness of vision, and counteracts damage to tissues from X-ray radiation.

Alcohol is deadly for all vitamins of the B Group. Sleeping tablets sulpha drugs, narcotic drugs, splashes from insecticides and other agro-chemicals, prevent the absorption of this vitally needed vitamin group.

Nutrition has been expressed as a right in International Human Rights Instruments since 1924. Among them are declarations which are not binding and conventions for the enforcement of law.

Human Rights Instruments contain the Declaration of the Rights of the Child (1924), the Universal Declaration of Human Rights (1948), the Declaration of the Rights of the Child (1959), the International Covenantion on Economic, Social and Cultural Rights of the Child (1989) and the World Declaration and Plan of Action on the Survival, protection and Development of Children (1990), all of which recognise the Right to Nutrition.

Malnutrition is known in Sinhala as 'Manda-Poshanaya', its corruption being 'Maandama'. A mother who breast feeds her baby for more than two years is likely to cause the child to suffer from malnutrition, unless the child is given supplementary food of nutritional value.

Some mothers think that as long as they keep breast feeding, there will be no conception. So, they continue to do so.

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