LAHORE: Pakistan is among top three countries for stunting –low height for age – with 43.7 per cent of the children under the age of five facing acute physical disorder due to malnutrition and unhealthy eating habits.

In addition to that, 31.5 per cent are underweight or low weight for age and 15.1 per cent are wasted low weight for height.

As many as 9.6 million children in Pakistan are stunted, the third highest population only behind India and Nigeria.

Stunting is irreversible after the child reaches second birthday and he/she grows up physically and mentally weaker than better fed children.

Dietary deficiencies and poor maternal and child health nutrition are responsible for high prevalence of anemia, deficiency of iron, zinc, vitamin A and D among children below five. Prevalence of anemia is 61.90 per cent, iron deficiency 43.80 per cent, vitamin A deficiency 54 per cent, zinc deficiency 39.2 per cent and vitamin D deficiency 40 per cent.

Besides these abnormalities, malnutrition also weakens child’s immune system, leaving him/her vulnerable to more diseases.

“Malnutrition and co morbidities like diarrhoea, dysentery and fever are major reasons behind children getting polio and other vaccine preventable diseases even after getting multiple doses of vaccine. Most of the polio victims last year received seven or more doses of vaccine. These children with weak immunity fail to produce antibodies (shield against polio) from the vaccine. As such they are not immune and can get polio if attacked by the virus. Vaccine is useless if administered to a child with weak immunity, bad stomach or if he/she vomits after getting the dose”, said leading family physician Dr Abdul Rauf.

“Expecting mothers need one and half time more nutrition rich food than the normal routine. In addition to meat, vegetables and pulses, they need supplement of iron and calcium to cope with growing nutritional requirements during pregnancy. There is no substitute of breastfeeding. Healthy lifestyle and food of a mother is necessary for feeding infants. Breastfeeding provides required nutrition to infants and saves them from physical disorders like stunting and wasting. It also provides them immunity against diseases. If breastfeeding is not possible due to some reasons, formula milk is the right choice. It should be continued even after start of transitional phase to complementary solid food at four months age. Formula milk should be continued till first birthday. After that child could be given cow or buffalo milk”, said Dr Khuzaima, pediatrician at Institute of Child Health, Children’s Hospital. 

“Prevalence of stunting is much higher than estimated. It is quite common even in the children of well off people. At least 85-95 per cent children are facing stunting or other complications due to malnutrition or unhealthy eating habits”, said Dr Shagufta Feroz, a leading dietitian. She said that lack of awareness regarding benefits of healthy lifestyle and eating habits was the main cause of high prevalence of stunting.

“Health of expecting mothers is important for wellbeing of babies. Unhealthy lifestyle and eating habits of expecting mothers can cause negative impact on health of babies. Breastfeeding is the best option for infants. It helps normal growth and save infants from diseases”, she said.

Consultant in Family Medicine having 28 years experience in treating patients by modifying food said that lifestyle and behavioral changes were key to improving health condition of kids.

“Parents, teachers and people enjoying respect in the society are vital in spreading awareness about benefits of healthy lifestyle and eating habits. Early breakfast, enhanced water intake and physical activities help normal growth in children. It can considerably decrease stunting and other disorders”, she said.

“I personally expect nothing from the state. All the stakeholders including civil society, media and concerned people should come forward and raise awareness about benefits of healthy eating habits in their respective areas of influence”, she said.

As part of United for Healthier Kids campaign, Dr Shagufta Feroz said that she has visited different schools for conveying message of adopting healthy practices like eating healthy food. She said that this was initiative started globally to eradicate the factors leading to poor health of children.

“Now it is in Pakistan after projects in Mexico and Philippines. Hopefully it will help improve the situation here”, she said.

Major stakeholders will work closely to determine obstacles as well as the solutions for a healthier childhood. These stakeholders include parents, teachers, government officials, NGOs and media. Parents are the most important figure in a child’s life. Parents are found to be the first and an important source for children’s health and nutrition knowledge accounting for 45 per cent. With the correct knowledge and training regarding nutrition could make a huge impact on their children’s health. Teachers are another source that can contribute towards the health of children especially in rural areas where they are respected and their advice is considered important.