Stunting, wasting as hidden threats to child’s cognitive development, productivity
By Folasade Akpan Like every other child her age, eight year-old Precious Mathew’s (not real name) parents expect her to be a certain height and physical stature.
But, that is not the case as she looks lean and physically under-developed.Many people do not believe she is actually eight years old. Also, she easily gets tired when playing with her mates.
Her mother, Mrs Grace Mathew, worried about her daughter’s condition decides to consult physicians.
She took her to a medical outreach where Precious was diagnosed to be stunted due to malnutrition.
Mrs Mathew was told that Precious’ low body weight, weakness, fatigue and stunted growth may hinder her intellectual development.
The World Health Organisation (WHO) said malnutrition as deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilisation.
According to UNICEF Nutrition Officer, Ms Nkeiru Enwelum, the forms of malnutrition to be acute malnutrition, severe wasting, stunting and obesity.
Enwelum spoke at a media dialogue on ‘`the Nutrition Situation in Nigeria: An Overview of Malnutrition in Nigeria and Its Impact on Children”
Citing the National Demographic and Health Survey 2018, she said that about 12 million out of the 35 million under-five children in Nigeria are stunted due to malnutrition and that one in three Nigerian children was suffering from stunting.
She described stunting to be a form of malnutrition which occurs when a child has low height for his age and that it was a form of malnutrition referred to as chronic malnutrition because it happens over a long period of time.
She also said stunting could contribute to developmental delays and impair cognitive development.
The nutrition officer said malnutrition can affect academic performance and productivity of a child up until adulthood.
Nigeria ranks first in Africa on malnourished and second in the world in the malnutrition chart.
Experts say that about one million people suffer from acute food insecurity, adding that about 17.7 million people are hungry in Nigeria, as they explore the causes of malnutrition.
“The states with the highest number of people suffering from food insecurity in Nigeria are Kano and Lagos.
“In spite of the fact that Kano, Borno, Katsina and Lagos rank high in the food insecurity ladder, malnutrition is wide spread in the country, affecting people living in other parts of the country“, Enwelum explained.
She also said that most of the burden of malnutrition, for both stunting and wasting, lies in the northern part of the country where one in two children is stunted.
Wasting is a condition in which a child is too thin for his or her height and as a result of recent rapid weight loss or failure to gain weight.
“Some of the diseases or resultant body malfunctions arising from malnutrition are micro nutrient deficiency, anaemia, rickets and vitamin A deficiency.”
“As we can see, Nigeria is off track to achieve most of the Sustainable Development Goals (SDG) Two nutrition targets.
“In fact, we may even be risking seeing some back-sliding of some gains due to the impact of COVID-19 on nutrition. The next two to three years are therefore going to be critical to set Nigeria on track”, Enwelum said.
Experts say the prevention of malnutrition is more cost effective its treatment.
During pregnancy, Enwelum recommends weight gain tracking, maternal supplementation and dietary counselling, infection control for malaria, HIV/AIDS and tetanus and ante-natal care.
At delivery, she prescribes early essential newborn care such as early initiation of breastfeeding, skin to skin, delayed cord clamping, birth weight, infection prevention and care of sick and vulnerable newborn, cord care, birth registration and immunisation.
Ensuring quality diet at early stages of life is also important.
“For zero to five months, there should be maternal supplementation and dietary counselling, exclusive breastfeeding and immunisation.
“From six months to 23 months there should be continued breastfeeding, complementary feeding, supplementation, immunisation for measles, yellow fever, “said.
Another nutritionist, Ms Uju Onuorah, says poor nutrition in the first 1,000 days of a child’s life can cause irreversible damage to the growing brain.
“Nutrition in particular plays a foundational role in a child’s development and the ability to prosper.
“It is during the first 1,000 days of a child’s life that the brain begins to grow and develop, and the foundations for their lifelong health are built.
“Research shows that 80 per cent of a child’s brain development occurs within the first 1,000 days of life, making those years important for lifelong health, learning and success”, Onuorah said.
Onuorah also said that stress, trauma, poverty and violence experienced during the first 1,000 days could have long-term adverse health effects on a baby.
She also established the implications of malnutrition on an economy saying it could lead to a reduced productivity, increased healthcare costs, reduced human capital and reduced economic growth.
“Stunted children are more likely to have poor cognitive development, which can lead to poor educational performance and reduced productivity in adulthood.
“This can have a negative impact on a country’s economic growth and development.
According to her, effects of stunting in children can also lead to increased healthcare costs for a country, as children who are malnourished are more likely to suffer from illness and disease.
The nutritionist also identified reduced human capital and reduced economic growth as consequences of stunting.
“They can lead to reduced human capital, as children who are malnourished are less likely to reach their full potential in terms of physical and cognitive development
“Malnutrition can slow economic growth and perpetuate poverty, as mortality and morbidity associated with malnutrition represent a direct loss in human capital and productivity for the economy.
“The physical and cognitive consequences of stunting are largely irreversible, in spite of parents’ best efforts later in the child’s life’’, she said.
She, however, said that to address this in children, it is important to focus on improving maternal and child nutrition, especially during the first 1,000 days of life.
Onuorah said that this should be by promoting exclusive breastfeeding for the first six months of life, providing nutrient-rich complementary foods after six months, and ensuring access to clean water and sanitation to prevent illness.
“The first 1,000 days of life which is from conception to two years of age, is a critical window to ensure that children have optimal nutrition for growth and development and lifelong health.
“The immediate causes of malnutrition (poor diet and ill health) as well as the underlying causes such as poverty, food insecurity, and poor sanitation should be properly addressed to reduce the prevalence of malnutrition in Nigeria.”
Onuorah also said that emphasis should be placed on implementing malnutrition prevention, interventions and approaches.
While medical steps are taken to improve nutrition among children, indulging in good feeding habits such as eating plenty of fruits and thoroughly cooking food before consumption are also helpful as well as nutritional literacy.
“Nutritional culture and literacy need to be considered. Low nutritional literacy will result in inadequate or inappropriate nutrition, malnutrition and other complications in children.
“Many of the current nutritional problems are due to wrong consumption culture in family that transfers to children’’, say Mohammad Mohseni and Aidn Aryankhesal in a study published in PubMed Central journal.  
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