There’s a disturbing rise in malnutrition among kids in Oman and parents’ ignorance, not starvation, is a major cause. Alvin Thomas checks out the alarming health reports with experts
Famous Canadian author Earle Gray once wrote: “Most of the seven billion people in this world suffer from malnutrition. Half do not have enough to eat and the rest of us have too much.” These are strong words that expose the irony that continues to exist in our world today.
And while most of us here today have the power to decide what we put in our mouths each day, it’s time to shed light on those that don’t – and it was a recent report published by the Ministry of Health (MoH) and Unicef Oman that highlighted this topic that is prevalent right under our own noses in Oman.
But, according to the World Health Organisation (WHO) not all cases of malnutrition can be as drastic as the inability to source nutrients from food – and thankfully, it is not the case in Oman.
In short, WHO classifies malnutrition as the deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. However, the term malnutrition covers two very broad groups of conditions. Easily put, the first group is ‘undernutrition’. This includes stunting – low height for age, wasting – low weight for height, underweight – low weight for age, and micronutrient deficiencies or insufficiencies – a lack of important vitamins and minerals.
The second group is overweight, obesity and diet-related non-communicable diseases – such as heart disease, stroke, diabetes
Albeit, the summary that was released to the public last week by Unicef Oman and the MoH – National Nutrition Survey 2017 – silently made matters clear to the public.
As per the report, 11.2 per cent of children in Oman under the age of five (5) are classified as underweight.
A child is considered underweight when the weight-for-age is approximately 2kg below standard at age one, 3kg below standard for ages two and three, and 4kg below standard for ages four and five.
It must also be noted that the numbers in Oman have been rising over the last decade (as per the CIA World Factbook). For instance, in 2009, it was noted that 8.6 per cent of children were underweight. The numbers then increased to 9.7 per cent in 2014.
But malnutrition affects people (including adults) in every country. An estimated 41 million of the children under the age of 5 years are overweight or obese, while some 159 million are stunted and 50 million are wasted.
Ignorance of the parents
To get to terms with the subject, we contact Dr Mary Ann, a nutritionist and well-being specialist who has been helping several clients in Oman to get back to health. She tells us: “There are several reasons why a child could go underweight. But I don’t think that it is starvation that is leading these kids into this stage. His Majesty takes great care of his subjects and that shows how all people in the country have access to food and necessities when compared with countries
around the Middle East.
“You see, a child can lose weight based on their genetics, dietary habits and so on. But from my time here in Oman, I feel that it is
the ignorance of the parents and other family members that leads
to this situation.
“Children are always growing and every single morsel is considered a building block in the child’s development. The mother’s milk, for instance, is very important for the child. But again, there are cases where I see that it is overdone.
“The child needs the right quantity of micro-nutrients to grow healthily. A child must be given semi-liquid (mushy) foods when they are three months old. Just a teaspoon of that is necessary to provide the child with the vitamins required for growth.
“And by the time the child reaches the six months’ mark, they should be reamed off the mother’s milk.”
The National Nutrition Survey 2017 also distinctly points out that early initiation of breastfeeding is reasonably good, but other indicators of infant and child feeding are suboptimal.
However, before you deduce your child underweight, it’s best to consult your local paediatrician or nutritionist.
Parents are the best judge
Pediatrician Dr Qais (name changed for legal purposes) with a leading private hospital in Oman says: “Every child is different – and their bodies differ. The optimal weight of the child cannot be determined by just looking at the child.
“Some kids are tall, short and some are stout.The concern is when you observe that your child’s weight percentile is declining on a regular basis. And as a parent, you’re the best judge for that.
“You must keep track of every change in the child – including those that are physical and emotional.
“If you notice that your child’s clothes are loose, or he or she isn’t growing out of their clothes, then it’s time to visit the doctor. Schedule an appointment with a paediatrician. Another sign is when you begin to see the child’s ribs. It’s a tell-tale sign that your child is underweight,” he adds.
But a consensus – throughout our meetings with doctors – regarding this topic teaches us that inadequate food intake is the root cause of underweight kids.
“Let’s face it: Children can be picky when it comes to food. And sometimes the parents just must put their foot down and facilitate healthy eating.
“But if you see that the child’s body still doesn’t respond to it, then it could be because of other medical issues. For example, children who fall ill regularly are constantly under medication, or have hormonal or digestive problems can find themselves absorbing lesser nutrients than many kids in their age.”
The doctor then goes on to tell that it is also a growing matter of concern in prematurely born children: “A child who has been born prematurely tend to be underweight because their growth can be a bit gradual.”
Stunting and wasting
While the collaborative report focuses on underweight kids in Oman, it also sheds light on the vital evils such as stunting and wasting among children in the same age group.
As per the report, a staggering 11.4 per cent and 9.3 per cent of children in Oman suffer from stunting and wasting.
WHO defined stunting as the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation. Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median.
On the contrary, wasting or thinness is the condition wherein the child suffers from a low weight-for-height ratio. It indicates a recent and severe process of weight loss, which is often associated with acute starvation and/or severe disease.
The report also emphasised other nutritional indicators, such as anaemia, iron deficiency, iron deficiency anaemia, sickle cell trait, vitamin A deficiency, and vitamin D deficiency and insufficiency.
All the aforementioned conditions can result in the child dropping weight and/or slow growth and development.
The results of children under the age of 5 suffering from various conditions in Oman goes as follows:
1) Anaemia: 23.8 per cent
2) Iron deficiency (6 – 59 months): 10.2 per cent
3) Iron deficiency anaemia (6 – 59 months): 1.6 per cent
4) Sickle cell trait: 5.3 per cent
5) Vitamin A deficiency (6 – 59 months): 9.5 per cent
6) Vitamin D deficiency (6 – 59 months): 10.6 per cent
7) Vitamin D insufficiency (6 – 59 months): 53.8 per cent
Concern over anaemia
Anaemia has also been in the news as a growing worry in the Sultanate, especially among children.
Internet health website WebMd describes anaemia as the condition that develops when one’s blood lacks enough healthy red blood cells or haemoglobin. Haemoglobin is a main part of red blood cells and binds oxygen. If one has too few or abnormal red blood cells, or if the haemoglobin is abnormal or low, the cells in one’s body will not get enough oxygen.
Dr Qais explains: “While anaemia can be caused due to various factors, it may not directly result in weight loss. However, weight loss in general can lead to a child to anaemia. But what it can do is make the child look pale or ashy. This can also result in irritability, weakness and tiredness.
“However, as a paediatrician, I make sure to alert the parent that an anaemic child can be prone to jaundice. Meanwhile, acute anaemia can cause shortness of breath and even swollen hands and feet. If you notice any of these conditions in your kids, take them to a doctor.