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HMG7130 Nutrition For Global Health, Victoria University, Australia

Maternal and Child Undernutrition

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Introduction: Maternal undernutrition has been identified to be contributing to about 800 000 neonatal deaths every year, which has been taking place through small for gestational age births. Furthermore, it has been estimated that micronutrient deficiencies, wasting and stunting underlie to about 3.1 million child deaths globally, every year (Bhutta, et al., 2013). It has been determined that developments have been made with several interventions that have been applied at a large scale and the suggestion of the effectiveness of nutrition interventions and distributiontactics have progressed since the release of the The Lancet series that was on "Maternal and Child Undernutrition" in the year 2008 (Bhutta, et al., 2013). It has been stated that "Maternal and child undernutrition contribute to deficits in children's health and development. It also impedes children's achievement of their full productive potential in adulthood". It has been determined that the undernutrition amongst the mother eventually reflects back to the child and prevails amongst them, which at later stage of their life affects their overall development.

It has been estimated that nourishment and diet is being a dreadfullyunkemptfacet ofnew born, maternal, as well as child health. The motives for this negligence are not justified, though they are understandable (Horton, 2008). When an individual or organisation considers specific actions for improving the maternal and child endurance, one is drawn to specific kind of interventions that ranges from oral rehydration therapy, vaccination, treatment for haemorrhage and infections and so on. It has been identified that the public health specialists and policy makers have not taken attempts towards gathering evidences regarding the significance of maternal and child nourishment, cataloguing the long term influence of undernutrition on the health and development, identify the confirmedintercessions for reducing undernutrition and call for national as well as international actions for improving the nutrition for children and mothers (Horton, 2008). In the following discussion, the various aspects associated with maternal and child undernutrition and its eventual impact on the health and development of the children and its reflection in their adulthood have been elucidated.

Question: Research and write an essay on the following statement:

"Maternal and child undernutrition contribute to deficits in children's health and development. It also impedes children's achievement of their full productive potential in adulthood". Discuss this statement.

Answer: Maternal and Child Undernutrition: Horton and Lo (2013) have mentioned that although the globalnourishment system is made up of intercontinental and donor associations, private sector, academia, and civil society, however, the same is dysfunctional and fragmented. Heikens, et al. (2008) have mentioned that undernutrition outcomes from intricate web of exchanges right from the molecular as well as microbiological level of a personto the socioeconomic and cultural features of the civilisations. The intricacies of undernutrition as a global issue appears to defy directed, unpretentious and uniform programmes.Nevertheless, the survival of children cannot be improved unless this web is untangled as over 50% of the deaths amongst children result primarily due to undernutrition (Heikens, et al., 2008). 

Prado and Dewey (2014) have mentioned thatadequate nourishment is significant for the normal development of the brain. Nutrition is significantly important during the period of infancy and pregnancy as these are the vitalstages for the development of the brain and lays the underpinning for the growth of the socio-emotional, cognitive, and motor skills thru the childhood along with their adulthood. Therefore, nutritivedeficitsthroughout the infancy and pregnancy are expected to impact efficiency, cognition, as well as behaviour thru the school ages and maturity (Prado and Dewey, 2014). Converging on this initial developmental stage for the deterrence of the nourishmentdeficits can result in enduring and extensiveadvantages for the persons and civilisations.

Maternal and child malnutrition comprises of both undernourishment and a risingissue with obesity and overweight. Truncated body mass index, which is indicative if maternal undernutrition, has reduced to certain extent within the previous twenty years, however, it remains to be predominant in the low income and middle-income nations such as Africa and Asia. Occurrence of maternal overweight has experienced a sturdy rise since 1980 and surpasses that of the underweights within all the regions (Black, et al., 2013). Prevalence of confining of the linear development of kids who are under the age of 5 years have declined in the past twenty years, however, it still remainsmore in sub Saharan Africa and south Asia, more than anywhere else, thereby universally affecting a minimum of 165 million kids, which was estimated in 2011 (Black, et al., 2013). Black, et al. (2013) have mentioned that wasting has affected about 52 million children, while there has been a rise in the deaths of kids due to deficits of zinc and vitamin A, while the deficiencies of iron and iodine results in stunting. As a result of these two factors, the kids are unable to reach their developmental capacities.

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It has been estimated by Black, et al. (2013) that maternal undernutrition results in foetal growth restrictions that increases the risks of neonatal deaths and may result in arrested growth after the age of 2 years for those who survive. Suboptimum feeding from breastfeeding consequences in an augmented risk for death within the first 2 years of lifetime. It has been estimated by Black, et al. (2013) that undernutrition in an cumulative manner, including foetal growth restriction, wasting, deficiencies of zinc and vitamin A and arrested growthalong with the suboptimum feeding from breastfeeding, are the causes od nearly 3.1 million children every year that comprised of about 45% of all the child bereavements in the year 2011 (Black, et al., 2013). Maternal obesity and overweight have been resulting in augmented maternal indisposition and infant deaths. Infantile overweight has been developing a progressively significant contributor towards diabetes, adult obesity, and several othersimilar diseases.

In the study that was conducted by Black, et al. (2013), it has been determined that maternity iron deficiencies are related with babies having low body mass, that is, less than 2500 g, at the time of birth. Furthermore, maternal and child undernutrition, amalgamated with uninspiringdomesticsurroundings have been identified to contribute to the deficits in the development of the children, as well as productivity and health during the adulthood. Maternal obesity and overweight results in increased infant mortality and preterm birth. It has also been determined by Black, et al. (2013), that the foetal growth restriction is related to the maternal short stature as well as underweight, which also results in 12% of the child deaths. There has been anincrease in the occurrence of overweight and obesity amongst the younger kids below the age of 5 years, across the world, and thereby has become a significant contributor to diabetes as well as other kinds of chronic diseases during adulthood.

It has been mentioned by Khalid, et al. (2017) that maternal undernourishment is a critical contributor of low body mass index,anaemia, long term cognitive impairments and micronutrient deficiencies amongst children. Additionally, biochemical mechanism of undernutrition results in stress conditions amongst the pregnant mothers due to which cortisol releases from the adrenal glands and this cortisol in turn facilitates the discharge of oxytocin from the posterior pituitary gland (Khalid, et al., 2017). As a result of this, the hormones induce the manufacturing of prostaglandins F2α (PGF2α) facilitated by the uterus, placenta andfoetus. Increasedquantities of oxytocin combine with the intracellularly Gq type GCRs thateventuallyresult in the discharge of second messengers, that is, Phospholipase C and Diacylglycerol through the inositol 1,4,5-trisphosphate pathway in order, leads to the in-flow of Ca+2 into the cell. Theincreased level of Ca+2results in the prematureretrenchment of the uterus eventually causing pre-term deliveries (Khalid, et al., 2017).

Several studies have conducted a comparative study of the school-age kids who had experienced severe acute malnutrition episode within the initialsome years of their lives, to their siblings or corresponding controls who did not experience such malnutrition. From these studies it is indicated that those with the experience of early malnutrition during extreme childhood, exhibited lower or poorer IQ levels, greater behavioural problems, poorer school achievement and lower cognitive functions (Pradoand Dewey, 2014). It has been opined by Pradoand Dewey (2014) that a study that was conducted in Barbados revealed that grownups who experienced episode of medium to extrememalnourishment within the initial year of lifetime, exhibited more attention difficulties as well as standard of living and social status, as compared to the corresponding controls, even after the age of 37 to 43 years.

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It has been estimated by Black, et al. (2008) that severe worsening, intrauterine developmentallimitations and restricted growth, together have been accountable for 2.2 million demises, as well as 21% of disability adjusted life years (DALYs) for the kids below the age of 5 years. The deficiencies of zinc and vitamin A has been identified to be responsible for a combined global childhood DALYs of nearly 9%. Iodine and iron combined deficiency has resulted in 0.2% of the worldwide childhood DALYs. However, iron deficits have given rise to in 0.4% of the entire global maternal DALYs.Suboptimum breastfeeding has been estimated to be responsible for nearly 44 million, that is, 10% of DALYs amongst children below the age of 5 years. In an analysis conducted by Black, et al. (2008), it has been determined that the co-exposure of these nutrition related factors is responsible for nearly 11% of entireworldwide disease problem and 35% of kiddemises. The high death and ailmentproblem that results from these nourishmentassociatedaspects make a persuasive case for the crucialexecution of intercessions for reducing their existence or amend their significances.

In the study that was conducted by Victora, et al. (2008), it has been identified that undernutrition from the early stage of growth has long term implications on the health of an individual. It has been determined that poor foetal growth or reduced within the first two years of the life results in irreversible damage that also encompasses lower attainment of schooling, shorter adult height, decreased offspring birthweightand reduced adult income (Victora, et al., 2008). In addition, the children who have been undernourished within the initial two years of life and those who have gained weight rapidly during later stage of their infantile and through youth lie at high risk of enduringsicknesses, which are associated with nutrition. However, there are no indications that rapid weight improvement or advancement in the length within the initial two years of life upsurges the risk of any kind of enduring diseases, even amongst the kids with deprived foetal growth (Victora, et al., 2008). Therefore, it can be stated that the deterrence of the maternal and kids undernourishment is a long term asset that is expected to profit the currentcohort as well as their children.

In the study that was conducted by Victora, et al. (2008), systemic reviews of studies were undertaken from middle income and low incomenations for the adult outcomes such as height, glucose concentrations, body-mass index,assets or income, blood pressure,off spring birthweight, andschooling along with indicators associated to cardiovascular disease, blood lipids, cancers, mental illness, osteoporosis, andlung and immune function. It was determined that undernourishment is highly connected with petite adult height, abridgedfinancialefficiency and less schooling amongst both the genders, while amongst female, it also results in lower offspring birthweight (Victora, et al., 2008). Furthermore, augmented size at birth and during infantile have been positively related with the mature body-mass index as well as to a minor extent with the values of blood pressure, however, no connection or relation was found with the concentrations ofblood glucose. It was also determined by Victoria, et al. (2008) that there is mountingsuggestions that a high birthweight and weight accumulation in infancy resultprincipally to build-up of slender body mass, whereas acquisition weight far ahead in infantile is highly likely to effect in build-up of fat mass.

In the analysis conducted by Victora, et al. (2008), along with several literatures, it has been identified that inferior undernutrition and birthweight within infantile were the hazardaspects for high blood pressure, glucose absorptions, as well as damaging lipid profiles, upon regulating the grownup height and body-mass index, thereby signifying that fast weight gain at postnatal, particularly after embryonic stage, is associated to these health conditions. Various literatures have revealed that there isinadequateevidence regarding the changes within the immune functions, osteoporosis indicators and blood lipids. Additionally, it has also been determined that birthweight is positively related with the lung purpose as well as certain incidences of some cancers. Furthermore, it has also been determined that undernutrition is associated with several kinds of mental illnesses. It has been identified by Victora, et al. (2008) that tallness for 2 years old was the best predictor of the human wealth and that undernourishmentis positively related with lowering of the human wealth. Therefore, it can be stated that nutritional damage that is suffered during the early stage of life results in enduringdamage and may also impact the future cohorts. Additionally, the prevention of undernutrition would possibly bring about significant educational, health and economic benefits. In fact, chronic ailments are particularly common and prevalent amongst the malnourishedkids who experience fastimprovement of weight right after embryonic stage.

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Conclusion: Maternal and child malnutrition comprises of both undernourishment and a risingissue with obesity and overweight.Nutritivedeficits during the infancy and gestationare likely to impact cognition, efficiency, as well as behaviour thru the school years and maturity. The high death and disease load that results from these nourishmentsassociatedaspects make a convincing case for the crucialapplication of intercessions for plummeting their existence or amend their significances. The prevention of undernutrition would probably bring about significant educational, health and financial benefits. In fact, lingeringillnesses are particularly common and prevalent amongst the malnourishedkids who experience fast gain of weight right after embryonic stage.

It is estimated that through suitable interventions, the issue associated with maternal and childhood undernourishment or malnutrition can be overcome, different interventions would include micronutrient interventions, elevation of breastfeeding, policiesfor promotingbalancing feeding, decrease of disease load, and overall supportive strategies for improvingdomestic household and community nourishment. Efficient micronutrient intercessions for expecting women can comprise of supplementation with iron folate. Suggested micronutrient intercessions for kids would include stratagems for supplementation of vitamin A, universal promotion of iodised salt, iron supplements for kids in areas where malaria is not widespread, and preventive zinc additions.To eradicaterestricted growth in the lengthierperiod, these intercessions should be complemented by developments in the fundamentalcauses of undernourishment, such asdisease burden, poor education, poverty,and absence of empowerment of women.

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