When two-month-old Prithvi had a seizure a week ago, his father Tarun Kumar thought the boy had brain damage. To his surprise, the infant was diagnosed with Vitamin D and calcium deficiencies.
“We were surprised, especially since he was being breastfed. But the doctor told us that if the mother doesn’t take in enough nourishment, it can affect the quality of the milk,” says Tarun, 29, who works with a blood bank.
When we talk of deficiencies in children, we usually don’t include infants, but people need to realise that what a mother eats or does not eat makes a huge difference to a breastfeeding baby, says Dr Chandrashekhar Singa, paediatric intensivist at Max Smart superspecialty hospital.
India celebrates the first week of September as National Nutrition Week, and experts say this is important because there needs to be a lot more awareness on the issue, especially when it comes to children. The earliest turning point for this comes at 12 to 18 months.
“This is a crucial developmental stage. The child is typically very fidgety, unwilling to sit in one place for something as unstimulating as a healthy meal. Given that this is also a period when the child is new to solids, it is very important to establish the right kind of dietary and eating habits and not give in to tantrums,” says Dr Anuja Pethe, consultant paediatrician at Mumbai’s superspecialty Nanavati Hospital. Indulge a fussy child at this stage and your toddler could develop a condition called physiological anorexia, a slump in appetite that leads to weight loss at a time when babies should be gaining weight.
The next tricky food phase is usually between the ages of 8 and 15, as the child starts making some of their own food choices. The most common deficiencies found in children are iron, calcium and Vitamins B Complex, D and A, and this is the period when they usually crop up.
It may sound contradictory — malnourishment among the affluent — but it is a very real problem today, as young Indians gorge on processed and packaged foods.
“Malnourishment and resultant low immunity are very common among youngsters from middle-class and affluent families in this age group,” says Dhvani Shah, nutritionist and author of Don’t Just Feed, Nourish Your Child. “This is the period when they consume a lot of junk food. Different children will see their bodies react differently. In some, the empty calories and high salt and sugar content begins to affect the body’s ability to absorb nutrients.”
Two years ago, for instance, Mumbai-based financial planner Vandana Gupta noticed that her son Aditya was noticeably thinner than his twin sister Mahek. They were both nine, and on the same diet, but while Mahek was a healthy 36kg, Aditya was only around 23kg.
“After approaching a nutritionist, I realised that to cater to his body type, which is lean, I had to include more nutritious food items that his body would respond to,” says Vandana, 40.
She began replacing granola bars at snack time with homemade oat cookies packed with almonds, or bhakri pizza. “These experiments were a success with both kids and I was happy to see Aditya begin to fill out and his stamina increase. He’s still lean, but he’s now energetic, always out playing football and tennis.”
There are two key lessons to learn from Vandana’s experience, doctors say. First, different children have different nutritional needs. And second, weight is an important indicator, but energy levels will really tell whether your child is well-nourished.
Balance, as with all parenting issues, is key. Mumbai homemaker Bijal Panchal, 38, learnt this the hard way. She had been fretting about her daughter’s weight ever since the child was born prematurely, weighing only 2 lb. Two years on she weighed only 9 kg, instead of about 12 kg.
“She was weak and lethargic, unlike other kids her age, and was prone to bouts of vomiting after eating,” Bijal says. “On approaching a paediatrician, I was told that, in my anxiousness to make sure she ate, I had essentially been forcefeeding her and hampering her nutrition.”
Bijal then began feeding Stuti smaller meals at regular intervals, focusing on nutritional value rather than quantity. So, tea and biscuits were replaced with milk and theplas or rotis.
“She gained 3 kg in six months and has a lot more energy now,” Bijal says. “Where she was once listless and tired, she now loves playing outdoors.”
Interestingly, 90% of children are referred to nutritionists by paediatricians.
“Most of the kids I see first visited a doctor for some other problem and had their deficiencies diagnosed accidentally,” said Neha Khanna, a Delhi-based nutritionist. “I hardly get any direct cases, which reflects the fact that most parents don’t even realise their children aren’t eating right.”
Mumbai homemaker Deepti Tamhane, 35, began the battle over mealtimes when her daughter Asya was 18 months old. “She was a fussy eater, extremely difficult to please and became irritable and cranky at the sight of food,” says Deepti.
For a year, the parents gave in and let her eat what she wanted, which was usually ghee-rice, with an occasional boost of sugar from biscuits. But when she was two-and-a-half and still scrawny and as fussy as ever, they consulted a paediatrician, Dr Rupal Dalal.
“She told us we had to stop giving in to Asya’s whims and take a firm stand. So we stopped letting her snack on processed food like biscuits and cornflakes,” says Deepti. “Initially she would sulk and refuse to eat, but once we explained that she would not get anything till the next meal, she started eating everything, from rotis to green vegetables and even bitter gourd!”
Although Asya, 6, still has a petite frame, she is very fit and energetic, loves playing outdoors and adores her mallakhamb class.