Swapnali, 4, Supriya Gurav's fourth daughter, is three kilos underweight and malnourished, despite there being adequate food at home. A resident of Shiv Shakti Chawl in Andheri (east), the 38-year-old has five daughters, the youngest being 17-month-old Arya, who weighs seven kilos and is 1.5 kilos underweight.
Supriya blames the poor health of her daughters on her five pregnancies. "In pursuit of a male child, we have ended up with five girls," said Supriya, whose husband Santosh said they want a male child for religious reasons.
Supriya is right: doctors said children like Swapnali and Arya don't attain healthy weight because they have low weight at birth, a result of the mother's poor health.
Children who are born low weight can suffer health complications later in life, said child health experts. "With multiple pregnancies, the mother's health will be compromised. Children who have intra-uterine growth restrictions can suffer from diabetes and hypertension later in life," said Dr Ashok Anand, professor of gynaecology, JJ Hospital, Byculla.
In the slums of Andheri, young girls are more likely to suffer from severe malnutrition than boys.
Malnutrition figures based on gender classification in this area reveals that malnourishment is higher in girls.
In July, 183 girls up to the age of six years were found to be severely underweight (SUW), a physical indicator used by the World Health Organisation to describe malnutrition, as compared to 155 boys in the same age group.
Under the Integrated Child Development Scheme's (ICDS) Andheri project, of 7,597 children weighed in September, 144 girls were SUW, compared to 127 boys.
"Somewhere, the mother is upset that she has delivered girls and she unknowingly or knowingly neglects the health of the girl child. The data may be reflecting this bias," said Prema Ghatge, child development project officer, ICDS Andheri.
Such discrimination is not restricted to Andheri alone - the slums in Bandra and Dharavi too reflect the trend.
Dr Anand said a woman needs to recuperate after childbirth. "Multiple pregnancies will not let the mother supply adequate nutrients to the foetus."
To address the health needs of malnourished children, Andheri's ICDS has tied up with Larsen & Toubro Health Centre in Andheri, and aanganwadi workers take the children and their mothers there for free consultation.
"Most of the malnourished children suffer from iron, vitamin A and C deficiencies, which affect growth. Their resistance is low so they are susceptible to various diseases and many have worm infections," said Dr Shubhada Joshi, paediatrician, Larsen & Toubro Health Centre, in Andheri.
Despite the availability of such facilities in the area, six-year-old Sahil Sawant, who lives in Subhash Nagar slums, which is spread on a hilltop, is eight kilos underweight. His mother Saylee has not yet taken the boy, who should weigh at least 17 kilos, to a hospital.
Children in the area who get interventional medical care have responded well and gained weight. Three-and-a-half-year-old Kartiki Patil from Janshakti Nagar slums is the youngest of three girls. At 10 kilos, Kartiki is about two kilos underweight.
"Kartiki weighed less than 2.5 kilos at birth. Till six months ago, she could not even walk properly, but after having vitamin tonics, she has now started gaining weight," said an aanganwadi teacher, on condition of anonymity as she is not authorised to speak to the media.
Some slum residents claim they visit expensive private clinics because the government clinics often don't have doctors and medical staff. "We take our son to a doctor who charges Rs 700 a visit. We can't afford it, but we have no option as there are no doctors at these government dispensaries," alleged Mayuri Dhuri, whose 20-month-old son Vedant is malnourished and ill all the time.