At birth her baby weighed just 2.5 kg -- the minimum weight for a newborn to avoid the underweight tag. "I was happy to have a healthy baby," says Sangeeta Pandey, a resident of Kathmandu. [break]However, nine months on, she noticed something unusual, and it petrified her. Her baby was not able to sit upright on the floor.
Last September, she took her baby to Kathmandu-based Nutrition Rehabilitation Home (NRH). He weighed just 6.1 kg. He should have been 7.3-8 kg for his height of 68 centimetres. The boy was evidenlty suffering from a severe malnourishment. She, however, could not keep her baby there more than 10 days. Her leave period was very short. "I was advised to keep my baby there for at least one month," she says. "It was difficult for me to arrange such a long leave."
Her baby has now gained a little more weight. However, he still cannot stand or walk without holding onto something. She finds it difficult to figure out what went wrong in her babycare. "I breast-fed my baby and also fed him milk formula like Lactogen, Cerelac as well as home-cooked rice gruel," she says. "But he just could not grow properly."
Though less heard of, a tale such as Sangeeta is not unique. In cities like Kathmandu, cases of malnourished babies of well-off parents are already galore -- if not still on the rise. According to Sunita Rimal, Project Manager of Friends of Needy Children (FNC), an NGO which operates 12 rehabilitation centres for undernourished children including one in Kathmandu Valley, over 15 percent of babies admitted at NRH are from well-to-do families.
"Malnourishment is not just a result of poverty and food insecurity," says Rimal, who is also a nutritionist. "It is a reflection of wrong feeding behaviour, which is prevalent in cities as well. If you fail to provide a balanced diet with adequate frequency, your babies are prone to malnourishment. It does not matter how nutritious the food you feed your babies if the diet is not balanced and sufficiently frequent."
According to Rimal, it is especially babies whose both parents are working that seem to be vulnerable to malnourishment. "Today, in cities like Kathmandu, mothers cannot give enough time to their babies. They have to go to work after a brief maternal leave," says Rimal. "It often takes a toll on their babies´ health. The babies end up being undernourished."
Over the past decade, Kathmandu has witnessed an unprecedented rise in the number of nuclear families, with the recently-published preliminary report of the Central Bureau of Statistics (CBS) putting the capital´s family size at 3.71. Most families consist of only the father, mother and one or two children in present-day Kathmandu. Unlike in the past, families lack the company of grandfathers and grandmothers. This means the babies are uncared for when their parents go to work. Arguably, this has given rise to the problem of malnourishment in city areas.
Even the recently-published report of the National Demographic Health Survey (NDHS)-2011 has shown that the problem of malnourishment is not insignificant in the wealthiest quintile of the population. "Of course, the intensity of the problem in the wealthiest quintile is not as high as in the poorest quintile," says Rajkumar Pokharel, Nutrition Section Chief at Child Health Division (CHD). "But it must not be overlooked."
As per NDHS-2011, 41 percent of under-five children are stunted -- down by six percentage points from 2006. Similarly, 11 and 39 percent of under-five children are suffering from wasting and underweight respectively.
With the rise of a consumer culture, children in the cities are getting increasingly accustomed to junk food. This has also added to the problem of malnourishment in city children. "Junk food has become an intrinsic part of the life of city children," says Rimal. "Relying heavily on junk food has complicated the problem of malnourishment."
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