Undernutrition among infants less than 6 months of age: an underestimated public health problem in India

Abstract

In India most childhood nutrition recommendations and interventions are still not focused on infants under 6 months. Secondary data analyses of National Family Health Survey-3 data from India were analysed to compare the prevalence of wasting, stunting and underweight in infants less than 6 months and 6-59 months. Our results revealed that wasting was higher (31%) in infants less than 6 months (P < 0.05) as compared with children between 6 and 59 months. Thirteen per cent of infants less than 6 months had severe wasting, 30% were underweight and 20% were stunted. Most infants (69%) were exclusively breastfed (EB) for the first 2 months, but exclusive breastfeeding dropped to 50% at 2-3 months and to 27% at 4-5 months. There was no statistically significant difference in wasting and stunting in the EB and not exclusively breastfed (NEB) groups. Significantly fewer EB infants were underweight (28%) compared with NEB infants (31%) (P = 0.030). However, among EB children, 29% had wasting and 21% were stunted. Eleven per cent of EB infants were severely underweight, 13% were severely wasted and 9% were severely stunted. Diarrhoea was significantly lower among EB infants compared with NEB infants (P < 0.05). We conclude that infants less than 6 months of age are vulnerable to suffer from acute severe malnutrition irrespective of their breastfeeding status and need to be seriously considered for inclusion in national guidelines for early detection and management of undernutrition.

Determinants of age‐specific undernutrition in children aged less than 2 years—the Bangladesh context

“…Finally, on the risk factors of being underweight, our findings are in line with results derived from similar cross‐sectional data on children aged less than 6 months that have shown association of exclusive breastfeeding with underweight (Kuchenbecker et al, ; Patwari, Kumar, & Beard, ). The data collection method for establishing exclusive breastfeeding was different for each of these studies, with some studies reporting a higher probability of recall bias, such that the results of the studies are not directly comparable.…”

Admission profile and discharge outcomes for infants aged less than 6 months admitted to inpatient therapeutic care in 10 countries. A secondary data analysis

“…We have previously showed that despite the lack of focus on assessing the nutritional status in this age group (Lopriore et al 2007), acute malnutrition among infants <6mo is a public health concern (Kerac et al 2011), a prevalence that others have characterized as an underestimated public health problem (Patwari et al 2015). Our analysis contributes to this evidence by showing that infants <6mo also account for an important proportion of children receiving inpatient therapeutic care.…”

“…), a prevalence that others have characterized as an underestimated public health problem (Patwari et al . ). Our analysis contributes to this evidence by showing that infants <6mo also account for an important proportion of children receiving inpatient therapeutic care.…”

The stunting syndrome in developing countries

“… 79 When linear growth among infants in developing countries was evaluated using 2006 WHO growth standards, the prevalence of stunting in the first half of infancy doubled compared to prior estimates; 80 in some countries, such as India, 20% of infants are stunted before 6 months of age. 81 , 82 There is therefore an increasing appreciation of undernutrition in infants under 6 months, who are often excluded from nutrition surveys and marginalised in nutrition programmes, 83 and a realisation that interventions need to be targeted earlier than was previously appreciated.…”