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milk. The child may not be given high energy food for similar reasons. Very often, food is prepared keeping in mind the likes of elders and not according to the requirements of a growing child. Adding to the list of myths related to bad nutrition, Dr. S. N. Rastogi, a leading private paediatrician of the city, comments that, There is a myth that the baby should not be given pure breast milk or cow milk, but it should be diluted with equal amounts of water, else it will cause diarrhoea. Under feeding in most children results from dilution of milk. Supplements which have high protein content should be given to low birth weight babies. Dr. Neelam Singh clarifies that, Good nutrition does not mean expensive food. Very often, expensive things lack sufficient nutrition or have the same nutrition as present in cheap, homemade food prepared from locally available resources. As an important example I would like to mention that although now the advertisement of Cerelac is not being broadcast on television, it remains a very popular food supplement. So much so, that even the household maids feed their children with it, in a bid to imitate their wealthy employers. Ceralac provides the same nutrition to the child as rawa/suji kheer (semolina), mashed daliya (porridge) and mashed dal (lentils) prepared at home. It is not only the illiterate masses of rural areas, but children of affluent and well-educated urban mothers also suffer from malnutrition. Inadequate access to clean water and good sanitation also encourage the incidence of pneumonia. To emphasize the role of hygiene in controlling diseases we have a World Hand Washing Day. Dr. S. K. Sehta says, Hygiene is very important for containing the occurrence of any disease especially gastrointestinal Infections. Even in the case of pneumonia handwashing before touching a child reduces transfer of infection to the child. Dr. Neelam Singh emphasizes, The carers of the child should be very cautious about hygiene and cleanliness. Hands should be washed properly with water and soap every time the child is cleaned after urinating/ passing stools, and also before and after feeding the child. The child should be given clean water to drink, and fresh and clean food to eat. The food should be kept covered and prevented from contamination. The childs surroundings should be kept clean and hygienic, water should not be allowed to collect, and the child should be bathed everyday and dressed with clean clothes. These simple hygiene practices play a crucial role in preventing infectious diseases, especially pneumonia and diarrhoea. Dr. S.N. Rastogi emphasizes on regular cleaning of the breasts before feeding the infant. His advice is that, if it is absolutely necessary to bottle feed the baby, a minimum of four bottles and 4-5 nipples should be used. They should be boiled properly before use. Babies should be made to wear clean clothes. Normally babies are dressed in old worn out clothes for first few months due to some tradition. This is not right.
Apart from international interventions, like reducing poverty, to cope with the problem of malnutrition, there is also a need to mobilize people about the importance of good nutrition. Dr. Neelam Singh suggests, The different nutritional requirements of children of different age groups should be discussed with the common public. These discussions must be carried out not only in national and international conferences with professionals, but the message needs to be spread to the rural masses-- to the last family of the last village.
This article is part of a Citizen News Service (CNS) series in lead up to the World Pneumonia Day, 12 November 2011. The project was managed by Abhinav Bharat Foundation and funded by the 2011 Small Grants for World Pneumonia Day Advocacy Program. We are grateful to the International Vaccine Access Center (IVAC), John Hopkins Bloomberg School of Public Health, GAVI Alliance, Global Alliance for Clean Stoves, and Best Shot Foundation for their support. We would like to thank all those who were interviewed as part of this project and who took the time to share their views.
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