DILI, 05 may 2022 (TATOLI) – UNICEF’s Country Representative to Timor-Leste, Bilal Durrani, says that malnutrition, especially stunting among children younger than five is a silent emergency in Timor-Leste. It should therefore be addressed today.
Durrani shared that 47% of Timorese children are stunted: “Stunting is almost impossible to reverse after a child turns two years old,” Durrani told reporters at the UNICEF office, in Caicoli Dili, on Wednesday.
Stunting results from chronic undernutrition. It is the impaired growth and development that children experience in the first 1.000 days (conception until a child’s 2nd birthday).
Durrani recommended the top three ways to stop stunting in Timorese children: “Through UNICEF’s experience in more than 190 countries and territories, we propose the following three evidence-based interventions. These are some of the world’s best existing tools to ensure that the next generation of Timor-Leste is protected from the lifelong consequences of stunting.”
“First of all, breastfeeding prevents malnutrition in all its forms. All babies should be breastfed early (within the first hour after birth), and exclusively (for the first 6 months of life, without other food or water).”
“Next, complementary affordable nutritious local foods should be included alongside breastfeeding in a child’s diet at the age of six months – an important growth period during which they are more vulnerable to undernutrition. Micronutrient powders, available free at Timorese health facilities, should be introduced from 6 months of age, together with complementary foods.”
“And the last one is handwashing by mothers/caregivers with soap helps to prevent and control the spread of infectious diseases such as diarrhea. There are five critical times when mothers/caregivers need to wash their hands: before preparing food, before cooking, before feeding the baby (including breastfeeding), after changing the baby’s diapers or washing the baby’s bottom, and after using the toilet. Proper management of human waste through toilets is also critical,” said Durrani.
One important step to combat stunting in Timor-Leste is teaching and raising awareness in the communities, schools, health facilities, and among parents, especially mothers.
According to the Timor-Leste Food and Nutrition Survey launched by Prime Minister, Taur Matan Ruak, the Minister of Health, Dr. Odette Freitas Belo, Development Partners, and UN agencies in Timor-Leste identified four alarming facts that lead to stunting in Timor-Leste:
a) The survey found that 53% of Timorese mothers do not “initiate” breastfeeding their children when a child is born. Early breastfeeding is especially important because the first feeds contain colostrum, special milk often referred to as “liquid gold” because of its immune properties. This colostrum serves as the baby’s first “immunization,” is rich in vitamin A and helps to ensure that the baby’s intestines and body grow and develop properly.
b) It is extremely dangerous to give any water or food to a child in the first six months, but 22% of Timorese parents start feeding their children with solid foods even before they turn 6 months old.
c) 86% of Timorese parents do not give their children healthy complementary affordable nutritious local foods when they turn six months old.
d) 94% of Timorese do not wash their hands after disposing of a child’s feces and the same percentage of people do not wash their hands before breastfeeding/feeding children. This leads to deadly diseases such as diarrhea and intestinal worms.
Mothers should stop giving formula milk to babies. Durrani stressed that the use of formula milk instead of Breastmilk contributes to the rise of stunting and wasting among Timorese children.
“Sometimes, mothers wrongly think that formula milk is better than breastmilk. The manufacturers of infant formula spend billions of dollars on predatory marketing to try and falsely convince families, everyone from mothers, fathers, mothers-in-law, and community members, that their artificial products contain the same nutrients as breastmilk. This is not true. It can never be the same,” he said.
It is deeply concerning and alarming that in the last two decades, the percentage of Timorese children that do not initiate early breastfeeding has increased to 53% in 2020! Because of this, a significant portion of Timorese children misses out on breastmilk which is rich in essential vitamins and nutrients.
“The national prevalence of bottle feeding is 32%, with as high as 53% in Dili. Mothers cannot read the instructions to adequately use formula milk, often giving the wrong formula milk to a child which is not adequate for the child’s age,” said Durrani.
He said lack of hygiene to properly clean milk bottles leads to diarrhoeal infection which can adversely affect a child’s ability to eat and absorb a nutritious diet.
Durrani called on mothers to stop giving formula milk to their children, and only provide Breastmilk for the first 6 months of life, without any other food or water.
“Compared with breastfed infants, non-breast-fed infants are more likely to die from acute respiratory infection (ARI) and diarrhea. The formula also makes children more prone to acute infections, asthma, meningitis, obesity, and diabetes. Breastfeeding on the other hand protects children against sudden infant death syndrome (SIDS), allergies, ARI, and ear infections,” he said.
Science shows that almost every mother can breastfeed successfully. Skin-to-skin contact and correct positioning of the baby help. Frequently breastfeeding the baby causes the production of more milk. Mothers should never use formula milk even if she is having challenges producing breastmilk, which is extremely rare. Instead, mothers can express breastmilk and feed with a cup, or breastmilk/breastfeed from a wet nurse.
Breastfeeding benefits mothers too. “Exclusive breastfeeding for at least six months helps women lose the weight they gained during pregnancy. International studies have found a connection between exclusive breastfeeding and decreased incidents of breast cancer. Breastfeeding soon after giving birth can also help mothers stop bleeding after birth and also helps the uterus to recover.”
In Timor-Leste’s Consolidated National Action Plan for Nutrition and Food Security (CNAP), the government has set the goal to reduce stunting in Timorese children by 22% (from 47% to 25%) by 2030.
“According to the researchers, if the government has a razor-sharp focus on only 10 critical health interventions (reaching 90% of the population), this goal of reducing stunting by 22% could be achieved,” Durrani recommended.
He said: “If the leaders of this beautiful nation want to reduce stunting among Timorese children and ensure a prosperous future for this country, the top priority of the government should be to ensure that a sustainable and adequate budget is allocated to implement the National Health Sector Nutrition Strategic Plan.”
Durrani said the government should also expedite and approve the draft Decree-Law for regulating the inappropriate marketing of Breastmilk Substitutes (BMS), which is pending since the first draft was prepared in 2010.
On may, 5, 2022, the government of Timor-Leste, together with development partners and UN agencies launched the National Health Sector Nutrition Strategic Plan for 2022 – 2026 to reach the CNAP goal of reducing stunting by 22%.
Journalist: Filomeno Martins
Editor: Nelia Borges Rosario
