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All is certainly not well in the  Nigerian southwest state of Osun under the leadership of Governor Rauf Aregbesola as fear and anxiety trail the stunning revelation over a United Nations damning report as a major disaster hits the state.
The report says as many as 200,000 children risk imminent death from malnutrition-related complications which has hit the state if urgent steps are not taken to arrest the situation.
Malnutrition is a condition that develops when the body does not get the right amount of the vitamins, minerals and other nutrients needed to maintain healthy tissues and organ function.
It is a condition of weakness and poor health that results from not eating enough food that has proper nutrients. For instance, micronutrients deficiency leads to hunger in children, which refers to child malnutrition.
This is the crisis that has hit about 200,000 children below five years in Osun State according to a United Nations Children Fund (UNICEF) report generated from National Nutrition and Health Survey of 2015. This was disclosed by a UNICEF nutrition expert, Mrs. Ada Ezeogu, at a recent media workshop.
The report added that the affected children which, represent 21.8 per-cent of the children’s population in the state risk stunted growth and mental retardation.
Daily Sun also gathered that 2.5 million Nigerian children under five years are malnourished with Oyo, Ogun and Osun  states leading in high  incidences of child malnutrition.
Nutrition experts attributed physical and psychological stunting in children to malnutrition in their first 1,000 days of life.
According to them, inadequate nutrition in a child’s early days affects memory formation, attention span, ability to process information as well as development of his psychomotor skills. In other words, the affected children are vulnerable to these health challenges.
A mother of twins who spoke to Daily Sun but did not want her name in print lamented how her two-year identical twins, Taiwo and Kehinde, both males, are seriously malnourished and stunted because of the parents’ inability to cater for them.
She comes from Ede to Osogbo two times per week to beg for alms from travellers at motor parks to feed the babies. Hers is not a case of poor information and awareness about child malnutrition but abject poverty:
“The babies are twins and clocked two years this December but none of them can walk. They were supposed to start walking when they became one year old but they can only crawl. My husband is an okada rider. Me, I don’t have a shop. I am not doing anything to earn money.
“We live in Ede, close to Osogbo. Every morning, I have to strap one of the boys on my back and hold the other one in my hand.
“I move around motor parks in Osogbo to beg for help from people that travel. The babies eat whatever I give them.  They eat eba, drink ogi (palp), rice, amala, anything.
“I manage to give them moin-moin and akara once in a while, but no money to give them balanced diet. We are just managing.”
Taiwo and Kehinde look pale, lean and very weak. They are not active. They always cling to their mother, looking malnourished. They are short and smaller than their ages.
Another one year and six months baby girl belonging to a woman who simply introduced herself as Jumoke is also a victim of child malnutrition and stunted. Her mother introduced her as Abigail.
Looking lean, pale and tiny but crawling and hanging lazily on her unkempt mother who sells vegetables at a bus stop at Alekuwodo, Osogbo, the first impression you get when you see Abigail is that she is a baby of about seven months old.
Jumoke confessed that feeding is a problem in the family of three where the breadwinner (her husband) is a cobbler:
“My husband is a shoe maker. She lost his job many years ago. I only manage to sell vegetables. So, to feed the family is very hard for us. This baby is exactly one year and six months old this month, but she cannot walk. All her mates are walking now but she cannot.
“When she was born, there was no money to buy baby foods. I was giving her ogi (palp) and small tea and breast milk. At times, she would reject the ogi when it became too much. But since there was no option and my breast milk could not ‘bele full’ her, I would lie her on my laps, hold her tight with her head down and feed her with ogi.
“When she became  about six months old, I started  giving her rice, amala, eba and yam. But I don’t know why she is looking very small, inactive and cannot walk.”
Does she give her proteins like fish, meat, eggs beans?
“Where is the money? Sometimes, I cook beans and mix it with gari which we all eat together.”
Another mother, Ronke, was carrying a one year and three months old baby boy who was also looking weak. She told Daily Sun that when the baby was one year and a month old, he could only crawl, sit down and sometimes lie on the floor playing lazily.
She placed her on exclusive breastfeeding right from birth, following an advice by her colleague in the office that it is good for new born babies. She said the baby was always crying, especially in the night when he was two months old. 

The colleague told her perhaps the breast milk was not enough to satisfy the baby. She therefore advised her to start giving the baby infant formula. But she said there was no money to buy them.

Ronke too was not feeding properly, which she blamed on recession, making her breast milk not to satisfy the baby.  She lamented that sometimes she could not feed the baby properly: “Things are hard now.”
She resorted to giving the baby ogi (palp) and supplementing it with breast milk. But as soon as the baby clocked six months, she started giving him rice, yam, amala and sometimes beans and akara.
Investigations confirmed that malnutrition comes with general signs and symptoms such as tiredness or fatigue, irritability, longer duration of ability to recover from illnesses, infections, wounds, weak immune system, low body temperature, loss of fats, higher risk of respiratory failure, breathing difficulties among others.
Over the years, child malnutrition remains a silent crisis and a killer due to different factors, including poverty, ignorance and lack of information and awareness on the risks.
According to UNICEF report, 50 percent of infant mortality rate in Nigeria is due to malnutrition. The report said that two out of three children in Nigeria are malnourished. Reports have also shown that the affected children are from poor families.
Ezeogu said malnutrition accounts for more than five percent of under five-age mortality in Nigeria. She called on government to pay attention to early childcare that would cover children below three years in addition to the school feeding programme.
She also urged mothers to pay attention to the feeding of their babies, especially for the first two years as children from 0-2 years are still undergoing a critical stage of growth and development that requires proper nutrition.
Ezeogu who attributed malnutrition to poverty, said it was not peculiar to children, as mothers were also greatly affected by the malady. The major factor that accounted for this was household food insecurity due to the current recession:
“If a pregnant mother was on a 1-0-1 or 0-1-1 or 1-1-0 square meal, it would affect the growth of the fetus in the womb and result in child malnutrition right from birth.”
She disclosed that 100 days of a child’s life begins from inception to two years, noting that global and acute malnutrition set in at this point if the mother is malnourished. She said child malnutrition is in stages: “One of the stages is stunting which means that the child may look normal but too short for the age. Other stages included underweight and wasting which means the malnourished child is too thin for the age and also skinny.”
Ezeogu lamented that over 50 per-cent of infant mortality in the country occurred as a result of malnutrition. She enjoined nursing mothers to embark on exclusive breastfeeding of their babies 30 minutes after birth to six months. She advised them to feed their children with meat, fish, eggs, nuts, legumes, fruits, milk and vegetables.
She said mothers could make juice drinks from watermelon, oranges, pineapples, apples etc for the child instead of giving them ogi consistently.
She called on government to integrate malnutrition intervention into all developmental programmes: “Health budgets have to cover children diets to ameliorate child malnutrition challenges. Budget rights for children is imperative with a view to guaranteeing proper child nutrition.”
Assistant Director, Nutrition, Ministry of Health, Osun State, James Oloyede, told Daily Sun that apart from the school feeding programme, government introduced Infant and Young Child Feeding (IYCF) programme through which health care givers are catered for and given orientations on child malnutrition programmes and how to handle the challenges. This, he said, was done through food demonstration to showcase different samples of the right diets to be given to children based on their ages and nutritional needs.
He added that the ministry engaged qualified nutritionists to train some community people as nutrition counsellors in three local government areas and mandated them to offer counseling  to mothers on how best to handle their children’s nutrition.
Oloyede disclosed that the ministry embarks on a routine training on Middle Upper Arm Circumference (MUAC) to handle child malnutrition cases in different categories. He said with the programmme,  mothers of children with moderate malnutrition cases are counselled on how to cater for their nutritional needs, while mothers of those that are severely malnourished are counselled to give them complimentary foods to back up the regular diets:
“Routinely, we embark on growth monitoring and promotion for babies whereby nutrition counsellors counsel mothers on babies’ weight to determine the quality of their nutrition and to ensure proper dieting in order to ameliorate child malnutrition challenge.”
Mrs. Funmi Shittu, a dietician at Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Osogbo, said one of the ways to enhance child nutrition was the need for mothers of new born babies to place them on exclusive breastfeeding at least after 30 minutes of birth till they are six months old. She urged them to ensure free flow of breast milk by eating balanced diet to guarantee their baby’s adequate feeding.
A nutritionist at the hospital, Adenike Akinyemi, attributed child malnutrition to poverty:
“So many people can no longer provide for their families because of the current economic recession. People now eat what they can only get to eat, whether it is balanced diet or not. Some people can not even afford one good diet in a day. It is a vicious cycle which goes a long way to affect the nutritional status of the vulnerable who are the children.”
She said child malnutrition was bound to persist, regardless of public awareness and enlightenment if the recession continues, noting that if people remained financially incapacitated, they would never be able to provide a balanced diet for their children:
“In other words, there is no way they can apply the counselling or enlightenment on child nutrition.” She, however, identified multiple birth such as twins, triplets and quadruplets as a major factor of child malnutrition, especially in a poor family that may not be buoyant enough to give them a balanced diet.

She added that some mothers, especially the working class ones, did not have enough time to put their babies to breast adequately, leading to malnutrition.

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