Maternal And Child Under Nutrition, Victoria University, Australia
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Introduction: Genetic and environmental factors including nutrition interact and provide the basis for physical growth, cognitive and socio-emotional development. Among the multiple early environmental influences, food insecurity and resultant dietary deficiencies, inadequate and poor feeding practices, recurrent and chronic infections, and low levels of infant-caregiver stimulation prevent children from reaching their full potential for growth and development and also increase the risk of poor health due to reduced immunity. Continuing to live in poverty further exacerbates the consequences leading to a perpetual vicious cycle of loss of intellectual, physical and economical potential especially among infants and children existing in low income countries.
The development of brain during early postnatal life, is rapid, demonstrating the highest degree of plasticity. The inherent capacity to acquire is present, however what the infant pick up is controlled by the specific determinants in the environment. The genetic expression is modulated by the biological, socioeconomic as well as the psychosocial effects and the timing of these can alter the structure and function of the brain and resultant behavior. In turn, infant behavior directly affects the development and ‘wiring' of the brain through its interactions with biological and psychosocial influences (Becker, 2006).
This paper will presents the current information on the impact of nutrition on the cognitive development in infants and young children and the adolescence. Impact of factors like maternal stress and depression are also discussed since these factors are known to influence mothers' care-giving behavior including feeding and interactions with young children.
According to FAO (2015), in India a very huge number of population are not receiving proper nourishment. FAO (2015) further investigated that the issue of malnutrition is complex and widespread and similarly many of health problems among the people of India is due to malnutrition. A very huge number of masses affected due to malnutrition in not only developing countries but also affect millions of masses in developed countries, such as UK, USA and China etc. It is commonly found among those peoples having health problems, social problems and physical damage such as injury or burns etc(Brown et al., 2017).
Question: Research and write an essay on the following statement:
"Maternal and child undernutrition contribute to deficits in children's health and development. It also impedes children's achievement of their full productive potential in adulthood". Discuss this statement.
Answer: Nutrition and Malnutrition: Diet, nutrition and malnutrition are commonly used terminologies but no one can clearly differentiate it. The following research evidences regarding diet, nutrition and malnutrition will easily help one to understand the difference between diet, nutrition and malnutrition. Diet denotes to the use and collection of such type of food ingredients which allow growth and maintain the various physiological functions of the body. Use of diet depends upon the age, sex and nature of activity performing by a person. Nutrition is a process of getting energy from the food that we eat. The energy that we get from the food helps the body to allow growth and maintain the body functions. According to definition, proper diet provide nourishment for the body such as
1. Materials which provide energy
2. Building blocks for bone, muscle, organs, hormones and blood
3. Materials which protect the body
4. Maintain and regulate the body temperature.
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Impact of Under-nutrition on infants development: In other words we can explain the under-nutrition as the inadequate, or improper use of nutrients. Maternal and Child need to utilize all component of diet in a right amount. Lacking of balance or sufficient diet unfavorably affects the whole functional capacity of the body. Each deformity or abnormality has some sign and symptoms. Sign and symptoms give indication to the person that they have a problem. In long term under-nutrition can caused so many problems such as lower sex drive, reduction in muscles mass, obesity and improper functioning of body parts. Use of nutrition varies from person to person and activity to activity. It is necessary for an individual to use diet to his/her physique and concerned activity. Diet problems, psychological problems, digestive complaints and stomach conditions, lack of food, high food prices and lack of breastfeeding all the main causes of malnutrition(Conkle et al., 2017).
From the different researches, we learn that despite the advances in food technology, breastfeeding is highly recommended for the new-born babies. This is because of milk, from a mother's breast, contains nutrients, which are required for the baby. In both developed and developing countries, breastfeeding is a common phenomenon and since the increase in the awareness regarding the benefits of breastfeeding (mother's milk), more parents prefer giving their new-born child breast milk rather than milk of an animal, such as goat or cow.The incapability of mother to feed her baby is different in women but the more usual reason is the occupation of the mother. As per journal, breast milk is rich in antibodies, which are essential to provide defense against viruses and bacteria. In addition, breast milk also increases the strength of the immune system, ensuring less vulnerability against diseases, caused by viruses and bacteria.
Long-term Under-nutrition impedes children's productive potential in adulthood: According to "Allergy and infant feeding guidelines in the context of resource-constrained settings", the feeding of infants becomes a most popular topic in recent years in many knowledge fields of education because it has a lot of aspect for discussion further than nutrition. The information about the long term and instant bad nutrition included much in it and know the good understanding is required to adopt and forming good habits of eating in the early years of life. These habits are generated or depend much on socioeconomic, genetic, religious, cultural and ethnic factors. From the start of pregnancy period, the association of amniotic fluid with a fetus and the construction of the habits of eating remain continue even during the childhood particularly in starting 2-3 years of mans' life and these factors affect the whole life of human beings. So the children or babies are dependent on the diet or food they are provided with as immaturity of biological. So the mother who is responsible primarily as she is the caregiver's of baby perform a vital role in the creation of eating habits (Huang, Vaughn and Kremer, 2015).
Therefore, the association between the life exposure of early age and the outcome of health in later age is the outcome of the planning of nutrition in infancy and this hypothesis can be analyzed by observation of under-nutrition effects on long-term health impact. The proper dietmay help in the reduction in tooth decay in early childhood, lower chances of high blood pressure, diabetes of type 2, stunning and the strong metabolism. In infants, the biochemical phenotype is different depending on their eating habits and also their food practice. The lipidomic profile of large scale can be obtained by the platform which is well-known for us in the sample of plasma and adapted successfully for the sample of DBS. In short, it can be said that approximately 3.2mm DBS was extracted from menthol which is coated by the glass and 2.4ml deep lipids were distributed in methyl butyl ether which is necessary to check the development in infant and childhood.
IUGR and Cognitive Development: Intrauterine growth restriction (IUGR) and low birth weight are potential risk factors for poor cognitive development. In a study in Guatemala, birth size adjusted for gestational age was associated with infant and toddler growth at 6 and 24 months of age (Kuklina et al., 2006). Higher birth weight (unadjusted for gestational age), was also significantly related to IQ at age 5 years (Santos et al., 2008) and the highest school grade achieved (Larson and Yousafzai, 2015).
Long-term effects of IUGR on cognition are not consistent probably because it is difficult to assess the effects of prematurity and other factors. Thus no significant difference was seen between term low birth weight (LBW) and the normal birth-weight children on IQ. Early severe protein-energy under-nutrition leads to growth restriction, and stunting in particular has been found to affect learning and consequent poor cognitive development that may even be irreversible (Lopes et al., 2012).
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Chronic under-nutrition: Chronic under-nutrition can able to lower the energy wealth of parents and children and thereby make children more apathetic and less able to attract and elicit the required attention from caregivers and parents. This leads to less attention and responsive care from parents and caregivers to support the child's growth and development (Valenzuela, 1997).
Most importantly, iron deficiency anemia can impede infant and young child's development and iron therapy may not be able to reverse its adverse effects. Preventive measures with iron supplementation to infants and their mothers during pregnancy were found to benefit children's motor, socio-emotional and language development (Lozoff et al., 2000).
Multiple Micronutrients Supplementation during Pregnancy and Infant Development: Multiple micronutrients supplementation during pregnancy shows better impact on child nutrition and development compared to supplementation with individual nutrients. Multiple micronutrients supplemented during pregnancy to Bangladeshi women and pregnant HIV-infected women in Tanzania showed a small assistances to infants' motor development (McGrath et al., 2006),
The inhibition of absorption of iron in the presence of zinc could be a plausible reason for the lack of benefits observed. Efficacy trials and programs of iodine supplementation in regions of the world where there is deficiency of iodine in soil show the significant positive effects of iodine on cognition and behavior. Iodine deficiency also causes cretinism in extreme cases and goitre. Foods fortified with iodine such as salt, flour, are now available in developing countries to control the deficiency.
Significant improvement in motor development was observed among infants fed complementary foods fortified with micronutrients and EFA in Ghana and China (Pérez-Escamilla and Moran, 2016). More detailed research is needed to explain possible cognitive benefits of such fatty acids to infants in developing countries.
Early stimulation can enhance neuro-cognitive processing and brain functioning and this could particularly be true for premature infants (Tumilowicz et al., 2015). Dramatic improvements in developmental indicators due to early stimulation were seen among undernourished, institutionalized kids espoused into the middle-class homes.
Caregiver-child interaction that provides learning opportunities and facilitates early stable socio-emotional development has been found to positively impact cognitive development. Caregiver behaviors that provide positive emotionality, involve sensitivity and awareness towards kids and those that avoid severe physical and verbal penance are critical in this context. Lack of early learning opportunities as a result of apathetic care giving contribute to loss of developmental potential.
A study in Southern India (Schmeer and Piperata, 2016) found higher scores on children's mental growth at 15 months age in the intervention group that provided education to mothers on ‘responsive complementary feeding and play' (RCF&PG) compared to the control group (CG) receiving standard care. The control group was similar to the second intervention group that received ‘complementary feeding' (CFG) education alone. However, the overall score on the Bayley II Psychomotor Index was higher in all 3 groups compared to the Bayley II Mental Development Index (MDI).
The Integrated Child Development Scheme (ICDS) implemented by the Women and Child Development (WCD) Ministry, is India's flagship multi-packaged intervention programme to improve nutrition of marginalized children and women in the country. In parts of the world that are presently torn with violence, acute food shortage and difficulty in reaching children and adults trapped in far flung areas poses a major hurdle to prevent starvation deaths. The long- term consequences will need special efforts at rehabilitation. From the child development perspective, few mechanisms are in place to deal with socio-emotional effects of violence in war-like situations that can leave indelible marks on the psyche of exposed infants and young children. The long-term consequences of children facing violent horrific experiences are difficult to imagine especially among those who are left orphans with no parental buffers to mitigate the effects. Cognitive development under the circumstances is likely to be a major casualty.
While brain and cognitive development in infancy and childhood is a determinant of long- term brain function, cognitive decline due to a variety of reasons also contributes significantly to the global burden of sub optimal mental function. The causes for progressive decline in mental function in the aged could be many e.g., chronic illnesses and medication, metabolic or endocrine derangements, depression and dementia particularly in Alzheimer's.
The role of B vitamins particularly folic acid and B12 and their interactions in the methylation pathways, high levels of homocysteine in circulation have all been linked to cognitive decline. However, wide differences exist in the various studies and one cannot categorically state how supplements of these vitamins would slow or delay progressive cognitive decline.At present there is insufficient evidence to confirm a relationship between cognitive function and nutrients in the elderly. There is, however, evidence that high levels of homocysteine are associated with cognitive decline (Streatfield et al., 2008).
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Policies Untaken by the government: The dissemination of research in India needs to improve in order to tackle under nutrition. At the moment there is a perception that not enough research is being done. However, the multiple recent and ongoing efforts researchers are making, but noted that very few people beyond the area of nutrition and related researchers are aware of some of these efforts and therefore they are not using the information. One potential solution could be through the current mechanism for nutrition and related research. The NRPs are comprehensive and identified key research areas and topics, and offer an opportunity to improve research uptake.
Recognizing the role of ministries other than the Ministry of Health in tackling under nutrition in India was highlighted as critical, and that research needed to be disseminated more widely to address this. Policymakers who can tackle under nutrition are no longer only in the Ministry of Health, and action goes beyond public health policies and interventions for NCDs. Therefore, in order to close the gap between knowledge and usefulness, it is important for researchers to link their results into practical policy actions and do so across all relevant ministries. In addition, coordinators will be needed to link under nutrition research with key stakeholders to translate it into practical policy actions.
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