Malnutrition

“ The physical effects of undernutrition and malnutrition made themselves felt in a manner which brought them home to every man. Working-capacity dropped to half the normal, or even less. Mortality increased by leaps and bounds, particularly among the children and the aged. ”

“ But babies of people in moderate circumstances, and even of wealthy parentage, are at times badly nourished, and require the same exacting care, the same attention to the food, the fresh air, and the sunshine that the poorer babies need in order to survive. Malnutrition may be the result of insufficient food, and it may also be due to the lack of one definite food element. Again, it may be brought on by some deformity of the mouth or stomach, which make it impossible for the baby to get all the food which he requires for his maintenance and growth. ”

“ If the conditions found by the medical investigators for this committee are representative of the whole of the United States, then we have not less than twelve million school children in the United States suffering from physical defects more or less serious, and not less than 1,248,000 suffering from malnutrition—from insufficient nourishment, generally due to poverty, though not always—to such an extent that they need medical attention. ”

“ At Bootle the School Medical Officer reports that out of 289 cases of sub-normal nutrition, the cause is to be sought in 78 per cent. in some definite disease or physical defect (including disturbances of digestion due to improper feeding) ; in 17 per cent. there are no definite signs of organic disease; while in 5 per cent. malnutrition is due to neglect. [469]
At Wolverhampton Dr. Badger reports that, out of 131 cases, malnutrition is due to the influence or reaction of disease, convalescence from recent disease, or defective heredity in 64; to pampering in 4; to excessive growth in 1 ”

“ Following on the trail of indigestion and intestinal trouble come anemia and malnutrition. The anemic child, suffering with malnutrition, as the result of improper feeding, loses weight steadily, has vomiting and diarrhea, sleeps badly, is listless and pallid. ”

“ According to this report the malnutrition is due in the great majority of cases to ignorance of the relative value of foodstuffs and the means of using them economically, and only in the minority to poverty. ”

“ This malnutrition is to be attributed to many causes besides actual lack of food. Improper food and hurried methods of eating account for much malnutrition. So much has been written on the subject of the wrong feeding of children that it seems unnecessary to labour this point. One can, indeed, hardly open a report of a School Medical Officer without finding this evil deplored. In the poorest homes there are frequently no fixed meal times; the children are given "a piece" when they are hungry, and this is often eaten in the street or on the doorstep. Bread and tea figure largely in the dietary. ”

“ In 69 cases malnutrition was due to some disease such as tuberculosis, chronic bronchitis, etc., while in 13 cases it was attributed to overcrowding, and in 10 cases to overwork with insufficient 175sleep. [467] In the following year a similar enquiry was made by Dr. Tate in a suburban residential area of the same county. Out of 167 cases, defective nutrition was found to be due to poverty and neglect in 23·3 per cent.; to rickets, adenoids, worms or digestive disorder in 28·5 per cent.; to lung affection in 5·4 per cent.; in 7·2 per cent. ”

“ The reasons for much of the undernourishment among people in this country to-day are to be found in certain widespread misconceptions of long standing as to what constitutes a state of good nutrition or malnutrition and the value and purposes of different foodstuffs. For malnutrition does not necessarily describe a simple condition due to an insufficient amount of food, but to any one of several complex conditions due to a lack in the food of one or more essential substances. ”

“ This condition may result from a lack of the proper amount of food and from unhygienic conditions. However, it is often found among the children who should be properly nourished, who have the very best of care and the most wholesome food. There is no definite standard by which to determine a case of malnutrition. The extreme cases are obvious, but a child may be simply underweight and still not be classed as a case of malnutrition. ”

“ Malnutrition is not confined to the children of the poor, though it is more common with infants of parents who have not the means to secure the best milk and give them the benefit of wholesome surroundings and plenty of sunshine. ”

“ When we add to these conditions of human existence the influence of imperfect feeding and malnutrition, we get the state of physical degeneracy largely increased and emphasized. In the paper alluded to great stress was laid upon the diet of the town-dweller, as compared with that of the countryman, as tending to degeneracy and impaired health. ”

“ Governments should initiate immediately a greater concerted attack on chronic malnutrition and deficiency diseases among the vulnerable and lower income groups. In order to ensure adequate nutrition for all, Governments should formulate appropriate food and nutrition policies integrated in overall socio-economic and agricultural development plans based on adequate knowledge of available as well as potential food resources. ”

“ Since scurvy and rickets by improper food, and gout, rheumatism and Bright's disease brought on by unbalanced indulgence, might both pass on a taint to the offspring, education in hygiene assumes special importance. Our recent pure food legislation, furthermore, is an indication of what enlightened public opinion can do to protect the careless and the ignorant against the evils of malnutrition and improper feeding. ”

“ Impure air and stuffy, ill-ventilated rooms are concerned in the susceptibility to both diseases, as is also malnutrition with its associated diminution of the innate powers of self-protection. But, in the one case, inability to provide suitable food is the general cause; while in the other, 248 inexcusable ignorance of the right forms in which food should be supplied to young children is a certain source of the evil. ”

“ And among these stone breakers there are young men, some of them mere boys! And when we think that these injurious attitudes are coupled with malnutrition, we must realise the extent of the organic disaster that accompanies diminution of stature as a result of adaptation to labour. ”

“ It is generally agreed that the two big problems of babyhood are proper nutrition and the prevention of infection, but nutrition is perhaps the greater problem, since any form or degree of malnutrition lessens the baby’s powers to resist and to recover from infection. ”

“ He showed that the average monthly wage is R32.24 and that 46 per cent of all African families in Johannesburg do not earn enough to keep them going.
Poverty goes hand in hand with malnutrition and disease. The incidence of malnutrition and deficiency diseases is very high amongst Africans. Tuberculosis, pellagra, kwashiorkor, gastro-enteritis, and scurvy bring death and destruction of health. The incidence of infant mortality is one of the highest in the world. ”

“ Diseases of many different organs, a run-down nervous condition, too much hard work and too little rest, improper food, and disorders of the digestive tract are among the causes that may produce malnutrition, and the first measure adopted by the painfully thin person should be a frank talk with her family physician, as the diet required may not be that intended especially for increasing weight, but one that shall improve nutrition by remedying the defective working of some organ or system of the body. ”

“ Without stopping to dwell very long on this part of our subject, it will suffice to enumerate one or two of the principal efficient agents. And the first and far the most important of these is malnutrition of the nerve tissues, whether accompanied by the signs of anæmia and general constitutional malnutrition or not, the main cause being our civilization, with its excessive nervous wear and tear, no less in the educational period than in the intense competition of mature life. ”

“ Unless extraordinary efforts are undertaken, an unacceptably large portion of the world's population, particularly in developing countries, could still be chronically undernourished by the year 2010 with additional suffering due to acute periodic shortages of food. Contributing to malnutrition is the lack of adequate food utilization which, in this context, is the proper digestion and absorption of nutrients in food by the human body and requires adequate diet, water sanitation, health services, and health education. ”

“ People suffer from diseases of malnutrition much more often through bad management than because of a short purse. It will often be found, especially with children, that they are ill for want of certain kinds of food and yet will not take them in their ordinary form; it is then the part of the housekeeper to reproduce the food so that it is not recognized, or to find the same substance in some other form. ”

“ Education given to children who are suffering from want of nourishment not only is ineffective, but may be positively deleterious. When the extent of malnutrition is known, is it reasonable to expect the Authorities deliberately to shut their eyes to the fact that so far from benefiting the children who suffer from it they may be positively aggravating their misfortunes? ”

“ Noel Paton considers that the “malnutrition of the mother helps to explain the very high infant mortality among the very poor. The infant starts life at a low level, and readily succumbs to the hardships to which it is too often subjected.” ”

“ The estimated number of this school population showing signs of malnutrition is variously given at from 10 to 20 per cent. Taking it at 15 per cent., or 800,000 children, we have more than half a million school children wanting meals and not getting them. ”

“ While there has been marked improvement in the health of survivors of the Nazi starvation and persecution program, there are many pathetic malnutrition cases both among the hospitalized and in the general population of the camps. ”

“ Relapse.—One danger which the nurse must always be on the lookout for is the relapse into the acute stage. The diet is the chief treatment. In acute gastro-intestinal disturbances rest from food is essential for at least twenty-four hours. Some infants can easily endure starvation for this short period. However, when malnutrition has already been established, it is not wise to carry out the starvation treatment over-long. A cautious return to a normal diet may be made as soon as acute symptoms disappear. ”

“ To prove this to the world the large death rate of children under one year of age in Lawrence proves that most of these children perish because they were starved before birth. And those who survive the starving process grow up the victims of malnutrition. ”

“ She does this by helping to keep the well baby well, rather than by nursing a sick baby.
The dangers which make babyhood such a precarious period may be grouped very largely under the general headings of unfavorable ante-natal conditions, nutritional disturbances and infections. The care and supervision of the expectant mother will remove many of the unfavorable ante-natal causes. Nutritional disturbances and infections must be dealt with after birth.
Faulty nutrition may result in rickets, scurvy, malnutrition, marasmus, acute inanition or the less serious colic, constipation or diarrhea. ”

“ Massive international food aid deliveries have allowed the regime to escape mass starvation since 1995-96, but the population remains the victim of prolonged malnutrition and deteriorating living conditions. ”

“ The strength of children and their ability to withstand disease depends to a great extent upon whether or not they are physically strong at the period of their birth and during the time they are under the direct care of the mother. A mother whose system has been weakened by the debilitating effects of anemia, cannot nourish her child and provide him with the necessary amount of food, and as a result, the child is either anemic, or a victim to malnutrition as a result of introducing solid food into his system before the digestive organs are prepared to take care of such food. ”

“ The effect of continued malnutrition seemed to have been surprisingly slight on those in the prime of life. The children of ten years before, men and women now, were plump and hardy, though the color in their cheeks was by no means equal even to that of the grandfather—sleeping now in the churchyard—at the time of my former visit. 168Of the two granddaughters, the one born three years before, when the blockade was only beginning to be felt in these backwaters of the Empire, was stout and rosy enough ”

“ About 40% of the deaths in London were among children under two, due to infantile diseases fostered by malnutrition, maternal ignorance such as giving babies adult food, ill-health, bad water, dirty food, poor hygiene, and overcrowding. Many children died from diptheria, measles, scarlet fever, and smallpox. Ten or twelve children with three or four surviving was a common family pattern. Many well-to-do in London kept their children in the country for their better health. ”

“ Which is more harmful to a child, reckless, indiscriminate over-feeding or under-feeding and starvation diet? In lands swept periodically by famine or flood or devastated by war and massacre, there are thousands of little children who literally starve to death while other thousands continue to exist,—but what an existence it is! How can it but have its evil effect on the mind and morals of a child as well as on its physical well-being to be deprived of proper or sufficient nourishment during the years of growth and development? ”