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Food myths fuel child malnutrition in Indonesia

Source
Jakarta Globe - January 24, 2012

Dessy Sagita – Since giving birth to her son three weeks ago, Airin Nofran has received a torrent of advice about her diet and that of her baby.

"Some of the advice was reasonable, but some of it was honestly very strange," she told the Jakarta Globe on Tuesday. Airin said her relatives and neighbors have encouraged her to eat the leaves from katuk, or star gooseberry fruit, because they are widely believed to help new mothers produce more breast milk.

People have also told her not to eat fish or seafood, which they warn will give her milk a bad smell and thereby discourage her baby from feeding.

But Subagyo Partodiharjo, a medical doctor who leads the health caucus at the House of Representatives, believes their advice is misguided and could ultimately have negative health consequences. "There are so many myths that have kept Indonesia far behind when it comes to nutrition," Subagyo said.

The World Health Organization has ranked Indonesia as the country with the globe's fifth-worst nutrition problem.

Indeed, an estimated 900,000 children aged younger than 5 are undernourished or malnourished nationwide. And although the Ministry of Health claims to allocate Rp 700 billion ($77.7 million) annually to tackle the issue, child deaths due to malnutrition remain a common problem.

"Most of the time, the problem is not because we don't have enough food, but because we don't eat properly, and that's in part due to those misleading myths," Subagyo said.

Among the most common myths, he said, are the beliefs that the protein from eggs will give children abscesses, and that fish should be avoided because it will hurt their mental development.

He added that although eating katuk leaves will not harm the mother, other nutrition myths that deny growing children important proteins and minerals are dangerous because they affect brain development.

Other false nutrition beliefs can affect newborn babies, he said. For example, many Indonesians think newborns should eat food to complement breast milk, including banana puree mixed with rice porridge.

"You shouldn't give anything to your newborn but breast milk until they're six months old," he said. "And banana puree mixed with rice has excessive carbohydrates that will make your baby overweight."

Another falsehood that needs to be tackled, he said, was the misconception that colostrum, the yellowish breast milk that mothers produce in the first few days after delivery, is spoiled milk that should be discarded.

"That's a very unfortunate belief because colostrum is good for your baby's intelligence, immune system and growth," he said.

He added that children who are deprived of proper nutrition suffer from stunted growth and end up eating excessively as adults, leaving them at a higher risk of stroke, heart attack and diabetes, which combined account for 63 percent of deaths among adults in Indonesia.

"We should be more like the Japanese," he said. "They eat a lot of fish when they're young and they eat more vegetables as they get older. For us in Indonesia, it's the complete opposite," he added. "We stuff our children with only vegetables, and when they get older they eat excess protein."

Minarto, the Ministry of Health's director of education, said it is crucial to debunk these common myths about nutrition because a child's most important development period occurs in the first 1,000 days of life, beginning at birth until their third year of life.

"In those first 1,000 days, physical growth happens so fast and it doesn't happen again at any other period of life," he said. He said any nutrition problem at this stage would likely affect children for the rest of their lives, causing health issues such as permanent mental development problems due to a lack of proteins or other nutrients.

The malnutrition problem in Indonesia, he added, is often not caused by an inability to afford proper food. In fact, he said, studies show that many children born in poor families suffer from over-nutrition and even obesity.

"So it's not always about the money," he said. "In many cases, the problem is because of the wrong kind of diet."

Poor nutrition during pregnancy is also responsible for stunted growth in children. An estimated 36 percent of Indonesian children are stunted, according to Ministry of Health research from 2010.

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