Book Review

Indian Pediatrics 2002; 39:513

Nutrition and Child Development

Author: K.E. Elizabeth; Paras Medical Publisher, 5-1-473, Putlibouli, Hyderabad 500 095, India, IInd Edition, 2002, Pages 341, Price Rs. 150/-

This book is a welcome addition to the rather scarce information on the problems of nutrition and child development, even though several authors have contributed towards it in recent years.

The book rightly starts with the various initiatives on breastfeeding and the Baby Friendly Hospital Initiative (BFHI) and the contribution Kerala has made towards it, being one of the pioneer states. There is practical advice on the management of various difficulties that mothers encounter as well as the unique properties of breast milk, its particular composition in case of the premature babies etc. Pros and cons of exclusive breastfeeding for the babies of HIV positive mothers for the first 3-4 months need emphasis. The book must have gone to press before the availability of Riverpine, which would explain why no mention is made of this.

The author has recommended semisolids at 4-6 months, while with common consensus 6 months is preferred and that is what the latest recommendations of WHO also are. The recommendations regarding complimentary feeding are not sufficiently precise or detailed., when we know that delayed and inadequate complimentary feeding is the main cause of malnutrition. In this regard some state-wise data on complimentary feeding from NFHS-I and II would have been useful, both regarding levels of malnutrition and infant feeding practices. Among the micronutrient deficiencies, the status of anemia among young children needs to be highlighted.

While undernutrition is rampant (Kerala is better off compared to other states) a detailed description of Kwashiorkor and its management seems superfluous considering the problem is hardly seen now and is only of historical interest. On the other hand poor complimentary feeding practices are the harbinger of malnutrition. Even in Kerala, only three fourth women offer complimentary feeding between 6-9 months while the situation is much worse in most other states.

The chapter on child development is very informative and useful particularly the Composite Stimulation Package (STIM). On the whole the book is a useful addition to the information available on the important aspects of nutrition and child development.