Outside the Beltway

Lack of Food Not Main Cause of Child Malnutrition

James Joyner · Thursday, March 2, 2006 · 2 comments

Poor feeding habits, not lack of food, is the chief cause of child malnutrition, according to a new report by the World Bank.

Rampant child malnutrition in poor countries is usually not caused principally by lack of food, nor are large, politically popular programs to feed schoolchildren the right way to tackle a problem stunting the intellectual and physical development of more than 100 million children worldwide, a new World Bank report says. The irreversible damage malnutrition causes to children occurs by age 2, long before they begin primary school, and the bank contends that efforts to combat this scourge must concentrate on the brief window of opportunity between gestation and age 2, with a focus on teaching mothers to properly feed and care for babies and toddlers.

While many experts would agree with the bank’s assessment of the evidence on malnutrition, its policy recommendations are sure to be controversial at a time when the world is pushing to halve poverty in the coming decade and school feeding programs are often seen as part of the solution.

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Nutritionists at the bank say programs should emphasize changing the behaviors of mothers — for example, to breastfeed exclusively for the first six months of life or seek quick treatment for their children’s diarrhea and other common childhood illnesses, rather than directly providing food. Providing school-aged children with nutrition education, iron supplements and deworming medicines are better ways to improve nutrition than simply providing them with meals, the report also says.

The lead author of the report, Meera Shekar, said feeding programs are costly and vulnerable to corruption, with publicly provided food too easily given to better-off people rather than to the poor, or siphoned off to be sold. “You get more bang for your buck without the food,” she said. “The food brings in votes for politicians. We have very little evidence it improves nutrition.”

This isn’t surprising. After all, poor people in the United States are not infrequently simultaneously obese and malnourished. And how many times do we need to relearn the lesson that despots will steal aid money to line their own pockets?