r.i.c.e.

Here at rice we have a big focus on sanitation and the problems that it causes for kids’ health, but we are often reminded that lots of things are going wrong for infant and child growth in India. One of them is the tendency for parents to give babies solid and semi-solid food much later than is recommended by doctors and public health organizations. In a recent look at the NFHS 2005, I found that the average 12-23 month old child was given fewer than 2 meals of solid or semi-solid food in the 24 hours before the survey. This is far lower than the 5 or 6 times a day that many US organizations say a toddler should be fed, and less than the approximately 3 solid or semi-solid meals that children of the same age are fed in Nepal.

As the babies I have been following get older, they are eating some solid and semi-solid food, but not very much, and a few of them are pretty much only getting milk. They are now about 18 months old, a whole year older than the age at which the WHO recommends introduction of solid foods.

One story about complementary feeding--or lack thereof--stands out from my July visits. I was visiting Leelam, who was, as usual very busy doing the housework when I arrived. This time, Leelam, together with her husband’s younger sister, was making roti for the laborers who were in the fields planting her family's rice. The younger sister was rolling out the roti dough, and Leelam was doing the hotter, harder work of putting them on the tava and then in the fire. It looked like she’d made at least 40 rotis! She would also make daal and chaval, and in the morning she had made chai and paratha to give the laborers before they started working.

Leelam’s older daughter came out from the inside room to see us, and at first I thought she was the younger one, who we’d been following since birth, but hadn’t seen in a couple of months. But then another baby started to cry, and I realized that the little one was still inside the room. Leelam hurriedly finished the rotis, and went to retrieve the crying baby. I expect the baby was hungry because when Leelam squatted down and offered the baby a breast, she drank greedily. Leelam said that she was late in feeding the little girl because of all of the rotis she was making. At one point Neelam tried to get her to stop breastfeeding so that she could get back to work but the little girl hung on. Eventually she fell asleep at the breast. The little girl was very thin, like her mom.

I asked Leelam what the baby was eating now, and she said that the baby drinks breastmilk, cow’s milk and eats Parle G biscuits. She does not eat food. I asked why she does not eat food, and Leelam said, "When her older sister doesn’t eat food, why would she eat it?” That made me shudder—the older girl is 3 years old. I really hoped that Leelam’s baby would make the switch to solid foods before she turned three.