BANGLADESH

Bangladesh's medical curricula is going to be updated with lessons of proper under-2 feeding practices in an effort to reinforce the battle against malnutrition.

With almost all health indicators showing the right move, the South-Asian country is still grappling to combat malnutrition, largely because of improper feeding practices, experts say.

The Bangladesh Demographic and Health Survey 2011 showed only 21 percent families strictly follow the under-2 feeding practices in the country where 41 percent children show dwarfed growth and 36 percent remain underweight.

"Doctors need to learn proper feeding practices of under-2 so that they can advise appropriately to the parents," Prof Md Ekhlasur Rahman, Line Director of the National Nutrition Services (NNS), told bdnews24.com.

The government launched NNS in July 2011 giving infant and young child feeding (IYCF) practices one of the top priority interventions.

The Line Director said IYCF was not 'adequately' mentioned in the medical curriculum.

"We have already started the process of inserting its details in the curriculum," he said.

According to IYCF rules, a child has to be breastfed within first hours of birth and continue exclusively up to six months and given homemade food after six months while continuing with breastfeeding.

Starting homemade food before six months is early while it is very late if someone starts after one year.

"We cannot tell mothers what type of food they should offer after six months," said Dr Samiul Islam, a medical officer of Nangalkot Upazilla Health Complex, Comilla.

"Not even doctors will be able to give the correct advice of what type of food should be given after six months, unless trained up," he told bdnews24.com, "We could not learn it during our medical studies."

Prof Sameena Chowdhury, a member of Obstetrics and Gaynecology Society of Bangladesh, who is also involved on the updating process, said they were trying to identify the gaps in the curriculum.

Nutritionists recommend homemade food twice a day in half of a 250 ml bowl for the babies of seven to eight months.

It is thrice a day with the same amount for babies of nine to 11 months, and in full bowl (250ml) thrice a day for between 12 and 23 months.

"Early start of homemade food causes indigestion as the babies' intestines are not prepared to digest," said Prof Chowdhury.

"If delayed, it does not meet the nutritional requirements for growth."