Breastfeeding may seem natural, but it requires extraordinary strength from every mother. Her body works tirelessly to produce the essential nutrition her baby needs to grow and stay healthy.

At Action Against Hunger, we stand beside mothers throughout this beautiful yet demanding phase of life. With the right nutrition and care, they can stay energized, recover better, and continue giving their little ones the very best every day.

Here’s a simple nutrition guide to help lactating mothers take essential steps toward better nourishment and well-being:

1️⃣ Iron – The Power Behind Energy¹⁻⁴

• Prevents tiredness, weakness, and anemia
•  Supports postpartum recovery
  Sources: Dark leafy greens, beans, jaggery, whole grains, eggs, lean meat

2️⃣ Calcium – For Strong Bones (Mother & Baby)¹⁻⁴

• Helps baby’s bone and teeth development
• Prevents bone loss in mothers
  Sources: Milk, curd, paneer, ragi, sesame seeds, almonds, broccoli

3️⃣ Protein – Fuels Milk Production³⁻⁵

• Repairs tissues and builds muscles
• Supports mother’s strength and baby’s growth
  Sources: Lentils, legumes, eggs, fish, chicken, soy, peanuts, dairy products

4️⃣ Healthy Fats – Brain & Nervous System Development⁴⁻⁷

• Supports brain and vision development
  Sources: Nuts, seeds, avocados, vegetable oils, fatty fish

5️⃣ Vitamin A – Immunity & Vision¹⁻⁵

• Strengthens the baby’s immune system
• Protects maternal eye health
  Sources: Carrots, pumpkin, sweet potato, spinach, milk, mango

6️⃣ Vitamin D – Helps Absorb Calcium²⁻⁵

• Supports bone strength and immunity
  Sources: Morning sunlight, fortified milk, eggs

7️⃣ Folic Acid – Cell Growth & Blood Health¹⁻⁴

• Essential for new cell formation
• Helps prevent nutrient deficiencies
  Sources: Green leafy vegetables, legumes, citrus fruits

8️⃣ Fluids – The Key to Milk Flow¹⁻⁷

• Boosts milk production
• Prevents dehydration
  Best choices: Water, coconut water, buttermilk, fresh juices, soups
  ⚠ Avoid packaged sugary drinks

Daily Diet Chart for Breastfeeding Mothers

This plan focuses on frequent, nutrient-dense meals to support energy, recovery, and milk production, incorporating the essential nutrients discussed in the blog.

Time	Meal	Recommended Foods	Key Nutrients Addressed
Early Morning (6:00 AM – 7:00 AM)	Drink + Light Meal	Warm water with soaked fenugreek seeds or cumin water (Hydration/Digestion). A bowl of oats porridge topped with almonds and walnuts (Protein, Healthy Fats). 1 boiled egg or sprouted moong dal salad (Protein, Iron).	Fluids, Protein, Healthy Fats, Iron
Breakfast (8:00 AM – 9:00 AM)	Main Meal	2 multigrain parathas with a dollop of ghee and curd (Calcium, Protein, Healthy Fats). Vegetable sabzi (methi, spinach, or dill) (Iron, Vitamin A, Folic Acid). A glass of fresh orange or pomegranate juice (Vitamin C, Folic Acid).	Iron, Calcium, Protein, Vitamin A
Mid-Morning Snack (11:00 AM)	Light Snack	A glass of fresh carrot and beetroot juice (Vitamin A, Folic Acid). A handful of dry fruits (almonds, cashews, or raisins) (Healthy Fats, Iron).	Vitamin A, Folic Acid, Healthy Fats, Iron
Lunch (1:00 PM – 2:00 PM)	Main Meal	2-3 whole wheat chapatis with ghee. Green leafy vegetable sabzi (Iron, Vitamin A). A bowl of dal with garlic and cumin (Protein). A small portion of brown rice or quinoa (Fibre, Iron). A cup of curd or buttermilk (Calcium, Fluids).	Protein, Iron, Calcium, Vitamin A, Fluids
Evening Snack (4:00 PM – 5:00 PM)	Light Snack	Fennel tea or buttermilk with roasted cumin powder (Fluids, Digestion). Roasted makhanas or a small portion of chivda with peanuts (Calcium, Protein, Healthy Fats).	Fluids, Calcium, Protein
Dinner (7:00 PM – 8:00 PM)	Dinner Meal	Multigrain roti or khichdi with vegetables (carrots, beetroots) (Fibre, Vitamin A). A bowl of dal or lentil soup (Protein). Steamed fish or paneer for protein (Protein, Healthy Fats/Calcium).	Protein, Vitamin A, Healthy Fats
Before Bed (9:00 PM)	Night Drink	A glass of warm milk with a pinch of turmeric and ghee (Calcium, Healthy Fats, Recovery).	Calcium, Fluids, Healthy Fats

Taking the Next Step

To break this cycle, Action Against Hunger focuses on practical, community-driven solutions that combine infrastructure with education:

While these recommendations lay a strong foundation, each mother’s dietary needs vary. For detailed guidance tailored to your specific dietary needs, we strongly encourage you to consult a healthcare professional.

Your baby deserves the best, and so do you! Start making empowering choices today and seek the expert support you need.

References 

1. World Health Organization. Infant and young child feeding: Guiding principles for breastfeeding mothers. Geneva: WHO; 2023.
2. UNICEF India. Maternal nutrition: Ensuring the health of mothers and babies. New Delhi: UNICEF; 2024.
3. Ministry of Health & Family Welfare. Dietary guidelines for lactating women. Government of India; 2022.
4. Indian Council of Medical Research (ICMR). Nutrient requirements and recommended dietary allowances for Indians. New Delhi: ICMR; 2020.
5. National Institutes of Health (NIH). Dietary supplement fact sheets. Bethesda (MD): NIH; 2023.
6. National Health Service (NHS). Breastfeeding diet recommendations. London: NHS UK; 2023.
7. American Pregnancy Association. Nutrition for breastfeeding mothers. Texas: APA; 2024.
   
8. Surya Hospital. Breast milk increasing foods: Indian diet chart for lactating mothers [blog]. Surya Hospital; 2025.

 

Picture Courtesy: The Gray Matter

As we mark World Food Day under the compelling theme, “WATER IS LIFE, WATER IS FOOD. LEAVE NO ONE BEHIND,” it’s imperative that we reflect on the profound role that water plays in shaping our lives, economies, and ecosystems.

Dr. Roshni Vakilna serves as the Technical Lead for Project Vruddhi at Action Against Hunger in Gandhinagar, Gujarat. Her dedication and expertise are driving innovative solutions to combat hunger and create a brighter, more sustainable future for communities in need. Dr. Vakilna, a brilliant mind is a passionate advocate for positive change.

Water is the lifeblood of our planet, an indispensable element that not only sustains us but also underpins the very foundation of our global food systems. As we mark World Food Day under the compelling theme, “WATER IS LIFE, WATER IS FOOD. LEAVE NO ONE BEHIND”, we must reflect on the profound role that water plays in shaping our lives, economies, and ecosystems.

With over 50% of our bodies composed of it and 71% of the Earth’s surface covered by it, water’s significance is undeniable. However, the troubling reality is that while only 2.5% of water is fresh and suitable for essential purposes like drinking and agriculture, we are facing an unprecedented challenge. Rapid population growth, urbanization, economic development, and the relentless impacts of climate change are straining our precious water resources, pushing them to the brink.

As fresh water becomes scarcer, it’s often the world’s most vulnerable communities, including smallholder farmers, Indigenous Peoples, migrants, and refugees, who bear the brunt of this crisis, sparking competition and conflicts over access to this life-sustaining source. In this pressing context, it is our collective responsibility to safeguard this invaluable resource and ensure that no one is left behind in our pursuit of a sustainable and equitable future.

In rural India, the struggle for access to clean and sufficient water is an ongoing crisis that refuses to relent. Recent data underscores the severity of the issue, with nearly one-fifth of rural habitations falling short of the minimum entitled water quantity of 40 liters per capita per day, equivalent to just two buckets a day. This water scarcity intensifies during the dry season, ushering in a period of dire need. With the onset of summer, media reports flood in from various corners of the country, highlighting the escalating drinking water crisis. For weeks, if not months, a significant portion of India’s population—especially those in rural areas—grapples with the harsh reality of water scarcity. During this time, millions of rural residents, along with their livestock, embark on a relentless battle for survival. It’s a recurring nightmare, exacerbated by insufficient rainfall and drought-like conditions in various parts of the nation. Reports indicate plummeting groundwater levels, dwindling lakes, drying wells, reservoirs, and rapidly vanishing dams.

As the mercury soars and heatwaves become increasingly severe, several regions in Gujarat face an alarming water crisis, particularly affecting Saurashtra, Kutch, North Gujarat, and parts of tribal areas in central and South Gujarat. Over 20 districts suffer from severe water scarcity, with towns and villages receiving water only twice a week. In more than 500 villages across 14 districts, drinking water is delivered via tankers, a number expected to rise.

The crisis manifests differently in rural and urban contexts, influenced by various factors such as water supply systems, institutional accountability, socio-economic conditions, and reliance on different water sources.

Historically, rural areas have leaned on community-managed water sources, like wells and ponds, accessible to specific communities. Public or common property sources, including lakes and rivers, were also used for drinking. A minority of affluent households had exclusive water sources. This reliance on community water sources introduced its own set of challenges, including laborious water collection processes, poor water quality, seasonal shortages, and a lack of maintenance. Additionally, certain social groups were excluded from specific water sources. In response to these challenges, individual and household-level piped water supply systems were introduced to complement community sources. Access to piped water at the household level came to be seen as an indicator of an improved standard of living, particularly in urban areas. This concept gradually extended to rural India in the era of local governance. Since Independence, numerous programs have aimed to provide rural households with individual water connections, a goal that remains central to all drinking water schemes today. However, despite decades of effort, progress in this area remains limited and unsatisfactory. Recent statistics reveal that only 18% of rural households have piped water supplied to their dwellings. Over half of rural households still rely on public or common water sources. The Comptroller and Auditor General (CAG) noted that despite an expenditure of Rs 81,168 crores, the coverage of rural habitations only increased by 8% at 40 liters per capita per day during 2012-17. More than half of rural households (51%) rely on sources like tubewells, handpumps, or borewells for their water needs, sources that often run dry during the summer as groundwater levels decline.

The decline in community and common property water resources, along with neglect and privatization by dominant rural sections, has led to their progressive disappearance from the rural landscape. Government water supply programs have fallen short in establishing sustainable water supply mechanisms. These programs often prioritize achieving numerical targets rather than ensuring the sustained availability of water. Consequently, there are few efforts to introduce techniques that can preserve local sources, preventing scarcity and fluctuations in drinking water availability. It’s crucial to preserve, conserve, and revive traditional and common water sources with public and state intervention as part of water supply programs. Simultaneously, access to common resources should not replace the provision of household-level piped water connections. These approaches must complement each other, adapting to local needs and conditions. Such efforts are especially critical in drought-prone regions to ensure access to clean, reliable water throughout the year.

It’s the moment to embark on a journey of prudent water management! What steps should YOU take?

1. 1. Rethink Our Relationship with Water: It’s crucial for all of us to recognize the value of water and cease taking it for granted.
   2. Mindful Food Choices: Our food choices have a significant impact on water resources. Opt for locally sourced, seasonal, and fresh foods to reduce water consumption in food production.
   3. Minimize Food Waste: Cutting down on food wastage is another way to conserve water. Be mindful of how much food you buy and consume and find creative ways to use leftovers.
   4. Safe Reuse Practices: Embrace safe methods of reusing water while being vigilant about preventing water pollution.
   5. Collaborative Action: Together, as a collective, we can take meaningful steps towards securing a sustainable water future for food, people, and our planet.

“Originally written and edited for The Gray Matter”

A Comparative Analysis of the Causes, Consequences, and Interventions Undertaken to Mitigate Malnutrition and hunger in India and Around the World

Aim: This article aims to investigate the issues of hunger and malnutrition in India and globally, comparing and contrasting the causes, consequences, and interventions. 

Abstract: This research article discusses and compares the food, nutrition insecurity of India, Yemen, Somalia and Haiti. This article also discusses the existing safety net schemes like Integrated Child development scheme and Public distribution scheme by the government of India to support the vulnerable section of the society to ensure food and nutrition security across different age groups. It further mentions Action against Hunger’s initiatives towards building a nutrition resilient community through its nutrition sensitive and nutrition specific interventions.

Introduction

Malnutrition refers to a condition that arises when the body does not receive adequate nutrients to maintain optimal health and functioning. It can result from a deficiency, an excess, or an imbalance of nutrients in the diet. Malnutrition can affect people of all ages, from infants and children to adults and older people, and is a significant global health concern. 

India has alarming malnutrition rates among children under five. Poverty, limited access to nutritious food, and inadequate healthcare contribute to this crisis. Even with the government having several initiatives to combat the issue and improve healthcare services, there are significant challenges in executing the same.  

Globally, nutrition crises continue to have devastating impacts. From Yemen and Somalia to Haiti, many countries are still struggling to address the nutritional needs of their citizens. This article aims to understand the causes and consequences of such food crises in India and globally and examine interventions undertaken to mitigate the problem.  

 

Methodology 

This article employed multiple data collection methods to facilitate comprehensive analysis and establish meaningful correlations.  

Primary data: A comprehensive interview was conducted with a distinguished expert from an esteemed organisation working in the field to address the issue – Action Against Hunger. A concise summary of the discussion, rewritten for easy understanding, has been included in the paper.  

Secondary data: Reliable sources and journal articles were used for a comparative analysis of the causes, consequences, and interventions executed to combat hunger in India and three other countries – Yemen, Somalia, and Haiti.   

Causes, Consequences, and Interventions for Hunger Crisis Around the World

Unfortunately, global hunger remains a pervasive issue today, resulting in approximately 25,000 deaths each day, with 10,000 of them being children, as reported by the United Nations. This dire situation has been further exacerbated by escalating food prices and the exorbitant fuel cost.

For this article, the food crisis is explained in these three specific countries – Yemen, Somalia, and Haiti.

 Since 2015 the civil war has led to violence, migration and breakdown of all kinds of essential infrastructure which disrupted agricultural production, distribution channels and access to food leading to a dire humanitarian situation in Yemen.  The severity of hunger has reached unparalleled levels now resulting in immense suffering for millions of individuals. It is reported that malnutrition levels are fairly high in Yemen with 1.3 million undernourished pregnant and lactating mothers, nearly 2.2 million undernourished children have been identified that need to be treated for acute malnutrition. 

 Similarly, Somalia is facing the dire hunger crisis due to grappling and devastating effects of droughts in the Horn of Africa. The situation is catastrophic as nearly 6.5 million individuals are facing food insecurity. Somalia has faced a different kind of crisis back in 2011 where nearly quarter of a million lives were lost due to famine. 

The cause of severe hunger issues in Haiti is due to food insecurity caused by poverty, deforestation and soil erosion have impacted agricultural productivity. Not only the country struggles with inadequate infrastructure but the climatic changes are badly affecting the harvests. Due to food and nutrition insecurity the population especially, children have become susceptible to infections.

Existing scenario of malnutrition in India

India has one of the highest rates of malnutrition globally. According to the National Family Health Survey (NFHS-5) conducted in 2019-21, nearly 36% of children under the age of five in India are stunted (low height for age), 19% are wasted (low weight for height), and 32% are underweight.

Malnutrition rates vary across different states and regions of India. Generally, states with higher poverty rates and lower socioeconomic indicators tend to have higher malnutrition rates. In India, Bihar has the highest malnutrition rate, while Pondicherry and Sikkim have the lowest malnutrition rates. 

 Contributing factors to malnutrition in India 

Malnutrition in India is caused by a complex interplay of factors, including poverty, limited access to nutritious food, inadequate healthcare facilities, poor sanitation and hygiene, and insufficient maternal and child care practices. These factors contribute to a significant impact on both children and mothers.For children, malnutrition poses serious health and developmental challenges, leading to physical and cognitive impairments, reduced immunity, heightened susceptibility to diseases, and increased mortality rates.

Similarly, malnourished mothers face adverse consequences. They are more likely to give birth to underweight babies, perpetuating the vicious cycle of malnutrition. Maternal malnutrition also raises the risk of complications during pregnancy and childbirth, further exacerbating the health and well-being of both mothers and their infants. 

Government Interventions to Combat Hunger in India 

The Indian government has implemented various programs to address malnutrition, including the Integrated Child Development Services (ICDS) scheme, which involves providing food, preschool education, and primary education to children under six years of age and their mothers, the National Health Mission (NHM), and the National Nutrition Mission (POSHAN Abhiyaan). These governmental programmes aim to reduce child stunting, underweight and low birth weight by two percentage points per annum and anaemia among children (and young females) by three percentage points per annum.

These governmental initiatives aim to improve the availability of nutritious food, enhance healthcare services, promote breastfeeding, and raise awareness about proper nutrition. The government also undertook the “1000-day initiative”, which provides parents and healthcare workers with the most recent and up-to-date knowledge regarding the most critical factors that can impact a child’s cognitive development during the first 1000 days of a child’s life, starting from conception. 

Challenges in Addressing the Food Crisis in India

Despite efforts to tackle malnutrition, several challenges persist, such as poverty, lack of awareness, poor infrastructure, and the complex nature of the issue. Implementation gaps, inadequate funding, and limited coordination among sectors such as health, agriculture, environment, sanitation, gender, and education hinder progress in effectively combating malnutrition.  

Insights from an expert working in the field in India 

Action Against Hunger India is actively engaged in addressing malnutrition by prioritizing various key areas. Their efforts are focused on enhancing nutrition literacy, promoting food security, and improving livelihood opportunities. Additionally, they aim to ensure access to clean water, sanitation, and hygiene, all of which are vital during the crucial 1000-day period of a child’s life.

To combat malnutrition effectively, the organization provides support and counselling to both primary and secondary caregivers of malnourished children. Through these efforts, they seek to strengthen nutrition-sensitive practices and create sustainable solutions. One way they do this is by establishing poultry farms, kitchen gardens, and pisciculture ponds. Concurrently, Action Against Hunger consistently offers guidance on WASH (Water, Sanitation, and Hygiene) practices and introduces cost-effective hand hygiene set-ups like tippy taps. 

In summary, Action Against Hunger India takes a comprehensive approach to tackle malnutrition, ensuring the well-being and development of children through improved nutrition practices, livelihood opportunities, and access to essential resources.

Conclusion

Malnutrition is a serious issue that has affected billions of people worldwide. It is an issue of concern in both developed and developing countries but is more detrimental to developing countries. A lot of people in Central African and South Asian countries are dying each year due to hunger and malnourishment. Most of India’s children under 5 years of age suffer from the severe effects of malnutrition. This is because of hunger, poverty, and food lacking essential nutrients.  

Several efforts have been taken by the government of India and globally to reduce poverty by launching initiatives at the state and national levels. The Integrated Child Development Services (ICDS) and the Midday Meal Scheme have provided supplementary nutrition, immunization, health check-ups, and preschool education to vulnerable populations in India. This has led to a positive effect. However, challenges remain in reaching remote areas and ensuring proper delivery of services.

The collaborative endeavours of both governmental and non-governmental organizations have demonstrated lasting effectiveness in addressing malnutrition and hunger. To combat these challenges successfully, it is essential to implement nutrition interventions that target not only the immediate issues of malnutrition but also the underlying social problems such as poverty, illiteracy, and unemployment. By tackling these interconnected issues, we can work towards eradicating malnutrition and securing a better future for children, ensuring they lead healthier and more fulfilling lives.

 

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References

1. Chakravorty, S., & None Manisha. (2023). Data analysis of malnutrition in India: a review of numerous factors. International Journal of Community Medicine and Public Health, 10(7), 2629–2636: https://doi.org/10.18203/2394-6040.ijcmph20232064
2. Combating Malnutrition With More Than Income Growth. (2012, August 30). PRB. https://www.prb.org/resources/combating-malnutrition-with-more-than-income-growth/ Hunger crisis in Haiti. (n.d.). Plan International Haiti: https://plan-international.org/haiti/hunger-crisis-in-haiti/
3. Malnutrition in India. (n.d.). NextIAS: https://www.nextias.com/current-affairs/28-07-2022/malnutrition-in-india
4. Mathew, M., Francis, P., & Sebastian, S. (2020). Studying the prevalence of malnutrition in India: An interstate analysis: https://www.academia.edu/51930317/Studying_the_Prevalence_of_Malnutrition_in_India_An_Inter_State_Analysis?source=swp_share
5. Somalia emergency | World Food Programme. (2023). www.wfp.org; World Food Programme: https://www.wfp.org/emergencies/somalia-emergency
6. Towle, M. (2011, March 24). India is booming – so why are nearly half of its children malnourished? (Part 1). State of the Planet: https://news.climate.columbia.edu/2011/03/24/india-is-booming-so-why-are-nearly-half-of-its-children-malnourished-part-1/
7. Yemen emergency | World Food Programme. (2022). Wfp.org; World Food Programme: https://www.wfp.org/emergencies/yemen-emergency

Authors

Seerath Prakash & Srinjay Mukherjee

Seerath Prakash is a Modern School Barakhamba Road student, currently studying in grade 12. She is keenly interested in human welfare and regularly organises drives to provide food for the underprivileged.

Srinjay Mukherjee is a DPS Monarch International School student in Doha, studying in grade 12. He is keenly interested in history, politics, and international relations and enjoys writing on fictional and non-fictional topics.

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Introduction 

Malnutrition remains a global health concern, affecting millions of infants and children worldwide. While malnutrition in older children is widely recognized, the alarming issue of malnutrition in infants under six months is often overlooked. This critical period of a child’s life is vital for growth and development, making early intervention essential. Unfortunately, the burden of wasting among Indian children in the first 6 months of life is not well-documented. Infants under the age of six months may exhibit various signs of malnutrition, including low birth weight (including premature birth), wasting, underweight, growth or feeding difficulties, and clinical illness. In India, the statistics reveal a concerning situation, with 27% of infants under six months being wasted or acutely malnourished (weight-for-length (WLZ) < -2), and 13% severely wasted (WLZ < -3). Additionally, 32% of infants are underweight (Weight-for-age (WAZ) < -2), and 10.6% are severely underweight (WAZ < -3) (Government of India, 2021). Furthermore, the prevalence of low-birth-weight infants stands at a staggering 18%, many of whom are already wasted or become wasted later. The rates of timely initiation of breastfeeding are low, with only 41.8% of children being breastfed within the first hour of birth, and exclusive breastfeeding is practiced by only 63.7% of infants under six months of age (Randev, 2020).

Unveiling the Etiology of Malnutrition Among Infants Less Than 6 Months of Age 

1. Inadequate Exclusive Breastfeeding Practices: One prominent etiological factor contributing to malnutrition in this age group is the practice of suboptimal breastfeeding. Exclusive breastfeeding for the first six months of life is crucial for providing optimal nutrition and protection against infections. However, challenges such as lack of knowledge, cultural beliefs, maternal employment, and aggressive marketing of breastmilk substitutes often impede exclusive breastfeeding rates. Studies have shown that suboptimal breastfeeding practices significantly increase the risk of malnutrition among infants (Victoria et al., 2016, Islam et al., 2018).
2. Maternal Malnutrition and Health Status: The nutritional status and overall health of mothers play a pivotal role in the etiology of malnutrition among infants. Maternal malnutrition, before and during pregnancy, can result in deficiencies of essential nutrients, which may cause prematurity or intrauterine growth retardation and directly affect the quality and quantity of breast milk. Term SGA (small for gestational age) and low birth weight babies are more likely to experiencing wasting and severe wasting (HRD, SAS & UNICEF). Furthermore, maternal illness and infections, particularly during pregnancy and lactation, can hinder the fetus’s and infant’s access to adequate nutrition and contribute to malnutrition (Bhutta et al., 2013). Addressing maternal malnutrition and improving maternal health is crucial for promoting infant nutritional well-being.
3. Infections and Illness: Infections and illnesses have a profound impact on the etiology of malnutrition among infants. The immature immune systems of infants under six months make them susceptible to infections, which can disrupt nutrient absorption, increase nutrient requirements, and reduce appetite. Common infections such as respiratory infections, diarrheal diseases, and malaria can lead to malnutrition in this age group (Caulfield et al., 2004). Addressing infections through improved healthcare access, vaccination and hygiene practices is essential in mitigating risk of malnutrition.
   

In addition to these factors, there are other identified factors like lower maternal education, caesarean section, low birth weight, gender and poverty and socioeconomic factors which contribute to malnutrition among infants less than 6 months of age. Infants under six months are particularly vulnerable to malnutrition due to their physiological immaturity, high nutritional needs, and exclusive reliance on breast milk. Wasting and severe wasting among this age group of young infants is significantly associated with increased risk of morbidity, mortality, and poor cognitive and physical development and thus it is imperative to address it. 

Current Context

While India has made significant strides in improving the survival rates of high-risk newborns and infants through the identification and management of illness withing dedicated facilities and targeted programs (Kumar et al., 2020), there remains room for improvement. The nutritional interventions in India have mainly targeted children aged 6 to 59 months, with facility-based management guidelines issued in 2011 to treat severe acute malnutrition among infants and young children aged 0-59 month. Various programs and platforms in India are aimed at detecting and managing early growth failure however, the utilization of these services often falls short of expectations. To address the needs of at-risk children, existing programs such as Home-Based Newborn Care and Home-Based Young Child Care should be strengthened and expanded to include actions for infants with malnutrition. Although infants with wasting in the first six months of life are also at high risk, they receive less frequent follow-up home visitation than low birth weight babies in the current program (as per HBNC/HBYC Guidelines, 2011).  

Progression

One intervention that can prevent and treat malnutrition in children under six months of age is optimal breastfeeding practices which include timely initiation of breastfeeding and exclusive breastfeeding up to 6 months of age. In fact, exclusive or predominant breastfeeding has been shown to reduce the risk of wasting in the first six months of life (WHO 2021). However, despite the recommended guidelines promoting optimal breastfeeding for the first six months, there is a low compliance rate due to factors such as lack of awareness, social norms, deeply rooted cultural practices, and inadequate support system. Additionally, many women in India suffer from anemia, which can have negative impacts on the mother’s health and increase the risk of low-birth-weight babies. Poor sanitation and hygiene practices also contribute to malnutrition, exposing infants to diarrheal infections and other illnesses that can affect their growth and development. Other key intervention includes improving maternal nutrition during pregnancy, addressing post-partum mental health issues, enhancing skills and knowledge of frontline workers on breastfeeding counselling and resolving challenges faced by mothers in breastfeeding. There is a need for enhanced community-based interventions that address the health and nutrition of both infants and mothers.

There is a great opportunity for further strengthening community-based interventions that focus on promoting the health and nutrition of both infants and mothers. While services for pregnant women primarily address physical ailments, there is a need for increased support for maternal mental health. It is important to address regional variations, improve service integration, and bridge the gaps in referral systems to ensure the seamless delivery of high-quality care. 

To enhance the effectiveness of community-based interventions, it is crucial to address practical constraints such as the limited availability of appropriate equipment and additional efforts are warranted to improve the skill levels of community health workers to ensure strengthened service delivery. 

In India, there is a pressing need for more evidence-based initiatives that specifically focus on the prevention, identification, and management of acute malnutrition in children under six months of age.  Addressing this gap will contribute to the overall well-being and healthy development of infants in the country (Chowdhury et al., 2021). 

Therapeutic approach calls for country-specific guidelines to address the issue of malnutrition among children under 6 months of age at community level (CMAM) and Indian growth standards for early identification of MAM and SAM children under 6 months. Development of a national guideline and protocol for the community-based management of early growth failure in infants under six months, based on the MAMI Care Pathway Package, spearheaded by the National Centre of Excellence for Management of Severe Acute Malnutrition at Kalawati Saran Children’s Hospital is very promising. The MAMI Care Pathway Package is tailored to the specific context by integrating its various components into the existing community-based programs.  

Conclusion

The nutritional needs of children under the age of six demand greater attention and emphasis than they currently receive. Implementing innovative and comprehensive strategies such as Community-Based Management of Acute Malnutrition for Infants (CMAMi) can prove highly beneficial in making a significant impact on the country’s malnutrition statistics. 

To acknowledge and address this, we at Action Against Hunger, India work with mothers, families, communities, and systems to foster requisite support, knowledge, and skills to assure optimal nutritional support to the children under 6 months. 

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References  

1. India State-Level Disease Burden Initiative Collaborators. Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet. 2017; 390:2437–60.
2. World Health Organization. Updates on the Management of Severe Acute Malnutrition in Infants and Children. Guideline. 2013. Available at: https://www.who.int/publications/i/item/9789241506328 . Accessed on 17th April 2023. 
3. Knowledge Integration and Translational Platform at Research and Development, society for Applied Studies, new Delhi, India and UNICEF, India. Analysis of wasting and severe wasting and its associated risk factors among under-5 children in India.
4. Kumar P, Meiyappan Y, Rogers E, et al. Outcomes of hospitalized infants aged one to six months in relation to different anthropometric indices – an observational cohort study. Indian J Pediatr. 2020. https://doi.org/10.1007/s12098-020-03236-9 .
5. National Center of Excellence for Management of Severe Acute Malnutrition, Kalawati Saran Children’s Hospital LHMC, New Delhi. National Consultation on Addressing Acute Malnutrition 2021, New Delhi.
6. Mwangome M, Ngari M, Fegan G, et al. Diagnostic criteria for severe acute malnutrition among infants aged under 6 mo. Am J Clin Nutr. 2017; 105:1415–23. 
7. Mwangome M, Ngari M, Bwahere P, et al. Anthropometry at birth and at age of routine vaccination to predict mortality in the first year of life: a birth cohort study in Burkina Faso. PLoS One. 2019;14: e0213523.
8. Randev S. Malnutrition in Infants under 6 months: Is it time to change recommendations? Indian J Pediatr. 2020; 87(9):684–685.
9. Bhutta Z. A, Das J.K, Rizvi A, et al. Evidence-based intervention for improvement of maternal and child nutrition. What can be done and at what cost? The Lancet 2013; 382 (9890): 452-477.
10. Black R E, Victoria C G, Walker S P, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet 2013; 382 (9890): 427-451. 

On June 5th, every year, the world unites to celebrate World Environment Day, a momentous occasion that serves as a powerful reminder of the urgent need to protect and preserve our planet. In 2023, as we commemorate this day, we must also reflect upon the profound interconnections between climate change, the environment, and the scourge of hunger and malnutrition. For humanitarian global organizations dedicated to addressing these pressing issues, this is a pivotal moment to highlight the critical linkages and advocate for comprehensive action. It is now a matter of much discussion and global recognition that how climate change and environmental degradation impact hunger and malnutrition around the world. As a world united in many ways, we must also explore the transformative steps needed to address this multifaceted challenge.

At Action Against Hunger, we are involved in some of the initiatives to address climate change that is becoming a major determinant of hunger and environmental degradation that can undermine our food security. We are prioritizing sustainable solutions at the intersection of climate change, environment, hunger, and malnutrition.

Through ‘Farmer Field Schools’, we are building the capacities of farmers, right from Central Africa to South Asia, on climate-smart farming techniques and educating them on a variety and types of crops that survive extreme weather but are also nutritious. Using satellite imagery of crops and water, we have set up a ‘Pastoral Early Warning System’ in the Sahel region of West Africa that, combined with on-ground mobile surveys, provide real-time alerts to herders to find comparatively better grazing lands for their livestock. Implementing innovations such as hydroponics and vertical gardens, that have revolutionized the farming sector, have proved to be a boon for our farmers’ struggle with inadequate access to water and soil. We have also strengthened inter-farmer bonds through farmer cooperatives that have enabled farmers to rent larger plots, and as implemented in Uganda, get together to obtain fair prices for their produce. As climate change has impacted the duration of farming seasons, and consequently elongated the hunger seasons, we have been working closely with families to inculcate food preservation practices by providing tools and resources for increasing the shelf-life of their crops. At network level, we are widely involved in emergency relief actions, and have consistently been better advocates for action-based change.

In India, as part of our food security and livelihood initiatives, our efforts strive towards promoting climate and nutrition sensitive farming and agriculture practices and mitigating the effects of climate change. We promote cultivation of nutritious fruits and vegetables through nutri-gardens. These also account for environmentally friendly designs of nutri-gardens, natural, eco-friendly pest control, and fertilizers. We set up vermi-composting units towards inculcating sustainable composting practices that do not limit in use to just the Nutri-gardens but expand beyond till field crops as well. Through poultry farming and pisciculture, we promote livelihoods, diet diversity, and sustainable community building behaviors and practices. However, with the ever increasing burden of climate change, these vulnerable populations are left to face extreme situations of heat and drought, leaving them with little to no sources of food and income. This invokes a sense and urge to flee elsewhere in search of livelihood, pushing them in a situation of distressed migration.

A common scenario in Action Against Hunger India’s working geographies, we have devised platforms to minimize the impact of migration on malnutrition by closely following up with families and helping them in accessing the health and nutrition services for their children.

World Environment Day 2023 serves as a powerful reminder that our action today will determine the future of our planet and generation. The time to save our planet is now and we are presented with a once in a lifetime opportunity to save our planet. As we reflect upon the undeniable links between global challenges and individual well-being, we must recognize the urgent need for comprehensive and sustainable solutions.

By addressing the root causes of hunger and malnutrition, including the impacts of climate change and environmental degradation, we can pave the way for a more resilient and equitable future. This requires a collective effort that spans governments, organizations, communities, and individuals. There is so much to be done at grassroots and at the national and international levels so as to achieve SDG 13 calling for action on climate.

On this World Environment Day, let us commit to promoting climate-smart agriculture, restoring ecosystems, strengthening food systems, prioritizing climate adaptation and disaster risk reduction, and advocating for change. By embracing sustainable practices and fostering collaboration, we can ensure a world where no one goes hungry, where ecosystems thrive, and where the environment is preserved for generations to come.

Let us leverage our expertise, influence, and resources to tackle the intricate web of challenges at the intersection of hunger, malnutrition, climate change, and the environment. Together, we can forge a path toward a sustainable and food-secure future, leaving a lasting impact on the lives of the most vulnerable populations worldwide.

This World Environment Day, let us renew our commitment to a healthier planet and a hunger-free world. The time to act is now.

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References:

1: UN Warns Climate Change Is Driving Global Hunger: UN Warns Climate Change Is Driving Global Hunger
2: A once-in-a-planet opportunity” UNEP Chief Inger Andersen at INC-2: A once-in-a-planet opportunity” UNEP Chief Inger Andersen at INC-2