Children’s health, growth and immunization: Our role in preventing preventable diseases

Unless we look after our women and children in a programmed manner in the field of health, we cannot have a happy world around us. Children are still killed or disabled each year by diseases that could have been prevented by immunization. The World Health Organization (WHO) is doing its best to eradicate/eliminate a variety of infectious diseases, but involvement of every citizen of the world is must for compliance of various programs of the WHO. The measles, mumps and rubella triple vaccine (MMR) should be included in the EPI (Expanded Preventable Immunization) program of every country. We should not ignore the facts that measles and mumps can cause considerable morbidity and mortality which could be prevented with optimum immunization. Optimum immunization means full course of vaccination schedule without missing any booster dose.

Apart from vaccination child nutrition and general health must be taken care of. The child health reminds me the efforts of Mr. James P Grant, the Director of United Nations' Children's Fund (UNICEF, 1984), who in 1984 brought out a Report on the State of World's Children, and forwarded a mnemonic GOBI-FFF to remember the techniques which could reduce sadness of the world. In GOBI-FFF, "G" stands for growth monitoring, "O" stands for oral rehydration therapy, "B" stands for breastfeeding, and "I" stands for immunization. The three Fs (FFF) stand for 'family spacing', food supplements and female education. The methods represented by GOBI-FFF are the simplest methods which could help us in tiding over the state of health of children and preventing diseases and saving lives. Consequent upon the compliance of GOBI-FFF, lives of millions of children are saved every year and the health and growth of millions more is protected. Still there is need to protect the children from episodes of common childhood diseases like measles, respiratory infections and diarrhoeal infections.

Various infections also interfere with physiological and psychological development of children. The malnutrition and infections perpetuate each other and may lead to suboptimum brain development. The GOBI methods are not so expensive. Community health workers can be assigned the responsibility of growth monitoring through periodic recording of weight and height of a child. The oral rehydration salts (ORS) should be supplied at cost price to prevent the dehydration caused by diarrhoea. The breastfeeding should be encouraged since it provides ideal nourishment to the child and saves from the infectious hazards of bottle feeding. Immunization against tuberculosis, diphtheria, pertusis (whooping cough) tetanus, polio, measles, mums and rubella protects the child against these serious as well as disabling diseases. Attention should also be given to the health education of mothers. Awareness about the child's health in mothers would definitely make all the healthcare and immunization programs successful. It is well established fact that proper spacing between child births decreases the risks to the heath of the mother and the infant. Food supplements should regularly be supplied to the mothers during pregnancy and vaccination against tetanus should be done. We must put in our best efforts to prevent the preventable diseases since prevention is better than cure.

Benefits of Breastfeeding

The new generation mothers should always be encouraged to breast feed their babies since the breastfeeding benefits the babies in many ways. Just after the birth, the baby's immune system is naive and for first few months of life the baby is dependent on the prophylaxis provided by the homologous maternal antibodies acquired through placental circulation. It is worth to mention here that there are 5 types of immunoglobulins in our blood but only the immunoglobulin-G (IgG) can pass through the placenta and reach the circulation of the baby in the womb. While the lymphoid system of the baby is developing in the first few months, it could get additional protection from the colostrum and the breast milk if adequately fed on the breast milk. The colostrum is the yellowish fluid discharged form the breasts during the first 2-3 days after the delivery and is very rich in immunoglobulin-A (IgA) content. The IgA present in the colostrum and other secretions is always in the dimer form stabilized by a secretory component and is inert to proteolytic action of digestive enzymes in the stomach and intestine. The IgA rich colostrum sucked in by the baby protects its oral and gastric mucosa from infectious agents and the amount of IgA reaching the small intestine is absorbed and transferred to the blood circulation. The IgA is synthesized locally in the breasts by plasma cells and dimerized together with a cystine rich polypeptide called J-chain. The breast milk is a very rich source of proteins, carbohydrates, calcium, minerals and hormones essential for the growth and development of the baby. No other food supplement or cattle milk could replace the human breast milk. Various studies have established that breastfeeding protects babies from respiratory problems in early life and may leave babies with stronger lungs well into the later life. The sheer physical effort involved in the suction of breast milk by the baby could be rewarding in many ways for acquiring stronger lungs, bones, immunity and health.