Breastfeeding is inversely proportional to household wealth and other factors, says study.

Malnutrition among children in urban India is characterised by relatively poor levels of breastfeeding, higher prevalence of iron and Vitamin D deficiency as well as obesity due to long commute by working mothers, prosperity and lifestyle patterns, while rural parts of the country see higher percentage of children suffering from stunting, underweight and wasting and lower consumption of milk products — these are among the findings of the first-ever national nutrition survey conducted by the government.

The Comprehensive National Nutrition Survey released by the government on Monday shows that 83% of children between 12 and 15 months continued to be breastfed, a higher proportion of children in this age group residing in rural areas are breastfed (85%) compared to children in urban areas (76%). Breastfeeding is inversely proportional to household wealth and other factors influencing this trend may include working mothers who have to travel long distances to reach their workplace.

Because of these reasons, it also noted that rural children receive meals more frequently in a day at 44% as compared to 37% of urban children. However, a higher proportion of children residing in urban areas (26.9%) are fed an adequately diverse diet as compared to those in rural areas (19%).

Children and adolescents residing in urban areas also have a higher (40.6%) prevalence of iron deficiency compared to their rural counterparts (29%), which experts say is due to a better performance of the government’s health programmes in rural areas.

Children in urban areas are also overweight and obese as indicated by subscapular skinfold thickness (SSFT) for their age. While 14.5% of children in the age group of 5 to 9 years in cities had higher SSFT than 5.3% in rural areas, 10.4% of adolescents surveyed in urban areas in the age group of 10-19 had higher SSFT than 4.3% in rural areas.

“We are aware of the need for a special focus on urban areas under the Poshan Abhiyaan [Nutrition Mission] and NITI Aayog is currently developing a strategy to deal with problems unique to children living in cities as well as factors hampering implementation of government programmes,” Alok Kumar, Advisor, NITI Aayog told The Hindu.

Wealthier households in urban areas and sedentary lifestyle of children may also be responsible for higher deficiency of Vitamin D in urban areas (19%) as compared to rural areas (12%), though the study shows that 74% of children living in cities consume dairy products as compared to 58% in rural areas.

Rural children lag in intake of zinc which causes diarrhoea, growth retardation, loss of appetite and impaired immune function. Among children aged 1-4 years, zinc deficiency is more common in rural areas (20%) compared to urban areas (16%).

Rural areas also witness higher prevalence of stunting (37% in rural versus 27% in urban), underweight (36% in rural versus 26% in urban) and severe acute malnutrition (34.7% in rural areas for children in 5-9 years versus 23.7% in urban areas and 27.4% in urban areas for adolescents in 10-19 years versus 32.4% in rural areas).