Fields, forks and breast milk
In Thailand, 4.1% of children under five in urban areas suffer from chronic malnutrition. This doubles to 8.4% outside the cities and in the hill-tribe communities of Mae Chaem rises to 33%. Better agricultural production and exclusive breastfeeding for the first six months are part of the solution, say Palika Champrasert, Natjan Chairat and Anna Roseler
Sustainably improving the local availability of food in Thailand through increased agricultural production, including agroforestry, can address poor nutrition in infants and children but there is little evidence of effective strategies on how to carry this out and, specifically, how to link improvements in agriculture with corresponding improvements in diet and nutrition.
The communities displaying high rates of malnutrition are often in remote areas with limited access to markets and health facilities and have marginal agricultural production that fluctuates widely owing to natural variability in climate and soil productivity. Their children are especially vulnerable to the negative health consequences of these environments. This is especially true for communities practising subsistence farming.
Two of the most important caring practices for good nutrition in early life are breastfeeding and complementary feeding. The World Health Organization recommends that all infants should be exclusively breastfed—that is, breast milk only—for the first six months because it protects against gastrointestinal infection and reduces the risk of morbidity and mortality associated with such infections. Breastfeeding may also help children avoid a host of diseases that occur later in life, such as type 1 and type 2 diabetes, high cholesterol and inflammatory bowel disease. Breast milk contains less insulin (Insulin stimulates the creation of fat) than formula and may therefore protect the child from obesity. Babies who are fed breast milk tend to have less allergic reactions than babies fed infant formula and show higher developmental scores and IQ test results.
The Field to Fork project, which is a multi-site research initiative to reduce malnutrition through nutrition-sensitive agricultural solutions, funded by the International Development Research Centre, found that only 10% of women in the Karen and Lawa hill-tribe communities of Mae Chaem province in northern Thailand exclusively breastfeed for six months. Most do so for only an average 2–3 months.
This is due to three main reasons. The first is the strong belief in the communities that the child requires rice to fill them up and to help them grow from the age of 2–3 months. Second, the mother is typically required to return to her agricultural work and the child is usually left with their grandparents and fed solid food (most often rice) in place of breast milk. The mothers are not aware of the option to express breast milk. Third, the hill-tribe communities are not aware of the benefits of exclusive breastfeeding nor that it means that not even rice or water are to be given to the child before 6 months of age.
To address both the issue of food insecurity and poor nutrition, the Field to Fork project will be supporting the hill-tribe communities with homestead gardening and chicken raising. The project will also raise the communities’ awareness about the benefits of exclusively breastfeeding for six months, particularly highlighting the effects of early food introduction and how to express breast milk. It is hoped that these initiatives will improve food availability and the nutrition status of the children in the hill-tribe communities.
This work is linked to the CGIAR Research Program on Forests, Trees and Agroforestry