Question 1

a) Vitamin A, Calcium and Carbohydrates

b) Peter’s breakfast is considered a balanced meal especially considering the 4 Namibian food
groups. Oats are considered to be one of the healthiest breakfast foods for children. Porridge is
made from oats that are high in complex carbohydrates and soluble fibre, meaning they release
energy slowly. A bowl of porridge should provide all the energy a child needs until lunchtime
while also providing nutrients for the growing body.

c) Breakfast is important because it helps kick-starts one’s metabolism, helping one burn calories
throughout the day. It also gives one the energy you need to get things done and helps you focus
at work or at school.

Question 2

a) Undernutrition is caused by a lack of nutrients, either as a result of a poor diet or problems

absorbing nutrients from food.

b)

i) Acute undernutrition is acute inadequate nutrition leading to rapid weight loss or failure to gain
weight normally.

ii) Chronic undernutrition is Inadequate nutrition over long period of time leading to failure of linear
growth.

iii) Acute and chronic undernutrition is a combination measure, therefore, it could occur as a result of
wasting, stunting, or both.

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c)

Adequate nutrition is defined as the intake and utilisation of enough energy and nutrients to
maintain nutritional and health well-being. Adequate nutrition is essential in early childhood to
ensure normal growth, neurological and cognitive development, and healthy life. Adequate
feeding and access to appropriate quality and quantity of foods are essential components of
optimal nutrition for children (Bruch, 1973).

Undernutrition continues to be a major public health problem throughout the developing world,
particularly in southern Asia and sub-Saharan Africa. There is evidence that diets consumed in
many parts of these developing countries are frequently deficient in macronutrients and
micronutrients or both.

Dietary intakes of children in many parts of developing countries are basically plant-based,
which are devoid of essential nutrients. Foods given to children are low in energy dense, protein
and micronutrients, couple with insufficient intakes. Epidemiological studies have reported that
prevalence of undernutrition among children is high due to poor child-feeding practices.
Solomon reported that poor foods and poverty among households are the most important direct
factors responsible for protein-energy malnutrition (Nordqvist, 2016).

Undernutrition in the form of undernutrition is the most significant risk factor for the burden of
disease in developing countries causing approximately 300,000 deaths per year accountable for
more than half of the deaths occurring in children in the developing countries. Undernutrition
causes a great deal of human suffering physically and emotionally. It is a violation of a child’s
human rights and a major waste of human productivity. Health consequences of inadequate
nutrition are enormous. It is estimated that malnutrition alone accounts for more than half of
children’s deaths annually. In developing countries, approximately 183 million children are
underweight-for-age, 67 million are underweight-for-height (wasted), and 226 million are low
height-for-age (stunted) (Bruch, 1973).

Evidence has shown that malnutrition is associated with more than half of all children’s deaths
worldwide and that children who suffered malnutrition are less physically and intellectually
productive at adulthood. It has been documented that undernutrition in young children causes

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disturbances in the morphological and functional development of the central nervous system,
thus affecting the cognitive and emotional development of the child. Both protein-energy and
micronutrient malnutrition have profound negative consequences for children’ health and
survival.

Micronutrient deficiencies, particularly iodine and iron, have been implicated to impair growth
and cognitive development in children. Iodine deficiency adversely affects development of the
central nervous system. Adequate iron intake also is necessary for brain development. More than
40 % of children ages 0–4 years in developing countries suffer from anemia. Anemia in school-
age children also may affect school performance whether or not there had been earlier impaired
brain development (Rabiee, and Geissler1990).

In most developing countries, the synergistic relation between malnutrition and infectious
diseases remains the most important immediate cause of death among children and of disability
worldwide. It has been estimated that problems involving interaction of malnutrition and
infection affect children worldwide and account for majority of illness and deaths recorded in
them. Undernutrition causes an increased susceptibility to infections; the latter leads to increased
requirement for nutrients by hypercatabolism and increased loss of body constituents
subsequently. Often, there is additional decrease in dietary intake, and together, these can result
in precipitation of acute deficiency states in the under-fives who are marginally compensated
before the infections (Bruch, 1973).

There are noticeable disparities between children from developed countries and those from
poor-resource countries. For instance, children from developing countries, who are mostly
malnourished, suffer more from underweight, stunting, impaired cognitive function, poor school
performances, higher risk of infection, ill health, and death than their counterparts of normal
nutritional status from developed countries (Nordqvist, 2016). The most severe effects of
undernutrition are more in children (<5 years) even; if nutrition improves from that time forward,
they are most likely to suffer from below-normal growth, which would affect their physical and
mental development, thereby compromising the future of these children, their communities, and
their countries at large.

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Question 3

a) Measles

b) The disease is transmitted through contact with some one who has measles or inhalation of
droplets containing the measles virus.

c)

i. Pneumonia
ii. Gastroenteritis
iii. Acute encephalitis
iv. Otitis media
v. Laryngotracheitis
vi. Conjunctivitis

Question 4

a)

i. Children who do not sleep as much as they should may see a negative effect on their growth
hormones. Because this hormone is primarily produced during sleep, a child that is lacking
rest may develop a growth hormone deficiency.
ii. Sleep for Babies not only helps them concentrate and learn new things, but it also
supports the brain to take in information and actually retain it.
iii. Lack of sleep can also effect a child’s weight. Children who suffer from sleep
deprivation may be effecting their leptin hormone which is the hormone that tells a
child they have eaten enough.
iv. Babies who regularly get an adequate amount of sleep have improved attention,
behavior, learning, and memory.

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b)

Sleep develops rapidly during the first few years of life and is a highly dynamic process. At
birth, infants lack an established circadian rhythm and hence sleep across multiple intervals
throughout the day and night in short bouts, which may also be due to infants’ feeding needs. At
about 10–12 weeks of age, the first signs of a circadian rhythm begin to develop, marked by an
increased ease of sleeping through the night. The change in total sleep duration over 24 hours
continues and decreases from 16 to 17 hours in newborns, to 14–15 hours at 16 weeks of age,
and 13–14 hours by 6 months of age. While the need for day sleep decreases, night sleep
duration increases through the first year of life, 5–7 5 resulting in a shift towards more nocturnal
patterns of sleep.

If a child is sleep deprived then generally their behaviours will change from the norm. They can
often become irritable, moody and more prone to tantrums. A child who doesn’t have enough
sleep will generally be less happy than a child who gets enough sleep. Studies have found that
children are more prone to suffer from anxiety or depression or ADHD if they don’t get the
required amount of sleep. Some say that childhood is the foundation for a person’s personality
and how they will act as an adult. Therefore if a child acts irritable and struggles to be positive
due to lack of sleep, they may continue to do so in the future, affecting their social relationships
in the long term (Adams, 2004).

Sleep deprivation can also affect a child’s development significantly. From the time you are born
to adulthood you are constantly learning and absorbing skills and information at a rapid rate. The
amount we learn at this stage, especially before the age of ten is phenomenal and consequently it
is vital that children have good sleep foundations so they can learn effectively. Sleep studies
show that the brain needs a certain amount of sleep to learn tasks that you have completed
through the day and to consolidate memories (Field,2011).This means that the ability for
children to learn effectively can be determined by the quality of sleep that they acquire. Studies
on children and sleep have found links between poor grades at school and sleep deprivation, due

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to a lack of concentration. Taking this into consideration it is vital to ensure a child gets enough
sleep as possible to make sure they are equipped for the day, when they are constantly learning.

Lack of sleep can also lead to health problems in children. Sleep allows the body to recharge
from the activities of the day. Children are constantly active, either it be physical or mentally,
and is one of the main reasons why children need more sleep than adults because they are
learning new things all the time. Sleep studies have shown that lack of sleep can lead to a low
immune system, which can be highly dangerous to children as they are at higher risk of illness
and disease.

Diabetes is thought to be caused by lack of sleep, as studies have found that the way in which the
body processes glucose is altered. This is a lifelong condition that increases blood sugar levels
and can often lead to other illnesses such as kidney failure, cardiovascular disease and visual
impairment and obesity or weight loss.

Weight gain or loss can be an effect of diabetes, but lack of sleep also. Studies have found that if
you have less sleep, then you are more likely to be obese. This is due to a lack of leptin (a
chemical that makes you feel full) and an increase in ghrelin (a hunger stimulating hormone). It
could also be because the lack of energy that we feel with less sleep. The body hasn’t had time to
recharge and therefore, we may feel the need to eat more food to give us energy and exercise is
often reduced as energy levels are low. Consequently, sleep for a child is vital to their health and
should be monitored as well as behavioural and learning development (Adams, 2004).

If you have a child then it is important to monitor their behaviour, physical health as well as take
note of their sleeping patterns to determine whether they are sleep deprived. Behavioural signs to
take note of are, irritable moods, being quieter than usual or acting out, or anger for no apparent
reason. Children are extremely changeable, therefore signs such as this may not seem unusual,
however it is important to take note of the behaviours and try to decipher whether it is hormonal
or due to sleep deprivation (Rasch,& Born, 2013).

Physical signs may help you determine whether a child is sleep deprived. Signs such as excessive
yawning, lack of energy and catching more colds or bugs than usual could be due to lack of
sleep. The immune system can be significantly affected by lack of sleep and affect our health.
When we sleep our bodies recharge and our immune system is strong, whereas when we don’t

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get the right amount of sleep, our immune systems can become weaker and unable to ward of
disease and illness. This can be potentially dangerous to children as they are at much larger risk
as their immune systems are constantly fighting off new bacteria (Field,2011).

Question 5

Mother-to-child transmission of HIV is the spread of HIV from a woman living with HIV to her
child during pregnancy. It can occur in the following ways, during childbirth also called labor
and delivery, or breastfeeding through breast milk. Mother-to-child transmission of HIV is also
called perinatal transmission of HIV.

Question 6

1. Baby’s gum become sore and red where the tooth is coming through.
2. One of the baby’s cheek becomes flushed.
3. The baby starts dribbling more than usual.
4. The baby starts gnawing and chewing on things a lot.

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 REFERENCES

Adams SM, (2004). What affects the age of first sleeping through the night? J Paediatr Child
Health.40(3):96–101.

Bruch H. (1973). Eating disorders: Obesity, anorexia nervosa, and the person within. Vol. 5052.

Field T. (2011). Prenatal depression effects on early development: a review. Infant Behav
Dev. 34(1):1–14.

Nordqvist C. (2016). Malnutrition: Causes, Symptoms and Treatments. UK: Basic Books.

Rabiee F, Geissler C. (1990). Causes of malnutrition in young children: Gilan, Iran. J trop
pediatr. 36(4):165-70.

Rasch B, Born J. (2013). About sleep’s role in memory. Physiol Rev. 93(2):681–766.