 Thank you so very much Hilary Dereva for that riveting interview and I really hope I said your name right this time. My name is Valentine or at ColourMeVal and you're still watching Why in the Morning the Littiest Breakfast Show Up Round. And if you don't believe me, in fact don't even take my word for it, just watch us Monday through Friday, 7 a.m. through 10 a.m. or day, every single day we have different themes for you, different ways to excite you and entertain you. Please appreciate it. And in case you missed an interview or you just want to watch it again at WhiteFive4Channel on YouTube is where you need to be. So this is the health segment on Monday and today we're discussing child nutrition. See, from two all the way to, what do we say, eleven? Eleven. Alright, there we go. So this is my lovely guest and I'll let her introduce herself. Good morning. Good morning. How are you? Fine, thank you. Welcome to studio. Thank you. What is your good name? My name is Nyambu Ranyaga. Yes, I'm a nutritionist and a dietitian and I'm also a mother. So when I'm talking about child nutrition, it's something that I've had a few years. Practical hands-on. Yes. Yes. Why do you prefer, this has nothing to do with anything, but why do you prefer your names like that? Because if I had introduced you, I would have introduced you with the other one. It's just preference. Yes. Yes, it makes you feel more African. Yes. Okay, I see you African. Yes. Talk to me about it. What is child nutrition? Just a few seconds ago I was being educated on malnutrition. Let's start with that. What's malnutrition? Okay, when you talk about malnutrition, we mean the deficiencies that come and in the effects of both overtaking something that is overeating something, a specific type of food, like when we talk about you've eaten too much proteins, too much carbohydrates, and the child is obese, too much weight, that is malnutrition in terms of you've overeaten. And there's malnutrition in terms of under you've not had enough or something, you are lacking, your body is lacking in a certain nutrient or a certain group of food, and now you are under, now reached in a certain area. So when we say malnutrition, we refer to both overeating or under eating over certain specific nutrient in foods. That was very fascinating to me too, to imagine that you can have too much of something like wow. Okay, so the body is capable of retaining, retaining, retaining to the point where it's becoming useless now. It's becoming harmful to me. Yes. Okay, so let's break this down a bit, and if it's okay, if we can study them, boys and girls separate. So it's two all the way to 11, so they are growing, they are infants, and there's a lot of these things we studied by the way in biology. So we know the girls, you know, tall, a bit develop and all these things, and boys grow taller, they have an Adam's apple, their voice breaks, and all these things. And I don't know, it's genetically proven that guys are stronger than girls. So does that mean they need more food than us? Does that translate into that? It does, it does. But at this age, when we're starting from two to 11, we've not really seen so much of the differentiation between the gender, like the boys and the girls. But at this stage, when you look at them, the characteristics are the same. They're all physically developing. When you look at the structural, they are growing tall, which talk about length. They're also the bone, they're gaining the strength. If it's about the teeth, they're developing. They move the same on the same sort of age, the growth is, the curve is the same. Only that, when it comes to the boys now, they seem to retain, you know, if you look at a boy and a girl grow, you see like the girl is growing faster. You see, the boys take time, but when they grow now, they become... It's a spurt. Yes, it's a spurt. And then it comes with the energy. Yes. Oh, that's why Where is it? All that going through. Yes. Okay. Yes. All right. So is it right to say that, okay, let me rephrase this a little bit so I don't step on toes. Nutrition is, is across the board. It does not matter where you're from, your level of income or your, your power of spending, Sindo, because at each level, we can attain a balanced diet. It doesn't matter whether I can afford bacon or not. If I can afford to have supplements, you know, or not. So maybe help me understand the basics without adding any decorative flowers. What is basic nutrition, child nutrition? What do they need upon a daily? You put it very well. When we talk about nutrition, we say it's a science. And when something is a science, it's proven. What happens to you and each an orange is the same thing that will happen to me when I eat the same orange. So, and it's the same, now that's why we're saying nutrition is a science. So when we talk about child nutrition, we are talking about the effects of food when it comes to growth, the development, disease prevention, or disease eradication, like a child has already a disease. So we want to look at what is it, what food can this child eat to help them grow. When you're talking about growth, we are talking about structural growth, you know, the refu. They need to be tall. They need to have strong bones. They need to have strong teeth. That is the structural. They need to have ideal weight. We need, we're looking at cognitive development. Is their brain developing and optimally, because their brain can develop, but not optimally. And you find that a child, when they go to school, if their brain did not develop optimally, they have issues with attention. They have issues with concentration. They have issues with memory. So we are looking at this, what can we give a child so that by the time they, we make sure that they are developing in all aspects of their life, and we make sure that that development is optimal. Yes. In our day and age, or this era, where Google is our best friend, and we can just Google any types of symptoms. So your child is there hyperactive, because maybe you've heard him all the wrong things, but suddenly it's hyperactive jumping around everywhere, even the teachers are complaining your child cannot sit still. And then you Google and then you find out it's ADD or CG autism. And now you start treating something that could have just been fixed by what's happening in your kitchen. How do I prevent that? Okay. Basically, you need to observe your child. Normally two to 11 children are hyper. But if you notice, your child has issues with concentration and they forget. You ask them something that happened outside in the country. Remember, it's normal because, you know, things are juggled up in their minds. But when they sit still, they should be able to sort of recollect. If they've gone to school, they should be able to tell you, this is what my teacher's name is. But you see that they're forgetting basic things, then you need to be concerned. And again, if you see other child can stay still, even for two minutes, they're always, you know, they fidgety and they just want to have something on their hands, then that could be a sign of ADHD. But all these other things, you know, it's, there's a very small deadline because children are normally active. So it may be, it may not be very easy for you to, for you to understand. But it's good. That's why we say it's good to take your child to what we call growth monitoring. When you take them to hospital for the checkup, the postnatal clinics, you know, actually ideally it should run up to five years. But most parents drop it after nine months. Nine months versus five years is a lot. Yes. You see what happens is then the immunization, they stop at nine months. So parents don't have time to continue with the, with the reviews. But it's very important if you continue with the reviews, because when this, you keep interacting with your doctor, the doctor can pick something that you as a parent cannot pick. Hey, that's magical. Okay. So let's turn on the cognitive one for a little bit. I know it's, okay, Mrs. Jazza, please, but I can assume that it's every parent's dream for their child to, you know, be president one day or something like that, you know, do their very best thrive and all these things. So if I want my, my child to grow and to mentally grow, sana-sana, what are the nutrients that I'm looking at? But we've been told, and they've not paid for the promo, but such things like cod liver oil or other type of supplements. Do they have any basis? Is that true? They need to know. Yes, I told you it's a science. It's proven. It's the same in Kenya, it's the same in Europe, wherever you go. And so I want to answer you by saying, if you want your child to be, to get to their optimal, in terms of cognitive, you need to start now. You're talking about which Jazza, you need to start now, because your nutrition, when you conceive, your nutritional status determines what kind of a child you will have. And one of the factors that affect even children when they are born is their maternal nutrition during pregnancy. So the moment you, like for example, if you don't have enough blood and you conceive, the placenta that, that feeds, is used to feed the child develop during the first, first, first, the first month. So if you've not had enough iron levels, you as a mother, that means that the placenta that will form will not be optimal, will not, will not be strong enough. And then that means that even your child will be affected. So if you want, ideally, you should purpose, you should plan to conceive. Don't just, oops, I'm pregnant. Yes, and then you, your, your, your low HB, you don't have enough energy, you don't have enough calcium. You pass that to your child. Fortunately, for, for some things like calcium, there is room for growth for improvement. Once the child is born, but for iron, a child is born with their iron stores for the next six months. Because the mother's milk does not have iron. Yes. So the mother's milk, which you give to a child for the first six months does not have any iron. But the baby needs it. The baby is born with enough, ideally should be born with enough iron stores to last them six months. So if they are born with deficiency, so they live forever with deficiency. And it's worse if it's a girl, because they pass it on. Oh, yes. You, you, if you don't get to overcome the deficiency, that means you go to puberty with deficiency. When you start your menses, you having a deficiency. Again, you see it's a cycle. When you conceive, you conceive and we have increased chances of even giving birth to a low birth weight infant. Oh. Yes. So nutrition is, is, is serious. It's serious. That's an intense domino effect from the time when I was conceived, the time that I am conceiving the same. Yes. Okay, that's a lot. What happens to, we said we're concentrating to kids between 2011. Yes. And what happens to girls who have their menses, you know, around that time? Because there's some girls who have very, very early onset of menses. Yes. I got mine just before class five, so I don't know. Ten years? That's not, no, wait, no. Eleven up or eleven. Yes. Actually, that's me. Yeah. Yeah. Most, most of them will start at 11. Okay. So, so what was the proper, maybe diet and nutrition for me? Because now I'm losing blood, you know? Yes. What's happening there? Ideally, you should just have a HB check to just tell, where are you at? What is a HB? HB is hemoglobin level. So you just check how much blood do you have? Especially the red, hemoglobin is the red. Blood cells. Yeah, the red blood cells in your blood. So they, they contribute in making you, making the blood. So when you check and you have a check and it's, it should not be for a girl, it should not be anything less than 10. So it's 10 to about 16. You're okay. If it's below or it's on the border, then you need to get supplementation immediately. You get, you start taking iron supplements or folic acid. Yes. That's intense. Okay. But again, I want us to look across the board. What happens to this parent who cannot really afford to go doing HB checks? Like all I have to do is just look at my child. Okay. The best I can do right now is provide you with the sanitary care that you need and the nutrition. So, how do I know? The way is you can observe. You can just do your finger like this and just check how fast does the blood come back. You look at the color of your eyes if they are very white. And then of course there are dizzy spells. If your girl is complaining about dizziness, those are some of the signs that they don't have enough blood. Your dizziness is on the member? No, no, no. It's just, it could be, if they're not pregnant, it could just mean they don't have enough iron levels in the body. Yes. All right. So is there a situation where boys develop a bit earlier for their age and need supplements as well or they need extra special attention in their nutrition? Everyone needs special attention because like when you're talking about cognitive development, when you're talking about cognitive development, we want that, you know, the brain to develop to its optimal level. And we don't want, it's also about structural. We don't want a child with rickets. You know, rickets, the one that the legs are like a part like this or knocked knees. Yes, the knees knock on each other. All those are effects of like calcium. So we want to be very specific about what we are giving our child in terms of quantity and in terms of quality. Yes. About supplementation, if you cannot get a proper, it's not something I would say that you can look at your child and decide you'll give them something. Supplementation should be advised by a professional medical or nutritionist. A medical doctor, a clinical officer, it's not something that you look at your child and you say, I think I'll give them peace. Yes, it's not ideal. Of course there are those ones that the doctors will keep telling you like the cod liver oil, you know, just a spoonful every day. It's very rich in vitamin A. We'd have some with omega, omega 3 and 6, which are very good for the brain development. But supplementation, I wouldn't tell you that. Just look at it and give your child. Don't make that decision. Have your child reviewed and then you'll be properly advised. And again, supplementation should never substitute a healthy diet. It supplements, does not substitute. So in as much as the child is on supplements, they must have a healthy diet. You must plan properly for their meals. How do you deal with fussy eaters? I have a baby cousin who takes a meeting for her to eat. It's 30 minutes of all of us just encouraging her. And there's one child who will stop eating when they're tired. So how do you deal with that? And you give a little of a lot of nutrients. So what should I focus there and what should I focus on this other one? Okay, I think we have a way. You see that, that, oh, the way you're saying like you all of you and now I'm telling this young, you're cheering. To eat. Yes, these are some of the things that a child can relate with food. Because if you all make this child know that if it's meal time, they must be a cheering squad. They will always start relating food with a cheering squad. So we must be very careful how we, what we are training our kids to. We think we're doing a good thing. You mean well, but at times it could have detrimental effects. Because what happens if there's no cheering squad? Yes. So when a child is fussy, that's, it's, it happens. During this, especially two to four years, they are very particular. You will take it, take so long for them to finish one slice of bread in the morning. And you're like, oh, I just need you to take this before you go to school. Yes. But what happens is if, if you don't have in a lot of time, you can look for something that is energy dense. For example, you can give them milk. You can give them a protein and a small carbohydrate. For example, if they can eat an egg or take a cup of milk without something that is small, but dense in terms of nutrients. If someone is a very good eater on the other side, just control on the quantity. Because again, as we said, we don't want a child who can comfortably finish seven sausages in the morning and you're okay with it. The effects will be coming up soon. So they will catch up with a child soon. They will start having issues with creeping because they have too much fat and then the system is clogged. And the two will still have issues, health issues. The one who doesn't eat and the one who eats too much. So let's begin on quantity and quality. But sometimes in an African type of setting, they don't give you food where you are. Your parents are not feeding you. And if you are looking for some type of thick, it doesn't matter whether that thick is healthy thick or not healthy thick. They are okay. You know how to eat. You know your way around the kitchen. Is there a stigma around this thing as Africans? If you look at personally, when I was growing up, we never had children who were overweight, like in the whole of my school. Because before you see a child, remember we say they are very active. So they eat but the output is equally very high. So if you see, you know calories in, calories out. So if you see a child who is overweight at this stage, that means they are taking more than the output. So you may not necessarily need to stop on the intake. You may need to work on the output. Let them stop the video games. Let them go out and kick a football. Let them run. Let them do something. Yes, it may not necessarily mean it's what they're eating is wrong. It could just mean they're eating yes, but the output. Maybe they are just watching cartoon. Yes. From morning till day after school it's just for stay. Maybe the school you don't want sports. Yes. Go run or do you know how I wish they just give me PE time. They used to hate PE when I was in school. I wish they had PE time. Yes. And there's also something else that is coming up that never was there. It's something that okay, I know the government is doing something about vitamin A supplementation. If you look right now, you can find a child who is in class one, but they're already putting on glasses. Yes. Yes. A few years back that was was unheard of. Yeah. Children never used to start having issues with their eyes at that age. And they are thick glasses. Because this child has vitamin A deficiency from pregnancy. By the time they are seven years, they just need glasses. So those are some of the deficiencies that we're talking about. Like vitamin A, the body can actually store it. So if the body stores, not all vitamins the body can store, but vitamin A, the body can store. And so by the time you're deficient, you with vitamin A, that means someone has really worked hard to make you deficient. It really works. Yes. Okay. I'm thinking because I don't, okay. In my, I want to say research, but in Conger to now or to, I sometimes understand that a lot of times pregnancy is not planned for. And we spend as a culture, we spend a lot of time. I don't spend time to think, okay, I am now carrying life. I need to start checking what I'm eating, what I'm as opposed to the future. You know, what's going to happen if I don't take these things right now is going to happen in the future. So maybe we need lessons with me including because you need to plan now that you know for you plan for it. Make sure you have enough iron and calcium. You could start check with the doctor and get a supplementation. Again, once you realize as a woman that you're pregnant, remember it's not about you. It's now stops being about you. Go to a clinic, have yourself checked. And some of these, like the government has a very good plan. It gives iron and folic acid for free. Wow. It gives you calcium. You just need to present yourself. And don't wait for when it's now one month to deliver it because nothing can be done at that time. Very little. What the body will do, you know, the way the body works. The body will make sure it drains you because it gives the baby priority. So the baby, the body will drain you. So all your calcium, all your iron will be drained to make sure that the baby is given priority. So what will translate when you give birth is also you will also become very weak. You know those dizzy spells. Now they will increase. And then you start having issues with your back, with your knees, with your, you know, you also, your high loads. Yeah, because you did not get optimal nutrition. So please, if you can't plan, just know that you make the baby and you may give birth to a normal baby, but you will also be equally affected. Wow. Yes. I hope we are taking notes, guys, at White 54 on Facebook, at White 54, channel on Twitter. Hashtag is white in the morning. Okay. So we've covered physical, we've covered cognitive, cognitive, sorry. What about these? Okay, they're not, I don't say they're unimportant, but I don't think they usually stand by themselves. Things like language, if, if my child is taking longer to speak than the rest or taking longer to put strings together, is that a problem with my child or is it something I can fix to the diet? And when can you tell when there's a problem that I can fix or it's genetic? Because, okay, have fun. Fast dance on that one. I have so many questions. It's okay. So when, when it's about your child development, okay, it, it, it happens that there's some, you will find that some families, a child will make the first step when they are three years. Others, the child will work when they are nine months. Yeah. There are those, those issues with, with genetics for, for speech. But, but there's a guideline when, when you keep doing monitoring, the doctors, when you keep going for them growth monitoring, the doctor will tell you, now this one, something is wrong. By now this child should be, should be doing this, maybe should be crawling. But if the child is just staying still, there's no sign of development, like structural, like the, you know, the crawling, even trying to pull themselves, then something is wrong. But there's some that could be, yes, genetically. And you could find that for some, it's just lack of, if you live in a big house, this child has no one to talk to. You know, for you to learn how to talk, someone needs to talk to you. Yes. Yes. Nabis, you are just living, maybe you just leave them with the maid and the health help has other jobs. So they just put the baby in a corner somewhere and give them many toys and put on the cartel. Yes. And then the, you know, the child does not have someone to talk to them as opposed to another child who stays with other siblings, maybe, or stays with other children. Yeah. So there are many factors. There's genetic, the environment of factors and also, of course, there are other health factors. If a child is constantly sick, yeah, their development is slowed. Yes, especially we have heart conditions, you know, respiratory, intestinal, kidney, or conditions like sickle cell anemia. Yeah, those are some conditions that will make a child growth and development very, very slow. You will notice that they are lagging behind in terms of milestones. But again, of course, nutrition. Yes, nutrition is key. Remember what we said, maternal nutrition, during pregnancy, what you're feeding this child. And of course, the history, if a child was born preterm or with low birth weight, yes, preterm, I mean below six, below 36 weeks, you find that those children tend to, their growth is a bit slow. They catch up at puberty, but during these formative years, you might notice that they are bit slow, but they eventually catch up. So there's a number of factors. And of course, again, there's something like we call the hormone. We have the growth hormone. We have the thyroid hormone. Yeah, those hormones are not functioning well. A child's growth is retarded. Yes. Okay. And my last question, okay, honest. I have seen some different types of cultures, and I feel sometimes their children grow a lot faster than Africans like, hey, they're gonna come biggie. They're telling you they are 16, but they look 25. I don't know if it's the food that they eat or something. But recently, I've also been seeing the same type of situation at home. I'm seeing someone who is their age and the way they look, they're like this, like, literally. Like, what's going on there? Are we not eating right? Are we eating the, is it what we're eating that's bad for us? What's going on? Remember, we are eating a lot of food that is genetically modified nowadays. A lot of food is genetically modified as opposed to we're eating the broiler chicken. You know, the, what we're eating is changing with time. You can't, you can't compare what our parents ate with what we were eating. Yes. So it's, it's basically what we're eating. We're eating too much of processed foods, too much of processed food. But, you know, like the way you grow so strong, you know, you shoot, but you're not necessarily that strong. If you look at that, that person, maybe they are 20, they are 16 and they look 25, but you look, if you look at them, they are bone mass. If you look at their micronutrients, you know, like the, the iron we are talking about, the zinc, you know, you may find that they're having deficiencies, but the structure because of the carbohydrates and the proteins that we are taking, the structure looks, yes. But, but the, you know, when you do a deep dive into the integrities of nutrition, like now, the, what I'm telling you about the iron, which is very key and the vitamins A, like vitamin A, vitamin D, you find that we are lacking in some of these things. Because we've concentrated mostly on the proteins and the carbohydrates, which we are doing very well. If you walk around, you will find someone deep-frying potatoes by the roadside and around doing mandazimui too, chapatimui too, you know, so the carbohydrate is all over. But, and this carbohydrate is from a processed flour. The flour has been processed. So it has lost most of the nutrients, the micronutrients. So when we struggle with issues with fiber, constipation, how fruits, and when you eat the fruits, they are ripened with chemicals. You know, we have, we have alluras changed. Yes, the yellow, the super yellow bananas. The way the good Lord made them. Yes. So there are all these factors. Yes. Lastly, what would you like to advise the audience? Because when, there's a certain time, when I was in high school, I don't know what was wrong with me, but my health was very, very imbalanced and I was around. But now, hey, my friends, anyway, so on holidays, I'd go home and the first thing we do for my gatherings is of course admire how big one boy is. Then they even lined me up. We start comparing with my elder aunties, who looks bigger. Oh, instead of doing all that, just tell the person, look, you're too young to be looking like this. Please just check yourself. Maybe there's something wrong, maybe there's something very, very wrong that could lead to something even more extreme. So how do we get ourselves out of, out of you? I don't even know that frame of mind is, but how, how do we? That, that the big is, is better? Not really better, but we don't, we'd rather laugh at you than advise you. Unfortunately, I think it's a culture thing. Yeah, people, people assume you know what you're doing most of the time. And you find that there are people who have no idea that being that raising a child that big, you find maybe when your parents don't have any idea that when you're too much, you have too much weight for your age that it's, it's detrimental. It's a disaster. You find that they don't know right now we're having issues of children who are informed to and they're having high blood pressure. They're struggling with type one diabetes because of the weight. Yes. So I think a lot needs to be done in terms of awareness and it may be school by school and case by case. We need to, the government needs to do what we call education, the mass education. Yeah, at least it's there. It's reaching out now. It's improved. It's not like before. But what I would say is even, even when, when now in the curriculum, like I see my, my son who is in grade three, he has nutrition and hygiene and I see they have good food, you know, there are those that have been marked X. So at least I think with this new curriculum, I think there's something because remember when the government, when the other curriculum dropped like home science and we stopped knowing what is a healthy diet, what constitutes a balanced diet. And children have grown thinking, you know, children think sausage chips and, and, and sodas are the best thing in life. And if, and, and so long as a parent can afford and also parents think if you're able to provide these types of food, you're doing well in life. So here's a child who can't wait to take chips and he is a parent who can't wait to provide. So both the child and the, and the parents are ignorant. So we need to create awareness both to the parents and to the children. So when it starts in school, they will know that this type of food that the teacher said it's not good. And then now if the parent doesn't know it's unfortunate, but at least by the time the child goes to high school, they will be at a better place. Yeah. But basically it's just education. Most people think that eating abu gari, skuma, and, and, and enyama, you're good. Balance. Yes. You balance. You need to eat a variety of food because different food have different nutrients. Yes. You can just live on ugali enyama and, and skuma wiki for the rest of your life in as much as the food is balanced. You need to have a variety of food. Change the ugali with bananas. Change the bananas with sweet potato. You know, change the sweet potato with white with, with wheat. Yeah. Change the skuma wiki with something different with the managu, the terreras. Yeah. Those traditional vegetables. Change the meat with beans and, and, and dango. Yeah. And lentils have a variety of food. It don't repeat a meal twice. It's, and even for your child, don't keep giving them the same type of food because they give them variety. Give them a variety of food so that you can make sure that they are getting different nutrients from different foods. Yes. And remember, always give children fruits, especially citrus fruits. Citrus fruits are very high in vitamin C and vitamin C is one of the nutrients that the body does not keep. So it's, it's, it's if any excesses gotten rid of through the sweat, through the urine. So a child needs vitamin C constantly. You need to give your child vitamin C throughout. The oranges. The oranges. The citrus. So the ones that will cure my IV, you feel something. You feel something. Yeah. Yeah. That's a nice little must taste. You just eat it. Yeah. You must feel something. Yeah. Thank you so very much for coming to studio. We have been informed. I am leaving a lot wiser. Thank you. Personally. Thank you. And if you want to thank her, do it at Y-5 on Facebook at Y-2-5-4 channel on Twitter. Hashtag is a Y in the morning. We are concluding the health segment and we're about to start Matt Crush Monday. So don't you go anywhere.