Childhood obesity is now epidemic. Although no figures are available for T&T and never will be while we debate if Ministers of Health should or should not have private practices, clinical anecdotal evidence, as well as simple observation at MovieTown, the place where, as Raymond Ramcharitar correctly writes, Trinis go while waiting for their "visae" for Miami, suggests that one preschooler in five is at least overweight.
Don't even talk about adults. On various occasions, stuck in my car on a Saturday afternoon outside PriceSmart, I have counted up to 35 per cent people overweight by simple "Oh my Lord" calculation.
And it's not the old-time "fatness." You know what I mean. There is a kind of West Indian fatness that is sweet. It is like the flesh of a breastfeeding baby. Firm and smooth, "tick," not bumpy and wiggly and oily. It fits pleasantly into tightish diapers or pants. It is plump rather than corpulent.
But this, this what we are now seeing, is distasteful. Heavy rolls of fat, pressing and pushing and pulling everything down. Distended tummies, flabby and hanging. A Walmart kind of fat, infant formula fed, like immobilised corn-fed cattle with fat-veined muscle.
The cause for this is obvious: too much formula, then fast food and not enough exercise. Years ago, you walked. To the parlour. To the square. To visit Mildred the dressmaker four streets over. Downtown, through the Red House to Frederick Street. You walked to the bus stop, to get a taxi. It kept you trim, firm, moving nice.
Nowadays, with the advent of the "roll-on, roll-off" millionaires, everyone has a car and, since gasoline is cheap and subsidised by a pliant government, uses it. To do what? To drive fast, fast, to the fast food place and eat chicken and chips fast.
Fast food, mindless food, is the other part of the equation. Fast food for a fast country. No more breastfeeding. Too slow. It faster to make a bottle of formula. No more dasheen and bhagi for the older baby. That too slow. Something called "baby food" now comes in a bottle. Never mind that it is stuffed with sweet potato as a base and the babies are slowly turning yellow because of the excess carotene.
If you don't like that you could give the baby something called "rice cereal," really processed chemical food. It comes in a nice little package with instructions on exactly how much to give the baby, as if the baby is a puppy. If the baby does not want that much, stuff the food down its throat, swell up the stomach and you are well on the way to having a fat, distended baby zombie drooling in front of the TV.
The solution is glaringly obvious. Slow down. Let's start from the beginning. Start back feeding the babies real food, breast milk, the original brain food.
Breastfeeding helps protect against childhood obesity. Since the baby regulates how much she takes from the breast and since the breast produces only as much as the baby demands, you cannot overfeed a breastfed baby. A baby's risk of becoming overweight goes down with each month of breastfeeding.
In T&T, most babies start breastfeeding, but within the first week, half have already been given formula, and by six months, only one in three babies are breastfeeding at all. The social pressure on mothers not to breastfeed is mind boggling.
What can be done?
Government should:
Promote maternity care policies and practices that increase breastfeeding rates.
Track hospital policies and practices that support mothers to be able to breastfeed.
Help all hospitals implement the Ten Steps to Successful Breastfeeding.
The present Government should also get off its "Milk for Mothers" campaign it has thoughtlessly embarked on, despite criticism from the technical officers in the Ministry of Health.
Hospitals can either help or hinder mothers as they begin to breastfeed. The Who/Unicef Baby-Friendly Hospital Initiative, endorsed by every influential paediatric association in the world, except ours, describes the Ten Steps to Successful Breastfeeding that have been shown to increase breastfeeding rates by providing support to mothers.
Sangre Grande Hospital is our only certified baby-friendly hospital. The others should do more to make sure mothers can start and continue breastfeeding.
The Baby-Friendly Ten Steps to Successful Breastfeeding:
Have a written breastfeeding policy that is routinely communicated to all healthcare staff.
Train all healthcare staff in skills necessary to implement this policy.
Inform all pregnant women about the benefits and management of breastfeeding.
Help mothers initiate breastfeeding within one hour of birth.
Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
Give newborn infants no food or drink other than breast milk, unless medically indicated.
Practise "rooming in"-allow mothers and infants to remain together 24 hours a day.
Encourage breastfeeding on demand.
Give no pacifiers or artificial nipples to breastfeeding babies.
Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.