Bringing baby Adaline's appetite back to life

Adaline has been sent home with a months-long course of Plumpy’Nut® – a peanut-based nutritional paste - that can return her to full health, little by little.

By Ethan Donnell, UNICEF New Zealand

Cradled in the arms of her mother, baby Adaline is too feeble even to crawl. Her legs and arms are malformed, the ribs visible through her skin. The bones of her jaw protrude, the mouth locked perpetually in an expression like agony.

Julie, the girl’s mother, looks on with concern. The top part of her baby’s arm – measured the whole way round with a malnutrition armband – is only 10.9cm, roughly the girth of a thin branch from the pandanus tree.

Her daughter is in the red zone, red that represents danger; red that indicates severe acute malnutrition.

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Julie says it wasn’t always this way.

“For the first six months of her life, she was a healthy baby. But then I became pregnant again, and soon everything changed.”

Julie explains that she stopped breastfeeding Adaline, in accordance with a traditional belief that, while pregnant, a mother’s milk is bad for her children. Adaline developed diarrhoea and, although she was hospitalised, she has continued to be unwell, struggling to keep down food ever since.

And now, even though she is one year and five months old, her underdeveloped body weighs only five kilograms.

Nearby in the billum – a traditional string bag woven from loosely-knotted twine – Julie’s two-month-old son, as yet unnamed, cries out for her mother.

Now, with two hungry mouths to feed, Julie is overwhelmed. And a disability from her childhood makes life even more complicated.

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When she was first learning to crawl, Julie’s own mother left her at home unattended, an open fire raging nearby. She fell into the flames, and the right side of her body was incinerated, the foot and arm singed to stumps.

Julie works hard not to let her disability define her but pressure to maintain the garden, and care for her babies, is a lot to keep up.

“My husband must help me with a lot of things, such as tending to the fields. I can only do so much.”

Julie must often head to the markets, to generate an income for the family. As it was that day Julie fell into the fire, Adaline is left unattended at home.

The family lives on the bank of a rambling creek in Kiburu Village, not far outside Mendi. They are fortunate not to be far from Mendi Provincial Hospital. Even more fortunate is that, in the wake of the 7.5 magnitude earthquake in February, UNICEF has been supporting nutrition services in the area, with a post only minutes away.

Julie was encouraged to bring her children to the post for vaccinations. It was only then that Adaline was measured and weighed, and found to be suffering from severe acute malnutrition. The family, meaning no harm, had not realised the severity of her condition.

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Nursing Officer Mendi Mesai says the health team treats between eighty to one hundred children every day.

The health team have found 12 cases of severe acute malnutrition in the Mendi area, in less than a week, and more are expected. Each case is serious and potentially life threatening.

Malnutrition is a silent killer throughout the provinces of Papua New Guniea, and the leading cause of deaths among children under the age of five.

National statistics show that close to half of children are stunted (45 per cent), while 24 per cent are underweight, and 14 per cent suffer from moderate to severe forms of wasting, which can be potentially life threatening for young children.

As a father himself, Mendi says it was difficult to see baby Adaline in such pain.

“I feel sad. My heart is heavy for that mother and her child. No child should have to experience that level of suffering.”

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Since that day, UNICEF’s nutrition team has been able to help the family in several ways. Firstly, they have provided Adaline with therapeutic foods that should return the baby to good health.

The team have also given Julie advice about general nutrition and breastfeeding, tips that should prevent her two-month-old son suffering a similar fate.

Adaline has been sent home with a months-long course of Plumpy’Nut® – a peanut-based nutritional paste - that can return her to full health, little by little.

UNICEF will continue to check in on the family, they want to give Adaline the best chance possible to recover. Only time will tell if baby Adaline makes a full recovery, but the chance she is being given makes her luckier than many others.

With so much of her short life restricted to the family’s thatched hut, Adaline’s cognitive functions haven’t developed properly. Her default mood is one of irritation.

When first presented with Plumpy’Nut®, she cries and pushes the packet away. But Julie dips her finger into the sachet, nudging the paste close to her daughter’s mouth. This time she swallows just a little, and even though she’s too weak to take in more, the hope that her appetite may return is strong.

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