HOFFMAN ESTATES, Illinois — Thailand grapples with the lowest breastfeeding rate, a moderately high low-birth weight percentage and an ever-increasing orphan crisis. Barriers to critical care during infancy have ramifications in later years, particularly in delays in academic performance. In Thailand, 20% of children face multidimensional poverty which prevents them from having the healthiest start to life. Although monetary poverty measurements indicate significant reductions in poverty in the last few decades, infants in Thailand continue to face a high risk of impoverishment. Fortunately, improvements in data analytics in developing countries such as Thailand are placing inequalities in a light that efforts are working to ameliorate.
Breastfeeding Deficiencies Hurt Children’s Health
Thailand holds the lowest breastfeeding rate in Southeast Asia, with less than 30% of newborns breastfed exclusively during their first six months of life. These numbers are dangerously low considering that the World Health Organization (WHO) and UNICEF propose only breastfeeding for babies during their initial months.
Milk alternatives to breastmilk are not recommended for infants, as substitutes can risk “hidden hunger,” or malnourishment due to deficiencies of key vitamins and minerals in children. According to a 2012 survey, roughly 800,000 children under 5 suffered from undernutrition in Thailand.
Infants in Thailand with micronutrient deficiencies can become vulnerable to infectious diseases, autoimmune disorders and chronic diseases, such as pneumonia, allergies and obesity. Without antibodies that breast milk contains, infants do not receive protection against infections and are more prone to death before the age of 5. Moreover, children who have been breastfed, on average, perform better on intelligence tests, according to Bangkok Post.
Inadequate Breastfeeding Hurts Thailand’s Economy
From an economic standpoint, investing in breastfeeding practices could save the Thai health care system more than $7.6 million in treatment expenditures due to insufficient breastfeeding. Costs related to inadequate breastfeeding include medical and therapeutic expenses for “cognitive losses in children not breastfed up to six months,” “health system costs for treatment for diarrhea and pneumonia,” indirect spending due to travel, caregiver time or uninsured health care costs and needs to purchase formula rather than using breastmilk without charge.
How Low Birthweight Plays a Part in Economic Decline
According to World Health Organization data published in 2020, low birth weight deaths in Thailand comprised 1,548 or 0.35% of total deaths. Prashant Bharadwaj, development and labor economist and co-editor at Journal of Human Resources and an associate editor at the Journal of Development Economics, explained his findings in his paper “Birth Weight in the Long Run” and related work to The Borgen Project saying that “there is a cohort effect of birth weight on permanent income, primary income” and other economic measures. According to a recent study, “Weighing less than 5.5 pounds at birth reduces yearly earnings by about 15% and burdens people in their 30s and 40s with the health of someone who is 12 years older.”
Considering the availability of birthweight data, Prashant explained that it is useful to measure summary statistics about the weight of a newborn to evaluate early life health impacts on long-term labor market gaps. He emphasized the importance of early intervention, such as studying birth weight, to narrow gaps and reduce preventable expenses. “The literal cost of the intervention is lower” when fixing something much earlier in life.
Prashant’s main concern is there is a less established science on this in the developing country context. “You could imagine that the returns to early life health are much greater in the developing country contexts where health is more fragile.” Even small improvements in health can have much greater impacts in a developing country context, as opposed to a developed country context.
The Orphan Crisis in Thailand
In Thailand, there are about 4,500 children raised in the 29 government orphanages nationwide; however, orphanages rarely provide the one-to-one care infants need to optimally develop. Thailand’s orphans often face perils such as “exploitation, sex trafficking, child labor, malnutrition, poverty and disease.” Consequently, orphans that face child poverty are often denied an education.
Inadequacies during Infancy Impede Academic Performance
Constraints during infancy produce unintended consequences later in life that could reflect in school. For infants in Thailand, inequitable education remains a pervasive issue, as the learning gap between students at elite and underprivileged schools is significant.
Inequality in opportunity exacerbates health and economic effects of the lack of breastfeeding, low-birth weight and deprivation of stable care. For instance, breastfeeding shares a connection with substantial increases in high school grades and in the probability of college attendance.
Prashant Bharadwaj further explained that “there is a causal link between birth weight and educational outcomes.” He added that medical research typically finds higher birth weight children to have higher test scores. As children who have not been breastfed experience slowed neurodevelopment at school age and score lower on intelligence tests, success in school becomes a greater challenge. A child that is born at a lower weight has an increased probability of dropping out of high school by one-third, according to a University of Michigan study.
Looking Ahead: Data Analytics Improvements in Thailand Detect Early Differences
Improvements in data collection may be an important pathway through which cognitive ability and adolescent health are explained by differences during infancy. Data analytics are one of the technologies coming after the age of data and they could be increasingly utilized in health care in order to better understand patterns such as birthweight implications on academic achievement.
Researchers are working to understand inequality in later life outcomes by thinking about inequality that might occur at birth. As Prashant puts it, “trying to understand outcome differences that we see down the road, in the labor markets, across income, across education, things like that, you might want to be able to trace some of those back to the disparities present at birth.”
Inadequacies during infancy and child development manifest as impediments to well-being, economic health and academic success. These issues incur additional costs and can thwart a child’s academic success in an already largely inequitable education system. However, numerous efforts underway are currently making data more accessible and are improving future prospects of thousands of Thailand’s infants.
– Anna Zawistowski