Consequences of Inadequate Nutrition in Mother and Child

By Julie Ekong

The joy of a family is to see a pregnant woman give birth to a healthy baby and the mother comes out strong and healthy.

Achieving this depends on the nutritional status of the woman starting from childhood to adulthood.

In most cases, it is not all bed of roses for some women because they have to face some challenges in the cause of the pregnancy.

In this Special report, Julie Ekong takes a look at inadequate nutrition and its consequences to the mother and child as well as, what should be done to change the negative outcomes for the development of the country.

It is common knowledge that eating well and eating right gives the body the right kinds of nutrients the body needs to prepare the woman for motherhood, because the child eats directly from the mother and if the mother is malnourished, the baby is likely to be deficient in some micronutrients and this will affect the development of the child and the mother could be anaemic.

Medical experts say, being deficient in multiple, critical micronutrients like Vitamins A, C, D, E, B1 (thiamine), B2 (riboflavin), B3 (niacin), B6, B12, folic acid and Minerals: iron, zinc, iodine, copper, and selenium is dangerous.

Report by the World Health Organization, WHO, indicates that micronutrient deficiencies can cause several serious health issues; a lack of iron, folate and vitamins B12 and A, for example, can lead to anaemia, a condition in which there is a reduced number of red blood cells or haemoglobin concentration, causing fatigue, weakness, shortage of breath and dizziness.

The report also says, Inadequate nutrition can also lead to serious maternal health outcomes and even to the death of the mother and her baby,

The Country Director, Vitamin Angels – Nigeria, Dr Francis Ohanyido in a chat with Radio Nigeria, said, globally, many women lack access to nutritious diets, quality healthcare and nutrition services.

On the consequences of inadequate nutrition, Dr Ohanyido noted, that malnourished women with severe anemia are two times likely to die during or shortly after childbirth, and if the baby lives, can have lifelong impacts on the baby’s physical, mental, and emotional development.

“170 million women, representing one in 10 women of reproductive age are underweight and 570 million women, representing one in three women of reproductive age are anemic; Worst still, only 38 per cent of women receive more than 90 Iron Folic Acid (IFA) tablets during their pregnancy ” – says Ohanyido

“A malnourished pregnant woman could suffer from impaired cognitive development, anemia and other micronutrient deficiencies, fatigue and impaired well-being, impaired productivity, obstructed/prolonged labour, eclampsia and pre-eclampsia and maternal mortality.

“The consequences for infants and children are low birth weight, small-for-gestational age, pre-term birth, stillbirth, spina bifida, congenital defects, child mortality and morbidity, poor post-natal physical and cognitive growth and development,” the country director stated.

Talking about the Nigerian situation, the
Implementation Research Consultant, Vitamin Angels, Nigeria, Dr. Yinka Obanewa, said, WHO estimated 300 million children globally had anemia in 2011, out of this number, children in Africa aged 6 to 59 months had the highest burden of anemia, estimated at 62 per cent.

Dr Obanewa noted that children in Nigeria are not exempted from the high incidence and prevalence of deficiencies of multiple micronutrients especially during the period of complementary feeding when breastfeeding alone can no longer sustain their nutritional needs. They are often fed with poor and inadequate complementary foods at such time.

“We are at that point in Nigeria where it is important that nutrition is put at the front burner of national discussions, adding that one sure way the country can tackle malnutrition during pregnancy is through the National roll out of Multiple Micronutrient Supplement (MMS).” – Ohanyido said

Looking at figures, the United Nations Children’s Fund, UNICEF, showed Nigeria has the second highest burden of stunted children in the world, with a National prevalence rate of 32 per cent of children under five. An estimated two million children in Nigeria suffer from severe acute malnutrition, SAM, but only two out of every 10 children affected is currently reached with treatment, while seven per cent of women of childbearing age suffer from acute malnutrition.

Since the challenges of pregnancy, birth and mothering could be frustrating for an average woman particularly if she is living in Low- and Middle-Income Countries (LMICs), like Nigeria,

Explaining the importance of nutrition to the health of pregnant women and their babies, the Country Director expressed dismay that a lot of pregnant women in Nigeria are poor and could not afford to eat adequate food and to help this set of women, Ohanyido suggested a national roll out of the Multiple Micronutrient Supplement (MMS).

MMS: a silver bullet
Ohanyido said several studies have showed that whatever a pregnant woman takes for the first 1000 days of life, meaning from conception to two years of a child, has an impact on the child’s health, hence the need for pregnant women to take in adequate nutrition.

MMS is a formulation of Multi Vitamin for pregnant women as identified by the United Nations to help pregnant women have a better value in terms of nutrition for themselves and their children, because several studies have showed that MMS has significant benefits compared to Iron and Folic Acid (IFA), as it contains 15 micronutrients, including IFA.

He says, before 2020, global policy guidance recommended the use of IFA, but with the introduction of MMS, several studies support switching from IFA to MMS, especially for women with poor diets.

“In fact, MMS provides even greater benefit for anemic and underweight women compared to IFA. Findings of a study carried out to assess the effects of MMS compared with IFA in Indonesia showed that early infant mortality of babies whose mothers were undernourished was reduced by 25 per cent with MMS. Even greater results for babies of anemic women, with reduction of infant mortality by 38 per cent and risk of Low Birth Weight (LBW) decreased by 33 per cent with MMS”.

“In addition, it reduces the risk of female infant mortality in the first six months by 15 per cent. More so, it is cost effective and safe,” he revealed.

Transiting from IFA to MMS can avert between 7 to 28 million additional infant deaths and disabilities across 132 LMICs, adding that scaling up MMS to 90 per cent coverage is projected to contribute to huge human capital gains for all babies born per year across 132 LMICs.- Ohanyido.

The place of government in this, is that, in January 2021, the Federal government approved MMS and micronutrient powder in the Micronutrient Deficiency Control Guideline, which is a policy document that regulate supplements given to women and children.

The Country Director expressed disappointment that MMS is not yet operational and called on critical stakeholders, including the media to advocate the rollout of MMS in Nigeria to avert maternal and child mortality.

” He suggested MMS inclusion in antenatal package of maternal nutrition interventions, adding that, “Iron and Folic Acid given at primary healthcare level are free.
Government should replace them with MMS which contains 15 micronutrients. The price difference between MMS and IFA is minimal, so the transition from IFA supplementation to MMS can be done once there is political will.”

Although government resources may be lean, the lives of women and children should be prioritised and if the country is going to achieve its demographic dividend, then the future of the country, must be preserved. – he argued.

“Our social sector has suffered; our primary healthcare centres are almost in comatose; Nigerians are paying for everything out-of-pocket. There is the need for a comprehensive health care package for Nigerians that are covered by health insurance, so that the average Nigerian can get quality healthcare services and pregnant women would be able to get MMS and other benefits enough for them to go through pregnancy and come out successfully,” Dr Ohanyido ###