POOR NUTRITION DURING LACTATION - THE GROSS IMPLICATIONS FOR NEWBORNS

CHAPTER ONE

INTRODUCTION

All human beings need a balanced amount of nutrients for proper functioning of the body system. Nutrition is a fundamental pillar of human life, health and development throughout the entire life span (Daba, Beyene, Fekadu & Geroma, 2018). Proper food and good nutrition are essential for survival, physical growth, mental development, performance and productivity, health and wellbeing. However, the nutrition requirement varies with respect to age, gender and during physiological changes such as pregnancy. Pregnancy is such a critical phase in a woman’s life, when the expecting mother needs optimal nutrients of superior qualities to support the developing fetus. Naturally, the urge to eat more is experienced by nearly all pregnant women. Pregnancy is considered a delightful experience for the expectant mother. Evidences manifested that adequate intake of nutrition is a key component for individual’s health and particularly during pregnancy. Nutrition is a central element of human life that is required for health and development (World Bank, 2016). Nutrition during pregnancy has a major impact on the outcome of pregnancy and accredited as an important determinant for a healthy and successful pregnancy including the life- long health of future generation (Adikari, Sivakanesan, Wijesinghe & Liyanage, 2016). Particularly, adequate nutritional intake during and after pregnancy is important for health and well-being of the mother, as well as the child (Bawadia, Al- Kuranb, Al- Bastonia, Tayyemia & Jaradatd, 2016). Unfortunately, rate of dietary inadequacies is reported to be higher during pregnancy than at any other stage of the life cycle (Rao, Sahoo & Basumati, 2016).

According to the (World Health Organization (WHO, 2019), many women do not get enough micronutrients in their diets during their reproductive age as well as during pregnancy. They are also unaware of how much their nutritional status impact their pregnancy and infant outcomes. In Nigeria, women are usually responsible for preparing food for the household, so their knowledge of good nutrition or lack of it can affect the health and nutritional status of the entire family. Studies from Nigeria have revealed a high prevalence of both under nutrition and over nutrition, as well as deficiencies including iron, folate, vitamin D and vitamin A (Senbanjo, Olayiwola, Afolabi & Senbanjo, 2018). According to (Nigeria Demographic and Health Survey, 2018), the 11% of women of reproductive age are thin or undernourished (BMI less than 18.5kg/m^2), 17% of women are overweight (BMI of 25-29kg/m^2), and 8% are obese (BMI of 30kg/m^2 or above). Consequently, Obstetric complications such as hypertension, anaemia, neural tube defects, night blindness, low birth weight and maternal and perinatal mortality are common.

It has been Opined that eating well during pregnancy means do more than simply increase how much the mother eats, the mother must also consider what she eats The ability of the mother to provide nutrients and oxygen for her baby is a critical factor for feta health and its survival. Maternal over-nutrition also has long- lasting and detrimental effects on the health of the baby. Undernourished mothers face greater risks during pregnancy and childbirth and their children set off on a weaker developmental path, both physically and mentally. Undernourished children have lower resistance to infection and more likely to die from common childhood ailments as diarrheal diseases and respiratory infections. Several studies has indicated that the correlation between poor maternal nutritional status and adverse birth outcomes is complex and are influenced by many biologic, socio- economic and demographic factors which vary widely in different population. Nutritional knowledge and attitude are important factors of dietary practices and are thus potential targets for appropriate panning of nutrition interventions for vulnerable population groups like those lactating and women that are pregnant (Popa, Nita, Graur, Popescu, Botnariu & Mohalache, 2018). Therefore in this study, the aim is to access the level of maternal knowledge and attitude towards good nutrition during pregnancy.

According to United Nations Children’s Fund (UNICEF, 2018), each year more than half a million women die from causes related to pregnancy and childbirth. Nearly 4 million newborns die within 28days of birth. Many of the 200 million women also become pregnant each year, most of them in developing countries suffer from ongoing nutritional deficiencies repeated infections and the long term cumulative consequences of under nutrition during their own childhood years. Many women suffer from a combination of chronic energy deficiency, poor weight gain in pregnancy, anaemia and other micronutrient efficiencies, as well as infections like HIV and malaria. Poor nutrition diminishes a woman’s productivity causing repercussions for herself, family, her community and the broader society. Maternal malnutrition is influenced not only by lack of adequate nutrition but also influenced by factors like socio-demographic factors, cultural factors and also nutritional knowledge of mothers during pregnancies.

The lactation period is a major source of concern in developing countries because of its positive impact on the health and nutrition of infants. Lactating women from developing countries are considered nutritionally vulnerable groups because this period places a high nutritional demand on the mother. Inadequate maternal diet during this period will lead to poor secretion of nutrients in breast milk and this can have long term impact on the child’s health (Marcos, Nova & Montero, 2018). It is reported that a lactating woman should produce about 700 to 800ml of milk per day and this requires an extra energy need of about 500 calories per day (Sylvia & Mary, 2017). Women who are severely malnourished have reduced lactation performance (Allen, 2019), thus, the quantity of milk produced depends a lot on the mother’s diet. The diet consumed by the mother will not only fulfill her own nutritional needs but will also enable her to produce enough milk for her infant (Sylvia & Mary, 2017). Information regarding the nutritional status and dietary intake of lactating mothers in the study area is scarce. It is on this ground that this research work investigates the health implications of poor nutrition among lactating mothers.

OBJECTIVE

The main aim of this study was to assess the gross implications of poor nutrition during lactation for newborns. Specifically, the following objectives guided the study;

1. Improve the knowledge of nutrition during lactation

2. Create awareness on nutritional intake and healthy practice during lactation

3. identify the gross implications of poor nutrition during lactation for newborns