Nutrition experts say that pregnant women must increase their dietary intake of vitamin A-rich foods if the burden of vitamin A deficiency among under-five kids and its attendant consequences must be curbed.
According to the experts, vitamin A deficiency increases children’s susceptibility to childhood infections and even death, especially those under-five.
A Lagos-based Registered Dietitian-Nutritionist, Cynthia Onyekwere, told PUNCH HealthWise that poor maternal diet during pregnancy was a major contributing factor to vitamin A deficiency in children, warning that it impacts on the growth and development of the child.
Onyekwere said, “Vitamin A, a fat-soluble vitamin, is required by children for growth, vision and strengthening of the immune system.
“The deficiency of vitamin A can lead to night blindness, poor growth, increased susceptibility to childhood infections and even death.
“Infants and children under-five years, especially those in developing countries, are at increased risk of vitamin A deficiency for a number of reasons, such as increased physiological needs, poor maternal nutrition during pregnancy, poor breastfeeding practices and inadequate dietary intake of vitamin A-rich foods.”
The United Nations Children’s Fund says vitamin A deficiency is the leading cause of preventable childhood blindness and increases the risk of death from common childhood illnesses such as diarrhoea.
UNICEF had, in a 2018 report titled, “Coverage at a crossroads,’ warned that more than 140 million children are at greater risk of illness, hearing loss, blindness and even death globally if urgent action is not taken to provide them with life-saving vitamin A supplements.
“The coverage of vitamin A supplement programmes dropped by more than half, in countries with the highest under-five mortality rates in 2016 – the countries where such programmes are needed the most.
“As a result, the number of children left unprotected in high-mortality countries more than tripled between 2015 and 2016, jumping from 19 million to 62 million,” the report notes.
The World Health Organisation has classified vitamin A deficiency as a public health problem affecting about one third of children aged six to 59 months in 2013, with the highest rates in sub-Saharan Africa (48 per cent) and South Asia (44 per cent).
Onyekwere noted that though the WHO had employed periodic administration of vitamin A supplements as one of the strategies to tackle the problem, she however, said it was important for mothers to understand their role in tackling the problem also.
The dietician emphasised that improved maternal nutrition during pregnancy would support efforts to reduce child mortality.
“However, nutrition wise, some measures can be adopted to reduce the burden of vitamin A deficiency.
“First, a mother should eat an adequate diet during pregnancy and lactation.
“Second, upon delivery, the medical team should ensure that the new born is fed with colostrum as it is rich in vitamin A.
“Third, lactating mothers should be encouraged to practice exclusive breastfeeding. Breast milk contains sufficient amounts of vitamin A.
“Fourth, when an infant clocks six months, nutritionally adequate complementary feeding should be introduced to meet the vitamin A needs of the child”, she explained.
Onyekwere listed animal sources of vitamin A to include liver, egg, butter, cheese, cod liver oil.
For plant sources of vitamin A, she identified carrots, mango, colourful bell peppers, dark green leafy vegetables, pawpaw, watermelon, palm oil, among others.
She, however, cautioned, “It is important to note that excessive intake of vitamin A (especially the preformed vitamin A from animal sources) can be very dangerous.
“In pregnancy, it can cause birth defects. Therefore, pregnant women are advised not to eat liver.”
Also, a Registered Dietitian-Nutritionist at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nwabumma Asouzu, told our correspondent that maternal nutritional and health status before, during and after pregnancy could result in poor growth and stunting in children.
“This influences a child’s early growth and development, beginning in the womb.
“For example, intrauterine growth restriction due to maternal under nutrition (estimated by rates of low birth weight) accounts for about 20 percent of childhood stunting.
“If a mother is malnourished, it’s more likely that her baby will be born underweight”, she said.
Currently, she said Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under-five.
She noted that action could be taken across multiple areas to reduce rate of vitamin A deficiency among children under- five beginning with improved maternal nutrition.
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