Malnutrition: Raising Nigerian Children with Low IQ

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With over 11 million children said to be malnourished in Nigeria, Martins Ifijeh writes on its mental, health and physical implications on Nigeria’s future leaders and its subsequent effect on the country’s economic growth

While well fed children of one year old are already exercising their cognitive prowess with commensurate physical growth. Baby Abigail did not show any sign of mental and physical development. She could pass for a three month old child despite being a year and two months old at the time. Her jaw bones and eye balls were the only prominent features around her face, her hair was too weak and tiny to form ponytail. Mentally, she runs from challenges fit for her age. All she does was grow thinner and smaller.

“When I discovered all these signs in her, coupled with the fact that she was not even sitting, not to talk of standing, I became concerned,” said her 21 years old mother, Aminat Babarinde, who sensed something was wrong with baby Abigail, but could not place a finger to what the issue was. “I then took her to the United Nations Children’s Fund (UNICEF) centre in Eruwa here in Ibarapa Local Government Area of Oyo State, where I was asked about her nutritional history,” she said.

Apparently, Aminat stopped breastfeeding baby Abigail when she was only one month old. She said her breast could not produce much milk, and overtime Abigail became used to the idea.

She was weaned on pap, ewedu and mashed fish. Just few months after, Aminat started feeding baby Abigail with rice, beans, eba and other types of adult food. When she noticed the retardation and underdevelopment, she started giving her herbal concoctions, which in no small measure compounded Abigail’s issue.

“The UNICEF personnel who attended to us said Abigail was not growing well because she was deprived of the essential nutrients for cognitive and physical development and that she still had a chance to regain what she had lost since her issue was reported on time,” Aminat said.

Abigail, who is two years and three months old now, is currently on a special therapeutic food regime which is mainly of soy and maize flour at the UNICEF centre in Eruwa. “Abigail is growing normally now and she is lucky her intervention came before her third year. So, she can develop her cognitive and mental features normally, as well as develop stronger immunity needed to fight off ill health both at her early life and even as an adult,” says Mrs. Ada Ezeogu, a nutrition specialist with UNICEF.

Gone with the wind
Unlike baby Abigail who got intervention before her third birthday and is undergoing normal mental and physical development, Malik, a five-year-old male is not a lucky child. He is already starting life disadvantaged. He has somewhat missed the vital years of acquiring high intelligent quotient and physical development. No thanks to his parents who deprived him of the basic nutrients needed to achieve this.

Despite being five years old, Malik could pass for a three years old, as his growth is not only stunted, but he looked too frail and emaciated for his age. Mentally, he only likes engaging in challenges befitting children of lower ages, and when he’s unable to do them, he gets angry and never goes back to such challenge. He often fails to understand boundaries and expectations, while exhibiting short attention span, poor emotional regulation and inadequate social skill.

According to his mum, Abosede, who is a cleaner with one of the banks along Medical Road, Ikeja, Malik stopped breastfeeding at the fourth month, and all through that period, he was not on exclusive breastfeeding. “In addition to the breast milk, I was also giving him other types of infant meal, until I stopped at the fourth month when I could not cope with work and the demands that come with childbearing. I started leaving him at home with my younger sister, who was helping me take care of him until I get back from work.”

Malik was not only deprived of exclusive breast milk, which he should have taken for the first six months of life before adding other meals till he clocks 1,000 days. There were times he was starved or given food deficient in many nutrients needed for all-round growth.

“When I could no longer afford the usual SMA gold and other baby food, I resorted to different types of regular meal, including amala, pap, fufu, rice and beans. Even at that, these foods were not regular in the house due to the situation of things. I live on N20,000 monthly, which hardly cater for everyone in the house,” she explained.

While the direct and indirect actions of Malik’s parents may seem insignificant to them as long as their child is breathing and ‘well’, Malik is currently battling with nursery one in a Nursery and Primary School in Idimu, Alimosho area of Lagos. His age mates may be starting primary one this September, while he is still grasping with nursery learning.

Abosede said his teacher have complained of his slow learning skill and inability to socialise with his peers.

Malnutrition has been linked to slow learning ability
Research by Amy Rose of North Michigan University, USA in 2010, showed that the developmental process associated with memory, mood, mental clarity, increased intelligence quotient, emotional and mental well-being is being altered when a child under five years is malnourished or is deprived of essential nutrients needed for optimal development, adding that this causes slow learning capacity in affected children.

On specifics, Rose said there was a huge correlation between iron deficiency in children and the inability to solve simple maths, adding that, an iron deficient child has a short attention span and could hardly be attentive enough in class to learn. “A child with low amount of zinc will most likely have issues with memory. While a well fed child would easily memorise something within a day, it may take the zinc deficient child three weeks. Also a protein deficient child would most likely be passive, withdrawn and lethargic in school, all of which negatively affects learning ability in children,” she explained.

Rose recommended in the research that parents and the society should pay special attention to the nutritional needs of infants and children under five years, as this determines how much impact they will make in life due to what has been learnt. She resonated the much popular phrase, ‘We become what we eat,” which most Nigerians take for granted.

She also added that malnutrition was fingered among causal factors for delays in vision, fine motors skills, language skills and personal-social skills.

Raising an economy of underperformance
No wonder Mrs. Ezeogu, during her presentation at the UNICEF Media Parley in Ibadan recently, raised the alarm that Nigeria may end up raising children of underperformance if malnutrition is not tackled head on in the country.

She said while there was high morbidity among malnourished children, those that are lucky to survive it may grow up to become suboptimal adults with underperforming economic abilities later in life, which on the log run would affect the economic strength of the country negatively.
Reports by the American Society for Nutrition suggests that countries with high incidence of malnutrition are more likely not to develop faster economically when compared to countries with less malnutrition cases.

Nigeria has one of the highest burdens of malnutrition in the world.
The Society also noted that an adult who is malnourished during his first two years of life is more likely to earn income 10 per cent below what he would have earned if his childhood was malnutrition-free.

Associated health risks of malnutrition in children
Apart from stunting, wasting and underweight, the Nutrition Officer, Oyo State Ministry of Health, Alhaja Alarape Khadijat, said malnutrition in children, especially for those below ages two could lead to incessant recurrent illnesses due to the decreased immune system in them, and that in almost half of the cases, it may lead to death, thereby leading to the high mortality caused by malnutrition in the country.

“Malnutrition can also make the children prone to nutrition-related non-communicable diseases in their adulthood, such as diabetes and hypertension.” This is even as she added that a malnourished child has a greater chance of dying from diseases like measles and diarrhea when compared to healthy children.

A study conducted by Orphan Nutrition, a humanitarian organisation based in the US, showed that a deficiency in one nutrient may lead to a deficiency in another nutrient.

For example,deficiency in iron, magnesium and zinc can cause anorexia and thereby result in reduced intake of other important nutrients such as protein. Low lipid intake can also affect the absorption of important fat-soluble vitamins such as vitamins A and D. It also showed that Zinc and protein deficiencies can retard bone growth and development, putting a child at risk for long-term complications.

The gloomy Nigerian statistics
According to Nigeria Demographic and Health Survey (2013), Nigeria has the second highest number of malnourished children in the world, just second to India, and way ahead of Somalia, Syria and other war-torn countries, as well as those with weaker economic strength.

The Survey also showed that Nigeria has the highest number of stunted children under age five in sub-Sahara Africa with 37 per cent of all children stunted, 18 per cent wasted, while 29 per cent are underweight.“Malnutrition, an underlying cause of death, accounts for more than 50 per cent of under five mortality in Nigeria,” the study shows.

The UNICEF Communication Specialist, Geoffrey Njoku, has stated during the UNICEF media parley, that in the South-west alone, about 22 per cent of the children under five were stunted, but was quick to add that the gloomy statistics from Nigeria does not represent children of the poor alone.

According to him, children of the rich also suffer from the menace also, as it was not exclusive to poor people alone. “About 13 per cent of children of the rich in the South-west are stunted,” he added.

Way to go
Mrs. Ezeogu, believes one of the contributing factors to the high incidence of malnutrition in the country was the apathy among parents to offer their children exclusive breastfeeding for the first six months of life. She said at the moment, only 17 per cent of Nigerians engage in exclusive breastfeeding, a figure far below the 50 per cent international standard requirement.
While stating that parents who want their children to live healthy lives with high motor and cognitive capacity must give them exclusive breastfeeding for six months, she added that after six months, breastfeeding must continue for the first 1000 days of a child’s life in addition to complimentary feeding.

A Nutritionist, Mrs. Faith Olaoluwa said breast milk contains all the nutrients needed for a child to grow. “A mother who denies his child this great gift is doing the child more harm than good,” she said.

Olaoluwa said on the short term, malnourished children should be identified using community approach, and then taken to special centres where malnutrition was being treated.

“On the long term, mothers and fathers should be sensitised on the many benefits of breastfeeding. I believe when fathers are are involved in this advocacy, mothers will take it more seriously.” She canvassed for policy, coordination and partnership to promote exclusive breastfeeding in the country.

On its part, the Federal Ministry of Health recently developed the National Strategic Plan of Action (NSPAN) in order to build upon framework outlined in National Food and Nutrition Policy to improve the nutritional status of the lifecycle of Nigerians.

The government said for the five year period of the project, an estimated N424 billion would be needed, adding that under the strategic plan, 3,738,700 children will get Vitamin A supplement yearly, while 3,854,800 children will get deworming medication, micronutrient supplements will be provided for 3,777,400 children and CMAM services will reach over 10 million children within five years.

One then hopes with both citizen and government participation in tackling malnutrition, it soon will be a thing of the past in the country.