CHAPTER ONE
1.0Â Â Â Â Â INTRODUCTION
1.1. Background information
Nigeria like many developing countries in Africa is still far from reducing the rate of infant and under-five (U5) mortality. Malnutrition in early life occurs due to nutritional deficiencies particularly energy and micronutrient deficiencies, including the foetal growth, development and health, contributing to impairment in immune competence and cognitive function, blindness, aneamia, growth failure, and increased morbidity, mortality and disability (FGN/UNICEF, 2001; ACC/SCN, 2001).
There is a wide range of factors leading to malnutrition. The most important direct factors include poor feeding practices and / or short falls in food intake as well as illness. In the case of children, three factors determine growth failure. They are birth weight, duration of breast feeding and adequacy of complementary feeding upto 24 months of age (Dewey et al., 1999).
It is generally agreed that breast milk is adequate both in quantity and quality to meet the nutrient and energy requirements of the infants. Breast milk alone can meet the nutritional needs of the child for the first-six months of life. After six months, the quantity of breast milk can no longer sustain the young child and must be complemented with other foods if the rapid growth rate usually associated with this period and optimal health must be maintained (ACC/SCN, 2001).
Complementary foods can be described as any nutrient containing food/ or liquid other than breast milk given to young children during the period of complementary feeding. Therefore, complementary feeding is the period during which foods or liquid are provided along with continued breast feeding. So this period is the most critical in the life of the infants. Unfortunately Nigerian traditional complementary foods are made from cereals, starchy roots and tubers that provide mainly carbohydrates and low quality protein. Also in Nigerian the use of fermented gruel or porridge alone made from maize, sorghum or millets are the leading cause of protein – energy malnutrition (PEM) in infants and pre-school children ACC/SCN, 2001; Dewey et al., 1999; Akinrele and Edwards., 1971).
The World Health Organization (WHO) recommends that children begin complementary feeding in addition to breast milk between four to six months of age in order to ensure adequate growth and nourishment (FMOH / WHO, 1999). In many developing countries, however, traditional complementary foods /gruels are based on starchy staple foods such as wheat, rice, maize or sorghum that produce viscous porridges that are difficult for children to consume (Hellstrom et al., 1981, Lungqvist et al., 1999).
The problem of high viscosity, low energy density or both in complementary food is referred to as dietary bulk. Children consuming these foods grow poorly and have higher mortality rate (Allen 1994; Pelletier et al., 1995). Therefore breast and complementary feeding behaviours are important predictors of infant and child nutrition, health and survival. In order to detect protein-energy malnutrition (PEM) and micronutrient deficiencies, it is very important to assess the nutritional status of any population at a given time.
1.2 Statement of the Problem
Food plays a very vital role in the life of every individual especially in young children that are growing. They need certain foods for their growth and development as well as good health. Adequate feeding during childhood will have a lot of impact on their health and nutritional status in later life.
Firstly, the poor nutritional status of children in early life could be attributed to the mother’s nutritional status at conception and during pregnancy. Studies have also shown that malnutrition and poor nutritional status in children were caused by inadequacies such as ignorance of food values and body needs due to lack of education, emotional problems or in difference, denial of protein rich foods due to cultural beliefs, religion and socio-economic status, respiratory infections, gastroenteritis, measles, chest and malaria infections (Brown, 1991).
Moreover, the food consumption habit of a population as reported by Brown et al. (1998) stated that the age differences in nutrient intake were related to custom of the people which stemmed from the habit of sharing food in proportion to age and position which a member occupies in the household or within a community.
Consequently, the younger age group would receive the smallest and poorest quality of food consumed by the household. Clearly, this custom was indicative of mass ignorance of nutrient requirements of children which required more than the very good quality of food given to the adults for their growth, development and body resistance.
Moreover, traditional complementary foods such as starchy staples, cereals and legumes have high content of anti-nutrients (phytates, tannins, fibres, oxalate etc.) that limit absorption and utilization of essential nutrients leading to micronutrients deficiencies. Detrimental traditional practices can also limit the amount and quality of animal products given to children. Children in developing countries often receive only small amount of animal products (if at all) which contain more retinal vitamin D and E, riboflavin, calcium and zinc etc. (Gibson and Ferguson, 1994).
Furthermore, it has been observed that some mothers introduced legumes to their infants much later due to the problems of indigestibility, flatulence and diarrhea. The cooking and processing methods as well as the oligosaccharides found in legumes are all contributing factors of late introduction of this food to the children (Ene-Obong and Obizoba, 1996).
Studies have also shown that whether the children were introduced too early or late to complementary foods was of no advantage rather it leads to malnutrition, energy deficiency growth failure, lowered immunity, diarrhea and micronutrient deficiencies (Dewey et al., 1999).
The use of amylase rich flour (ARF) in complementary foods to reduce viscosity has equally been advocated (Mosha and Svanberg, 1990). Repeated laboratory studies have equally encouraged these practices. It is therefore appropriate to study the nutritional status of children aged 6-24 months living in Ika North East Local Government of Delta State.
1.3 Objectives of the study
The general objective of this study was to investigate the nutritional status of children aged 6 – 24 months
The specific objectives were:
1. To identify the foods and the combination used for feeding children aged 6-24 months.
2. To determine the processing methods used by mothers in producing complementary foods.
3. To assess the nutritional status of children using anthropometric indices.
4. To estimate the adequacy of foods given to children.
1.4 Research questions
This research will attempt to answer the following questions:
i. What are the various complementary foods and combinations used by mothers?
ii. What are the processing methods used by mothers during production?
iii. What are the nutritional status of children using the anthropometric indices?
iv. What is the adequacy of the diets given to the children?
1.5 Significance of the study
The findings of this study will provide useful information to health personnel on nutrition education, programme planning and implementation.
The finding could serve as a foundation for nutritionists, nurses and doctors in counseling pregnant and lactating mothers on proper usage of complementary foods. It would also highlight the extent of the problems encountered by mothers. This could be utilized as a base for nutrition and health education aimed at improving traditional complementary food practices and consequently the nutritional status of children living in Ika North East Local Government Area of Delta State.
