Role of nutrition in pregnancy and child's development

Nancy Kimaro, 27, is drinking water from a yellow plastic tumbler on her desk. She works at a communications company in Tabata Dar es Salaam and her job requires her to report at 8.00 am and update the company’s website and file all reports until 5.00 pm. She looks tired at the time I make my way to her desk. She smiles and welcomes me to take the next seat besides her desk.

Since it is exactly 2.00 o’clock, I ask her if she had any lunch and she smiled pointing to a snack box at the corner of her table. She had French fries for lunch today.

“I was so busy to go for lunch, so I called this guy who delivers chips in the workplaces to bring me some, though I only eat such junks once in a while,” she explained.

This led us to the second question of what her diet looks like in a week.

She says she is very conscious of what she eats since she is aware certain foods like eggs can make the baby really big so she is on a balanced diet.

“I drink plenty of water, eat fruits, vegetables and chicken and include a small portion of carbohydrates as the doctor advised me during the pre-natal clinic visits. He also advised me on what to eat since whatever goes into my body has an impact on my child’s development on the womb and even after birth.” She adds that it is her first pregnancy so she does not want to mess it up by wrong diet.

Adela George, 30, is also expecting her first child. She and her husband George Mtulya operate an Mpesa shop in Mwenge.

She says that her doctor told her what to eat when she visited the clinic last month.

“My doctor is happy with my progress because I eat as he has instructed me. My diet comprises of green leafy vegetables, beans, fish, rice and fresh juice,” she states adding that her husband is very supportive and helps her prepare healthy meals.

“Apart from nutritious foods, I was also told to drink plenty of water to reduce fatigue,” she adds. At this point her husband quips by saying he should be thanked for supplying more than enough food plus waking up dead hours of the night when cravings hit.

What poor diet can do

Not so many women are aware of their prenatal diet like Mrs Kimaro and not all partners are supportive like George.

Some do not know that poor nutrition in the first months of life, during pregnancy can affect the development of the baby’s brain in ways that leave traces into this child’s life through to adulthood. However, not all pregnant women are able to afford balanced diet even if they are willing to eat healthy meals.

Speaking to Your Health, Dr Shafiq Mohammed, the Director of Msasani Peninsula Hospital in Dar es Salaam and a consultant gynaecologist emphasises that nothing can replace a diet as food is extremely important for an expectant mother as what one eats determines the quality of the baby you will have.

“The supplements we give to expectant mothers are very important but should only complement and not replace the food,” he stressed.

Dr Shafiq who is also a lecturer at Muhimbili University of Health and Allied Sciences elaborated on the fact that what an expectant mother eats can have a long lasting impact on the child’s development.

“What an expectant mother eats can also put the child at the risk of developing lower cognitive abilities, mental health disorders and even increased response to stress, so women need to pay attention to their diet and ensure they attend prenatal clinics without fail,” Dr Shafiq adds.

How society can intervene

Dr Shafiq urges all medical practitioners especially gynaecologists to give education to their patients from time to time when they visit about the importance of a healthy diet to the growth and development of a baby.

He says hospitals could also explore outreach programmes to impart knowledge about early childhood development and how nutrition and proper care both at home and at the community level to national level plays a significant role not only to the expectant mother but to early childhood development.

“We as the medical fraternity should give health knowledge to create awareness about this issue,” Dr Shafiq says.

He also urges people to try and attend clinics even before conceiving for advice to prevent issues like miscarriage and many others. He says during these clinics, one is advised on what to eat, what supplements to take and what kind of things to do to ensure their bodies are ready for a healthy baby.

“It is not a custom here for people to come for clinics before conceiving but they are very important. Some people come to clinic very late,” he explains.

Those who have nothing to eat

A report titled “The Impact of Prenatal and Early Postnatal Nutrition on Child Development” by Prof Lise Dubois Published on Encyclopedia on Early Childhood Development reveals that poor families that lack food experience highly stressful situations, which may limit the ability of the parents to respond to the many other stimulation needs of their children.

And for this, they advise that support programs that target poor pregnant women need to address not only their physical and nutritional needs, but the issues of low self-esteem, lack of autonomy and stress that are a day-to-day reality for people who have to beg for food or who live in fear of having nothing to eat.

Effects of hunger on pregnant women

Dr Elisha Osati from Muhimbili National Hospital, Department of Internal medicine issues some warnings about adverse effects of hunger during pregnancy. He says the baby will not get the proper nutrients needed to grow if an expectant mother starves or miss meals plus daily supplements including folic acid.

“The spinal cord and brain of the growing foetus can be damaged easily and requires a daily supply of folic acid. It could also result in effects like spina bifida. For instance lack of calcium rich foods like milk could prevent the baby from forming healthy bones,” Dr Osati points out adding that nutrients play important role in prevention of neurological issues, cardiovascular issues and helps in maturation of cells and body organs.

He warns that a mother might even risk losing the baby or end up with premature delivery depending on the stage of pregnancy and can delay a child from achieving development milestones.

Tips from an expert

Jane Msagati, a nutritionist and Programme Coordinator at Partnership for Nutrition in Tanzania (Panita) encourages men’s involvement during entire period to ensure expectant mothers get nutritious meals.

She says the nutritional support for pregnant women should start at house hold level as there are some women who are unlikely to eat without family support adding that others even forget to take their folic acid tablets.

So when men accompany them to the clinic, they are likely to remind their wives about everything they were advised, such as taking the supplements on time and foods to eat.

“Some women fail to consume the iron supplements they are given and the folic acid so this usually results in low birth weight below the recommended 2.5 kilogramme thus narrowing survival chances of the baby. It could also result into stillbirth,” she explains.

She also advocates for household food security to ensure an expectant mother get nutritious meals, which comprises of carbohydrates, proteins, vitamins, fats and minerals. This ensures they have healthy babies.

“Good food is food which is locally available for instance you can have ugali (for cabohydrates), dagaa (sardines for protein, calcium and vitamin D), mchicha (amaranth leaves for vitamins) and an orange to get all the basic nutrients that you need.”

She adds that the focus should be on locally available food within reach for instance banana, ugali, rice or cassava plus beans and pumkin leaves are also nutrient laden.

You could also get eggs from your chicken at home for your protein and milk for both protein and calcium depending on what is available.

She points out that healthy nutrition should continue even during the breastfeeding period for child’s development.

National policies

So far Tanzania has set up some food security and nutrition systems and mechanisms in place including instituting a separate budget line for nutrition according to Panita.

This is aimed at improving public oversight and accountability for spending and substantial investment in health, thus supporting access to essential services for children and women.

Hopefully this would have positive impact on early childhood development in the country.