It’s been said that Africa’s newborns are Africa’s future, which makes the statistic that over one million African babies are estimated to die in the first four weeks of life all the more disturbing.
This Pregnancy Awareness Month, independent midwifery consultant, Dr Diana du Plessis examines how we can protect our most vulnerable members of society.
Breaking the Cycle of Malnutrition
“Mothers, newborns and children are inseparably linked in life and their health care needs. Many unnecessary deaths can be prevented by educating mothers on the benefits of early and exclusive breastfeeding, as it not only influences survival after the first month of life, but also has a direct impact on newborn health. Optimal breastfeeding is one of the most achievable essential nutrition actions,” explains Dr du Plessis.
Malnutrition, she adds, is of great concern in developing countries, especially where poverty is widespread. Lack of knowledge on the importance of exclusive breastfeeding for the first six months of a baby’s life; premature weaning of babies onto solids; and inadequate nutrition for toddlers are some of the biggest contributing factors to malnutrition.
“It is common for a breastfed baby, who is weaned as a result of the arrival of a new sibling, to be malnourished in environments where there is a lack of food or no food available. With this in mind it is vital that all mothers understand that the condition of malnutrition in babies and toddlers is life-threatening, hinders growth and lowers their potential substantially,” adds Dr du Plessis.
According to Dr du Plessis the first two years of life is a crucial period to break the vicious cycle of malnutrition. After birth, early and exclusive breastfeeding for the first six months, and continued breastfeeding for up to two years will improve the health and survival of newborns and children.
The Consequences for Our Babies
Dr du Plessis outlines the following conditions as examples of the consequence of malnutrition for Africa’s babies:
Kwashiorkor is known as severe protein and nutrient deficiency. It is generally found in young babies between 12 months and two years, who are bottle-fed or prematurely weaned from the breast. The diet consists primarily of only maize meal (pap) and water due to food shortages. The diet consists of inadequate quantities of energy, protein and a staple carbohydrate diet.
Marasmus is a child in a state of chronic starvation because of a lack of food. The onset of Marasmus is found in South African infants between the ages of three months and one year. It is generally associated with inadequate nutrition after a baby is weaned.
Preventing the Unnecessary Deaths of our Babies
“According to UNICEF, malnutrition, especially among younger children, is a public health challenge in South Africa that requires a systematic approach to improving nutrition services and promoting behaviour change. UNICEF is helping the Department of Health to improve policies, strengthen capacities of health workers and implement essential nutrition services in under-served communities. This is good news indeed for our babies,” says Philips AVENT’s Astrid Anderson.
Dr du Plessis adds that many of the conditions leading to the death of a baby could have been prevented by ordinary measures such as: immunisation programmes to reduce the risk of infections that cross the placenta and harm the developing foetus; early diagnosis and treatment of HIV and a number of maternal conditions; and abstaining from drugs and alcohol during pregnancy, especially while breastfeeding.
All prescribed medicine, over the counter treatments, herbal remedies or recreational drugs taken during pregnancy can reach the foetus through the placenta. During the first trimester, substance abuse alters the formation of the foetal organs and influences the brain development adversely. During the third trimester, substance abuse can alter labour patters and cause stillbirths.
Even light smoking (<10 per day) during pregnancy, cautions Dr du Plessis, is bad for both the mother and foetus, and has been linked with prematurity, low birth weight, newborn breathing problems and death. After birth there are also reports of an increased risk of sudden infant death syndrome in babies of women who smoke during and after pregnancy. Prenatal use of marijuana seems to have similar effects as those of cigarette smoking.
“Infants born to heroin-addicted women show, almost immediately, signs of withdrawal and the severity of symptoms are related to the duration and type of maternal addiction, as well as to the mother’s drug level before giving birth. These babies are difficult to comfort and show little response. Bonding is negatively influenced and this child is at risk of abuse, neglect and developmental and learning disabilities,” says Dr du Plessis.
Cocaine is transferred through the placenta and abuse during pregnancy is associated with preterm labour, miscarriage, prematurity and still birth, low birth weight, heart defects in the baby, neonatal addiction, as well as maternal and foetal death. Cocaine is usually not taken in isolation and drugs are often taken in combination. The dangers of maternal drug abuse do not end with delivery as many substances can be passed to babies during breastfeeding, posing long-term threats to infant development.
Heavy and steady alcohol consumption during pregnancy has been correlated not only with a high incidence of newborn mental retardation, but also with foetal alcohol syndrome (FAS). Excessive alcohol consumption is most dangerous during the first 11 weeks of pregnancy. Immediately after the birth, a baby affected by alcohol in the womb may show indications of alcohol withdrawal and need special care,” concludes Dr du Plessis.