Myths and misconceptions to blame for iron deficiency in pregnant women
Grace Adhiambo, a middle aged woman from the sprawling Kibera informal settlement in the outskirts of Nairobi says she does not eat green vegetables whenever she is pregnant for the fear of giving birth to a dark skinned child.
“It is wrong for a pregnant woman to eat a lot of sukuma wiki (kale) and all those traditional vegetables. That is why most of women here in Kibera give birth to very dark children,” says Adhiambo. She adds: “Even bananas and avocados are not good for a pregnant woman because such food will make the baby grow so big then the next thing you will be told by the doctors is caesarean delivery.”
The mother of three says all these she learned from her grandmother whom she says is very knowledgeable on traditional medicine and is also a traditional birth attendant in her rural home.
“All women who give birth at my grandmother’s place, get very beautiful and brown children because she advises them on what to eat and what not to eat during pregnancy,” says Adhiambo who dropped out of school after class eight examinations due to lack of school fees .
These myths could be the reason behind the growing number of pregnant and lactating women suffering from micro deficiencies especially anaemia.
A 2011 report by the Ministry of Health shows that over half of pregnant women in Kenya experience iron deficiency anaemia compared to 47.9 per cent of non-pregnant women and 16 per cent of adult men.A 2011 report by the Ministry of Health shows that over half of pregnant women in Kenya experience iron deficiency anaemia compared to 47.9 per cent of non-pregnant women and 16 per cent of adult men.
The report also reveals that about 52 per cent of mothers experience zinc deficiency, 40 per cent of women experience vitamin A deficiency, underweight women ranges from three percent in Nairobi Province to 25 per cent in North Eastern Province.
Women who are undernourished and have multiple micronutrient deficiencies are also at higher risk of infection, pregnancy and labour complications. They also recover more slowly from illnesses, posing heightened morbidity and mortality risks for their children.
According to Lina Njoroge, a nutritionist, most women also do not eat enough food for fear of gaining more weight and losing their shape.
“The weight gained during pregnancy will be lost in the first six months of exclusive breastfeeding so women don’t have to starve for fear of being sick with these deficiency diseases especially anaemia which is now common among pregnant women,” Njoroge notes.
Josephine Wanjiru from Kasarani Children’s Hospital says anaemia occurs when a person’s red blood cells is too low. Red blood cells are important because they carry oxygen from the lungs to all parts of the body. Without enough oxygen, the body cannot work as well as it should, and one will feel tired and run down.
Wanjiru says anaemia is common in pregnancy because a pregnant woman needs to have enough red blood cells to carry oxygen around her body and to her baby.
“So it’s important for women to prevent anaemia before, during and after pregnancy,” says Wanjiru.
She says that women who go to her clinic for prenatal care are tested for anaemia at least twice during their pregnancies, that is during the first prenatal visit and then again between 24 and 28 weeks.
“Anaemia can affect anyone but women are at greater risk for this condition since they lose iron and red blood cells during menstruation period,” Wanjiru explains.
Manan Mumma, a nutritionist from Kenya Aids Ngo’s Consortium (KANCO) says usually a woman becomes anaemic because their bodies are not getting enough iron.
Iron mineral helps create red blood cells in bodies since half of all pregnant women do not have enough iron in their body.
According to Mumma, it is advisable for a women to get about 18 milligrams of iron per day before getting pregnant. During pregnancy, the amount of iron a woman needs jumps to 27 mg per day.
Most pregnant women get this amount from eating foods that contain iron and taking prenatal vitamins that contain iron. Some women need to take iron supplements to prevent iron deficiency.
Mumma says pregnant women can lower the risk of anaemia by eating foods that contain iron during entire pregnancy.
“Some of these foods include poultry, dried fruits like dates and apricots, whole grains, liver, spinach and other green leafy vegetables, beans, nuts and backed potatoes,” she says.
Foods containing vitamin C will increase the amount of iron in the body. Eating orange juice, tomatoes, strawberries and grapefruit every day is highly recommended.
Coffee, tea, egg yolks, milk, fibre and soy protein can block the body from absorbing iron and therefore should be avoided when eating iron-rich foods.
In the case where a pregnant mother is already anaemic, the health provider will prescribe an iron supplement. Some of these supplements may cause heartburn, constipation or nausea.
To reduce constipation caused by these supplements, a mother is advised to take more water and eat more fibre. Fibre is found in whole grain foods, breakfast cereals, fruits and vegetables..