Breastfeeding increases the risk of childhood anemia in a rural community in south-eastern Nigeria – Emphasis on maternal nutritional status may be the key to reducing child mortality from anemia
S. Buck, K. Rolnick, A. Nwaba, J. Eickhoff, K. Mezu-Nnabue, E. Esenwah, O.J. Mezu-Ndubuisi
Child mortality rate in sub-Saharan Africa is 29 times higher than in industrialized countries. Anemia is one of the preventable causes of child mortality. Volunteer medical staff from University of Wisconsin (UW), Madison used a free humanitarian medical mission conducted by Mezu International Foundation (MIF) in rural South-Eastern Nigeria to determine the prevalence and risk factors of anemia in that region, in order to identify strategies for reduction.
We conducted a cross-sectional study on 96 children aged 1-7years from 50 randomly selected families seeking care at the august 2015 MIF medical mission. The number of children surveyed was determined from attendance at prior medical missions. Institutional Review Board (IRB) was obtained from a collaborating local institution, Federal University of Technology, Owerri. Verbal informed consent was obtained from parents or caregivers prior to study participation. A study questionnaire was used to collect information regarding socio-economic status, family health practices and nutrition. Other clinical diagnoses were obtained from medical records at the mission. Anemia was diagnosed clinically or by point of care testing of hemoglobin (Hgb) levels.
Out of 96 children that were selected for the study, 90 completed surveys were analyzed (49% male and 51% females). Anemia was the most prevalent clinical morbidity (69%), followed by intestinal worm infection (53%), and malnutrition (29%). All children were breastfed beyond five months of age. Mean age (months) that breastfeeding was stopped was 11.8 (±2.2) in children with Hgb <11mg/dl (severe anemia), 10.5 ± 2.8 in children with Hgb = 11-11.9mg/dl (mild-moderate anemia), and 9.4 ± 3.9 in those with Hgb >12mg/dl (no anemia) (p = 0.0445).
The longer the infant was breastfed, the worse the severity of childhood anemia. Childhood anemia was likely influenced by the low iron content of breastmilk, an indication of maternal anemia and poor nutrition. Although continuous breastfeeding is a known strategy to reduce child mortality, a family-centered preventive intervention to diagnose and treat maternal anemia may be more effective in reducing childhood anemia in the community, which could lead to reduced mortality from anemia.