Iron intake: a must for weaning diet

Pakistan has a high prevalence of malnutrition, especially among children, which leads to a high infant mortality rate. Malnutrition is also associated with an increased risk of morbidity among children coupled with impaired growth and developmental outcomes. All efforts to address malnutrition over the past few decades have not been very effective. According to the National Nutrition Survey (NNS) 2018, four out of every 10 children under the age of five are stunted with nearly five million children suffering from wasting, or low weight for their height. The survey also shows that more than half of these children are anaemic and more than one-third have iron deficiency anaemia. Iron deficiency leads to an enlarged spleen, lack of energy and attention, irritability, developmental delays and behavioural problems. Many medical conditions occurring among children under the age of five are preventable through a sufficient intake of iron.

To reduce the number of anaemic children and improve the status of iron deficiency anaemia, it is important to focus on improved maternal nutrition and education. Low rates of literacy especially a lack of awareness in mothers in terms of a proper weaning diet and feeding practices is also an important driver of malnutrition among children.

As evidenced by the NNS 2018, Pakistan performs poorly on all the indicators of complementary or weaning foods. Weaning is the process of gradually introducing an infant to semi-solid or solid foods in addition to regular milk intake. Not initiating a timely, appropriate and diverse weaning diet can lead to severe anaemia in children. There is no argument over the fact that weaning or complementary feeding has to have all the essential nutrients required for an ideal growth. For example, not having substantial iron in an infant’s diet can lead to lasting delays, cognitive impairments and behavioural under-development.

After the first six months, appropriate weaning foods containing adequate nutrients are the basis of an ideal nutritional diet. Ensuring sufficient iron is imperative for the babies’ growth. A study conducted by the Canadian Paediatric Society Nutrition Committee states that from the age of six months (more or less), an infant’s iron stores, accumulated from the mother, deplete. This makes the dietary sources of iron even more important. A six to 12-month-old baby needs about 11 milligram (mg) of iron per day. An infant on iron supplements continues to absorb iron from the source in addition to the milk in his/her diet. However, if the infant is six months or older and does not eat at least two servings of iron fortified cereal or meat per day, he/she could be at risk of iron deficiency.

Iron can also be introduced in an infant’s diet through ingredients that are rich in iron such as apples, egg yolk, barley, spinach, kale, broccoli, and home-made cereals. Moreover using water instead of milk to prepare the infant’s food assures adequate iron absorption. Similarly, adding vitamin C in the infant’s meal doubles the absorption of iron from the source, as per research studies.

There is a greater need now to introduce public-private partnerships at the very local level where parents, specifically mothers, are educated about weaning foods, their efficacy and timing. This can bring about quicker and desirable results. In Pakistan, nutrition support programmes can play a decisive role in terms of different partners coming together and collaborating to address malnutrition challenges. This will help avoid the preventable illnesses caused due to iron deficiency among children under five.

Published in The Express Tribune, December 22^nd, 2019.

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