Every baby in the womb eats what its mother does, or more accurately derives its essential nutrients from her. Thus, even mild maternal malnutrition can impair fetal development. The consequences are serious, profound, last a lifetime and yet happen silently. In India a large number of women are undernourished when they conceive; the situation gets worse as the pregnancy progresses. Studies show that malnourished women are more likely bear malnourished children who either die early or grow into sickly adolescents and adults.
What deprives women of the nutrition they need? Some reasons are societal, others economic and still others stem from entrenched gender biases. Here again while the poor are the most vulnerable, surprisingly even other segments of society do not always adhere to good nutritional practices although affordability is not an issue.
There is increasing evidence to show that more progress in reducing child morbidity and mortality can be made if we improve the nutritional status of mothers before and during pregnancy. We need to use the pregnancy period as a window of opportunity to deliver high-impact interventions in order to ensure that the number of malnourished pregnant mothers declines rapidly enabling them to give their babies a healthy start in life.
"Infants born to mothers with anaemia are at far greater risk of low birth weight, premature birth, and early death."
Infants born to mothers with anaemia are at far greater risk of low birth weight, premature birth, and early death; those that survive are at risk of impaired physical and cognitive development. Nearly half of India's pregnant women are anemic and this percentage is higher in some states because of factors such as sickle cell disease, worm infestation and lower access to iron rich foods.
Screening of pregnant women for risk factors that lead to malnutrition becomes critical to tackle the situation. High-risk factors are maternal weight below 40kg, weight gain of < 6 kg during the pregnancy, hemoglobin < 9gms, maternal age < 18 or above 35 years and earlier history of still birth and abortions. Such mothers need supplementation with additional proteins and calories, with continuous monitoring throughout their pregnancy. Correction of anemia with proper iron and folic acid tablets can help reduce incidence of complications related to anemia. In addition, providing women with access to nutrition education on the importance of a balanced diet (and what that is), how to get the nutrition they need through traditional home food and locally available ingredients can go a long way in improving their nutritional status.
Preventing malnutrition of women in the childbearing age also requires social intervention and political commitment. We need to share nutritional information with all pregnant mothers and their families. It is vital that nutrition interventions are integrated into antenatal care programmes; public health systems need to prevent and treat nutritional deficiencies, encourage households to meet the dietary needs of women throughout their lives and ensure their access to high-quality health services, clean water and adequate sanitation.
UNICEF India supports the government in strengthening capacities of health managers and supervisors at district and block-level to plan, implement, monitor and supervise effective maternal health care services with a focus on high-risk pregnant women and those in hard-to-reach communities. We believe that these cross-sector efforts to improve maternal nutrition and health will lay the foundation for healthier pregnancy outcomes, paving the way for healthier children and bringing down the high incidence of malnutrition in children.
Read Part 1 of Breaking The Cycle Of Malnutrition here.