CHAPTER ONE
INTRODUCTION
1.1 Background of the study
The causes of malnutrition are many and complex. Inappropriate breastfeeding and complementary feeding practices coupled with high rates of infectious diseases are the major immediate cause of malnutrition during the first two years of life. Reports show that the rate of exclusive breastfeeding for 6 months is still very low in Nigeria- between 15% and 17%. Children who are not breastfed have repeated infections, experience poor growth and are almost six times more likely to die by the age of one month than children who receive at least some breast milk. From six months onwards, when breast milk alone is no longer sufficient to meet all nutritional requirements, infants enter a particularly vulnerable period of complementary feeding. They make a gradual transition to eating family foods. The incidence of malnutrition rises sharply between this age and 18 months in most countries (UNICEF, 1998; Dewey, 2003; WHO, 2003). The deficits acquired at this age are difficult to compensate for later in childhood. Infants therefore, need nutritionally adequate energy-dense complementary foods in addition to breast milk (NFCNS, 2003; WHO, 2003).
Unfortunately, complementary feeding begins too early or too late, and foods are often nutritionally inadequate and unsafe (WHO, 2002). This results to protein-energy malnutrition (PEM) and micronutrient deficiency (hidden hunger). NFCNS reported very high levels of iron deficiency anemia among infants. Poor absorption of iron, parasitic infestation and disease are equally contributory factors. Often, the traditionally complementary foods consist mainly of porridges made from un-supplemented cereals and starchy food such as sorghum, maize and millet (WHO, 1998). The foods are mostly inadequate in energy, protein and micronutrients (ACC/SCN, 2000; Jarkata, 2005).
To this effect, the formulation and development of nutritious complementary foods from local and readily available foods had received considerable attention in Nigeria (Nnam, 1994; Ifudu & Obizoba, 1989; Obizoba, 1989; Nnam, 1998; Nnam, 2001; Nnam, 2000; Ibeanu & Obizoba, 2004; Nnam, 2002).
Staple foods such as maize, soybean and iron-rich green leafy vegetables e.g. Moringa oleifera (“drum stick” or “Okwe Oyibo”) could be good for the development of good complementary food. The thrust of this study is to develop and determine the nutrient value, and acceptability of maize-based complementary food fortified with Moringa oleifera and access its quality in infants.
1.2 Statement of the problem
Micronutrient deficiencies have been recognized as an important contributor to the global burden of disease. Iodine deficiency in pregnancy has long been linked to intra-uterine brain damage and possible fetal wastage. This has led to effective programs for making iodized salt available in iodine-deficient areas (Black, 2003). Iodine deficiency disease has been improved.
Iron deficiency also affects about two billion people. However, interventions to control iron deficiency have been less successful. Recent estimates finds that iron deficiency anemia is responsible for a fifth of early neonatal mortality and a tenth of maternal mortality. Iron deficiency also reduces cognitive development and work performance. Iron deficiency is the attributable cause of about 800,000 deaths and 2.4% , of the global burden of disease (Black, 2003).
Vitamin A deficiency (VAD) harms the eyes and increase childhood and material mortality. Globally, 21% of children have vitamin A deficiency and suffer increased rates of deaths from diarrhea, measles, and malaria. About 800,000 deaths in children and women of reproductive age ate attributable to VAD which accounts for 1.8% of the global burden of disease. This appears to be lower than previous estimates possibly due to vitamin A supplementation or food fortification programs during the last decade.
The importance of zinc deficiency is being increasingly recognized. Trials have shown that zinc supplementation results in improved growth in children, lower rates of diarrhea, malaria, and pneumonia, and reduced child mortality. In total, about 800,000 child deaths per year are attributable to zinc deficiency. Zinc deficiency is responsible for 1.9% of global burden of disease.
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