When a child cannot cry at birth

2010-02-24
THE PUNCH Newspaper-Akeem Lasisi


Neonatal mortality rates ascribed to Nigeria by researchers are so high that some people express doubts about their credibility. But a former President of the Paediatricians Association of Nigeria, Dr. Mobolaji Lawal, gives insight into the country’s vulnerability.



Several myths are woven around the cry a baby makes on being born into this sweet and sour world. But while one can readily sympathise with those who hold that it is the tender gift‘s way of announcing its coming, the rate of babies who cannot cry at birth is high, a syndrome that, doctors say, is a sign of major crises.

According to a former President of Paediatricians Association of Nigeria, Dr. Mobolaji Lawal, widespread complication accounts for a lot of neo-natal deaths in Nigeria. The expert, who is also the chief medical officer of Festac, Lagos-based Emel Hospital, notes that the inability of the child to cry results from some problems that occur around the time the baby is being born.

He explains, ”Because the baby does not cry when he is being born, he does not breathe in oxygen. So, supply of oxygen to the brain is reduced. That‘s why the baby becomes very sick, and in many cases it leads to death. It‘s a major cause of death and hospitalisation during the first month of life. Some also result in neurological cases.’’

Lawal, who recently bagged the PAN‘s lifetime award, cautions those that doubt statistics on child mortality in Nigeria especially by the World Health Organisation. He said, ”The first question is: do we have figures to contradict them? We should put our house in order and have our own national information system. If you have your statistics, nobody can tell you just anything.

”But for those who are asking where the people are, they should go into the villages, into the nooks and crannies of the county. A lot of babies are dying, especially during the first month of life. Unfortunately, because people refer to those babies as disposable, some of them don‘t have a name before they die, they don‘t really enter into any records. Nobody even knows them in the neighbourhood. They are largely unknown items. That‘s why the impact is not felt. But the people losing the babies know.”

Lawal adds that the diseases around the neonatal period, being the first one month of life, claim a lot of lives, saying it is a period when many mothers take children to hospital.

”When you look at under five mortality, which is about 197 per a thousand now, about half of that number occurs during the first year of life. Of the deaths that occur during the first year, half occurs during the first month. So, you can say that, roughly speaking, a quarter of the deaths that occur under five occur during the first month of life,’’ he adds.

To reduce the calamity, Lawal explains that government at all levels have to do more in the areas of poverty-reduction schemes, immunisation and provision of free meals for pupils. Particularly, he notes, poverty is a major force that prevents many children from having access to health care.

”But there are other challenges,” Lawal notes. ”Routine immunisation should be further embedded in our primary health care system. In this way, we will be able to prevent to a great extent, attacks of polio tuberculosis, whooping cough, tetanus and measles, which are still the commonest ailments plaguing children in the country.

‘’Another area is the nutritional care of our children. It is still very poor. In about 50 per cent of cases, you find that poor nutrition adds to the cause of death. Not that poor nutrition causes 50 per cent of deaths, but in about 50 per cent of children who die from other diseases, malnutrition is very common.”

As a result, Lawal has for long been an advocate of exclusive breastfeeding for babies for the first six months of life. According to him, it is a message that needs to be reinforced. He also calls for the continuation of breastfeeding well into the second year of life while complimentary foods are being added.

”But in addition to this, when the children have passed the age of two years, and they are starting school, there is the need to consider seriously giving them nutritious school meals, at least one school meal,” he explains.

He further notes that a child should ideally eat breakfast because they are very active. If he or she misses this, there must be provision for the meal to be taken somewhere along the day in the morning hours. And such meal, he adds, must be a balance diet - rich in carbohydrate, protein and fat.

His words, “It is important that children should eat breakfast. And they should have lunch. Children should eat five times a day - three main meals and two snacks in-between. While adults can survive on two meals, children need three and the supporting ones. It does not have to be expensive. And while high-protein foods like egg and beans are very good for children, the in-between meals can be orange, banana etc. What we need to bear in mind is that children need food in order to grow. Adults eat food just to sustain their activities. But children are maintaining their activities and growing at the same time. . There are local foods that are very rich. When children eat meal that is rich enough, it may be good enough to prevent malnutrition.”

 

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