Impacts of Maternal and Child Under-nutrition

This article discusses the impacts of maternal and child under-nutrition on health and development. It covers the risks, complications, and long-term implications of under-nutrition. Find study material and solved assignments on Desklib.

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Impacts of maternal and child under-nutrition
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Under-nutrition is the intake of nutrients and energy insufficiently such that the needs of an
individual in the maintenance of good health are not met. Maternal under-nutrition has been
attributed for causing both long term and short term adverse health effects on the child (Crowley,
2017). Under-nutrition is classified into two broad categories; macronutrient deficiency and
malnutrition. The former occurs when a pregnant woman generally consumes enough food but
fail to intake some specific essential micronutrients. Such nutrients are vital for maintaining
healthy growth and functioning of specific body systems and/or parts. On the other hand,
maternal malnutrition occurs when a pregnant woman continuously consumes less energy than is
required by their bodies (Ricci & Kyle, 2009). Such energy is measured in calories and is
predominantly obtained from carbohydrates and proteins.
The nutritional status of a woman prior to pregnancy influences her health during her pregnancy
period and subsequently that of their baby. The key determinant of nutritional status is primarily
their nutritional intake. Undernourishment prior to conception due to lack of proper feeding
causes a woman to be underweight and malnourished at the time of conception. Consequently, a
continuous negative impact on her nutritional status during pregnancy arises. The resulting
malnutrition condition affects the fetus and the newborn baby even in its long term growth
(Symonds & Ramsay, 2010). When malnourishment occurs in the early and late stages of fetal
development, lifelong programming effects occur. As such, the baby is predisposed to chronic
health complications later in life. To cope with malnutrition, for example, the fetus may develop
metabolism adaptations that reduce production of glucose and insulin. Research has shown that
such adaptations result in permanent programming of the metabolic system. As a result, the child
is at a higher risk of developing chronic health conditions such as diabetes later in life (Frayn &
Evans, 2019).

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There are various micronutrients whose deficiency before pregnancy affects the health and
development of the fetus and subsequently implicates the child negatively after birth. During
early pregnancy, deficiency of folate is attributed to poor development of the neural tube. This
tube is vital for growing fetus as it is the foundation from which the spinal cord and the brain
develops. As such, spina bifida among other conditions may arise out of folate deficiency
(Pavord & Hunt, 2010). The nutrition of a woman prior to conception plays a vital role in the
determination of folate status. Researchers have established that calcium plays an important role
in the formation of the skeletal structure. Its deficiency results in poor formation of bones of a
fetus. It is therefore essential for pregnant women to have sufficient deposits of calcium in their
bones (Irving, 2012). It is worth noting that a woman can only possess adequate amounts of
calcium through long term consumption.
Iron is another micronutrient vital for healthy fetal development. Its deficiency brings about
maternal anemia which is attributed to the occurrence of retarded intrauterine growth (Arnold &
Flint, 2017). Additionally, iron deficiency plays a significantly contributes to low birth weight as
well as slow absorption of folate. It is, therefore, a matter of great significance to ensure that
expectant mothers consume foods rich in iron prior to and during pregnancy to boost their iron
status. In the long term, deficiency of various micronutrients has adverse effects on the growth,
development of children even in their adulthood. Research has established that defects in the
neural tube cause spina bifida, a lifelong health complication (Klein, 2013). It is also proven that
the majority of children born while underweight have a relatively higher risk of developing
mental impairments while at the same time experiencing poor physical growth. Additionally,
underweight babies may have a shorter height as well as experience difficulties in learning in
comparison to babies born at a healthier weight.

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Malnutrition during pregnancy has significant contributions to the development of the fetus and
consequently to the health of a baby after birth. Some of the common impacts of malnutrition are
retarded intrauterine growth, low birth weight as well as intrauterine growth restriction (IUGR)
(Gleicher, 2012). IUGR, in particular, is a condition whereby the fetus is relatively smaller than
the anticipated normal size for a particular duration of pregnancy. All the aforementioned
conditions are directly associated with a wide array of antagonistic implications on the
developing fetus as well as the born baby. First is an increased risk of stillbirths and premature
births. Various studies have established that intrauterine growth restriction is attributable to more
than 50% of all stillbirths. Malnutrition has been a leading causal of infants’ death within the
first seven days of birth. This condition is known as perinatal mortality and is largely influenced
by underweight births (World Health Organization, 2009). The chances of infants weighing less
than 2.5 kilograms dying within the initial seven days are 5-30 times higher than infants born
with a normal weight.
Additionally, malnutrition has been attributed to several complex disorders that affect a child
both in their early lives as well as in their adulthood. Intestinal, circulatory, neurological, and
circulatory complications are such disorders that affect a child both in their early lives and in
their future lives thus affecting the child’s potential and their productivity in the long run (Ricci
& Kyle, 2009). Cretinism is another impediment that may arise out of malnutrition during
pregnancy. This congenital condition causes poor coordination, dry skin, and dull facial
expression by affecting the normal functioning of the thyroid gland. Brain damage is another
implication that extends to the later years of a child. This affects child potential and productivity
by implicating their learning, coordination, and social capabilities.

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As previously and lightly mentioned, a wide variety of metabolic changes emanate from
maternal under-nutrition. Consequently, the metabolic responses after birth are programmed
accordingly as per the fetal status. A malnourished foetus, for example, adapts to certain
maternal conditions by lowering the levels of glucose and insulin production (Gleason &
Devaskar, 2011). This adaptation is known to alter the metabolism of an individual permanently
resulting in increased chances of acquiring long life disorders related to nutrition such as obesity,
type 2 diabetes mellitus as well as metabolic syndrome. In one study, for example, it was
established that the chances of an infant acquiring type 2 diabetes mellitus was inversely
promotional to birth weight (Sawaya, 2006). As such, the probability of men born at a very low
weight developing diabetes is seven times higher in comparison to men born at a higher weight.
However, the pregnancy stage at which maternal undernutrition occurred results in variation of
impacts of undernutrition. In one study, for example, it was established that increased risk of
coronary heart disease and obesity is associated with maternal malnutrition in the first trimester
of pregnancy. Additionally, poor glucose metabolism was linked to malnutrition while in the
second or third gestation trimester (Vaillancourt, et al., 2012). There are other health conditions
that are likely to be developed by children born by malnourished women during their pregnancy.
Glucose intolerance is one such condition. This is a malfunction that occurs prior to full
development of diabetes where the normal metabolism of glucose fails to occur. Mitochondrial
dysfunction is another such condition. Here, the mitochondria located in the cell nucleus and
responsible for the provision of cell energy fails. It is also common for such children to develop
schizophrenia among other psychiatric disorders (Blackburn, 2012).
Obstetricians have also established a link between poor developmental outcomes and
underweight births. These developmental drawbacks are visible during infancy, childhood and

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may extend to later years of an individual (Crowley, 2017). The nutritional intake of a mother
before and during pregnancy principally impacts a child’s mental performance and development
both in the short term and in the long term. The largest percentage of brain growth occurs
between three months prior to birth and two years after birth. Consequently, the brain’s nerve
system and the interconnections between the nerves are at the peak of development and thus
requiring relatively higher amounts of energy to maintain the growth. This growth is vital since it
permanently impacts the functional and structural organization of the brain. This organization is
commonly referred to as cortical organization (Cicchetti, 2016). Lastly is abnormal development
of organs or dysfunction of organs such as the testes, liver, and heart. As such, complication
arising from these health disorders disrupt the normal life of children born of maternally
malnourished mothers and thus hindering realization of their full potential. More so, such
children perform poorly in school, develops learning and social skills slowly, have a lower
ability to perform physical tasks and poor economic productivity.
Having covered on the impacts of maternal undernutrition on a child, inscribed henceforth is a
comprehensive discussion of the impacts of child undernutrition. Morbidity is a key impact of
child undernutrition. The susceptibility of children who are poorly fed to diseases is high in
comparison to nourished children (Black, et al., 2016). Various studies have shown that
underweight children below the age of 5 years are more likely to acquire anemia, diarrhea, acute
respiratory infections as well as malaria and fever. In 2012 for example, Ghana recorded two
hundred and thirty-six thousand, two hundred and fifty-six cases of new children illnesses
propagated by underweight situations (Black, et al., 2016). Additionally, pathologies causing
protein and calories as well as low birth weight are attributed to causing intrauterine growth
restriction. Consequently, high morbidity increases the cost of healthcare.

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Stunting in children is another effect emanating from undernutrition. A significant population of
adults in the working age category usually have suffered from growth obstruction before they
had attained five years of age. As such, a huge pool of individuals between sixteen and sixty-four
years old are at disadvantaged positions when in the workplace in comparison to those who were
well nourished in their early years (International Food Policy Research Institute, 2016). Increase
in mortality rate has also been linked to child undernutrition. However, when the causes of such
deaths are established, they are minimally connected to nutritional deficits in a child but rather to
nutritional propagated illnesses. This has been a leading cause of early deaths, more so in
underdeveloped nations as well as developing nations.
Critically recurring costs in the healthcare systems across the globe have been realized as a result
of undernutrition and related diseases treatment (Martins, 2011). A comprehensive protocol, for
example, is required during the treatment of a child who is severely underweight. Such a
condition can be prevented through relevant nutritionally acceptable interventions. The economic
costs for each treatment period or episode increases depending on the severity of undernutrition
case and what is required for the individual to recover fully. The costs are also dependent on the
specific child under nutrition-caused illness that an individual may be suffering from. Type two
diabetes mellitus, for example, is a relatively expensive disease to manage especially when it is
in an advanced stage. Other than from an individual perspective, treatment of under nutrition-
related illnesses requires higher healthcare staffing (Martins, 2011). This translates to a huge
economic burden and inconveniences since such personnel would have been deployed to carter
for other illnesses such are cancer.
Child undernutrition is known to have severe economic and social implications of a child's
education. Various researchers have come forth to ascertain that indeed underperformance in

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school is more likely to prevail in children who were stunted before the age of five years. As
such, undernutrition before the age of five is most likely to cause repetition of grades. In a
Ghanaian study done in 2012, for example, the net enrollment of children into primary school
was at 81%. However, enrollment to secondary schools was at 45% indicating a near half
repetition rate (International Food Policy Research Institute, 2016). More precisely, data
emanating from the Ghanaian ministry of education revealed that one hundred and sixty
thousand, five hundred and seventy-six children did not proceed to the next grade in 2012. It has
therefore been established that a 3% repetition rate exists for un-stunted children while stunted
children recorded a 4% repetition rate. Consequently, repetition hinders the productivity and
realization of a child's potential by increasing the anticipated education repetition time.
Repetition has also been linked to low self-esteem which could, in turn, cause psychological
disorders over time.
Human capital is on a larger extent driven by progressive education. Keeping children longer in
school signifies inclusive economic and development growth. Consequently, prolonged
repetition results in school dropouts and thus a challenge in retention (C. Smith & Haddad,
2015). Taking into consideration risks emanating from child undernutrition, there exists a huge
gap in school completion rate between stunted children and those who lead a healthy life. Data
exists to prove that in the current 20-64 years working-age population, 87% of those who
completed primary education were never stunted in comparison to 81% of those who were
stunted and completed school. This significant variation can be attributed to higher absenteeism
as well as prolonged repetition (Vaillancourt, et al., 2012). The cost attributable to dropping out
of school is realized later in life when an individual enters the labor market. Due to a lack of

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relevant knowledge and skills, such individuals who were stunted at their early ages and dropped
out of school tend to be of low preference among employers.
Child undernutrition has been marked as a significant contributor to stress as well as impaired
living and mental conditions due to its life-threatening nature. There are two main response
mechanisms invoked by stress in a human body; the HPA axis whose mode of action is
stimulating the production of cortisol and the adrenal medulla, an axis formed by the sympathetic
nervous system, which stimulates production and discharge of noradrenaline and adrenaline
(Blackburn, 2012). Nutritional stress in the events of daily living that emanate from the intake of
foods of inadequate quality and quantity could cause long-lasting physiological stress. With the
passage of time, such stress causes weakening of various body organs subsequently leading
death. There are a huge array of researches and studies that have been conducted to confirm the
possibility of undernutrition causing deviations in the normal functioning of the autonomic
nervous system (Klein, 2013). As such, these impairments hinder individuals who were stunted
at the age of five years and below due to malnutrition from attaining their full productive
potential.
Conclusively, undernutrition has been defined as the intake of nutrients and energy insufficiently
such that the needs of an individual in the maintenance of good health are not met. It has been
clearly stated that maternal and child undernutrition cause both long term and short term adverse
health effects on the child. Various implications of maternal malnutrition as well as
micronutrients’ deficiency have been discussed comprehensively. Folate, calcium, and iron have
been identified as key micronutrients essential during pregnancy. The implications of their
deficiency on the growth and development of a healthy fetus and a subsequent newborn have
been discussed comprehensively. Malnutrition has been attributed to several complex disorders

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that affect a child both in their early lives as well as in their adulthood. Intestinal, circulatory,
neurological, and circulatory complications are such disorders that affect a child both in their
early lives and in their future lives. The impacts of child undernutrition have also been discussed
comprehensively encompassing areas such as education and working capacity in the long run. As
such, it is indeed true that maternal and child under-nutrition contribute to deficits in children’s
health and development. It also impedes children’s achievement of their full productive potential
in adulthood.

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