Sreelatha Menon: Brain for thought

Given the widespread iron deficiency, countries are looking at promoting iron supplements

Given the fact that iron deficiency is widespread, coupled with the belief that breast-fed babies don’t get enough iron in their blood, many countries are looking at promoting iron supplements.

Do brains of Indian children grow to their full potential? This is the fear that some researchers express, considering that brain ceases to develop after a person is two years old.

Given the fact that iron deficiency is widespread, coupled with the belief of some scientists that breast-fed babies don’t get enough iron in their blood, many countries are looking at proactively promoting iron supplements. Sri Lanka recently tied up with Unicef to supply iron fortified “sprinklers” for pre-school children.

 

Recently, a researcher from the University of Iowa, Ekhard E Zeigler, came to India on behalf of the Nestle Nutrition Foundation to spread awareness about iron deficiency in breast-fed babies. According to him, without iron supplements, brains of Indian children have little chance of developing after six months as their blood would become totally deficient in iron.

He says breast milk has very little iron and even if the mother were to eat red meat, little would she be able to pass on to the infant. The child is born with a limited endowment of iron from the mother, which lasts till he or she is six months old. After that, it needs supplements through iron drops or cereals or micronutrient supplements or some mashed meat or fish.

The only consolation for Indians is a study done by Shashi Raj, MMA Faridi and Usha Rusia of the division of neonatology and the pathology at the University College of Medical Sciencs, Delhi, and National Institute of Immunology, Delhi, published last year.

The study went into the iron parameters in the cord blood of normally delivered babies of non-anaemic and anaemic mothers for six months during 2003-04. It found iron parameters within normal limits at birth, 14 weeks and six months. In fact, it found that iron levels were normal even in babies of anaemic mothers. Thus they could establish that there was no relationship between breast milk iron and iron status of babies.

The researchers say that the study was done after a committee of the World Health Organisation expressed doubts over iron adequacy in breast-fed babies after they are four months old.

It is precisely the fear expressed by Zeigler. He advocates use of “sprinklers”, which are micronutrient supplements given with cereals or other gruel normally fed to babies.

According to the National Institute of Nutrition (NIN), 87 per cent of women suffer from anaemia and the highest prevalence of 98 per cent is in Rajasthan. A study done in an urban slum in Delhi showed iron deficiency in 41 per cent of children. A study by NIN in Hyderabad found the figure to be 68 per cent in pre-school children.

These are the data which call for remedial measures, the first of which should begin with educating mothers. The National Rural Health Mission of the Government of India provides iron tablets for pregnant mothers, but iron drops or iron supplements are yet to be introduced.

NIN has worked out technologies for fortification of common salt as a long-term strategy to control iron deficiency anaemia in the population. Studies have found this salt improving haemoglobin status. Iron drops, according to Zeigler, can cause adverse reactions in places where there is malaria.

Fortification helps in such situations, he says, citing the Lankan sprinklers made by Unicef for infants. He says this should serve as a pointer to what the Indian government should also consider. And perhaps more scientific research could clarify what is the need and what can help without policies getting stuck in the lobbies of vested interests represented by cereal companies or those represented by their critics.