Weaning practices in Kaduna, Northern Nigeria.

PIP: A standardized questionnaire was administered to 65 mothers attending the Nutrition Clinic of the Ahmadu Bellow University Teaching Hospital, Kaduna, Northern Nigeria, over the October-December 1978 period to determine at what age the 1st supplementary diet was introduced, the age the child was weaned, and the weaning practices. The questionnaire dealt with various aspects of weaning knowledge, attitudes, and practices. The mothers were referred to the Nutrition Clinic because their babies already were suffering from protein energy malnutrition, had failed to thrive, or had severe infections, e.g., measles, gastroenteritis, or respiratory diseases. 58 (89.2%) of the families were of low socioeconomic status. 36 mothers (55.4%) introduced supplementary feeds to their babies between 4-6 months of life; 27 (41.5%) mothers introduced supplementary feeds when their children were between 7-9 months. All the mothers used corn, guinea corn, or millet gruel. A decision to wean a child may be made if the child can crawl, walk, or has a good set of erupted milk teeth, even if the child has not reached the traditional weaning age of 20-24 months. The mean age of weaning was 17 months in this study. 51 (78.5%) of the mothers responded to the question about weaning food taboos, prohibitions, and their reasons during the weaning period. Even when protein is available, a child may be denied the protein because of sociocultural factors. The use of carbohydrate gruels among these low socioeconomic families coupled with sociocultural factors compounded the feeding problem, and, consequently, protein energy malnutrition was common during the weaning period.^ieng

Morbidity and mortality patterns among malnourished children in Benin City, Nigeria.

A morbidity and mortality survey was carried out amongst 196 malnourished children attending the Nutrition Unit, Ministry of Health, Owina Street, Benin City, Nigeria, between January 1971 and December 1973 (morbidity) and also between October 1974 and March 1975 (mortality). Gastrointestinal disorders (77, 39.3%) and measles (67, 34.2%) predominated in both morbidity and mortality patterns. In all, 30 (15.3%) of these children died, and kwashiorkor contributed 14 (46.7%) of this total. The age group of the majority of the sick and dead children was 1-2 years, which is within the traditional weaning age of Nigerian children. Immunization of children and their mothers at appropriate times, coupled with sound nutrition and health education to their mothers, will go a long way towards ensuring the good health and welfare of our children.

PIP: A morbidity and mortality survey was carried out among 196 malnourished children attending the Nutrition Unit, Ministry of Health, Owina Street, Benin City, Nigeria between January 1971 and December 1973 (morbidity) and also between October 1974 and March 1975 (mortality). Gastrointestinal disorders (77, 39.3%) and measles (67, 34.2%) predominated in both morbidity and mortality patterns. Kwashiorkor in 74 children (37.8%) was the most frequent malnourished condition. Of the 196 malnourished children, 30 (15.3%) died. Kwashiorkor had higher overall mortality and case fatality rates than the other 2 nutritional disorders. Of the 74 kwashiorkok cases, 14 died--a case fatality rate of 18.9%, and a mortality rate of 46.7% of the total deaths. The correspoding case fatality rates for marasmus and undernutrition were 13.6% and 12.7%. Malnutrition associated with respiratory diseases and measles had higher case fatality rates than the other morbid conditions. 75 (38.3%) were 1-2 years; 67 (34.2%) were less than 1; 46 (23.5%) were 2-3; and 8 (4.1%) were 3 or over. The corresponding deaths for these age groups were 14, 9, 6, and u respectively. Malnourished children in the 1-2 year age group had the highest case fatality rate (18.7%). This age group is within the traditional weaning age in Nigeria.

Neonatal tetanus in Zaria, Northern Nigeria.

PIP: This discussion describes the problem of neonatal tetanus as seen in the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Northern Nigeria over the January 1975 to December 1977 period. Appropriate health actions to be taken regarding prevention and management of neonatal tetanus are described. The pediatric ward of ABUTH, Zaria, admitted 4600 during the study period. Of these, 54 (1.2%) were neonatal tetanus cases. For these tetanus babies, information was available as to the age, sex, apparent portal of entry of the organisms, and the outcome of the infection. Analysis of their mothers included antenatal clinic attendance, residence, and place of delivery. More perinatal babies were infected and died than the other age groups. By the end of the 2nd week of life, over 90% of all the infected babies died. Home delivered babies were more infected than other babies delivered in hospitals. Only 7.4% of the mothers had any form of antenatal care. Zaria City, the traditional residence of the indigenous, had the highest number of cases and deaths. 44 (81.5%) of the babies had septic umbilical cord stumps with 35 deaths among them. The best treatment for an established case of tetanus is total muscle relaxation with anesthetic agents and intermittent positive pressure ventilation. This requires a specialized intensive care unit and a highly skilled personnel that are not yet available in Zaria. Simple sedation and expert and dedicated nursing and medical supervision can go far in reducing the mortality rate.^ieng

Weaning practices amongst the Hausas.

The weaning age amongst the Hausas was found to be 12-18 months, rather than between 22-24 months as enjoined in the Holy Quran. The reasons for weaning a child were found to include religion, the attainment of the traditional age of weaning, observed normal physical and mental developmental processes, onset of another pregnancy, severe illness and or death of the mother, and the husbands' unwillingness to observe the traditional abstinence from sexual intercourse during lactation. Introduction of supplementary feeds was between 5-9 months, and thin guinea-corn, millet or maize gruel is mainly used. This diet is deficient in energy, essential nutrients and proteins. The weaning practices were considered as well as suggestions for improvement outlined.