The unspoken anaemia risk for exclusive breastfeeding mothers


Development work can depress me at times. For, I have always understood that exclusive breastfeeding until six months was fabulous for a baby’s health. In fact, it can cause lifelong impairment: yet, now I have discovered this, the silence is horrifying.

So, here is where the problem is: it’s a matter of malnutrition in mothers. Now, mothers need quite a lot of extra nutrition during pregnancy.

An example is iron, which is necessary to create the haemoglobin that carries oxygen around the body. Without it, we get anaemia with a whole row of consequences, including exhaustion.

Pregnant mothers can move quickly into anaemia, because they quite suddenly develop a lot more blood, at an average of 45 percent more, so if their haemoglobin production doesn’t jump that blood is left as a substandard oxygen transporter.

About half of anaemia is caused by too little iron. But other shortages can also trigger it, including deficiencies in zinc, vitamin B12 and other micronutrients.

As a result, with all that extra pressure on the body and often a diet that is hardly more nutritious, around 55 percent of Kenyan mothers are anaemic during pregnancy.

Now that affects the baby a lot, since iron and other nutrients, such as the vitamin Bs, are critical to the development of their brain and organs. Shortages at that point lead to high blood pressure and heart conditions later in life, as well as impaired intelligence, social and motor skills.

So far, so well known. The thing that isn’t talked about is what happens when that mother with anaemia — who rarely gets tested for anaemia, which is rather costly – starts exclusively breastfeeding.

In a well-nourished mother, breast milk is the perfect food. But testing its nutrient content in other circumstances had been hard, until recently. Now, it’s possible, and the results show malnourished mothers deliver breast milk substantially short of nutrients that cause anaemia and multiple problems for babies.

If a mother breastfeeds on top of anaemia during pregnancy, the damage is a double burden, from gestation and the poor breast milk, too.

If that mother is getting daily iron supplements or multivitamins during pregnancy and breastfeeding, the problem is substantially solved, but very few are. Indeed, one Chinese scientist reported exclusive breastfeeding without an iron supplement as one of the four greatest risks of brain damage.

Yet, in the development world, every piece of literature I have ever seen pushes exclusive breastfeeding, and none of it says it’s only healthy if the mother is taking supplements. Nor does it propose testing for anaemia or any other flags of poor or unbalanced diets. So, we push breastfeeding for every mother, and sometimes it’s harming babies.