An overview of the Nigerian Cultural dietary practice in relation to infant malnutrition
Over the past few days, I have become so “obsessed” with the topic malnutrition in infants and I asked a few Nigerians I came across the question “what do you think are the underlying causes of malnutrition among infants in Nigeria”. Well, I basically got the same response which was “Poverty” from all except one which wasn’t surprising because I had the same perception of the “Poverty-Malnutrition” bond. Quoting the one legendary exception from my mini survey, “the Nigerian custom of using pap as a weaning food and other cultural dietary practices are the underlying problems affecting the children”. And that right there is the truth of all time!!!
Very recent and previous findings have shown that increased income does not necessarily reflect significant changes in the nutritional status of the growing infants in Nigeria. There are locally available legumes and oil seeds that are cheap but of high quality protein and energy, but Protein energy malnutrition remains prevalent in Nigeria[1]. In that case, poverty could take a break from all the accusations while cultural dietary practices take over.
Pap, Ogi, Kunu or Kamu as most Nigerians will call it is a thin gruel made from either corn, sorghum or millet and is the most popular complementary diet in Nigeria for infants from 7 months to 12 months. Corn Pap, as grandma will refer to it as “colored water” due to its low nutritive value is known to have only 0.5% protein and less than 1% fat, as compared with 9% protein and 4% fat in the original corn[2]. In fact! a study conducted by Akinrele and Edwards concluded that the protein content of pap (corn gruel) was too low even to support the growth of rats![3]
This is the story of Aisha, a victim of the Boko Haram violence from North-eastern Nigeria. Right inside the outpatient center of the Community Management of Acute Malnutrition, sat Aisha in a posture that cast the image of a helpless mother. Aisha had a one-year old child with severe acute malnutrition. Quoting Aisha’s comment, “When I stopped exclusive breastfeeding, I started giving him pap and to our greatest surprise, he started losing weight”. Her child’s condition worsened after he had a bout of diarrhea, which automatically worsened his situation.
Similar to the story of Aisha is that of Fatima, a one-year old child suffering from Severe Acute Malnutrition. Her mother Hafsat claimed that her breasts weren’t providing enough milk and she couldn’t keep up with Exclusive Breast Feeding. Alternatively, she substituted breastfeeding with Pap and Water. Unfortunately, this resulted to more harm than good as Fatima’s condition worsened.
The question is, why is pap then considered to be the major weaning food among infants in Nigeria?!!!
Well, being a Nigerian myself, I personally believe “Myths” and assumptions behind highly nutritious foods are the underlying factors that drive exclusion of such foods in children’s diet. Furthermore, a series of studies that have been conducted explored the common infant nutrition “Myths” in Nigeria[4] [5]. This is quite baffling but based on finding of related studies, here are few among “hundreds” of myths associated with highly nutritious foods.
Summary of Food Items Proscribed to Infants in Nigeria[4][5]
| Food Item | Reason for proscription | Target Group |
| Meat, Egg and Fish |
Development of expensive taste which may lead to stealing behavior
|
Infants |
| Groundnuts | Causes Pile and is hard to digest | Infants |
| Cow milk | Causes black stool | Infants |
| Cowpeas |
Cases diarrhea, Indigestion and aggravates cough
|
Infants |
| Cocoyam |
Causes hemorrhoids and infertility
|
Infants |
| Banana |
Causes dysentery
|
Infants |
| Food rich in Fat |
Causes colic and diarrhea
|
Infants |
Another factor that contributes to the overall use of pap as a weaning food is Tradition. The fact that our parents and grandparents used pap as a major weaning food makes it a norm. Also, the idea of it being a traditional practice makes it right and therefore assessment of its nutritional value is being ignored. Specific to Northern Nigeria, the nature of traditional foods being mostly grains may have something to do with it as well. For example, the most common traditional food among the Hausa tribe in Northern Nigeria is Tuwo which is made from either Maize, Millet, Rice or Wheat. So the same traditional concept of adults eating mostly grains is then applied to make pap the major food for infants.
With this situation, what should be done then?
Amaka Benson to the Rescue!!!
Amaka is a Nigerian and the author of Micah’s Meals, a book which entails 180 easy, nutritious and tasty recipes for all babies, each with a full nutritional breakdown. The book also provides information on taste, texture and what foods to avoid in order to help make the transition to family meals easier for the little one. However, this may only be useful to educated parents who can afford the ingredients.
Alternatively, many researchers have worked extensively on cereal-legume combinations in Nigeria. For example, Fashakin and Ogunsoola formulated the “nut-ogi” (a mixture of corn pap and peanut), Akinrele and Edwards formulated “soya-ogi” (corn pap plus soya bean). Among all the cereal-legume combinations, a mixture of Cowpea, Melon, Soya bean, and Pap was found to be superior in terms of nutritional value.
Summarizing it all, Pap is certainly not enough to support infants, i mean it is pure carbohydrate! A synthesis with other foods is definitely needed. This is just one example among many other ways culture contributes to Food Insecurity. Yes, it is a fact that Culture is valuable because it shapes us and therefore has a great influence on the kind of food we eat. But this perception may be doing more harm than good and therefore should be reconsidered.