JORIND 11(1), June, 2013. ISSN 1596-8308. www.transcampus.org/journals; www.ajol.info/journals/jorind
FOOD SUPERSTITION, FEEDING PRACTICES AND NUTRITIONAL ANTHROPOMETRY OF
PREGNANT WOMEN
A.N. Maduforo and O.I.C. Nwosu
Department of Nutrition and Dietetics
Medical Service Subsector, PHCN Staff Clinic, Maitama, Abuja, Nigeria
C.I. Ndiokwelu
Department of Nutrition and Dietetics, University of Nigeria Teaching Hospital, Enugu
and
P.N. Obiakor-Okeke
Department of Nutrition and Dietetics, Imo State University Owerri Imo State, Nigeria
E-mail: [email protected]
Abstract
The survey assessed the food superstition, feeding practices and nutritional anthropometry of pregnant women
attending ante-natal clinic in university of Nigeria teaching hospital Ituku/Ozalla, Enugu state, Nigeria. This survey
was embarked upon to identify the superstitions held on food during pregnancy among pregnant women attending
ante-natal clinic in university of Nigeria teaching hospital Ituku/Ozalla, Enugu state, to determine their acceptance
of these superstitions and to assess their feeding practices and nutritional anthropometry. Structured and validated
questionnaires were used to obtain information on the socio-economic characteristics, food superstitions and
feeding practices of the subjects. Anthropometric indices of the subjects were also assessed using weighing scale,
height measuring rod and tape. The data was analyzed using the SPSS version17 to determine the means with their
standard deviations, frequencies, and percentages as well as drew charts. The result of the survey shows that the
mean weight and height of the subjects were 77.47 ± 12.23kg and 1.66 ± 0.06m respectively. Their mean wrist
circumference was 16.17 ± 0.99cm. Also, the mean frame size and mean expected weight were 10.30 ± 0.60 and
66.97 ± 7.91 respectively. Food superstitions were held on foods like fufu, beans, snail, cocoa drink, okro, dika nut,
etc. Conclusively, this research has revealed that 29% acknowledged that there is still an existence of food
superstition among pregnant women that attend ante-natal in UNTH Ituku/Ozalla and about 19% of them still
practice it. The feeding pattern of this 19% was being affected by these superstitions. Their nutritional status is
certainly determined by what they eat because "we are what we eat". However, about 42% had normal expected
body weight while 58% of pregnant women were malnourished. Hence, I recommend that nutrition education be
intensified in ante-natal clinics and different villages in Nigeria to help teach pregnant women on healthy food
selection and importance of nutrition before, during and after pregnancy.
Keywords: Food superstition, nutritional anthropometry, pregnant women
Introduction
Superstition is a belief or practice generally regarded as
irrational and as resulting from ignorance or from fear
of the unknown. It implies a belief in unseen and
unknown forces that can be influenced by objects and
rituals. Magic or sorcery, witchcraft, and the occult in
general are often referred to as superstitions (John,
2009).
In general, superstitious practices and beliefs are most
common in situations involving a high degree of risk,
chance, and uncertainty, and during times of personal or
social stress or crisis, when events seem to be beyond
human control. The question of what is or is not
superstitious, however, is relative. One person’s beliefs
can be another’s superstitions. All religious beliefs and
practices may be considered superstition by
unbelievers, while religious leaders often condemn
unorthodox popular practices as a superstitious parody
of true faith (John, 2009).
Taboo food and drink are food and beverages which
people abstain from consuming for religious, cultural or
hygienic reasons. Many food taboos forbid the meat of
a particular animal, including mammals, rodents,
reptiles, amphibians, bony fish, and crustaceans. Some
taboos are specific to a particular part or excretion of an
animal, while other taboos forgo the consumption of
plants, fungi, or insects (John, 2009).
All communities have their own cultural (traditional)
pattern. The cultural pattern of a group is based on
learned behaviour, acquired partly by deliberate
instruction on the part of parents, but mostly
subconsciously by incidental observation of the
behaviour of relatives and other close members of the
community (Ogbeide, 1974).
Food taboos can be defined as rules, codified or
otherwise, about which foods or combinations of foods
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may not be eaten and how animals are to be
slaughtered. The origins of these prohibitions and
commandments are varied. In some cases, these taboos
are a result of health considerations or other practical
reasons. In others, they are a result of human symbolic
systems. Some foods may be prohibited during certain
festivals (e.g., Lent), at certain times of life (e.g.,
pregnancy), or to certain classes of people (e.g.,
priests), although the food is in general permissible
(John, 2009)
Traditional beliefs and attitudes influence women’s
health. Even when women have access to appropriate
healthcare, they often prefer home/community based
care. Women’s overall health and nutritional status,
pregnancy outcomes and other reproductive health
problems are considered to be the major biological
causes of maternal mortality; therefore, the overall
nutritional status of a pregnant woman is principally
determined by the feeding practices and care facilities
available to her (Saba, 1996).
Statement of the problem The problem of malnutrition among pregnant women
poses a great challenge to nutritionist and the health
sector as well as to the government. Malnutrition of the
mother does not just affect the pregnant woman only
but also has a devastating effect on the foetus (unborn
child). Malnutrition has ranked as the major cause of
maternal mortality and it is a major determinant of a
successful pregnancy and a healthy well nourished
baby.
According to UNICEF (2009), each year, more than
half a million women die from causes related to
pregnancy and childbirth. Nearly 4 million newborns
die within 28 days of birth. Millions more suffer from
disability, disease, infection and injury. The lifetime
risk of maternal death for a woman in a least developed
country is more than 300 times greater than for a
woman living in an industrialized country.
Africa and Asia account for 95 percent of the world’s
maternal deaths, with particularly high burdens in Sub-
Saharan Africa (50 percent of the global total) and
South Asia (35 percent). These statistics above showed
while it is important that the major avoidable causes of
maternal mortality and adverse pregnancy outcome are
eliminated by looking into the feeding practices of
women due to their traditional belief and taboos and
also to determine its effect on their nutritional status.
Methodology
Study area
The study was carried out in University of Nigeria
Teaching Hospital, Enugu. It is a tertiary health
institution that offers services which include training of
medical and paramedical students, graduates and
practitioners, research and treatment and management
for both in-patients and out-patients.
Data collection
Structured and validated questionnaire was used to
collect data. The questionnaire was designed to elicit
information on personal, socio-economic status, food
taboos, beliefs and feeding practices of the women. The
literate women were given the questionnaire to fill
while the illiterate ones were interviewed from the
questionnaires and the answers recorded.
During the data collection, I visited the ante-natal clinic
of UNTH Ituku/Ozalla on their ante-natal days to meet
with the pregnant women and randomly collect
samples.
Anthropometric measurement
Weights of the pregnant women were obtained using
portable body weight measurement scale (kg). Height
measurement was obtained using measurement tape in
centimetres (cm).
Weight
The actual weight was determined with a bathroom
weighing scale. The weighing scale was checked and
adjusted if need be to the zero mark before the subjects
mounted the scale and their weight was recorded.
Height
Heights were measured with a vertical measuring rod
calibrated in centimetres (cm). The subject stood erect
looking straight on a levelled surface with heels
together and toes apart, without shoes. The moving
head piece of the measuring rod was lowered to rest flat
on the top of head and the reading was taken to the
nearest centimetre.
Wrist circumference
The wrist circumference was measured using a cloth
tape wrapped around the bony part of the wrist
(anatomical point) and the reading was taken to the
nearest centimetre.
Frame size The frame size was determined using the measure
height and wrist circumference. Basically, frame size is
categorized into three;
1. Small frame: when the calculated frame size
value is greater than 11.0 (FS>11.0) for
females
2. Medium frame: when the calculate FS
value is between 10.1 – 11.0 (FS = 10.1 –
11.0) for females
3. Large frame: when the calculated FS value
is less than 10.1 (FS<10.1) for females.
Hence, to calculate the frame size (FS), the following
formula was used;
FS = Height (cm)
Wrist Circumference (cm)
Ideal Body Weight (IBW) This is calculated using the height and frame size,
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Hamwi Formula was used to determine the IBW; 45kg
for the first 5feet (60inches) + 2.3kg for each inch over
5feet (medium frame). For small frame, subtract 10% of
the calculated value and for large frame add 10% of the
calculated value. Determination of
Additional weight
Ellie and Sharon, (2008) method for weight gain pattern
during pregnancy was used to determine the expected
additional weight at each stage of pregnancy.
For a normal- weight woman, weight gain pattern
ideally follows a pattern of 3½ pounds (1.6kg) for the
first trimester (12 weeks) and 1 pound (0.45kg) per
week thereafter.
Expected weight
At each stage of pregnancy, there is an expected weight
for each individual, using the ideal body weight and
additional weight for each stage of pregnancy. Hence,
the formula for expected weight includes;
Expected Weight = IBW + Expected additional weight
at each stage.
Sample size
The following formula was used to calculate the
required sample size
for 10% of women
that attend antenatal
clinic in UNTH
using the medical
record data. This was determined using the Fisher’s
formula (Vaughan et al., 1989) (8) where:
n= Z2 PQ/d
2
P is the prevalence of the attribute
q is 1-P i.e. the proportion of the population that does
not have the characteristic
Z is the standard normal deviate for 95%
confidence level (1.96)
• d is the precision, Total sample size was
100
Data analysis The data was analyzed using SPSS version 17 to
determine the means with their standard deviations,
frequencies, and percentages as well as drawing of
charts.
Results
One hundred pregnant women completed the study and
the result of the survey is shown in the tables and charts
below.
Figure 1 revealed that the most of the respondents are
within the age 21 – 30 years of age (58%) and those that
are 31 – 40 years of age (40%) while those within 15 –
20 & 41 – 50 years of age make up 1% each.
1%
58%
40%
1%
Figure 1: The age of the respondents
15 – 20
21 – 30
31 – 40
41 – 50
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Figure 2 showed that 98% of the respondents were married while 1% each is single and widow.
Figure 3 revealed that 58% of the respondents attended
tertiary institution, 33% attended secondary school, 6%
attended primary school and 3% did not attend any
formal education.
98
1 1 0
Figure 2: The marital status of the respondents
3 6
33
58
3 6
33
58
INFORMAL PRIMARY SCHOOL SECONDARYSCHOOL
TERTIARY
Figure 3: Highest educational attainment
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Figure 4 revealed that the respondents have varied
occupations and this include 37% civil servant, 22%
business women, 4% skilled workers and non is a full
time farmer. However, 37% of the women were
unemployed, students of housewife.
Figure 5 showed that 99% of the respondents were Christians while only 1% was a Muslim.
0%
22%
37%
4%
37%
Figure 4: The occupation of the respondents
FARMER
BUSINESS
CIVIL SERVANT
SKILLED LABOUR
UNEMPLOYED/HOUSEWIFE
CHRISTIAN MUSLIM TRADITIONAL OTHERS
99
1 0 0
Figure 5: The religion of the respondents
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Figure 6: Here, 95% of the women are from the South-
Eastern part of Nigeria where the survey was carried
out, 3% are from south-south which is the closest
geographical region to the survey site, 1% from North
Central, and 1% from south west.
Figure 7 showed that 8% of the women were in the first
trimester, 32% were in the second trimester and 60%
were in their last trimester.
0 0 1
95
1 3
NORTH EAST NORTH WEST NORTHCENTRAL
SOUTH EAST SOUTH WEST SOUTHSOUTH
Figure 6 :The geographical region of the respondent
8%
32%
60%
Figure 7:Stage of pregnancy of the respondents
FIRST TRIMESTER
SECOND TRIMESTER
THIRD TRIMESTER
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Table 1: Existence, acceptance and practice of foods superstition by pregnant women
Parameter Frequency Percentage
Existence of food superstition
Yes 29 29
No 71 71
Those that accept the beliefs
Yes 17 17
No 10 10
Not all 2 2
No response 71 71
Those that eat all these forbidden foods when they were not pregnant
Yes 8 8
No 18 18
Not all 3 3
No response 71 71
In table 1, 29% acknowledged that food superstitions about pregnant women exist in their areas, 19% accepted and
practiced it.
Figure 8 showed that 68 percent from the 19% of the
entire sample population of the women that accepted
and practiced the food superstitions in their community
attended tertiary institution, while 32 percent attended
secondary school.
68%
32%
Figure 8:Educational background of the women that
accepts and practices these superstitions
TERTIARY
SECONDARY
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Table 2: The different foods held in superstitions
Name of food/meat/drink Reason for superstition
Grass cutter Prolonged labour; Causes false labour in pregnant women
Honey Makes the baby to have soft head and spots on the skin
Snail Causes the baby to split (salivate excessively)
Pig meat (Pork) Makes the baby to breath like a pig
Banana No reason was given
Udah (Senegal Pepper -Xylopia
aethiopica) Causes early contraction and abortion of the baby
Alcohol
To avoid spitting; Christian; causes abortion of the baby and kidney
dysfunction
Coffee Health hazard risk
Akpu Makes the child to be over-weight
Beans Makes the child to be over-weight
Okro Makes the baby to salivate excessively
Ogbono (Dika nut) Makes the baby to salivate excessively
Cold water The baby could be born with pneumonia
Bitter cola Causes constant convulsion in babies
Smoking cigarette It is not good for mother and baby
Donkey (Jaki) It behaves like human beings in the olden days
Snake (Python) It is forbidden
Beverages Causes the baby to be big
Malt Causes the baby to be big
Ona No reason was given
In table 2, different foods, meats and drinks that are held in superstition for various reasons were listed.
Table 3: The Percentage of Response to the Different Superstitious Foods
Name of food/meat/drink Frequency Percentage
Grass cutter 10 10
Honey 3 3
Snail 4 4
Pig meat (Pork) 1 1
Banana 1 1
Udah (Senegal Pepper -Xylopia aethiopica) 3 3
Alcohol 6 6
Coffee 1 1
Akpu 1 1
Beans 3 3
Okro 1 1
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Ogbono (Dika nut) 1 1
Cold water 1 1
Bitter cola 1 1
Smoking cigarette 1 1
Donkey (Jaki) 1 1
Snake (Python) 1 1
Beverages 1 1
Malt 1 1
Ona 1 1
Table 3, revealed that grass-cutter (Nchi) meat featured
more frequently in the response of the respondents it
has 10% of the responses. Alcohol (6%), Snail (4%),
honey, beans and uda (3%) featured more than once in
their responses.
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Table 4: The Feeding Pattern of the Respondents
Parameter Frequency Percentage
No of meals per day
1 2 2
2 7 7
3 63 63
> 3 28 28
How often they take snacks (eg: meat pie)
Daily 18 18
1 – 2 times a week 21 21
3 – 4 times a week 9 9
Rarely 52 52
Meal(s) they usually skipped
Breakfast 6 6
Lunch 2 2
Dinner 1 1
None 91 91
Total 100 100
Reasons for skipping meals
Limited fund 0 0
Fear of vomiting 2 2
Insufficient time to prepare meals 0 0
Lifestyle 6 6
Tiredness 0 0
Do not want my child to be too big 1 1
No response 91 91
How often they eat fruits and vegetables
Daily 53 53
1 – 2 times a week 12 12
3 – 4 times a week 25 25
Rarely 10 10
How often they take their routine drugs
Daily 79 79
1 – 2 times per week 9 9
3 – 4 times per week 6 6
Rarely 6 6
Those that considered they should change
their food habit
Yes 29 29
No 71 71
Table 4, showed the feeding pattern of the respondents, 53% takes fruits and vegetables daily, 9% skip meals and
6% rarely take their supplements.
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In table 5, the incompatible lifestyles with pregnancy among the respondents as well as different diseases they
suffer from were revealed. Seven percent (7%) are on weight reducing diet, 1% smokes and 67% do not take
alcohol at all.
Table 6: Anthropometric Parameters of the Pregnant Women
Parameter Mean±SD Range
Table 5: The Incompatible lifestyles of The Pregnant Women
Parameter Frequency Percentages
Those on weight reducing diet
Yes 7 7
No 93 93
Total 100 100
Their smoking history
Current smoker 1 1
Ex – smoker 0 0
Never smoked 99 99
Those that take coffee often
Yes 1 1
No 99 99
How often they take alcohol take alcohol
Daily 3 3
1 – 2 times a week 3 3
3 – 4 times a week 0 0
Rarely 27 27
Not at all 67 67
Quantity of alcohol per day
1 bottle per day 11 11
2 bottle sper day 0 0
3 bottles per day 1 1
Above 3 bottles per day 0 0
1 glass per day 21 21
No response 67 67
Type of alcohol taken
Beer 8 8
Kaikai 0 0
Palmwine 14 14
Others 11 11
No response 67 67
How often they take their routine drugs
Daily 79 79
1 – 2 times per week 9 9
3 – 4 times per week 6 6
Rarely 6 6
Do you suffer from any chronic disease
Diabetes mellitus 0 0
Hypertension 1 1
Anaemia 0 0
Arthritis 3 3
None 96 96
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Weight (Kg) 77.47±12.23 60.00 – 120.00
Height (M) 1.66±0.06 1.51–1.84
Wrist Circumference (cm) 16.17±0.99 14.00 –19.00
Expected Weight (Kg) 66.97±7.91 49.00 –86.00
Frame Size 10.30±0.60 8.17 –11.77
As presented in table 6, the mean weight and height of
the subjects were 77.47 ± 12.23kg and1.66± 0.06m
respectively. Their mean wrist circumference was 16.17
± 0.99cm. Also, the mean frame size and mean
expected weight were 10.30 ± 0.60 and 66.97 ± 7.91
respectively.
Also it important to report that 42% of the women were
within normal expected body weight while 3% were
underweight and 55% overweight
Discussion
Socio-economic characteristics of the subjects
The age of the women ranged from 15 to 50 years. The
highest number 58 (58%) of the pregnant women were
within the age range of 21 - 30 years, It is also
important to note that although the incidence of teenage
pregnancy among the respondents was very low; about
1% of the women are teenagers, which belong to the
age range of 15 - 20 years. Contrary to a similar study
carried out in Ganye L.G.A. in Adamawa state where
the incidence of adolescent pregnancy was very high.
The result of the study in Ganye showed that prevalence
of adolescent pregnancy in Ganye was 51%. The
research revealed the occurrence of adolescent
pregnancy in each of the tribe sampled which showed
84.61% for Hausa, 63.15% for Fulani, 43.54% for
Chambas and 33.33% for others (Maduforo & Ojebode,
2011). This however, is of a great concern in that
nourishing a growing foetus adds to a teenage girl's
nutrition burden, especially if her growth is still
incomplete. Simply being young increases the risks of
pregnancy complications independent of important
socio-economic factors (Klein et al., 2005).
Another important factor to note here was that the
highest number 58 (58%) attended tertiary institution
and 33% attended secondary school, still amongst these
groups food superstitions were being practiced. A
common saying that says "Knowledge is power" was
being demonstrated which revealed that although these
women attended school but they lack the correct
nutrition knowledge and wisdom which the inability to
apply the knowledge in everyday life this however is a
very serious threat to adequate nutrition. Poverty and
shortage of nutritious foods are of the most important
factors related to malnutrition. Everyone needs nutrition
education to fight malnutrition (Okoli, 2009).
Existence, acceptance and practice of foods
superstition by pregnant women
Most women (71%) said there are not food superstitions
during pregnancy. However, some women (29%)
admitted the existence of food superstition in pregnancy
in the various communities. The food superstitions here
was in line with a similar research published in the
American Journal of Clinical Nutrition on the topic
“Nutritional Hazards of Food Taboos and Preferences
in Mid-West Nigeria” by Ogbeide (1994) which
revealed the following food taboos in:
Meat – are not to be eaten by children because it makes
them acquire excessive food habits which they cannot
afford unless they steal.
Eggs – not to be eaten by children because it makes
them steal.
Liver – not to be eaten by children because it causes
abscess of the liver.
Milk – not to be eaten by children because it makes
them to develop bad habit.
Coconut Milk – not to be eaten by children because it
renders them unintelligent.
Snail – not to be eaten by pregnant women because it
causes excessive salivation in the newborn baby.
Porcupine – not to be eaten by pregnant women because
it causes delay in labour.
Oil – not to be eaten by newly delivered mothers
because it causes jaundice in babies.
It is important to note therefore that the customs that
prohibit consumption of certain nutritionally valuable
foods may not have an important overall nutritional
impact, particularly if only one or two food items are
affected. Some societies, however, forbid such as wide
range of foods to women during pregnancy that it is
difficult for them to obtain a balanced diet.
Among the 29% that admitted it, 65.52% accepted these
superstitions and practiced it. It quite unveiling that
among those that accepted and practices these
superstitions 68% of them were educated at least they
have attended tertiary institution while the rest 32%
attended secondary school. This is quite important to
note that being educated in a particular discipline do not
guarantee that one has a good nutritional knowledge.
Acquiring knowledge is required that one gets it from
the right source, i.e. somebody who is trained in that
area.
In table 2, different foods, meats and drinks that are
held in superstition for various reasons were listed. The
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result shown revealed that fufu (akpu), beans, beverages
(cocoa drinks) and malt were attached with a
superstition that they believed it results to overweight
child. Most of these foods such as fufu, beverages and
even malt are good sources of carbohydrate and energy
in the south-eastern part of Nigeria where this research
was carried out. Pregnancy imposes greater need for
energy in the body hence, when all these easy sources
of energy foods are forbidden, the women would find
little to select food from and hence, monotonous
feeding will set in. Furthermore, cocoa
drunks/beverages like milo were believed to result to
overweight baby while it is an important fast food for
breakfast in Nigeria. It contains energy and protein and
never results to overweight baby except if consumed
excessively.
Also, there is a superstition, snail, beans, bush meat
(Grass cutter), and pork that are good sources of protein
especially beans that is easily affordable. Also, bush
meat has very high biological value protein and it is
common in Enugu that their consumption could
ameliorate the problem of protein deficiency and even
other nutrients present in meats and beans.
Donkey meat and snake were forbidden but they are not
easily available so even when there were no
superstitions attached, a pregnant woman might not
even see it. However, the beliefs placed on them are not
scientifically proven. Three leave yam (Dioscorea
dumetorum) (Una) had been forbidden without any
reason. However its consumption had not been proven
detrimental both to the mother or child.
Okro, dika nut and snail also had superstitions attached
to them. They believed that this causes the child to
salivate excessively. This is completely a wrong
superstition because okro is a good source of
micronutrient; dika nut is common soup thickeners that
contain micronutrients as well as protein. Cold water
was also said to cause pneumonia for the child, this as
well is wrong information. Pneumonia is cause by
bacteria and not water born disease. It is important for a
pregnant woman to drink enough water of any type to
replenish fluid loss. Honey was said to make the baby
have soft head and spots on the skin, however, the
complexion off a child of any mark is not as a result of
what the mother ate but genetically determined.
Bitter kola, coffee, smoking and alcohol were other
things that were found to be forbidden for pregnant
women. According to Odebunmi et al. (2009) bitter
kola (Garcinia cola) is also known as African wonder
nut. It comes from Garcinia cola trees, which belongs to
the family Clusiaceae and grows in coastal rainforests
in the South Western and South Eastern parts of
Nigeria. Traditionally, these nuts were chewed as a
masticatory substance, to stimulate the flow of saliva
(Leakey, 2001) but are now widely consumed as snack
in West and Central Africa. The kernels of the nuts are
widely traded and eaten as a stimulant (Leakey, 2001;
Omode et al., 1995). Bitter kola is also rich in caffeine
and threobromine and is also believed to be an
aphrodisiac. Unlike other kola nuts however, bitter kola
is believed to clean the digestive system, without side
effects such as abdominal problems, even when a lot of
nuts are eaten (Onochie and Stanfield, 1960). In folk
medicine, bitter kola is dried, ground and mixed with
honey to make a traditional cough mixture.
Alcohol consumption during pregnancy can cause
irreversible mental and physical retardation of the
Fetus-Fatal alcohol Syndrome (FAS). Of the leading
causes of mental retardation, FAS is the only one that is
totally preventable. To that end, the surgeon generally
urges all pregnant women to refrain from drinking
alcohol (United States Morbidity and Mortality Weekly
Report, 2004).
Also coffee has high content of caffeine. Caffeine
crosses the placenta, and the developing foetus has a
limited ability to metabolize it. Research studies have
not proved that caffeine (even in high doses) causes
birth defects in human infants (as it does in animals),
but some evidence suggests that heavy use increases the
risk of foetal death (Bech, 2005). (In these studies,
heavy caffeine use is defined as the equivalent of eight
or more cups of coffee a day). All things considered, it
is most sensible to limit caffeine consumption to the
equivalent of a cup of coffee or two 12 ounce cola
beverage a day.
Smoking cigarettes and chewing tobacco at any time
exert harmful effects, and pregnancy dramatically
magnifies the hazards of these practices. Smoking
restricts the blood supply to the growing fetus and thus
limits oxygen and nutrient delivery and waste removal.
A mother who smokes is more likely to have a
complicated birth and a low-birth weight infant. Indeed,
of all preventable causes of low birth weight in the
United States, smoking is at the top of the list.
Although, most infants born to cigarette smokers are
low birth weight, some are not, suggesting that the
effect of smoking on birth weight also depends in part,
on genes involved in the metabolism of smoking toxins
(Wang, 2002).
In addition to contribution to low birth weight, smoking
interferes with lung growth and increases the risk of
respiratory infections and childhood asthma (Difranza
et al., 2004). It can also cause death in an otherwise
healthy fetus or newborn. A positive relationship exists
between Sudden Infant Death Syndrome (SIDS) and
both cigarette smoking during pregnancy and postnatal
exposure to passive smoke (Difranza et al., 2004).
Smoking during pregnancy may even harm the
intellectual and behavioural development of the child
later in life. According to Ellie and Sharon, (2008), the
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JORIND 11(1), June, 2013. ISSN 1596-8308. www.transcampus.org/journals; www.ajol.info/journals/jorind
following complications are associated with smoking
during pregnancy;
Foetal growth retardation
Low birth weight
Complications at birth (prolonged final stage
of labour)
Misallocation of the placenta
Premature separation of the placenta
Vaginal bleeding
Spontaneous abortion
Foetal death
Sudden Infant Death Syndrome (SIDS)
Middle ear diseases
Cardiac and respiratory diseases.
Infants of mothers who chew tobacco also have low
birth weights and high rates of foetal deaths. Any
woman who smokes cigarette or chews tobacco and is
considering pregnancy or who is already pregnant
should try to quit.
Feeding pattern of the women
Table 4; showed that 63% of the women eat 3 meals per
day which is the highest while most of the women do
not skip any meal, 91% of them, however, the meal
they most frequently skip is breakfast (6%) and lunch
(2%), while supper showed to be 1%. Nutritional status
is the outcome of food consumed, absorbed and utilized
by the body. Hence, weight-loss dieting, even for short
periods, is hazardous during pregnancy. Low-
carbohydrate diets or fasts that cause ketosis deprive the
fetal brain of needed glucose and may impair cognitive
development. Regardless of pre-pregnancy weight,
pregnant women should never intentionally loose
weight (Ellie & Sharon, 2008).
Another important parameter in table 4 is their intake of
fruits and vegetables, which is the richest way of
meeting the needs of micro-nutrients like vitamins and
minerals. Only 53% actively engage in daily
consumption of fruits and vegetables while 10% rarely
consume it. Another way of meeting these needs is by
taking their vitamin supplements daily. But however,
about 6% rarely engage in the act while 79% rightly
take their supplements daily.
Alcohol consumption during pregnancy can cause
irreversible mental and physical retardation of the
Fetus-Fatal alcohol Syndrome (FAS). Of the leading
causes of mental retardation, FAS is the only one that is
totally preventable. To that end, the surgeon generally
urges all pregnant women to refrain from drinking
alcohol (United States Morbidity and Mortality Weekly
Report, 2004).
The incompatible lifestyles of the pregnant women
Table 5 showed that about 7% were on weight reducing
diet, 1% smoked, 1% took coffee often and 33% took
alcohol. Krummel (2007) posits that weight-loss dieting
during pregnancy is never advisable. Overweight
women should try to achieve a healthy body weight
before becoming pregnant, avoid excessive weight gain
during pregnancy, and postpone weight loss until after
childbirth. Weight loss is best achieved by eating
moderate amounts of nutrient-dense foods and
exercising to loose body fat.
Smoking cigarettes and chewing tobacco at any time
exert harmful effects, and pregnancy dramatically
magnifies the hazards of these practices. Smoking
restricts the blood supply to the growing fetus and thus
limits oxygen and nutrient delivery and waste removal.
A mother who smokes is more likely to have a
complicated birth and a low-birth weight infant. The
Federal Ministry of Health warns that smokers are
liable to die young yet a percentage of the women
smoked which may be harmful to the foetus, 99% never
smoked. Caffeine crosses the placenta, and the
developing foetus has a limited ability to metabolize it.
Research studies have not proved that caffeine (even in
high doses) causes birth defects in human infants (as it
does in animals), but some evidence suggests that heavy
use increases the risk of foetal death (Bech, 2005). (In
these studies, heavy caffeine use is defined as the
equivalent of eight or more cups of coffee a day). All
things considered, it is most sensible to limit caffeine
consumption to the equivalent of a cup of coffee or two
12 ounce cola beverage a day. Only a percentage of the
pregnant women take coffee while 99% don’t take
coffee at all.
Alcohol consumption during pregnancy can cause
irreversible mental and physical retardation of the
Fetus-Fatal alcohol Syndrome (FAS). Among the
leading causes of mental retardation, FAS is the only
one that is totally preventable. To that end, the surgeon
generally urges all pregnant women to refrain from
drinking alcohol (United States Morbidity and Mortality
Weekly Report, 2004). Table 5 also reveals that up to
6% of the women drink alcohol within the week, of
these, 3% drinks daily, 3% drinks 1 - 2 times in a week.
About 67% of the women do not drink alcohol at all.
The quantity of alcohol taken mostly by the pregnant
women was seen to be a glass per day (21%), seconded
by a bottle per day (11%). According to table 5 palm-
wine (14%) was the most favourite of the women while
beer (11%) was the least. Pregnant women who
suffered from chronic diseases were very few. Some
women develop hypertension during the second half of
pregnancy. Most often, the rise in blood pressure is
mild and does not affect the pregnancy adversely.
Blood pressure usually returns to normal during the first
few weeks after childbirth. This transient hypertension
of pregnancy differs from the life-threatening
hypertensive diseases of pregnancy – preeclampsia and
eclampsia (Ellie & Sharon, 2008). Only a percentage of
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the women had hypertension. However, 3% of the
women had arthritis. Majority (96%) had none of the
chronic diseases.
Nutritional status of the pregnant women figure 9 showed that 42% of the women were within the
range of expected body weight while 55% were
overweight and 3% were underweight. This statistics is
abnormal and needs an urgent intervention.
Surkan, (2004) stated that without adequate nutrition
during pregnancy, foetal growth and infant health are
compromised. In general, consequences of malnutrition
during pregnancy include fetal growth retardation,
congenital malformations (birth defects), spontaneous
abortion and stillbirth, preterm birth and low infant
birth weight. Preterm birth and low infant birth weight,
in turn, predict the risk of stillbirth in a subsequent
pregnancy. Ellie and Sharon, (2008) says that
malnutrition, coupled with low birth weight, is a factor
in more than half of all deaths of children under four
years of age worldwide.
Obese women have an especially high risk of medical
complications such as hypertension, gestational
diabetes, and postpartum infections. Compared with
other women, obese women are also more likely to have
other complications of labour and delivery (Young et
al., 2002). Overweight women have the lowest rate of
low-birthweight infants. However, overweight women
are more likely to born post-term and to weigh more
than 9 pounds. Large newborns increase the likelihood
of a difficulty labour and delivery, birth trauma, and
cesarean section. Consequently, these infants have a
greater risk of poor health and death than infants of
normal weight (Ellie & Sharon, 2008).
Obesity may double the risk for neural tube defects.
Folates role has been examined, but a more likely
explanation seems to be poor glycaemic control (King,
2006). In addition, both overweight and obese women
have a greater risk of giving birth to infants with heart
defects and other abnormalities (Watkins, 2003).
An underweight woman has a high risk of having a low-
birthweight infant, especially if she is malnourished or
unable to gain sufficient weight during pregnancy. In
addition, the rates of preterm births and infant deaths
are higher for underweight women. An underweight
woman improves her chances of having a healthy infant
by gaining sufficient weight prior to conception or by
gaining extra pounds during pregnancy (Ellie & Sharon,
2008).
Conclusion
Conclusively, this research has revealed that 29%
acknowledged that there is still an existence of food
superstition among pregnant women that attend ante-
natal in UNTH Ituku/Ozalla how much more those that
do not come for ante-natal and about 65.52% of the
29% them still practice it. The feeding pattern of this
65.52% was being affected by these superstitions. Their
nutritional status is certainly determined by what they
eat because "we are what we eat". However, about 42%
had normal expected body weight while 58% of
pregnant women were malnourished.
Recommendation
The findings of this research work have necessitate that
we salvage the incidence of maternal and preterm death,
I therefore recommend the following to be carried out
in ante-natal clinic UNTH Ituku/Ozalla and as well as
other localities that practice similar food superstitions;
Nutrition intervention such as nutrition
education in different villages, health centres
and women organizations to be given mainly
on the area of food superstitions against
pregnant women.
A healthy eating pattern to be taught to these
women when they are pregnant and the
importance of consumption of fruits and
vegetables to supply micronutrients and fibre
to the body.
Husbands should be educated on the
importance of their wives' food and nutrition
during pregnancy.
Government should also provide employment
to the vast population of women that are
unemployed in the area.
These women should be educated to engage
in subsistence farming which will help
alleviate the level of poverty and hunger in
the area.
These women should also be educated to eat
more of unrefined food instead of the refined
foods that predispose them to overweight and
obesity.
Women should be educated on the
importance of healthy weight prior to
pregnancy.
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