Module 7

Question 1

Why are women disproportionately affected by poverty/malnutrition

Answer 1

Infant girls are more likely to have low birth weight, growth restriction in womb, risk diarrhea, learning difficulties –> young girls more likely stunted, wasted, rickets (Vit. D), learning difficulties –> teenager delayed menarche, narrow pelvis –> potential mother with MN deficiency, risk of anemia, goiter, infection –> pregnancy with more birth complications, risk anemia

cycle repeats

women more likely experience:

• poverty
• low SES
• discrimination
• lack family planning service
• lack education
• lack health care
• early pregnancy

Question 2

what are WHO breastfeeding recommendations

Answer 2

1-6-24

1. Begin within hour of birth
2. exclusive breast-feeding up to 6 months
3. continued along with complimentary foods up to 2 and beyond.

• should be on demand
• bottles/pacifiers avoided- “nipple confusion”

Question 3

explain why proper breastfeeding is optimal, comment on extent to which they are followed

Answer 3

globally, 42% of infants are exclusively breastfeed for first 6 months (96% moms produce enough to do so)

benefits:
1. reduced risk infant mortality. non-breastfeed bb in developing countries 6-10x more liekly to die in first months. diarrhea/pneumonia also more common.
following recommendations would save >800,000 child lives. prevent 50% cases diarrhea, 33% respiratory infections in <5 months old

0-5 month old infants not breastfeed are 14.4 times more likely to die

2. reduced postpartum hemorrhage. BF –> hormones –> placenta expulsion
3. increased birth spacing- interval of 2 years reduces negative outcome for mom and infant

Question 4

explain why foods need to be introduced to compliment breast milk when infant is 6 months old and nutritional properties

Answer 4

infant needs more energy and nutrients by 6 months than just milk
priority: iron, running out of stores. and fat

challenges:

• timing (too early/late)
• may not be nutritionally adequate
• may be unsafe

Question 5

describe breast milk

Answer 5

big proportion of calories from gat. sufficient amounts of vitamins (except D and K). bioactive factors (anti-infective, and lipase, GF, laxatives)

• composition changes over time to meet infant need

1. colostrum- thick, sticky, very nutritious, laxative (meconium), GF, abs. 2-3 days after birth
2. transitional milk- until 2 weeks
3. mature milk- highest volume produced, until 6 months
4. extended lactation

changes within each feed (foremilk-less dense, hindmilk- high in fat/vitamins)

Question 6

identify strategies to promote optimal breastfeeding and myths (breastfeeding in emergencies)

Answer 6

some women discard colostrum, thought to be “dirty, harmful” esp. in rural/remote settings. give pre-lacteal feed instead

myth: mother under stress/malnutrition can’t nurse, not true. some countries (i.e. Indonesia, tsunami) have increased rates breastfeeding after emergencies.

strategies:

1. opportunity to feed right away
2. supportive sociocultural context
3. direct info/support

Question 7

explain how/when infants can become infected with HIV through vertical transmission

Answer 7

HIV+ woman transmits virus to child during pregnancy, labour, or BF

is child is breastfeed for 18-24 months:
5-10% become infected in pregnancy
10-20% in delivery
10-20% in BF
50-75% WILL NOT BECOME INFECTED (without art), if art is used then 1% risk

children of HIV+ mothers are more likely to be;
stunted (28%)
wasted (26%)
underweight (26%)

Question 8

breastfeeding recommendations for HIV+ mothers

Answer 8

need to balance risk HIV infection and risk other causes of death (diarrhea, infection)

if a save alternative to BF is available, use that. (formula, donor)
If not, breastfeed and ARV
reduced BF, parental care, also might be HIV+

Question 9

define maternal mortality and its causes

Answer 9

= death of woman while pregnant or within 42 days termination of pregnancy

• 20% due to iron deficiency
• other causes: high bp (eclampsia), delivery complications, bleeding, infections, unsafe abortion
• greatest risk ppl in poverty, young women

Question 10

describe patterns in maternal mortality over time, throughout world

Answer 10

up to 50% pregnant women in low-mid income countries have anemia, making them 2.36 times more likely to die.

malnutrition: pelvis may be too small (i.e. if stunted, or vit D deficiency in development, or young age), mechanically block fetus

Question 11

describe various strategies to reduce maternal mortality

Answer 11

strengthen health care systems to respond to needs of women
ensure accountability to improve quality of care
having trained professionals at the birth
promote access to necessary health care
universal health coverage

Question 12

ex. of factors that affect birth rate, strategies reduce family size

Answer 12

decreased GDP linked to increased fertility
number of children/women decrease when:
1. children survive
2. many children are not needed for work
3. women are educated
4. women join labour force
5. accessibly family planning
** women do not live in deep poverty

Question 13

define “gender gap”, comment on it globally

Answer 13

measure of equality between men and women. measures things like political representation, years of education, types of employment

global gap is around 69%
but the types of things vary. 
health has made notable improvements
political empowerment (reflected by women elected) has a very long way to go

Iceland has smallest gap, Canada is 19th
Yemen has greatest gap

Question 14

evaluate role women’s education in reducing poverty/undernutrition

Answer 14

displaces young marriages/births, increases livelihood opportunities, increases money in household, decreases fertility rates

increasing education for women by 43% improved food availability by 26% in children and improved status of women by 12%

women’s education/status contribute to more than 50% reductions in child malnutrition