Everything else.. How to Overcome Sri Lanka’s Iron Deficiency Issue

How to Overcome Sri Lanka’s Iron Deficiency Issue

2020 Nov 26

Iron is one of the most important substances that play a vital role in our growth, as it is responsible for the generation of ‘haemoglobin’ – as you might know, a substance prevalent in our blood, that carries oxygen to our brain and other organs. 

As well as oxygenating blood, iron is also required for a lot of biological processes such as DNA synthesis, mitochondrial respiration, neurotransmission, and myelin synthesis and to maintain brain function. The mineral is stored in the liver, spleen, skeletal muscle and other areas and can prove essential for a child’s cognitive development.

Sri Lanka’s status on the matter

As per a survey conducted in 2014 by The Ministry of Health and UNICEF Sri Lanka, 15.1% children were found to be anaemic and 52.3% were found to be iron deficient, of the total sample that was carried out in 25 districts in Sri Lanka, including areas like Matale, Puttalam, Matara and Galle. The test results that were shown in the survey concluded that iron deficiency was the leading cause of anaemia within these children. 

Even though a traditional Sri Lankan meal is considered healthy and nutritious as it usually consists of green vegetables, fish, pulses and other meat items, iron deficiency still stands a prominent issue within the community. 

Why the issue deserves our attention

Iron deficiency is said to be most prominent in children between 6 months and 5 years of age, as a baby will start adjusting to a normal diet aside from breast milk, during this time period. Babies are born with sufficient amounts of iron in their bodies that will sustain them for the first six months of their lives, after which the introduction of iron sources into their diet is important. 90% of a child’s brain development is said to occur during this period. A lack of iron could significantly impact brain growth and its intelligence quotient. 

However, older children can also be at risk, particularly girls who are approaching puberty. This can be due to the start of menstruation as well as changes in diet (sometimes due to peer pressure). Levels of activity and diet also affect a boys chance of developing ID.

ID is found in children amongst all socio-economic groups. Often, children from affluent households are more likely to have ID, as an increased disposable income would mean that processed and less nutritious foods are common in their diets. Although children in villages are more likely to eat a more well balanced and nutritious meal, they tend to have ID due to the price of meat.

What we must do 

The food items that are recommended by doctors to ensure that the iron stores of children are nutritionally rich are pulses, cereals, iron-fortified milk, meat products such as chicken, fish, dried fish and red meat items, eggs and other green vegetables. 

The aforementioned food items produce two types of iron namely, ‘haem iron’ and ‘non-haem iron’. Haem iron is produced by red meat and other meat products whereas non-haem iron is produced by cereals, pulses and some green vegetables like spinach and gotukola. While both these types of iron are important, babies tend to absorb haem iron much faster compared to non-haem iron. These food items should be given to the child in proportionate portions in order to ensure that the child is obtaining a balanced diet. 

This would be assessed via the ‘Child Health Development Records’ that is provided to new mothers by the clinic that they go to, which will aid in assessing if the child is obtaining balanced nutritional levels in their diet. 

Education and building awareness is also relevant, for both children and parents. Keeping a child informed of what they are eating and encouraging enthusiasm pave the way for positive transformation. Parents are required to communicate with their paediatricians in order to enable effective care.

Symptoms and treatment

Some of the symptoms of anaemia can be identified by mothers; for example, if they notice that their child is always sleepy and lethargic when they are supposed to be more active at home. This will become a clear indentation for doctors to conduct relevant testing and check if an iron deficiency is present. In this case, doctors will advise mothers to include more iron-rich food items in their child’s meals and in necessary cases, will also prescribe medical iron supplements in the form of drops, tablets and powders. 

A delay in speech, a short attention span, pale skin, a faint heartbeat, and an enlarged spleen are also amongst symptoms of ID. Observing a child’s response to circumstances can also be an indicator; irritability and reactions to being asked to do something may point towards a lack of nutrients. However, the individuality of the child has to be taken into consideration as the rate of development in different children can vary.

ID is commonly treated through nutrition. Severe deficiencies may require iron fortification and supplements.

The COVID-19 context

Unfortunately, access to iron-rich food items is not as versatile as we think, especially in light of the Coronavirus pandemic where most household incomes took a drastic negative hit and a scarcity for healthy food items arose. The harsh reality is that most households in rural areas are struggling to source and afford iron-rich food items daily, especially since meat items are expensive in this day and age. However, iron-fortified milk may be a good iron-rich substitute, since milk is a staple in many Sri Lankan households. 

Raising awareness on this iron deficiency issue prevailing at large in Sri Lanka, while providing necessary solutions is of utmost importance so that our country’s future can be in the hands of a healthy generation.