Anaemia and the world of motherhood


In the world of Paeds, I was countlessly thrown with a question which I think needs a wider attention “doctor, my child does not want to eat, what is wrong with him/her?” This usually happens, when I notice that the child that they bring in for a simple cough or cold looks pale and a subsequent blood test proves that they are indeed anaemic. Some are also below their normal weight-for-age centile. Further questions regarding dietary regime at home usually reveals that either the 1 year old does not eat much because being offered breast milk most of the time when they should have regular adult meals or a three year old who only eats 3 spoons of rice each time, spitting out the chewed chicken or meat!

Whenever I encounter cases of children who are anaemic, I will start with a thorough physical examination and subsequent blood investigations to make sure that the child does not have any underlying diseases like thalassemia or any blood malignancy. I have encountered a 6 months old baby with thalassemia coming to the ward for blood transfusion every month but reassuringly, most cases of anemia that I see has a simple but yet difficult explanation.

Anaemia in children can be a sign that they need more attention from their mothers. I say this because eating is a habit that needs to be taught although we are well aware that food is a basic human need. When a child goes through their developmental milestones, they should acquire certain skills that will equip them to handle the challenges for later life. For example, when a baby reaches 6 months of age, they need to be trained to eat solid food because breast milk alone cannot provide adequate amount of iron levels for the thriving baby. Of course breast feeding should be continued until the child reaches 2 years old but relying on breast milk alone can be hazardous to a child. When a baby reaches around about 7-9 months of age for instance, they learn the ‘pincer grip’ – subhanallah and should be offered finger foods such as cuts of fruit and vegetables as well as biscuits and healthy snacks. A paediatrician who trained me at Modbury Hospital, Adelaide once said that if a child’s development is not picked up by the caregiver at that point, the skill will not develop until at a later stage when it might be difficult for parents as well as toddlers themselves to go through. Subsequently, when a baby is denied of the exposure to solid food after 6 months of age, it might be trickier later to develop their eating habit. They can be picky eaters or refuse to chew on lumpy food such as meat.


Training a baby to eat is a process which needs perseverance and patience. It will not happen in a day. It also needs time and rapport between the stakeholders. With the requirements of the current economy, mothers need to ensure that whilst they continue to work, the children’s dietary requirement is looked at. This include training babies to develop a proper eating habit as well as having home cooked meals for most days of the week to ensure hygienic food preparation and proper nutritional intake for the family. Mothers and mothers to be MUST be mentally prepared to value their babies’ developmental milestones. This can be achieved by reading books pertaining to this topic as well as having a support group from families and friends. As a mother, I wish that these topics were taught by our formal education system because a mother without knowledge is like a hunter going into the thick forest without his rifle. If he survives, he’ll come out pretty confused, dismayed and wished that he’d never go through that again! I hope to see happier, solehah and more knowledgeable mothers – and fathers of course, in my future practice.

Dr. Nur Farrah Nadia Najib
Chairperson,
Biro Keluarga dan Masyarakat,
Ikatan Muslimin Malaysia (ISMA) cawangan Johor

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