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Script 39.3

Script

If your children are having trouble seeing, you probably want to put something special over their eyes _ a pair of eyeglasses. But for a common kind of vision problem, the kind that starts when a child has trouble seeing in dim light, you should put something special in their stomachs.

The special something you should put in your children’s stomachs is vitamin A. Vitamin A prevents blindness. Nightblindness and dry eye are the kinds of blindness caused by a lack of vitamin A.

Sometimes nightblindness is called chicken eye, because children trip over things in the half light before sunrise or after sundown, the way chickens trip when there isn’t much light. This is also called nutritional blindness, because it is caused by the lack of the nutrient vitamin A. One thing to watch for is children who just sit quietly when the light is dim. If they have nightblindness and were teased for tripping, they may just be too embarrassed to walk around.

If children with nightblindness don’t get extra vitamin A, they can develop dry eye. The doctor’s name for dry eye is xerophthalmia (zer-e-thalmia). With dry eye, parts of the eye lose their natural moisture, making it more and more difficult for the eye to see. Finally no light can get into the eye at all, and the child goes completely blind.

Blindness isn’t the only danger. Children who don’t get enough vitamin A often have more severe diarrhea or respiratory illness and many of them will die. This is because vitamin A helps the body fight against infection. It helps the body make a protective layer around our throats and the tubes of our stomachs. In fact, even if there are no signs of dry eye, children who lack vitamin A are four times as likely to die as those who have enough Vitamin A. Children with dry eye are eight to twelve times as often.

The need for vitamin A is greatest when we are growing. This is why children between six months and six years old are most likely to show the signs of too little vitamin A.

Vitamin A deficiency often starts when the mother stops breastfeeding too soon, so it is important to breastfeed as long as possible. Children are at risk for nightblindness when they start to eat solid food. That is the time when they are growing very fast but are no longer getting enough vitamin A in their mother’s milk. Children who are not given breastmilk at all are much more likely to lack vitamin A.

A lack of vitamin A makes everyone more vulnerable to illnesses that can be fatal. Measles is one disease that is a particular danger to children who don’t get enough vitamin A. They often go blind soon after having measles, and many of them die.

So, how do you give your children enough vitamin A to prevent nightblindness, dry eye, and other diseases? The first way is to breastfeed babies as long as possible. Then, as soon as they start on solid food, give them regular portions of food containing vitamin A. These are: animals foods such as eggs and liver, yellow fruits and vegetables, and dark green, leafy vegetables.

Here are some examples of the best foods to eat for vitamin A. Milk, egg yolks, and liver contain a lot of vitamin A, so they are important foods to eat. One piece of liver the size of an egg (20 grams) will give your child enough vitamin A for four days, so prepare liver as often as possible.

Good yellow or orange vegetables to eat are: carrots, yellow sweet potatoes, pumpkins, and winter squash. Yellow or orange fruits that are high in vitamin A are: mangoes, apricots, cantaloupes, papayas, carambolas, nectarines and peaches.

You can also get vitamin A from dark green leafy vegetables such as spinach, amaranth, kale and leaves of cassava, watercress and beet greens. Red palm oil is one of the highest sources of vitamin A. But don’t overheat the oil because when its red colour goes away, vitamin A also disappears.

These fruits and vegetables are good for children, and they should start eating them as soon as they start on solid food. Pregnant women and women who are breastfeeding should try to get extra vitamin A for their newborns by eating more of these fruits, vegetables and some liver.

There are a couple of important things to remember when preparing these foods.

One is that our bodies can’t absorb vitamin A if we don’t eat fat with the vitamin A rich foods. Also, when preparing the vegetables, it is best to cook them as little as possible so most of the vitamin A goodness is not lost. So if, for example, you quickly stir fry the vegetables with a bit of fat, the vegetables still have a lot of vitamin A and you get the fat you need to absorb it.

Remember also to dry vegetables in the shade rather than in the sun to keep in more vitamin A.

When children already have nightblindness, it is time to act quickly.

They should get vitamin A supplements, that are usually in capsules, from the health centre or health workers. If children get vitamin A early in life, there is a very good chance their sight will become normal and they will grow up strong and healthy. But the longer they go without enough vitamin A, the worse their eyes will get.

Young children who get measles should also receive a vitamin A capsule to protect their eyes and their life. However, these vitamin A capsules are strong. You should only use them as advised by the health worker.

Getting too much vitamin A in pills may be dangerous. These capsules are best for children and adults who already lack vitamin A in their body.

Remember that the best way to prevent dry eye and other problems due to lack of vitamin A in the first place is to eat foods that contain vitamin A. Your family should eat lots of animal foods such as eggs, liver, milk, and fish oil, yellow or orange fruits and vegetables, and dark, green, leafy vegetables.

Vitamin A Sources
Amaranthus gracilis (amaranth), leaves
Basella alba (alugbati), leaves
Capsicum annuum (green pepper), leaves
Capsicum frutescens (hot pepper), leaves
Colocasia esculenta (taro), leaves
Corchorus olitorius (jute), leaves
Cucurbita maxima (squash), tops
Daucus carota (carrot), tuber
Hibiscus sabdariffa (roselle), leaves
Ipomoea aquatica (swamp cabbage), leaves
Ipomoea batatas (sweet potato), leaves
Momordica charantia (bittergourd), leaves
Moringa oleifera (horseradish), leaves
Portulaca oleracea (purslane), leaves
Psophocarpus tetragonolobus (winged bean), leaves and flowers
Talinum triangulare (Philippine spinach), leaves

(list fromNutritional dimension of bio-intensive gardening, published by International Institute of Rural Reconstruction, Silang, Cavite, Philippines.)

Acknowledgements

This article was researched and written by Katie Gillmor Ellis, Writer, Toronto, Canada. It was reviewed by Dr. Helene Delisle, Department of Nutrition, University of Montreal, Montreal, Canada, and by Dr. Paul Pencharz, Professor of Paediatrics and Nutritional Sciences, University of Toronto, Toronto Canada.

The publication of this script was made possible with the generous support of the McGeachy Charitable Foundation, Chatham, Ontario, Canada.

Information Sources

Fat soluble vitamins: vitamin A“, June No. 2 & July No. 1, 1992, Nyam News, Caribbean Food and Nutrition Institute Information Service, P.O. Box 140, Kingston 7, Jamaica.

The vitamin A+ sieve (Issues of July ’88, January ’89, July ’90, July ’92, January ’93, July ’93, January ’94). Rodale Institute, Rodale Press Information Services, 33 E. Minor Street, Emmaus, Pennsylvania, U.S.A. 18098.

BOSTID Developments, Vol. 7, No. 1, Winter 1987, Board on Science and Technology for International Development, Office of International Affairs, National Research Council, 2101 Constitution Ave. N.W., Washington, D.C., U.S.A. 20418.

Disease control priorities in developing countries, Chapter 19 -Micronutrient deficiency disorders, edited by Dean T. Jamison, W. Henry Mosley, Anthony R. Measham, and Jose Luis Bobadilla. Published for the World Bank by Oxford University Press.

Where there is no doctor, David Werner, Carol Thuman, Jane Maxwell, 1989, The Hesperian Foundation, P.O. Box 1692, Palo Alto., California, U.S.A. 94302.

Vitamin A deficiency and xerophthalmia, Edouard M. De Maeyer, 1984, F. Hoffmann La Roche and Co. Ltd. Basle, Switzerland.