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Job Osazuwa
Many Nigerians have been wallowing in ignorance, superstition and misconceptions over how to best feed their babies, especially within the first 1,000 days, starting from conception.
Myths about breastfeeding practices often pass from one generation to the next through the advice of family and community members, especially grandmothers and mothers-in-law, who believe that their experiences are all that are needed to make “faultless” decisions.
Nutritionists have said that there are damning consequences when a mother refuses to properly breastfeed her new born baby. Such a child is denied certain immunity that comes with breast milk, experts have noted.
Babies who are fed with only breast milk for six months and continue to be fed on breast milk for two more years, along with other foods, are believed to do better in academics than those who don’t enjoy the same opportunity. Though exclusive breastfeeding comes with immense benefits, millions of Nigerian mothers and infants are missing out from the gain.
It was gathered that only 25 per cent of children under six months of age in Nigeria are exclusively breastfed. This is one important issue that stakeholders said must be improved upon. There have been warnings that such habit increases vulnerability to diseases that could lead to infant and child mortality.
According to researches, optimal breastfeeding practices have the potential to prevent 103,742 child deaths, which is an important contribution to reducing overall under-five child mortality. It can also prevent over 10 million cases of childhood diarrhoea and pneumonia.
An estimated 5.4 million children do not get the powerful health and immunological benefits of breastfeeding each year in Nigeria. When children are not exclusively breastfed for the first six months and continue to receive breast milk up to two years, they are more susceptible to different diseases.
The three key components in infant and young child feeding practices are: early initiation – introducing the baby to its mother’s breasts within the first hour of birth; exclusive breastfeeding within the first six months- no water or infant formula, or any other liquid or food. And between six and 23 months when breast milk is no longer adequate, the baby is introduced to appropriate complementary feeding with emphasis on dietary diversity.
Researchers have revealed that an improved infant and maternal health will pave the way for a productive workforce and a stronger economy in the long term. To sustain the campaign, a behavioural change is imperative so that the rate of malnutrition will drastically drop in Nigeria.
Experts have stressed that breastfeeding saves lives, improves women’s and children’s health, and lifelong productivity. It is also reduces families’ out-of-pocket expenditures to treat diarrhoea and pneumonia.
To achieve a better result, there has been a strong advocacy for improving maternity protections in Nigeria, given that nearly half of all women in Nigeria are part of the labour force. Therefore, it is believed that extending paid maternity leave and workplace support for breastfeeding could help boost the low rates of exclusive breastfeeding.
Unfortunately, only a few states – Lagos, Enugu and Ekiti – have approved a six-month maternal leave, while others including majority of private companies, still grant three months or less to their employees.
A non-governmental organisation (NGO) funded by Bill Gates and Belinda Gates Foundation has been in the forefront in the campaign to ensure that all stakeholders in the health sector encourage exclusive breastfeeding. The NGO, through the “Alive and Thrive” project in Lagos State, has been supporting health facilities across ten local government areas in the last three years, mainly to improve infant and young child feeding practices.
The NGO has been working with the Primary Health Care Board and the Health Service Commission, where the secondary health facilities report to.
Stressing on the diverse benefits of exclusive breastfeeding, the Lagos State Health Education Coordinator, Sola Hassan said the partnership between the state and the Alive and Thrive in the last few years has helped Lagos to reduce the number of malnutrition and stunting, especially at the community levels.
She shed light on some of the challenges the ministry, alongside the NGO, had been encountering while enlightening pregnant and nursing mothers. She said most of the women usually complain that breast milk alone was not enough for their babies. She said that some of the health workers were also guilty by encouraging nursing mothers to add infant formula to breast milk for their babies.
“This is why we are focusing on behavioural change on the part of women so that we overcome all these challenges. We have recorded a lot of success working with Alive and Thrive in delivering and nurturing healthy babies. We always ask them to come to the clinic to know how to take care of their children at every stage as the baby grows.
“Sometimes, lactating mothers are not patient enough to allow their babies suck very well before jumping into conclusion that breast milk is not enough for the sucking baby. The baby should be allowed to suckle on both breasts for as long as possible. Sadly, a lot of mothers are always in a hurry, which leads them to patronise breast milk substitutes.”
Also, the Chief Nutrition Officer, Lagos State Ministry of Health, Mrs. Taiwo Adejoke Fadairo, said that there was an increase in the number of women who have embraced exclusive breastfeeding and other areas of infant and young child feeding since Alive and Thrive started the campaign in the state.
Said she: “For the number of stunted children, which is an irreversible situation, the state dropped from 11.4 as it was as in 2013 to 6.6 per cent in 2018. This is a huge success, though we are not yet there; there is still a lot of work to do.
“In the area of awareness creation, nursing mothers are now more aware of the benefits of exclusive breastfeeding and adequate dietary.
“We also know the challenges facing our women, especially in Lagos. Many women know what to do but some don’t have the six-month leave. As a matter of fact, some women don’t have up to three months leave, and there are no crèches or lactation rooms in many companies. In such cases, the mothers are left with no other option than to leave their babies with nannies.”
On the role of husbands in the campaign, she said: “We encourage fathers to provide food, money, materials, and encouragement to pregnant and breastfeeding mothers. The fathers need to be there always; they need to encourage their wives in this period because their wives might be tempted to give up. The jingle that was produced by Alive and Thrive in collaboration with the state took care of this aspect.”
In her contribution, the matron of a private hospital, Soteria Maternity and Hospital at Omole area of Lagos, Mrs. Margaret Oluwafumilayo Giwa, said that breast milk contains all the water and nutrients a baby needs during the first six months of life, even in hot, dry climates.
She explained that giving infants water before the age of six months reduces breast milk intake and supply; hinders absorption of nutrients from breast milk; and increases the risk of illness from contaminated water and feeding bottles, especially in emergency situations.
She said: “An infant’s stomach is very small; any amount of water or other liquids can fill the stomach and reduce appetite for nutrient-rich breast milk. Breast milk is 88 per cent water, which is clean, safe, and designed specifically to meet the needs of the baby. Giving the baby water is exposing it to harm because that water could be contaminated. Replacing breast milk with another fluid can negatively impact an infant’s nutritional status, survival, growth, and development” she said.
Mr. Chinedu Nwoadazie, who is a community facilitator and influencer at Sango Primary Health Care Centre, Agege, said that he was able to correct some misconceptions in the community.
“For instance, some of the men we met told us that the reason they have more than one wife was because when one of them give birth, they cannot have sexual intercourse with the wife because she is breastfeeding. They said when they do so; the baby would be sucking their semen from the woman’s breasts. But we have to correct that.
“We go ahead to educate them that it actually encourages natural family planning throughout the period of breastfeeding. During that period, there is no fear of getting pregnant.”
A nursing mother of with a pair of eight-month-old twins, Mrs Rofiat Yusuf, said that she was able to survive exclusive breastfeeding with the help of her husband’s support. She said that the two babies could be crying at the same time, but insisted that the benefits of breastfeeding were worth the sacrifice.
Also lending his voice to the issue at the Dopemu Primary Health Care Centre, the Medical Officer of Ministry of Health, Agege Local Government Area, Akinayo Akintoba Adebayo, said that with the help of Alive and Thrive, the centre was able to raise ambassadors for best breastfeeding and other nutrition practices.
He said that in addition to being an immune builder, exclusive breastfeeding gives rise to more bonding between the mother and her child. He added that the family and the society benefit from exclusive breastfeeding.
