Nigerian mothers denying babies exclusive breastfeeding
…Only 25% infants breastfed exclusively
…50% breastfeeding target by 2025 achievable — UNICEF
By Chioma Obinna
Seated among hundreds of nursing mothers at the Adeoyo Hospital, Ibadan, Oyo State, was 29-year-old Mrs Saidat Ganiyu. Her face was radiating with smiles, while she proudly breastfeed her baby.
Watching from afar, no one needs a soothsayer to say Saidat was happy doing what she was doing as her two months and 22 day-old baby Ajarat latched on the breast.
While Saidat is one of the Nigerian women that have realised the importance of Exclusive Breastfeeding, EBF, her daughter also is one out of the unacceptable figure of 25 percent children exclusively breastfed in Nigeria.
It is no longer news that tackling malnutrition begins with investing in the first 1,000 days of a newborn, what is of interest at this time is getting Nigerian women to breastfeed their babies.
In 2016, President of the World Bank, Jim Yong Kim, remarked that “One of the biggest obstacles to a better world is our collective failure to help parents provide adequate nutrition… to children during the first 1,000 days.”
Another world leader, Keith Hansen of the World Bank, published in The Lancet 2016 that “If breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel Prize in medicine and economics.
However, the Bible in Lamentation 4:3-4: states that “Even the sea monsters draw out the breast, they give suck to their young ones: the daughter of my people is become cruel, like the ostriches in the wilderness. “The tongue of the sucking child cleaveth to the roof of his mouth for thirst: the young children ask bread, and no man breaketh it unto them.”
These remarks are not unconnected with the many benefits of breastfeeding to newborns.
Unfortunately, despite the role of human breast milk in child development and survival as recognised by these world leaders including the Holy Bible, 75 percent of Nigerian babies are not exclusively breastfed.
Breast milk, nature’s food described as the cornerstone of care for childhood development and the gold standard of infant feeding provides all the nutrients that a child needs for the first six months of life and continues to provide essential nutrients for childhood development up to two years.
According to a Lancet on Child Survival Series 2003 tagged: “Child mortality: effective interventions”, Exclusive Breastfeeding, EBF, reduces child mortality by 13 per cent.
Sadly, Nigeria loses about 2,300 under-five year olds every day, and over two-thirds of these deaths are often associated with inappropriate feeding and poor practices.
According to the National Demographic Health Survey, 2013, the prevalence of EBF in children below the age of six months was only 17 per cent which means that at least 5.4 million Nigerian children each year do not get the benefits of breastfeeding.
However, imagining poor breastfeeding rate is one thing, but beholding the number of deaths (103,742 child deaths each year) caused by low breastfeeding rate and the economic cost to the nation which is estimated to the tune of $21 billion per year, equivalent of 4.1 per cent of Gross National Income, GNI, cost is another.
The poor breastfeeding habit is largely becoming an emergency. Anyone who has visited some of the UNICEF Malnutrition Sites across the country will understand the benefits of breastfeeding.
Emphasis has been on the fact that adequate and exclusive breastfeeding is not only an investment in improving children’s health and saving lives, but also an investment in human capital development that can benefit a country’s economy.
From the South to the North, there is no cheering news about breastfeeding. According to the 2013, Multiple Indicator Survey, MICS, percentage of EBF nationally is still 15.0 percent.
Ekiti State tops the list with over 45.0 percent, followed by Osun 40.0 per cent, Lagos was 25.0 per cent, Delta 10.0 per cent, Ogun 15.0 per cent, Ondo 10.0 per cent and Edo 25.0 per cent among others.
Currently, to meet the World Health Assembly target of increasing the percentage of children under 6 months of age who are exclusively breastfed to at least 50 per cent by 2025, it is expected that an additional $4.70 per newborn is required.
So what needs to be done to achieve the UN 50 percent exclusive breastfeeding target? Health watchers say with the right level of ambition and the right policies and investment, countries can fully realise the potential gains from breastfeeding.
UNICEF Nutrition Specialist, Akure Office, Mrs. Ada Ezeogu says breastfeeding is one of the best investments in global health as every $1 invested in breastfeeding generates $35 in economic returns.
For her, with the right policies and behavioural change of mothers and health workers, exclusive breastfeeding will soar up to 90 percent in the country.
“The 50 per cent UN target is achievable in Nigeria because if you look at the pattern you will find out that most mothers in Nigeria is breastfeeding but the problem we have is that many of them give water.
“So if we can change their orientation on how to position and attach the baby to breast, provide them with the support they need at home and get them to understand that breast milk itself has over 88 percent water even in Nigeria climate where it can be pretty hot.
“The breast contains enough water for the baby. If we can just drop the water from 0-6 months, we will indeed achieve much more than 50 per cent if not almost 90 per cent of EBF. We will then derive the benefit of breast feeding.
“Again, if 90 per cent of mothers exclusively breastfed their infants for the first six months of life, we will derive 13 per cent reduction in infant mortality.
“We need to change the norm of breastfeeding in Nigeria. EBF has the potential to save more children’s lives than any other preventive intervention.
“Breastfed children have at least six times greater chance of survival in the early months than non-breastfed children. And an exclusively breastfed child is 14 times less likely to die in the first six months than a non-breastfed child.
Ezeogu further explained that another strategy to achieve the UN target was by enforcing the BreastMilk Code.
Lamenting non implementation of the code, she stressed the need for the National Agency for Food and Drug Administration and Control, NAFDAC, charged with enforcement of the Code to go in and enforce the code.
According to Ezeogu, aggressive marketing by infant formula companies, non-enforcement of the Code of Marketing of BMS are currently posing a barrier to the campaign.
The Code of Marketing of Breastmilk Substitutes aims to shield breastfeeding from commercial promotion that affects mothers, health workers and health care systems. All forms of product advertising and promotion are prohibited. Mothers should not be given free product samples and promotional devices such as discounts.
Ezeogu stressed the need to build the skills of health workers who engage women on daily basis to be able to teach them how to breastfeed and why they should not give water until after six months.
“Knowledge is dynamic and they should be retrained. There is also the need to support these mothers. Usually there are a lot of pressures from grandparents who did not do exclusive breastfeeding that is why there is need for social mobilisation of the community to understand benefit of EBF and to encourage community members to do that.”
The UNICEF Nutrition Specialist also called for a holistic budget line for nutrition that would cover all aspect of nutrition because after breastfeeding the child will go to complementary feeding and adequate feeding for all.
On the benefits of breastfeeding, Ezeogu advised mothers to ensure that their newborns are put to breast within an hour of delivery as well as ensure that the baby is fed with the first milk they produces known as Colostrum. According to her, colostrum serves as the baby’s first immunisation and contains antibodies that can protect against allergy & infection, many white cells – protects against infection, purgative that can clear meconium, helps to prevent jaundice, rich in Vitamin A among others.
Dissuading mothers from artificial feeding, she said it interferes with bonding, causes persistent diarrhoea, frequent respiratory infections, malnutrition; Vitamin A deficiency, milk intolerance, increased risk of some adult on set of chronic diseases.
lower scores on intelligence tests, increases risk of anaemia, ovarian cancer, and breast cancer in mothers.
“WHO and UNICEF recommend that breastfeeding be initiated within one hour of birth, that it continue with no other foods or liquids for the first six months of life, and that it be continued with complementary feeding (breastfeeding with other age-appropriate foods) until at least 24 months of age.”
In her views, Chairperson, Oyo State Nigerian Association of Nurses and Midwives, NANM, Mrs Rukayat Afonja sad employers of labour should provide crèches in the workplace as a major tool to encourage EBF. “Every mother should be entitled to maternity leave.” She advised women who claimed to be experiencing difficulty in producing milk to check the position of their babies properly when feeding.
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