By Chioma Umeha
Mrs. Chinedu Chukwuma, from Agwu in Enugu State, is a happy woman. One needs no fortune teller to understand the source of happiness of the 20-year-old mother. The healthy look of her two children tells it all. You could see the bond between Chinedu and her three-month-old baby, Ebelechukwu, as she cuddles her, all thanks to exclusive breastfeeding.
The World Health Organisation (WHO) explains, “Exclusive breastfeeding means that the infant receives only breast milk. No other liquids or solids are given – not even water – with the exception of oral rehydration solution, or drops/syrups of vitamins, minerals or medicines.”
For Chinedu, exclusive breastfeeding is not a new practice. She has done it before and had seen the benefits. She did not need any persuasion to adopt it for Eberechukwu, her second child. Apart from immunisation, she has had no reason to be shuttling between hospital and home unlike some mothers.
Chinedu told Independent during an investigative visit to Enugu that she came to know about exclusive breastfeeding while attending antenatal classes for her first baby. “We were told that it is a very good practice. I also did it for my first baby for six months and even this baby; I will also do it for him,” she said.
WHO recommends that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up to two years or beyond.
To promote the exercise, the Federal Government integrated education on exclusive breastfeeding into the antenatal programmes at the Primary Health Care(PHC) Centres for nursing mothers to be taught about its benefit.
Only recently Federal Government pledged its commitment towards supporting breastfeeding and improving funding to scale-up nutrition and breastfeeding practices across the country.
Mrs. Aisha Muhammadu Buhari, wife of the President, disclosed this in Abuja, during the Launch of 2016 Lancet Series on Breastfeeding and High – level Policy Dialogue on Promoting Breastfeeding for National Development in Nigeria.
Mrs. Buhari, represented by the wife of Niger State governor, Dr. Amina Abubakar Bello, informed that Federal Government would prioritise breastfeeding as part of the efforts to roll out the National Strategic plan of Action for Nutrition.
Ngozi Onuora, a Nutritionist at UNICEF at the Port Harcourt office of the United Nations Children’s Fund (UNICEF), Nigeria, addressing journalists recently at media training on child nutrition, said that exclusive breastfeeding reduces infant mortality.
Onuora explained that this is due to the protection it gives the baby against common childhood illnesses such as diarrhoea or pneumonia, and helps for quicker recovery during illness.
She said: “Good nutrition is the bedrock of child survival, health and development. According to her, well-nourished children are better able to grow, learn, participate in and contribute to their communities. It also makes them resilient in the face of disease, disaster and other crisis.”
Mrs. Igbe Assumpta, a 26-year-old mother also attested to the benefits of practising exclusive breastfeeding. Though a student, she got the first information about exclusive breastfeeding from her elder sister who told her how beneficial it is before she started antenatal.
Igbe said, “Exclusive breastfeeding boosts my baby’s intelligent quotient, as she is very sharp. Even my friends who are not doing exclusive breastfeeding used to tell me that my baby is very sharp. My baby is also strong and healthy.
“Since I gave birth to her, I haven’t taken her to the hospital. It saves me money. My baby is five months and two weeks and I will complete the six months exercise. I will still practise it for my next baby. I also advise other women to go for exclusive breastfeeding.”
As for Celestina Nwankwo, a 35-years-old farmer and mother of six children, the difference between her children who were exclusively breastfed and those who were not is clear.
She told Independent, “I have done it for two of my children and I saw the difference. They don’t fall ill often; they do not go to toilet anyhow. My advice to mothers is that they should try and adopt exclusive breastfeeding because it is very good.
“I did not do exclusive breastfeeding for all my children. There is a big difference between those who benefitted from it and others who did not. The ones that were exclusively breastfed are very intelligent and are closer to me,” Celestina said.
The 35-years-old farmer also said she heard about it in the Health Centre during antenatal.
According to Mrs. Monica Igbofunanya, the Education Officer at Primary Health Centre (PHC) Agwu Local Government of Enugu State, the main challenge facing nursing mothers in the area is the mother- in-laws who try to persuade their daughter-in-laws to give pap or water to the children.
She said, “The major challenge is mother-in-laws who insist on feeding the baby with other foods and water after they have been delivered. I call most of them during their ANC period to counsel them with their husbands.”
To enable mothers to establish and sustain exclusive breastfeeding for six months, WHO and UNICEF recommend initiation of exclusive breastfeeding within the first hour of life, that is, the infant receives breast milk without any additional food or drink, not even water.
WHO further recommends that breastfeeding should be done on demand and that is as often as the child wants, day and night, and bars the use of bottles, teats or pacifiers.
However, despite how important and beneficial exclusive breastfeeding is, many women do not adopt it. WHO report has it that currently, less than 40 per cent of infants who are less than six months of age are exclusively breastfed worldwide. Many women go for artificial breast milk thereby leaving many children without necessary protection in their early stages of life.
Experts are worried given the Nigerian situation where many families hardly have enough to eat, not to talk of buying sufficient milk for their newborn babies.
Some women, out of ignorance or a show of affluence, introduce artificial breast milk to their babies within the first six months. Many of them claim that breast milk alone cannot satisfy their babies.
Sadly, some health workers even encourage mothers to give their babies artificial milk soon after delivery. In some hospitals where artificial milk is forbidden for new born babies, some health workers secretly help the mothers feed their babies with artificial milk.
Again, some mothers and mothers-in-law make things difficult for their daughters and daughters-in-law who want to breastfeed their babies exclusively. They still regale in the old tradition that new born babies must be fed with water which they believe the baby needs most to be alive. Refusal to abide by such tradition often results to misunderstanding.
Meanwhile, some working class women, out of circumstances, are forced not to breastfeed their babies exclusively for the recommended six months.
Some organisations, especially private ones, give six weeks maternity leave and do not allow the women to come to work with their new born babies. Many organisations do not have crèche for new born babies, thereby forcing them to either stop breastfeeding abruptly or combining breast milk with artificial milk.
Corroborating earlier views, Dr. Chris Osa Isokpunwu of the Federal Ministry of Health, Abuja, told journalists during a two-day Media Dialogue on Leveraging Resources for Child Malnutrition in Nigeria that exclusive breastfeeding for six months prevents childhood illnesses like diarrhoea, infection
He said that exclusive breastfeeding prevents childhood obesity and the associated non- communicable diseases in adulthood, adding that the mother only needs to be adequately fed on normal family diet.
Isokpunwu revealed that “it is cheaper when compared to what is spent on baby formula, hospital bills, energy cost of boiling water and sterilisation of bottles, cups and spoons, and above all, the consequences of non-communicable diseases like diabetes, hypertension, cardiovascular diseases later in life.”
To curb child malnutrition, WHO recommends exclusive breastfeeding of infants for six months as the breast milk contains all the nutritional value a child needs for proper growth and continuous breastfeeding and adequate complementary foods until 24 months.
The basic drivers of malnutrition are poverty, failure in governance, institutional weaknesses, gender issues, the underlying causes are food insecurity, inadequate care, access to health care services, while the immediate causes of malnutrition are; inappropriate food intake and diseases.
With Nigeria currently recording a huge number of malnourished children, the Gross Domestic Product (GDP) might just be affected years from now as malnutrition accounts for low Intelligent Quotient (IQ) of an individual.
Every single day in Nigeria, malnutrition accounts for 2,300 under-five deaths and 145 women of child bearing age and this makes the country the second largest contributor to the under-five and maternal mortality rate in the world.
United Nations Children’s Fund (UNICEF) data said annually, up to one million children die before the age of five in Nigeria, 50 per cent of the cause is undernutrition, and 26 per cent are neonatal deaths and figures by World Bank suggests that Nigeria loses over US$1.5 billion in GDP annually to vitamin and mineral deficiencies alone.
Also a survey by UNICEF indicates that malnutrition does not just make the child stunted, wasted, it also prevents the child from achieving his potential and children who are malnourished in their first two years of life lose 11cm of potential height.