Lagos – There have been growing calls for Nigerian mothers to adopt exclusive breastfeeding for their new born within the first six months of life in order to break the vicious cycle of malnutrition and poverty in the country.
There have also been series of global and national awareness campaigns by government and health related non-governmental organisation aimed at taking the message of effective exclusive breastfeeding (EBF) across homes in towns and villages.
Despite efforts to curb the rising cases of infant and child malnutrition via exclusive breastfeeding across Nigeria, the country is yet to achieve the goal.
Global requirement on breastfeeding.
The World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) recommend that infants should be breastfed within one hour of birth.
WHO and UNICEF also say infants should be breastfed exclusively for the first six months of life and be breastfed continuously for up to two years of age and beyond.
Similarly, the WHO’s member States had in 2014 endorsed global targets for improving maternal, infant and young child nutrition and are committed to monitoring progress.
According to them the targets are vital for identifying priority areas for action and catalysing global change.
The global nutrition targets 2025 focuses on increasing the rate of exclusive (EBF) breastfeeding in the first six months up to at least 50 per cent.
It further aims at reducing the by 40 per cent the number of children under-five who are stunted.
It also targets to reduce by 50 per cent the incidence of anaemia in women of reproductive age.
Other areas targeted include; 30 per cent reduction in low birth weight, zero increase in childhood overweight and reduce and maintain childhood wasting to less than five per cent.
NBS and MICS report
Latest Multiple Indicators Cluster Survey (MICS) conducted by National Bureau of Statistics (NBS) 2016- 2017 shows that country’s breastfeeding rate remains low, with only 23.7 per cent of babies being breastfed exclusively.
Analysts believe that although the percentage of mothers exclusively breastfeeding their babies aged under six months, increased from 15.1 per cent to 23.7 per cent, the slow rate is a major setback to the country’s efforts to stop malnutrition in children.
A breakdown of the MICS shows that women in Northern Nigeria rank lowest in breastfeeding their children exclusively while women in the South-West zone lead in exclusive breastfeeding.
If any zone in Nigeria would attain the United Nations global targets to improve maternal, infant and young child nutrition by 2025, the South West States is not far from championing this cause.
A further breakdown of the MICS showed that the South-West has the highest number of exclusively breastfed children with 43.9 per cent and 70.5 per cent predominantly breastfed. However, the North-West zone has the lowest number of children breastfed exclusively with only 18.5 per cent. About 56.6 per cent were predominantly breastfed only in the North West.
The South-South zone followed with 27.2 per cent and 52.5 per cent were exclusively and predominantly breastfed, while the South-East had a share of 25.3 per cent with 47.8 per cent exclusively/predominantly breastfed, respectively.
The survey also showed the North-Central with 24.9 per cent EBF, while 45.8 per cent were predominantly breastfed. Further, the North-East had 21.3 per cent EBF, while 50.4 per cent were predominantly breastfed.
The MICS also found out that of the 60 per cent child deaths attributed directly and indirectly to under nutrition, two thirds of child deaths have been attributed to improper feeding during the first year of existence.
A comparative analysis of data from the MICS, conducted in 2007, 2011 and 2016/17, revealed that exclusive breastfeeding under six months has gradually improved consistently over the years in all states in the South- West zone and Edo State.
The MIC survey is an international household survey on a wide range of indicators on situation of children and women.
Experts say exclusive breastfeeding for the first six months of life is key to achieving these targets. In 2007, the South West could only boast of 17.1 per cent of exclusive breastfeeding rate. But, recent 2016/2017 MICS report showed an increased by over 200 per cent.
Today, the region has 43.9 per cent exclusive breastfeeding rate by mothers in 2016 and 2017 as against 17.1 per cent in 2007.
In the region, Osun had the highest percentage of exclusive breastfeeding rate with 55.3 per cent in 2017 followed by Lagos State with 51.8 per cent. Edo state increased from 11.9 per cent in 2007 to 27.1 per cent in 2017.
However, Ogun and Ondo States had the lowest percentages of exclusive breast feeding.
The MICS report showed that exclusive breastfeeding rate in Ogun was 23.1 per cent in 2007, 13.6 per cent in 2011 and 20.9 per cent in 2016 and 2017.
Also, Ondo State recorded 14.3 per cent of exclusive breastfeeding rate in 2007, 8.6 per cent in 2011 and 23.5 per cent for 2016 and 2017.
Commenting, Dr Niyi Olaleye, United Nations Children’s Fund (UNICEF), Planning, Monitoring and Evaluation Specialist, says the percentage of mothers in South-west and Edo engaging in exclusive breastfeeding for their infants less than six months has improved over the years.
In a presentation entitled, “The Situation of Children & Women in South-West States based on MICS data in the last 10 years (2007 – 2017),” Olaleye corroborated that the South- West zone, Ogun and Ondo states recorded the lowest rates over the years.
Osun, he said, recorded the most improvement rising from 12.5 per cent in 2007, 40.7 per cent (2011) to 55.3 per cent (2016/17).
The average rate of infants under six months old who were exclusively breastfed in the South west zone was 43.9 per cent, with the highest rate occurring in Lagos at 51.8 per cent, and lowest in Ondo at 23.5 per cent.
The UNICEF Planning, Monitoring and Evaluation Specialist observed that exclusive breastfeeding is positively related with mother’s education, wealth status and is now practised more in urban areas.
On her part, Mrs Ada Ezeogu, UNICEF Nutrition Specialist, Akure Office, breastfeeding is one of the best investments in global health as every $1 invested in it 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 per cent 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 per cent 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 zero to six 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 also explained that another strategy to achieve the UN target was by enforcing the Breast Milk Code.
Dissuading mothers from artificial feeding, she said it interferes with bonding, causes persistent diarrhoea, frequent respiratory infections, malnutrition; Vitamin A deficiency, milk intolerance, increases risk of some adult on set of chronic diseases.