Chioma Umeha
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.
South-West leads
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.
