Promoting Nutrition, Child Development Through Exclusive Breastfeeding

Health experts have been vigorously campaigning for mothers to practise exclusive breastfeeding for the first six months of the birth of babies because of its numerous benefits. 

The dominant among the benefits are that it reduces the infant mortality rate caused by childhood illnesses, such as diarrhoea, pneumonia, asthma and the likes. They posit that breast milk builds antibodies that help babies to ward off viruses and bacteria in babies which often lead illness and consequently death.

The World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first six months of life.

This means that no other foods or liquids are provided, including water within the period.

The duo of the United Nation (UN) body on health and children also advocate that infants should be breastfed on demand – that is as often as the child wants, day and night.

They further recommend that between the age of six and 23 months when breast milk is no longer adequate, babies should be introduced to appropriate complementary feeding with emphasis on nutritional dietary component.

However, in spite of the benefits of exclusive breastfeeding, health experts and non-government organisations have identified ignorance, religious, socio-cultural beliefs among other factors as obstacles to the practice.

The WHO report reports that less than 40 per cent of infants who are less than six months of age are exclusively breastfed worldwide. Many mothers go for artificial breast milk thereby leaving many children without necessary protection in their early stages of life.

The 2016- 2017 Multiple Indicators Cluster Survey (MICS) conducted by the National Bureau of Statistics (NBS) shows that Nigeria’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. 

Research has shown that an improved infant and maternal health will lead to a productive workforce and strong Gross Domestic Product (GDP) in the long run. To strengthen the campaign, a behavioural change is vital so that the rate of malnutrition will significantly drop in Nigeria.

Experts have confirmed that breastfeeding saves lives, improves women’s and children’s health, and lifelong productivity. It also reduces families’ out-of-pocket expenditures to treat diarrhoea and pneumonia.

To win the campaign on exclusive breastfeeding, there have been calls for improving maternity protection in the country, given that nearly half of all women in Nigeria are part of the labour force.

There have also been campaigns on the extension of paid maternity leave and workplace support for breastfeeding to increase the low rates of exclusive breastfeeding.

Regrettably, only a few states – Lagos, Enugu and Ekiti – have approved a six-month maternal leave, while others including majority of private companies, still offer three months or less to their employees.

To ensure that mothers embraced exclusive breastfeeding, Alive & Thrive, an Initiative funded by Bill Gates and Belinda Gates Foundation had been leading the campaign to ensure that all stakeholders in Lagos State spread the gospel of exclusive breastfeeding.

The initiative, through its “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.

It has been working with the Primary Health Care Board and the Health Service Commission, where the secondary health facilities report to.

Underscoring the benefits of exclusive breastfeeding, Sola Hassan, Lagos State Health Education Coordinator, said the 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.

Hassan pointed out some of the challenges the ministry, alongside the initiative, had been encountering while enlightening pregnant and nursing mothers. The Health Education Coordinator lamented that most of the women usually complain that breast milk alone was not enough for their babies. She complained 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 to 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.”

Contributing, Mrs Taiwo Adejoke Fadairo, Chief Nutrition Officer, Lagos State Ministry of Health, 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 commenced the campaign in the State.

Fadairo said; “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.”

Concerning the role of husbands in the campaign, Chief Nutrition Officer 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 stressed on this.”

On her part, Mrs Margaret Oluwafumilayo Giwa, matron of a private hospital, Soteria Maternity and Hospital at Omole area of Lagos, listed some benefits of breast milk, saying it contains all the water and nutrients a baby needs during the first six months of life, even in hot, dry climates.

On administration of water to infants before the age of six months, she clarified that it 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.

Giwa 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.

She said that giving the baby water before the age of six months, 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.”

Commenting, Mr Chinedu Nwoadazie, who is a community facilitator and influencer at Sango Primary Health Care Centre, Agege said that his work has been focused on correcting some misconceptions in his community.

Sharing his experience, Nwoadazie said; “For instance, some of the men we met told us that the reason they have more than one wife was that 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.”

At the Dopemu Primary Health Care Centre, the Medical Officer of Ministry of Health, Agege Local Government Area, Akinayo Akintoba Adebayo said that through the support of Alive and Thrive, the centre was able to raise ambassadors for best exclusive breastfeeding and other nutrition practices.

Adebayo said that in addition to being an immune builder, exclusive breastfeeding promotes more bonding between a mother and her child.

Mrs Rofiat Yusuf, a nursing mother with a pair of eight-month-old twins said that she successfully practised exclusively breastfeeding with the support of her husband. On the challenge of practising exclusive breastfeeding for twins, she complained that her babies sometimes cry at the same time for breast milk, but stressed that the benefits of  exclusive breastfeeding far outweigh the challenges.