Recommends Expanding Paid Leave From Three To Six Months
August 1 to 7 is celebrated every year as World Breastfeeding Week. The theme of World this year’s celebration is ‘Invest in breastfeeding, invest in the future’. Championed by World Health Organisation (WHO), United Nations Children Fund (UNICEF), Ministries of Health and civil society partners around the globe, it is a time to recognise breastfeeding as a foundation for lifelong health, development and equity. However, despite the reported health and social benefits of breastfeeding, especially exclusive breastfeeding, less than 20 per cent of nursing mothers comply. There are ongoing efforts globally championed by the WHO, UNICEF, civil society organisations including Child Health Advocacy Initiative (CHAI) and Ministries of Health under the banner of WHO’s ‘Healthy Beginnings, Hopeful Futures’ campaign. A child health activist and Executive Director and Founder of CHAI, Dr. Elizabeth Lola Alonge, is a leading crusader of exclusive breastfeeding in Nigeria. Alonge, in this interview, explains why and how more nursing mothers in Nigeria could be encouraged to practise exclusive breastfeeding.

Why are more than 80 per cent of nursing mothers in Nigeria not practising exclusive breastfeeding and another 20 per cent not breastfeeding at all despite the reported health and social benefits?
There are several factors behind these low rates. Many mothers lack proper breastfeeding education and are exposed to misinformation from aggressive formula marketing. Cultural beliefs, myths, and family pressures often discourage exclusive breastfeeding. Additionally, many mothers resume work early after childbirth without adequate support for breastfeeding at workplaces or public spaces. Healthcare workers also lack adequate training to support breastfeeding mothers. All these create barriers to what should be a natural, supported practice.

Why should nursing mothers practice exclusive breastfeeding or even care about breastfeeding?
Breastfeeding is nature’s first immunisation. Exclusive breastfeeding for the first six months provides all the nutrients a baby needs, boosts the immune system, reduces risk of infections, and promotes healthy growth. For mothers, it lowers the risk of breast and ovarian cancers, aids postpartum recovery, and strengthens the mother to child bond. Beyond individual health, breastfeeding also promotes family well-being by reducing healthcare costs and ensures children grow into healthier adults who contribute more meaningfully to society.

What support do women and babies need from the healthcare system through their breastfeeding journey?
Women need skilled counselling from pregnancy through postpartum, baby-friendly hospital policies that support immediate skin-to-skin contact, early initiation of breastfeeding, and rooming-in. Continuous follow up care, access to lactation consultants, and practical help addressing breastfeeding challenges like latching or low milk supply are vital. Health facilities should provide breastfeeding education, not just for mothers but also for family members, as support from the home is equally critical.

How can civil societies ensure that every mother has access to the support and information she needs to breastfeed as long as she wishes to do so?
Civil society organisations can play a transformative role by raising awareness, providing community-based education, supporting peer counsellor programs, and advocating for better breastfeeding policies at national and local levels. Child Health Advocacy Initiative visits health facilities regularly to counsel mothers on exclusive breastfeeding and complementary feeding. We also have an online platform called Chai Nutrimums where we counsel mothers regularly. We tackle misinformation and resist unethical formula marketing through sensitization campaigns. Civil societies must hold governments and employers accountable for creating supportive environments for breastfeeding mothers.
To promote breastfeeding in public, CHAI developed an innovation called “Mamajoy breastfeeding suite” a mobile private room that can be placed in public spaces for mothers to breastfeed when they are outside. It can be placed in shopping malls, airports, offices, churches etc.

What are your plans for this year’s World Breastfeeding Week and local theme for the celebration?
At Child Health Advocacy Initiative (CHAI), our activities include community sensitisation events in various councils, breastfeeding walk to raise awareness, visit to hospitals to celebrate with new mothers, healthcare worker training, media advocacy, and collaboration with faith-based and women’s groups to spread the breastfeeding message. We will also be launching a digital breastfeeding support platform to connect mothers with lactation consultants and peer support groups.

How can these noble ideas of skilled counselling, enforcing the International Code of Marketing of Breastmilk Substitutes and supportive environments be enforced in Nigeria?
The National Policy on Infant and Young Child Feeding needs to be actively implemented and monitored. Government must invest in training health workers on breastfeeding counselling and enforce the International Code of Marketing of Breast-milk Substitutes by regulating formula advertising and ensuring accountability for violations. Workplaces public and private sector must be mandated to provide paid maternity leave, breastfeeding breaks, and lactation spaces. Legislation without enforcement is meaningless. We need civil society and media to hold authorities and companies accountable.

Breastfeeding is smart economics, according to WHO and UNICEF. Please explain?
Breastfeeding is a low cost, high impact intervention. It reduces household spending on infant formula, cuts healthcare costs by preventing childhood illnesses, and contributes to cognitive development, which leads to higher educational achievement and productivity in adulthood. WHO estimates that increasing breastfeeding rates can save countries billions of naira yearly in health expenses and lost productivity. Breastfeeding supports economic growth, reduces poverty, and fosters a healthier, more capable future workforce.

Do women everywhere need paid maternity leave to encourage breastfeeding?
Absolutely. Paid maternity leave allows mothers time to recover from childbirth and establish exclusive breastfeeding without the pressure of returning to work too soon. The International Labour Organisation (ILO) recommends at least 14 weeks of paid leave, but for exclusive breastfeeding to succeed, six months would be ideal. Nigeria’s current leave policies fall short, especially in the private and informal sectors, where most women work. Expanding paid leave is essential for maternal and child health.

Why do many women not breastfeed for as long as they would like?
Many women face social, economic, and practical challenges such as early return to work, lack of family support, physical difficulties like pain or poor latching, and lack of access to lactation consultants. Some are influenced by marketing of formula milk or discouraged by myths and misinformation. Without supportive policies, skilled guidance, and enabling environments, even motivated mothers may find it hard to continue breastfeeding.

What are the steps to successful breastfeeding?
The 10 Steps to Successful Breastfeeding, developed by WHO and UNICEF, are key. These include: Early initiation within the first hour of birth, Exclusive breastfeeding for the first six months, Skin-to-skin contact and rooming-in, On-demand feeding (day and night), No use of bottles, pacifiers, or formula unless medically necessary, Continued breastfeeding for up to two years alongside complementary foods, Regular support and follow-up from health professionals, Community and peer support, Educating family members and employers and Empowering mothers with accurate, culturally appropriate information.

Why are civil societies, WHO, UNICEF, Ministries of Health pushing against use of formula milk and its advertising despite some perceived benefits?
Formula milk can be life saving when breastfeeding is not possible, but it is not equivalent to breastmilk. The pushback is against unethical marketing that undermines breastfeeding by promoting formula as superior or necessary. This misleads mothers and erodes breastfeeding culture. The International Code of Marketing of Breast-milk Substitutes exists to protect mothers from commercial exploitation and ensure breastfeeding remains the norm, not the exception. Breastfeeding is a public health imperative, not just a personal choice.

The National Agency for Food and Drug Administration and Control (NAFDAC) is actively implementing the International Code of Marketing of Breast-milk Substitutes in Nigeria. The agency just inaugurated Breast Milk Substitutes (BMS) State Multi-Sectoral Technical Committees in 32 states to enforce the code and national regulations at the state level. We look forward to seeing the state committees perform to expectations.

Moving forward, what is you call to action?
As we mark World Breastfeeding Week 2025, the call to action is clear: Invest in breastfeeding, invest in the future. Let us create a Nigeria where every child receives the best start in life, and every mother is supported to nourish her baby naturally, confidently, and with dignity.