WBW 2023: Helping working mothers preserve their health, nourish their babies

From Tuesday, August 1 to 7, the World Breastfeeding Week would be commemorated. With this year’s theme focused on making a difference for working mothers, experts insist that providing new mothers with access to free education on updated breastfeeding best practices is a sine qua non for entrenching the practice. They also maintain that long-term breastfeeding has enormous health benefits for mothers, including helping to shed excess weight acquired during pregnancy and reducing the risk of breast cancer. IJEOMA THOMAS-ODIA writes.

Banke Eniola is an Information Communication Technology (ICT) professional, who works in an upscale financial services outfit. Before she got married in 2016, she had fantasised about exclusively breastfeeding her children for the maximum number of months recommended by medical experts.

According to her: “My children must be like my older sister’s children all of whom were exclusively breastfed by her. I lived with my sister when she started having babies, and I can attest to all the benefits that her children derived from being exclusively breastfed. None of them ever fell seriously ill during growing up, much less spent a night in a hospital. It was because of all these that I told myself that I would never deny my children exclusive breastfeeding when I get married.”

Seven months after Banke got married, her husband’s office transferred him to the company’s head office in Lagos state. Away from the warm embrace of relatives as well as kith and kin. Consequently, the Eniolas had to start a new life all by themselves.

Before long, Banke got a good job with her present employer, and within four years, she was promoted twice, with commensurate remuneration to make up for her increasingly crowded schedule. That notwithstanding, Banke has a big regret – her employer’s failure to create a friendly atmosphere to encourage breastfeeding at workplace, as well as the company’s failure to allow her spend a single day off after her maternity leave. Consequently,  she failed to exclusively breastfeed her three children the way she had wanted.

According to medical experts, babies who are fed with only breast milk for the first six months of life get sick less often than babies who eat other foods. They have less pneumonia and other respiratory illnesses. They also have less intestinal disease, fewer ear infections, and fewer allergies.

Sutter Health, a California, United States-based not-for-profit integrated health delivery system, in explaining the importance of breast milk to infant development explained that the early months of a baby’s life are essential to long-term development.

“Breastfeeding gives your baby the body-building components that are particularly suited to his or her health and development. Milk from animal and plant sources do not contain the body-building components particularly suited to the human body,” it said.

In a piece entitled, “Importance of Exclusive Breastfeeding,” the group stated that breast milk is all that a baby needs for the first six months of life. “The first milk is colostrum, and colostrum is in your breasts starting about the fifth month of pregnancy. Colostrum is available in small amounts, which perfectly match your baby’s stomach size at birth. Breast milk begins to be produced when your baby is born, and increases in amount daily, as your baby’s stomach size grows. Small amounts of colostrum in the first few days keep your baby from overfilling his or her stomach. This is important while your baby is learning to coordinate sucking, swallowing, and breathing.”

The outfit continued: “Breast milk is the only food your baby needs for the first six months of life because it has all the nutrition and fluid that your baby needs; it is better for your baby than any other food or fluid. Giving other foods or fluids may decrease your baby’s desire for breast milk.

In maintaining that breast milk should still be the baby’s main source of nutrition for the first year of life, the integrated health facility said: “Breast milk is better than any other food for nutrition and disease protection. It is important to introduce solids after six months so your baby will learn to eat different foods. But it is important to continue breastfeeding. Breastfeed before each meal of solids, as the “first course.” You can also keep up your baby’s breast milk intake by gradually increasing meals as they age. Try one meal of solids a day at six months old, then two solid feedings a day at seven months old, three meals a day at eight months old, then three meals plus snacks at nine months old. Breastfeed before each meal, and before and after sleep periods.

At a zonal media dialogue on the forthcoming 2023 World Breastfeeding Week (WBW), which runs from August 1 to 7, the United Nations Children’s Fund (UNICEF) emphasised that exclusively breastfeeding a child for, at least, six months after birth remains a powerful life saver, even as it is critical to long-term health and wellbeing of both mother and child.

The nutrition specialist at the UNICEF Field Office, Enugu, Mrs. Ngozi Onuora, while speaking at the World Breastfeeding Week, and Zero Water Campaign for Anambra, Benue, Cross River, and Enugu states, described as unfortunate, the failure of the majority of nursing mothers do not optimally breastfeed their children.

Noting that only 38 per cent of infants are exclusively breastfed in the first six months of life, a practice that has led to about 800,000 child deaths annually, she added: “The practice of feeding babies extra water, in addition to breast milk, is common in Nigeria. This is harmful as extra water not only introduces illness-causing pathogens but also reduces the child’s thirst and effective suckling.

“The zero water campaign, therefore, promotes giving babies breast milk only on demand day and night, and stopping the practice of giving water and other liquids and foods from the moment of birth through the first six months of life, to achieve the World Health Assembly global breastfeeding target of 50 per cent by 2025,” she added.

The UNICEF Enugu Office Communications Officer, Dr. Ijeoma Onuora Ogwe, urged the media to set agenda for the Zero Water Campaign on exclusive breastfeeding, arguing that every working nursing mother should enjoy six months of maternity leave, with assurance of job security.

“Practicing breastfeeding at work makes societies work, as it provides vital health and nutritional benefits for children with positive lifelong impacts, building healthier populations and workforces for the future. Women should not have to choose between breastfeeding their children and their jobs because exclusive breastfeeding is possible regardless of workplace, sector, or contract type.

“Also, effective maternity protection improves children’s and women’s health and increases breastfeeding…All women everywhere, no matter their work, should have at least six months paid maternity leave, paid time off for breastfeeding, and flexible return to work options,” she said.

Corroborating claims made by experts, as well as, stakeholders in the health value chain regarding the benefits of exclusive breastfeeding, the World Health Organisation (WHO) stipulates that breast milk is the ideal food for infants as it is safe, clean and contains antibodies, which help protect against many common childhood illnesses.

It also provides all the energy and nutrients that infants need for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life.

The theme of this year’s WBW set by the World Alliance for Breastfeeding Action (WABA), “Enabling breastfeeding: making a difference for working parents,” serves as a poignant reminder for employers of labour and working parents to maximise the benefits of breast milk as the society strives to groom healthy babies and by extension, a healthy society.

Recalling her journey on that path, a civil servant, Mrs. Bernard Funmilola, said that she had stopped breastfeeding her last baby when she clocked one.

“My daughter is now one year and a half, and I could not afford to breastfeed her up to this age because I have to resume work as early as 7:30 am, and most times, I am always stressed out. While I breastfed her, I also noticed that the sweetness in the breast milk makes her reject some foods, so I felt it was time I stopped breastfeeding completely. Thankfully, she eats well, so what does she need the breast milk for now? I am aware of the benefits of breastfeeding, hence I ensured that my baby was breastfed for the first six months exclusively.”

Another mother, Favour Olawale, who has a seven-month-old baby, said that she breastfed her daughter exclusively for six months before introducing pap and Amala alongside breast milk.

“Working in a school allowed me to take her along to the school’s crèche from where I could attend to her when the need arises,” she added.

Oluwaseyi Isreal, a working mother who has pledged to breastfeed her three-month-old for at least six months, “but will not exceed the one-year mark, which is a common landmark among working women.

According to her, “I don’t run my business; I am working for someone, and so it is not easy to deliberately decide to keep breastfeeding for a longer period. Our economy too has not been friendly, especially with policies that would allow working, breastfeeding mums to thrive. There are so many demands that are waiting to be met, especially as a mother who has other children, and so the last thing on my mind is how to breastfeed for long. That is why I am eagerly looking forward to ending breastfeeding.

For a breast milk advocate and medical doctor, Dr. Chinny Obinwanne-Ezewike: “I have been doing my best to help working mums since I am also a working mum, and I know the struggles that come with exclusively breastfeeding when you also have to work. I faced a major challenge, especially being on call overnight.

“However, due to the challenge that I faced on the first night that I was on call despite expressing breast milk and leaving it with my husband to feed the baby, she cried all through the night, and that left me with a huge mum guilt. Based on my experience and expert knowledge, I have been able to draft a workable plan for working mothers, whether they are working full-time, are on calls, working part-time, or hybrid.

“First, I encourage new mums going back to work to start preparing early from the first two weeks after delivery. I advise them to start pumping early by adding an extra pump session every day to their baby’s feeding demand; and start storing the milk that they express during that extra pump session.

Obinwanne-Ezewike, a lactation expert, and Founder of Milk Booster continued: “They should store the breast milk in their freezer, which can last for six months minimum. With this extra pump session, many of my mums already have a milk stash by the time they are heading back to work in three months. I also get them to have the difficult conversation of discussing with their human resource units, break times and pumping breaks. At this point, the response varies amongst mums and the organisations that they work for, and I tailor the plan according to what is feasible per mum.”

She explained that while some mums have had to fragment their lunch break into three parts to enable them to pump three times at work, others have appreciated our low-sound wearable breast pump, which they can have inserted into their bra and pump while working and nobody notices that they are pumping. We also consistently help them to maximise their efforts with our lactation treats so that they can produce more volume of breast milk. We have also introduced a thermal sensor breast milk storage bag, and cooler bag to enable them to store their pumped milk safely for their babies.

As the founder of the first milk bank in the country, Dr. Obinwanne-Ezewike admits that it has been a very challenging experience running the facility. “Our challenge started with setting up our machinery. There was nobody on ground that had set up such a machine before. Finally, we found someone that collaborated with our United Kingdom supplier to set up the equipment and get it working.

“Funding was the second challenge that we faced because we did all we did without any external funding, The Milk Booster has been taking care of the cost implication of running the Milk Bank- from paying the staff; blood screening of each donor mum; the numerous pre-pasteurisation and post-pasteurisation milk screening, to running the facility, etc. It’s been very challenging especially when I remember the number of times that we had a post-pasteurisation milk sample test come back uncleared. We kept going back and forth with the team in South Africa that helped us until we got past that hurdle.

She described as enormous, benefits accruing to both mothers and newborns from breastfeeding, stressing: “Breast milk provides the specific nutrients that meet baby’s needs and reduces baby’s risk of sudden infant death syndrome (SIDS). It allows babies to feel close to the ‘home base’ that they’ve known while in the womb. Hearing the mother’s heartbeat and feeling her warm skin helps babies to transition from the inner world to the outer world.”

She also said that Docosahexaenoic acid (DHA), a polyunsaturated fatty acid found in breast milk, helps support proper brain development, just as breastfeeding can reduce baby’s risk of developing middle ear infections; reduce baby’s risk of developing diabetes, since breast milk contains no artificial sugar.

Another outfit that has been doing a lot to support breastfeeding mothers is Milky Express.

According to lactation consultant and founder of the outfit, Titilayo Medunoye: “We believe that for babies to be healthy and thrive well, mothers must be of sound body and mind. Over the years, we have worked with over 10,000 mothers across Nigeria, providing them with access to free education on updated breastfeeding best practices. We have organised several outreaches, where our in-house international board-certified lactation consultant offers consultations to mothers, guiding them through their breastfeeding difficulties.

“Another focus for us is to empower healthcare workers who work directly with mothers in hospitals, and health centers. We equip them with the necessary knowledge and tools, which enable them to provide the utmost care to mothers and babies. Aside from the products that we offer breastfeeding mothers, we also develop a mobile solution that offers real-time solutions to mothers; it helps them to monitor their baby’s growth and to store their baby’s health records electronically.

“This is very beneficial especially for working mums because, with the app, they can set a schedule for whoever is watching their children to manage things like feeding time; when to give medication, or change diapers. All these are recorded for the caregiver.

“Furthermore, the parents get real-time updates for when things happen. So, you don’t have to call home to ask if your baby has eaten, or how much food he/she ate. The app gives you the information provided the caregiver puts it on. Vaccine records and reminders are also provided for parents by the app.

Commenting on the rate of exclusive breastfeeding in the country, Medunoye noted that it has improved over the years, even though a lot of work still needs to be done.

“One of the major reasons for the low breastfeeding rate in Nigeria is the lack of proper breastfeeding education around what it means to exclusively breastfeed, and understanding the safe and proper way to handle, store and preserve breastmilk. Another challenge is the lack of support from organisations for their staff w ho have newborns. If new mothers are only given three months of maternity leave, how are they expected to feed her baby exclusively for six months? Managements, as well as, human resource departments need to look into other ways to support new mothers to care effectively for their newborns.

“One way to go will be to extend maternity leave to six months. Another will be to offer them the work-from-home option, or even provide a daycare centre within the premises. This way, a lot of the difficulties that come with having a newborn are removed, and mothers can focus on giving their best to the organisation.”

Reliving her experience, she said: “I remember when I had to return to work after my three-month maternity leave was over, it took me almost two hours to get to work in the mornings due to the traffic situation. This meant I would have to leave my house very early, and by the time I leave my house, no daycare would have opened that early for me to drop off my baby. My next option was to get a nanny, which I did, but she would end up resuming work late thereby making me also get to work late. Women will always have children, and women are a very vital part of the workforce. If we want women to continue to give their best to their organisation, then organisations need to look for creative ways to support them.”

Speaking on difficulties women face with breastfeeding, Medunoye said, women experience breastfeeding difficulties for several reasons, and being lazy is not part of it at all. If we understand the physiology of breastfeeding, we will understand why it could be difficult for mums. A few reasons are oral anomalies in babies like tongue tie, breast anatomies like flat or inverted nipples, insufficient glandular tissues, poor latch, or breast and nipple pain. One key factor that enables breastfeeding is the presence of glandular tissues in the breast. Women have this in varying numbers. So, the absence of this tissue will make it impossible to breastfeed.

“Breastfeeding saves money as prolonged breastfeeding prolongs anovulation – it can halt ovulation, which will require very frequent breastfeeding of between two to three hours. Long-term breastfeeding helps in reducing the risk of breast cancer, ovarian cancer, endometrial cancers, cardiovascular disease, and type 2 diabetes mellitus.”