Nigeria joins world to mark breastfeeding week

As Nigeria joins rest of the world to commemorate this year’s World Breastfeeding Week (WBW), which kicks off today, nutrition and breastfeeding experts have decried the rapidly dwindling breastfeeding rate nationally and the rise of malnutrition in children, reiterating that poor nutrition and child development is linked to the poor national breastfeeding rate which currently stands at 29 per cent.

Speaking with The Guardian, Lagos State’s Nutrition Officer, Olubunmi Braheem, said this year’s theme of Step Up For Breastfeeding: Educate and Support, is needed more than ever to curtail rising malnutrition, infections and diseases.

“Lagos has a 51.8 per cent breastfeeding rate as the last national survey conducted in 2018 as opposed to the national rate of 29 percent which is very alarming. There is no reason babies should not get the first food necessary for development and survival so far the mother is alive and well.

“Even in extreme cases such as when the mother passed on or has serious complications, such babies should not be deprived of breast milk. Babies must be breastfed for at least 24 months as this has a very strong impact in the child’s first 1,000 days in terms of brain development.”

Braheem added that breast milk is the first right of every Nigerian child and breastfeeding must be initiated early, immediately after birth before separation of the placenta. “Health workers must put the baby to the mother’s breast immediately after birth even in cases of caesarean births.”

The very first milk that comes out, the colostrum must be given to prevent life-threatening infection and diseases.”

Braheem said while it looks like many Nigerian women are breastfeeding, their research and studies show that this is not the case, hence the rise in malnutrition and preventable diseases. Describing breast milk as the best and most complete meal for a baby, she said it is the primary role of health workers to ensure that it is initiated at most, one hour after birth. “Mothers should be encouraged and given all the support necessary to continue breastfeeding even after they go home. In the case of caesarean sections (CS), health workers should give support by placing the baby to the mother’s breast until she can do it on her own but unfortunately, this is not the case in our health facilities these days.”

The chief nutrition officer reiterated that the colostrum which serves as the first form of immunization is sadly not given to many babies just as exclusibe breastfeeding must take place till six months of a child’s life without water, glucose or any other substance. “We need community actors to help and support us in this fight. Giving babies herbal concoctions (agbo) and supplements is totally forbidden and we continue to plead with mothers not to give or allow anyone give their babies these mixtures. This is one of the major problems we have as it leads to problems for the baby. Even after six months, breastfeeding must not stop but appropriate complementary food should be added to it as breastfeeding alone cannot support the baby after six months.”

Founder and president of the Child Health Advocacy Initiative (CHAI) Nigeria, Elizabeth Lola Alonge said the importance of breastfeeding cannot be overemphasized, not only for its inherent nutritional value and cognitive outcomes in children but also for social and emotional development. “Breast milk contains antibodies and protective enzymes that fight infections. Exclusive breastfeeding for six months can reduce the risk of a baby contracting an upper respiratory viral infection by 35 percent. Breastfeeding an infant can lead to higher IQ for the child, especially if breastfed exclusively and for a longer period of time. Also, babies who are breastfed have a lower risk of obesity later in life and children and adults who were breastfed have a lower rate of food allergies, asthma, eczema, Celiac Disease, and Type I and Type II diabetes, amongst others.”

Regretting that most organisations in Nigeria do not actively encourage breastfeeding, Alonge said employers should create a conducive environment for nursing mothers to support breasting through workplace strategies including longer maternity leave provisions; flexible employment practices/part time work, lactation breaks and physical facilities such as private rooms, access to refrigeration and creation of breastfeeding support programs in the workplace.

“Nigeria can support breastfeeding practices through reviewing the national guidelines on baby friendly initiatives, creating sustainable infrastructures for breastfeeding practices, introducing activities to support education in nutrition for breastfeeding mothers, including peer support groups, providing financial support to sponsor long lasting breastfeeding campaigns and initiatives and censoring breast milk substitutes campaigns and promotions. Establishing a surveillance system to monitor programmers and policies over the years can help to clearly establish progress.”

Citing some barriers for breastfeeding mothers in Nigeria, she listed a lack of knowledge about breastfeeding for women, misconception that formula is equivalent, poor social norms, zero or poor family and social support as some of the factors. Others include embarrassment about feeding in public, lactation problems, returning to work and accessing supportive childcare, bad policies and practices in health services by health workers as well as bad policies and practices in health services by some health workers as other barriers. Reiterating that poor breastfeeding leads to chronic malnutrition and/or over nutrition later in life, she urged the government and stakeholders to take action as soon as possible.

Braheem said while it is understood that mothers have to go back to work or their businesses, they need to adequately express milk for the child even when they will be away. “A baby’s brain is formed in the first 1000 days, these days are very critical as nothing can be added to the brain after this, the brain only expands. If the child misses key nutrients and nourishment during this window period, it can never be regained again; this is why the right nourishment from the mother to the child is important during this period. This is why we have to fight malnutrition early on, right from conception because if we do not get it right at that time, nothing can be done afterwards.”

Braheem said the state is focused on informing, engaging, galvanizing and anchoring breastfeeding as the only nutrition for a baby for the first six months. “We are targeting 65 percent breastfeeding rate by 2025 and we know this is achievable and possible.”

Citing health workers shortage as one of the major problems preventing the strict compliance to breastfeeding in health facilities, Braheem said the ratio of health workers to patients is overwhelming. “We need to change our mindset to breast milk substitutes. We are not saying they shouldn’t be used but shouldn’t be given to babies in the first 24 months of life; the current nation’s Breast Milk Substitutes (BMS) Code frowns at it.”