Exclusive breastfeeding and public policies

A recent report that out of the approximately seven million children born in Nigeria every year, only 27 per cent are exclusively so breastfed from age zero to six months, leaving a deficit of 73 per cent, being denied the right, is not a good human development story. The development in Africa’s most populous nation denies millions of such children the benefits of breast milk, an unnecessary and unacceptable phenomenon that should be vigorously campaigned against.

Health professionals have noted that breast milk contains all the nourishments a new born needs for proper development in the early stages and later in life. However, what is responsible for this low rate of breastfeeding?

Virtually all mothers can breastfeed, provided they have accurate information, and the support of their families, the health care system and the society at large. However, pressure from family members and friends to give water, other liquids, herbal concoctions, and other forms of milk in addition to breast milk prevents them from exclusively breastfeeding their babies. This pressure is needless and it is a disservice to the child as health professionals have argued that breastfeeding is beneficial to the child, mother and community. They recommend early initiation of breast milk and that the new-born be fed with breast milk within the first hour of its life.

Specifically, colostrum, which is the yellow custard-like milk produced in the first few days after birth is described as the infant’s first immunisation because it is very rich in substances that fight infections, protecting infants from potentially deadly diseases.

Furthermore, breast milk is the ideal food for babies and infants as it contains nutrients in the right quantity, giving them all the nourishment they need to survive and thrive. Breast milk is easily digestible and well absorbed. Besides, it is safe and contains antibodies that help protect infants from common childhood illnesses, such as respiratory tract infections, diarrhoea and pneumonia, which are the two primary causes of child mortality worldwide. Exclusive breastfeeding (EBF) can also reduce the risk of coeliac disease and chances of developing type II diabetes, asthma and other allergic problems. Breastfeeding also prevents obesity in childhood and adulthood, as well as diet-related chronic diseases, such as hypertension and cancers. In addition, breastfed infants are known to show better vaccine responses after vaccination against childhood diseases. They perform better on intelligence tests, when compared with infant formula-fed babies. Again, breast milk is readily available and affordable, which helps to ensure that infants get adequate nutrition at all times and at very little cost, and at the right temperature. As a result, the death of children under the age of five could be prevented with increased breastfeeding and the incidence of certain diseases among babies would be significantly reduced.

According to the 2018 Nigeria Demographic and Health Survey (2018 NDHS), child mortality accounts for 52% of all under-five deaths. The child mortality rate is 69 deaths per 1,000 children surviving to age 12 months, while the overall under-five mortality rate is 132 deaths per 1,000 live births. Fifty-one per cent of all deaths among children under age five in Nigeria take place before a child’s first birthday, with 30% occurring during the first month of life.

On the part of the mother, early initiation of breast milk helps to fast-track expulsion of the placenta while breastfeeding helps burn extra calories and helps the mother lose pregnancy weight faster. It releases the hormone, which helps the uterus to return to its pre-pregnancy size and may reduce uterine bleeding after birth. Breastfeeding has also been associated with reduced risk of breast and ovarian cancer, type II diabetes and postpartum depression in mothers, thereby reducing the incidence of baby abandonment and abuse.

What is more, exclusive breastfeeding promotes emotional bonding between the baby and the mother, and it also has 98 per cent efficiency in preventing unwanted pregnancy.

Also, the community reaps a lot of benefits when mothers practise breastfeeding because breastfed babies are healthy babies and healthy babies make a healthy nation as cases of and severity of childhood illnesses are reduced, thereby improving child survival. This, of course, leads to a huge reduction in national expenditure because the country will spend less on the importation of formula and curative health care for children.

So, the World Breastfeeding Week, which has just ended, provided an opportunity to engage and sensitise all stakeholders to the importance of breast milk and draw the attention of the world to the need for nursing mothers to lay a healthy foundation for their babies’ growth through EBF for the first six months. Hence, the Zero Water Campaign  as stated by the Permanent Secretary, Federal Ministry of Health, Abdulaziz Mashi in Abuja on Tuesday, August 6, in commemoration of 2019 World Breastfeeding Week, celebrated every year from 1 to 7 August, to encourage breastfeeding and improve the health of babies around the world; as it has been established that poor infant feeding practices negatively affect the growth, health, and development of children, and a major cause of mortality in infants and young children. This is a demonstration of the political will of the Federal Government of Nigeria.

Notwithstanding, government should walk the talk and support breastfeeding because the government has a huge role to play in increasing breastfeeding rates. The government needs to create policies that would favour nursing mothers. They can borrow a leaf from Lagos and Kaduna states that have adopted six months maternity leave to enable mothers to have enough time to rest from the stress they go through during labour and also the time to feed their babies.

Let’s learn from Spain too, where maternity leave is one year to give nursing mothers enough time to breastfeed their babies. This will enhance the child’s right to survival, development, protection and participation (CSDPP); which is the foundation of our national development. In other words, if we must have a future as a country, having healthy children who will come up with innovative solutions is an imperative.

So, it is heart-warming that the wife of the President, Mrs. Aisha Buhari has affirmed her commitment to align with relevant stakeholders to ensure effective implementation of Zero Water Campaign through her Future Assured Programme. As such, she should lead the advocacy for the six months maternity leave for working mothers in Nigeria as one of her legacy projects in the country. Similarly, all governors’ wives should follow in this direction of advocacy and also enlighten women on the importance of exclusive breastfeeding. In addition, they need to sponsor breastfeeding programmes, including lactation.

It bears repeating that breastfeeding is not a one-woman job. Mothers need support from their husbands, family members, community, health workers and governments to give children the healthiest possible start of life.

Therefore, husbands and family members should provide good nutrition from available local foodstuff for nursing mothers because it is vital in ensuring sufficient and quality breast milk production needed to feed their babies. Furthermore, since Nigerian government recommends that mothers breastfeed exclusively for six months, the breastfeeding policies that are already in place in Nigeria should be strengthened such that the maternity leave should be a minimum of six months. Also, the legislature should enact laws to protect the breastfeeding rights of working women such that they would be able to exclusively breastfeed. Employers too should be involved: they need to create the enabling environment by providing crèches. Government at all levels should also protect breastfeeding by enforcing its code on the marketing of breast milk substitutes, which ensures that all formula labels state the benefits of breastfeeding; and frown on the free distribution of breast milk substitutes to mothers and health workers.

The health promotion department in the Federal Ministry of Health, their state counterparts, the National Orientation Agency (NOA), and the multilateral and bilateral agencies, and related civil society organisations should adopt a participatory approach in promoting exclusive breastfeeding; and in their communication planning and information sharing on the benefits of EBF to reach the relevant stakeholders within their socio-cultural networks. This will in turn lead to improvement in the uptake of EBF amongst nursing mothers in Nigeria.