Breast feeding, HIV/AIDS and child survival strategy in the north east
At the meeting, explanation was given on a test carried out on the knowledge, attitude and practice of exclusive breastfeeding (KAP-EBF) as a way to reduce infant mortality. Madam Edele Thebaud, the chief of field office (UNICEF, Bauchi), said the meeting was based on the study conducted earlier this year in which nine wards and […]
At the meeting, explanation was given on a test carried out on the knowledge, attitude and practice of exclusive breastfeeding (KAP-EBF) as a way to reduce infant mortality.
Madam Edele Thebaud, the chief of field office (UNICEF, Bauchi), said the meeting was based on the study conducted earlier this year in which nine wards and 18 communities were selected in three local government areas of the affected states.
It was observed that based on the National Demographic Health Survey (NDHS, 2008); under five mortality rate in Nigeria stands at 138/1000 live births even as there are differences in figures in geo-political zones.
From the study, the north east zone remains on top of the ladder because 222/1000 children die before the age of five. North West follows with a recorded death of 217/1000 live birth and therefore, the need for proactive measures to stop the negative trend.
Health officials say Exclusive Breast Feeding (EBF) remains the single most effective child survival intervention that can avert by 13 per cent, under-5 mortality.
According to them, breast milk is the natural resource that has the most positive impact on child’s health, growth and development. They also recommended that mothers should feed their babies exclusively with breast milk for the first six months and thereafter, complement it with other foods during two years of child’s life.
A study by UNICEF in 2009 which was showcased at the seminar, showed that a newborn Nigerian baby has a 30 times higher chance of dying before the age of five years than a baby born in the developed, industrialised countries. Poor nutrition occasioned by lack of proper breastfeeding is said to be responsible for this.
Speakers at the forum said there were many factors responsible for poor breast feeding attitude by mothers, especially in the northeast part of the country.
In Yobe State for instance, the Multiple Indicator Cluster Survey (MICS, 2007) shows that exclusive breastfeeding was at an appalling rate of 1.3 percent while the national EBF rate is put at 11.7 percent. It is believed that children are more likely to die where EBF is low.
Based on the recent study conducted in Damaturu, Machina and Nangere LGAs of Yobe State, religion, culture and tradition play vital roles on mothers towards breastfeeding their new babies.
The study revealed that shortly after delivery and depending on circumstances, mothers are found to be giving different types of foods to their babies instead of starting with, and remaining consistent with breast milk for the recommended period.
Some of the foods given to babies include water, herbs, animal milk, Zam-zam (Sacred water found in the Holy City of Meccah) and dates (dabino).
It was also noticed that more often than not, mothers deliberately delay initialising breastfeeding for their new born babies, a development which on many instances, do claim the lives of such babies.
Out of 541 nursing mothers selected in the aforementioned LGAs, 39 percent of the mothers admitted to giving their babies’ breast milk immediately after delivery, while 30 percent gave water. 17.8 percent of the mothers gave animal milk (goat, cow, sheep or camel) as the first food while 4.3 percent commenced with dates or other supplements.
While it is advisable to initiate breastfeeding within the first hour of delivery, the case seems different in the northeast. During the time of the recent study, only 46 percent of the women claimed to be aware of the concept of EBF.
Some of the challenges identified for the low practice of exclusive breastfeeding in the zone include the influence of family members, the perception that the child needs to drink water because of the hot environment, culture and tradition among others.
Mr. Oluniyi Oyedekun, a nutrition specialist from the UNICEF, said poor knowledge of the advantages of exclusive breastfeeding was also to a large extent, responsible for the prematurely demise of many children.
He added that with improved enlightenment, the trend was gradually changing in the zone and that very soon, the lives of many children will be saved.
In Yobe state, 64.5 percent of the mothers who are aware of EBF following the intervention by various stakeholders said health workers are the main source of information for them.
The situation is the same in Borno in which 77.1 percent of the women said same; 84.6 percent in Adamawa and 47.6 percent in Gombe. “Mothers are being encouraged to embrace breastfeeding because many of them are now aware of the health benefits of the practice,” Oyedekun said.
Prior to the commencement of massive campaign against infant mortality, it was observed that in Yobe State, about 78.8 percent of children don’t get breast milk within the stipulated one hour time after delivery. The reason given for this was poor mother’s health and child refusal to suck, among others.
Professor Tunde Oguntona, one of the resource persons during the Kano meeting, said there was need for mothers to be encouraged to give their babies adequate milk because of its obvious advantages.
Most significantly, it was noted that health officials should start encouraging HIV positive mothers to breastfeed their babies during the first three month of birth.
The essence, according to officials of the Federal Ministry of Health and the Nursing and Midwifery Council of Nigeria was to give the babies the vital energy they require to have a fulfilling life.
Because of the complications associated with transmission, breastfeeding by HIV positive mothers was seriously discouraged especially during the ‘distress period’ when HIV/AIDS were discovered.
Experts believe that without preventive interventions, approximately one-third of infants born to HIV-positive mothers contract the ailment through mother-to-child transmission (MTCT).
In 2001 it was estimated that about 800,000 children under the age of 15, contracted HIV, over 90 per cent of them through MTCT. 15 percent of the children got infected through breastfeeding.
However, as time goes on, it was discovered that the decision to completely avoid breastfeeding babies born by HIV positive mothers does more harm than good to the babies and therefore, experts posited that it is possible for the infected mother to breastfeed her baby during the first three months.
A study conducted in Durban, South Africa, showed that exclusive breastfeeding by HIV positive mothers during the first three months of life results in a lower risk of MTCT than mixed feeding (breastfeeding combined with other foods, juice or water).
Giving credence to this assertion, Mrs. Aishatu Hassan, the resident matron of the Maitama General Hospital, Abuja, at a different seminar in Abuja, told nurses to encourage their HIV positive mothers to breast feed their children to help build their immune system.
Aishatu advised that HIV positive mothers should not view their situation as the end of the world and emphasized the need for them to seek voluntary counselling and testing at HIV centre to prevent mother to child transmission.
She however, said mothers with advanced HIV status should not breastfeed their babies because there is increased risk in it.
In order to reduce child mortality in the northeast, the study by the UNICEF concludes that the average EBF for the northeast zone which stands at 8.7 should be improved.
It therefore recommend community awareness programmes; the need to establish and strengthen community support groups and develop behavioural change communication (BCC) messages specifically to address identified contributory factors to low EBF rate in order to save the lives of children.