Exclusively breast milk

The baby wailed on, but there seemed no way his mother could nurse him in front of three strange men seated under a roadside shed where she sold drinks and biscuits to travellers at Nataco, a rest stop in Lokoja. One of the men surprised her by asking whether her baby still nursed. She answered […]

The baby wailed on, but there seemed no way his mother could nurse him in front of three strange men seated under a roadside shed where she sold drinks and biscuits to travellers at Nataco, a rest stop in Lokoja.

One of the men surprised her by asking whether her baby still nursed. She answered yes. “Breastfeed him,” he said quickly. “What are you waiting for. Or are they for fancy?”

The woman lost all shyness and did as told. Her reluctance to nurse her baby in public is one drawback that proponents of exclusive breastfeeding want to push away by enlisting a network of support for nursing mothers and their babies.

“If you are proud to be a woman, you should be proud to breastfeed you baby, because God has crowned you with a baby showing that you are a woman,” says Prof Ngozi Nnam, a public health expert at University of Nigeria and president of Nutrition Society of Nigeria.

Faith Ugwu has exclusively breastfed her four-month-old baby just as she was told during antenatal clinic. After delivery, her husband stopped her working until their baby turns six months, and she has had his and her mother’s support.

That support is lacking for countless nursing mothers around the country, according to a recent survey by the charity Save the Children and Nigerian Academy of Science released last week.

Across three regions in the survey, less than one in five women got information and support about exclusive breastfeeding from friends or relatives. And there was virtually none at all from religions centres and schools for women in the northwest.

In each region, more than 90% of women did breastfeed, but the difference lies in making breastfeeding exclusive—sticking to breast milk for the baby’s first six months of life without any other drink or food.

The goal is to get mothers to put babies to the breast immediately after birth—to get that first protein-filled, immune-boosting milk called colostrums—maintain exclusive breastfeeding for six months, and continue for at least two years while introducing filler foods thereafter.

In the northwest—with the highest proportion of women getting information from health centres and mass media—three in 10 women could not correctly define exclusive breastfeeding, the survey shows. In the southwest, four in 10 women could not, compared one in 10 in the southeast.

In a statement last week, Save the Children called for increased training of healthworkers, include breastfeeding and infant feeding in curriculum for healthworkers, creating baby-friendly workplaces where mothers are encouraged to breastfeed exclusively.

At present, jobs affect the ability for exclusive breastfeeding for up to 7% of women in the southwest, a proportion which doubles to 16% among women in the northwest.

Conditions are hardly adequate. At least 33% of women in the northwest reported their workplace had any facility for babies, compared with up to 80% in the southwest.

The proportion of women able to take their baby to work or take maternity leave was consistently lower in the northwest, compared with other regions.

Save the Children also urged for moves to eradicate community and cultural practice that discourage women from breastfeeding exclusively.

Across the regions, mothers’ perception of support from doctors, nurses, midwives, friends, religious leaders, relatives, parents, in-laws and husbands was lower than average in the northwest, according to the survey.

 

A Zaria grandmother, whose daughter had twins, faced stiff resistance from in-laws when she tried to convince her daughter to breastfeed exclusively, she related in a focus group discussion in the survey.

Another grandmother in Ibadan told her daughter exclusive breastfeeding wasn’t good. “It is like eating without drinking water,” she told a focus-group discussion. “She insisted that the doctor told her not to give the baby water. I had never heard of such before. I don’t agree with it at all. The baby should drink water, even if once a day.”

It’s a typical thought, say proponents, noting breast milk is liquid and contains enough water for babies at the right age. In fact, it is so nutritionally adequate for a baby, that proponents have dubbed it the superfood.

Ugwu’s husband firmly supported her but there are fathers who have heard about exclusive breastfeeding but never allowed for any of their babies, according to one man who took part in the survey. “We cannot bear refusing to give the baby water, we sympathise with the baby,” he said.

Quality of sympathy water cannot be guaranteed, and, while breast milk helps build child immunity, proponents suggest introducing foreign foods and water after six months—when breastmilk alone is insufficient and enough time to have a stronger immunity.

“The disadvantage of adding something to breastmilk is that you fill the stomach with things that [the baby] cannot deal with at that age, and he is going to be eventually stunted in growth because we are not giving the baby the natural food that God has provided, which should [help] a child go through the dangerous part of life—which is infancy,” says Dr David Olayemi, who presented the survey findings last week.

In the first few months of life, exclusive breastfeeding saves families money that might have been spent on formula. But proponents point to bigger saves.

A child is spared the onslaught of malnutrition, an “underlying factor for more than 50% mortality among children less than five years,” according to health minister Onyebuchi Chukwu. “It is also the lowered immunity due to malnutrition that that worsens the under-five’s deadly diseases, notably pneumonia, diarrhoea and malaria.”

In early stages, especially in children less than two years, malnourishment leaves them vulnerable to conditions that cause irreversible physical and cognitive damage, he said.

Gross domestic production could suffer for it. Save the Children country director Susan Grant “Malnutrition will knock $125 billion off the global economy by 2030. That is when children [today] suffering from malnutrition should be reaching working age.”

Statistics also indicate Nigeria’s GDP could slump 3% on account of malnourished children alone, says Nnam.

Since 2011, rate of exclusive breastfeeding has hovered near 15%, compared with Ghana’s 50%. “It is because the common Ghanaian mother now realizes the baby loses nothing if you exclusively breastfeed for the first six months,” says Olayemi.

Breastfeeding proponents insist Nigerians need a similar education—one woman on the roadside at a time.