5 August 2012

Nigeria: 'Save the Child, Give Breast Milk'

Photo: Boakai Fofana/allafrica.com
A mother breastfeeds her baby

Despite the vigorous campaign mounted to create awareness for improved exclusive breastfeeding, statistics still show a dismal outing. On this World Breastfeeding Week, WINIFRED OGBEBO reiterates the benefits of exclusive breastfeeding.

Breastfeeding is recommended during the first six months of life as a way to meet infants' nutritional requirement and reduce neonatal mortality by perhaps 20 per cent.

However, there is some evidence, says the UNICEF's Save Our World Children's Report, that urban mothers are less likely than rural ones to breastfeed -and more likely to wean their children early if they do begin.

An analysis of Demographic and Health Survey (DHS) data from 35 countries found that the percentage of children who were breastfed was lower in urban areas.

Low rates of breastfeeding may be attributed in part to a lack of knowledge about the importance of the practice and to the reality that poor women in urban settings who work outside the home are often unable to breastfeed.

On the 20th anniversary of World Breastfeeding Week, UNICEF says strong national policies supporting breastfeeding could prevent the deaths of around 1 million children under five in the developing world each year.

The theme for this year's celebration is, "Understanding the past, planning the future: Celebrating 10 years of WHO/UNICEF's Global strategy for Infant and Young Child Feeding". It has the slogan "Save the Child, Give breast milk"

However, despite compelling evidence that exclusive breastfeeding prevents diseases like diarrhoea and pneumonia that kill millions of children every year, global rates of breastfeeding have remained relatively stagnant in the developing world, growing from 32 per cent in 1995 to 39 per cent in 2010.

Ironically, says United Nations Children's Fund (UNICEF), Communications Specialist, Mr Geoffrey Njoku, while exclusive breastfeeding rate is on the increase globally and in Sub Saharan Africa, in Nigeria, it is actually on the decline.

According to the Nigerian Demographic and Health Survey (NDHS) 2008, it decreased from 17% in 2003 to 13% in 2008.

Some of the reasons attributed to why exclusive breastfeeding is declining in Nigeria, include, reduced baby friendly hospital initiative programming, inadequate training, poor enforcement of the code of marketing of breast-milk substitutes and weakened compliance with the Ten Steps in accredited maternities.

The UNICEF Executive Director, Anthony Lake noted, "If breastfeeding were promoted more effectively and women were protected from aggressive marketing of breast milk substitutes, we would see more children survive and thrive, with lower rates of disease and lower rates of malnutrition and stunting."

Some of the roadblocks to improving breastfeeding rates are widespread and unethical marketing by makers of breast milk substitutes, poor national policies that do not support maternity leave, and a lack of understanding of the risks of not breastfeeding.

In June, world leaders meeting in Washington, D.C., pledged as part of the "Committing to Child Survival: A Promise Renewed" movement to work toward ending preventable child deaths.

The 2008 Lancet Nutrition Series highlighted the remarkable fact that a non-breastfed child is 14 times more likely to die in the first six months than an exclusively breastfed child. Breast milk meets a baby's complete nutritional requirements and is one of the best values among investments in child survival as the primary cost is the mother's nutrition.

"Breastfeeding needs to be valued as a benefit which is not only good for babies, mothers, and families, but also as a saving for governments in the long run," said Lake.

Similarly, the Minister of Health, Prof Onyebuchi Chukwu, has campaigned for the education of nursing mothers on exclusive breastfeeding, many of whom he said, have been mis-informed on the principles of infant and young child feeding.

Marking this year's Word Breastfeeding Week, he said "We need to reinforce their knowledge and help them overcome any subsisting doubt about their ability to feed the baby solely from breasts within the first six months, without even water."

Chukwu noted that infants and young children need support from families, friends and the community to survive, grow and to develop their god-given potentials in life stressing that a mother needs support to breastfeed to ensure optimal feeding practices for her children's growth and development.

According to him, as soon as an infant attains six months of age, adequate age appropriate complementary food that is locally sourced can be added to the breast milk while the baby continues to breastfeed till two years of age or beyond.

Under-nutrition is associated with 35% of the disease burden for children under five. Infant and young child feeding is a key area to improve child survival and promote healthy growth and development.

Infants should be exclusively breastfed - i.e. receive only breast milk - for the first six months of life to achieve optimal growth, development and health, says Dr Abiodun Ewepo.

"Exclusive breastfeeding" is defined as giving no other food or drink - not even water - except breast milk. It does, however, allow the infant to receive oral rehydration salts (ORS), drops and syrups (vitamins, minerals and medicines). Breast milk is the ideal food for the healthy growth and development of infants; and it's also an integral part of the reproductive process with important implications for the health of mothers.

According to the World Health Organisation (WHO), the first two years of a child's life are particularly important, as optimal nutrition during this period will lead to reduced morbidity and mortality, to reduced risk of chronic diseases and to overall better development. In fact, optimal breastfeeding and complementary feeding practices are so critical that they can save the lives of 1.5 million children under five every year.

The WHO and UNICEF recommendations for optimal infant and young child feeding are:

• early initiation of breastfeeding with one hour of birth;

• exclusive breastfeeding for the first six months of life; and

• the introduction of nutritionally adequate and safe complementary foods at six months together with continued breastfeeding up to two years and beyond.

However, many infants and children do not receive optimal feeding. For example, on average, only around 35 per cent of infants 0 to 6 months old are exclusively breastfed.

Exclusive breastfeeding for six months has many benefits for the infant and the mother, says the WHO. "Chief among these is protection against gastro-intestinal infections which is observed not only in developing but also in industrialized countries. Early initiation of breastfeeding, within one hour of birth, protects the newborn from acquiring infections and reduces newborn mortality. The risk of mortality due to diarrhoea and other infections can increase in infants who are either partially breastfed or not breastfed at all."

"Breast milk is also an important source of energy and nutrients in children 6 to 23 months of age. It can provide one half or more of a child's energy needs between 6 and 12 months of age, and one third of energy needs between 12 and 24 months. Breast milk is also a critical source of energy and nutrients during illness and reduces mortality among children who are malnourished."

"Adults who were breastfed as babies often have lower blood pressure and lower cholesterol, as well as lower rates of overweight, obesity and type-2 diabetes. Breastfeeding also contributes to the health and well-being of mothers; it reduces the risk of ovarian and breast cancer and helps space pregnancies -- exclusive breastfeeding of babies under six months has a hormonal effect which often induces a lack of menstruation. This is a natural (though not fail-safe) method of birth control known as the Lactation Amenorrhoea Method".

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