Every first week of August Nigeria joins the rest of the world to commemorate World Breastfeeding Week. Yet, if statistics are anything to go by, one might question what impact this 26-year long tradition has had on the rate of breastfeeding in Nigeria. Exclusive breastfeeding rates in Nigeria still remain dismally low, tottering between 17 - 25 percent nationally.
During the week starting August 1, 1992, nations around the world commemorated World Breastfeeding Week. The purpose of this weeklong awareness campaign, marked by over 120 countries, was to highlight the huge health benefits that breastfeeding brings to babies, as well as a wider push for a mother's health, focusing on good nutrition, poverty reduction and food security.
At a high-level Policy Dialogue to flag off the World Breastfeeding Week in Nigeria, which held on Thursday, August 2, Dr. David Olayemi, a public health consultant, who moderated the event, challenged those gathered to reflect on whether Nigeria had progressed over the last two decades. "What has changed in the 26 years Nigeria has marked World Breastfeeding Week? What will change because of this meeting?" he asked.
These questions are important given the data out of Nigeria- according to the 2013 Nigeria Demographic and Health Survey (NDHS), only 17% of mothers in Nigeria exclusively breastfed their babies between the ages of zero and six months. When it comes to the Early Initiation of Breast Feeding, Kogi state has the highest rate at 73.6% while Kebbi has the lowest rate at 8.3%. Hopefully, by the time the anticipated 2018 NDHS comes out, these numbers would have gone up.
Breastfeeding for a Nation's Development
Why is exclusive breastfeeding so critical for national development? Auwalu Kawu of Alive and Thrive made a compelling argument for the economic benefits of breastfeeding to Nigeria at the policy dialogue. He argued that increasing breastfeeding rates could add 150 million dollars to Nigeria's economy over a one year period, as a result of increased productivity, as well as save a large chunk of the 11 billion naira households spend on breastmilk substitutes in the first six months of children's lives. Breastmilk is free as it is produced at no extra cost to the mother, and simply requires that the mother be healthy and nourished herself.
Kawu pointed out that over 100,000 child deaths in Nigeria could be prevented if children are exclusively breastfed in the first six months of their lives, and slowly introduced to other complementary foods for the next two years. The available evidence indicates that breastfeeding without any substitutes for six months prevents 72% of hospital admissions for diarrhoea and other common childhood infectious diseases. Feeding infants nothing but breastmilk for the first six months of life helps babies grow, prevents undernutrition, promotes brain development, and reduces the risk that children will become overweight when they get older. Why is such a great intervention - done so infrequently in Nigeria?
Importantly, especially in a country where immunization coverage is low, breastfeeding is also a newborn's first vaccine, providing vital antibodies and a boost to a baby's immunity. From the earliest moments of a child's life, breastfeeding can mean the difference between life and death. Putting new-borns to the breast within the first hour of life safeguards against new-born deaths.
In emergency settings, when communities are faced with limited access to clean water and basic health services, breastfeeding guarantees a safe, nutritious and accessible food source for babies and infants, while shielding them from disease.
Behind the Numbers: Unpacking Nigeria's Low EBF rates
Given the obvious benefits, one would wonder why EBF rates are so low in Nigeria, at 17% nationally. Why would a family, especially in low resource settings, opt to buy breastmilk substitutes, which can be quite expensive, when breast milk is free and enough for all a child's nutritional needs from zero - six months of their life?
In her presentation at the dialogue, Advocacy Manager at Save the Children, Seyi Abejide, explained how baby formula manufacturers frequently and flagrantly violate the International Code of Marketing of Breast-Milk Substitutes approved by the World Health Assembly (WHA). She indicated that these manufacturers use deceptive advertising to lead health workers to indiscriminately promote the use of breastmilk substitutes in the first six months of a child's life. She noted that this is one crucial factor why many women give up on exclusive breastfeeding.
Other factors that most likely contribute to mothers opting for substitutes instead of breastfeeding include working environments that are not conducive for mothers to breastfeed babies, and the unproven but highly held myth that breastmilk content is insufficient for a baby's nutritional needs. The length of time mothers have to spend waiting for their baby to become full while breastfeeding may be another factor. Some women also complain that breastfeeding is painful for them and that expressing their breastmilk is time-consuming.
A call to exclusive breastfeeding in Nigeria
Many of these myths and challenges can be mitigated with proper education about the benefits of breastfeeding, and with baby-friendly, breast-feeding friendly adjustments to work places and public spaces. We must make sure that healthcare providers deepen their knowledge on the benefits of exclusive and complementary breastfeeding and equip them with the skills to counsel mothers and caregivers. Policy makers must put in place interventions to ensure breastfeeding mothers are protected and cared for in their workplaces, so they are supported to breastfeed appropriately.
Such interventions can include establishing the right amount of paid maternity leave for breastfeeding mothers and providing breastfeeding rooms in work environments, as recommended by the World Health Organisation (WHO). The best interventions will be targeted at informing, supporting and educating all women of child bearing age to breastfeed their babies for at least two years, as well as educating the society around women; men, organisations and institutions, on the best ways to support breastfeeding mothers, with an eye on national development.
Minister of Health, Professor Isaac Adewole, was candid in his comments at the policy dialogue when he said, "Don't even dream of breast milk substitutes during the first six months of a child's life." He encouraged women to think of breastfeeding as a national assignment with huge returns on investment.
Many countries are turning to the benefits of breastfeeding to advance health and development. An investment in breastfeeding in Nigeria is a cost-effective investment in our nation's health, our economy and our future workforce.
Are you a breastfeeding mother? What challenges do you face when breastfeeding in public spaces? Please let us know! Tweet at us @nighealthwatch or leave a comment on our blog.
How is your organisation or institution supporting breastfeeding mothers in Nigeria? Drop us a line and let us know! Tag us @nighealthwatch on Twitter and use the hashtag #WBWNG2018
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