Many Nigerian women are having to quit their jobs or remain unpaid to achieve exclusive breastfeeding for their babies.
Felicia Dairo was an education instructor at a mission school in Osogbo, the Osun State capital, when she had her first child.
The maternity policy of the school was one of the reasons Mrs Dairo quit the job.
"Prior to delivery, we were told that pregnant workers were entitled to six weeks of maternity leave before delivery and six weeks after. I questioned the process and asked if we could move the six weeks before to after delivery, to make a straight three-month maternity leave," Mrs Dairo told PREMIUM TIMES.
"But the headteacher at that time said the mandate didn't accommodate that. She said if one doesn't take the six weeks before, then you forfeit it and take only the six weeks after. It sounded unbelievable. I never knew such a hard rule was in place for female workers.
"Meanwhile, all through the maternity period, you are entitled to half of your salary. Sadly, the salary was not even up to N30,000. I felt so bad because the conditions were too stringent but you either accept it or leave the job.
"To avoid receiving half salary for two months, some teachers even resume before the six weeks deadline lapses. A colleague at that time who gave birth through surgery also resumed immediately after her six weeks elapsed. It is pathetic! I also had to resume after my six weeks leave to avoid losing the job."
The situation is similar across many private establishments in the country.
Rofiat Olayinka, a holder of a Master's certificate in Education Planning and Administration from the University of Lagos (UNILAG), Akoka, no longer has a job. The mother of three angrily resigned from her teaching job at a private college in Lagos in 2021.
"I was the only teacher with such qualification at the school but each time I delivered a baby, I would not be paid until my maternity leave was over. So I could decide to go on leave for one month, two months or even six, depending on how long I could survive without the token I was paid," she told PREMIUM TIMES' reporter.
In her own case, Ayishat Mukthar has constantly moved from one school to the other over the same policy, as she usually resigns from work whenever she delivered a baby.
Mrs Mukthar, who has taught in different private schools in the Badagry area of Lagos State, said without doing that there was no way she could have exclusively breastfed her kids for six months.
Also, Lois Ugbede, who works with a private organisation in Abuja, Nigeria's Federal Capital Territory, said it is difficult for working mothers to exclusively breastfeed their children throughout the first six months.
"Once the three months maternity leave is over, it is difficult to fully divert all attention to exclusively breastfeed the child," Mrs Ugbede said.
She said she opted for the use of breast pumps to extract milk and store it for the child.
Govt workers lament too
Though Lagos State Government has enacted a policy granting nursing mothers a six-month maternity leave, it is restricted to two children. And if a mother already had up to two children before the introduction of the policy in 2014, she would not be a beneficiary.
Such was the case of Wuraola Ogunwemimo (not her real name), a nursing mother and senior nursing sister at one of the state-owned general hospitals in Lagos.
When Mrs Ogunwemimo delivered her third child in 2021, she was no longer entitled to the six-month maternity leave.
She said; "I'm nursing my third child now and it has not been easy breastfeeding as expected. In fact, I didn't consider exclusive breastfeeding for this child. I close from work at 2 p.m. but I am worried because I cannot be sure every day that the breast milk I expressed for my child would be well handled at the creche and safe enough for the baby to consume."
Mrs Ogunwemimo's concern is relatable as research has shown that expressed breast milk should not be kept for more than four hours outside normal room temperature except if it is stored in a fridge. However, not all creches have the facility and knowledge of the required temperature for breast milk.
The nursing mother said though she is expected to close at 2 p.m. for the first three months after resumption from her maternity leave, the workload never allowed such a schedule.
She also cited the distance from her place of work to her house and the daily traffic logjam in the densely populated city. "I spend roughly three hours from work to home almost every day," she said.
The mother of three said by the time she gets home, she is already worn out "coupled with the discomforts from my heavy painful breasts."
Significance of exclusive breastfeeding
The Director-General of the World Health Organisation (WHO), Tedros Ghebreyesus, in a statement to mark the 2022 World Breastfeeding Week, said the world must intensify efforts to promote exclusive breastfeeding.
Mr Ghebreyesus said as global crises continue to threaten the health and nutrition of millions of babies and children, the vital importance of breastfeeding as the best possible start in life is more critical than ever.
He said lack of exclusive breastfeeding has resulted in high stunting rates of 37 per cent of children under five, noting that only nine per cent of organisations globally have a workable breastfeeding policy.
The statistics by the WHO boss are an indication that mothers do not have the enabling environment to breastfeed their babies optimally.
"Breastfeeding also acts as a baby's first vaccine, protecting them from common childhood illnesses. Yet the emotional distress, physical exhaustion, lack of space and privacy, and poor sanitation experienced by mothers in emergency settings mean that many babies are missing out on the benefits of breastfeeding to help them survive," he said.
WHO, UNICEF recommendation
WHO and the United Nations Children's Fund (UNICEF) recommend that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health.
And to meet evolving nutritional requirements, these global health institutions recommend that infants should receive nutritionally adequate and safe complementary foods, "while continuing to breastfeed for up to two years or beyond."
Exclusive breastfeeding, they said, also plays a vital role in the prevention of different forms of childhood malnutrition, including wasting, stunting, over- and underweight and micronutrient deficiencies.
However, despite its numerous benefits, research by UNICEF shows that 70 per cent of Nigerian children lack access to exclusive breastfeeding.
The children of Mrs Ogunwemimo, Mrs Mukthar, Ms Ugbede and Mrs Dairo may be some of the unlucky 70 per cent Nigerian children.
Maternity entitlements in Nigeria
A 2019 study of maternity entitlements in Nigeria by the Federal Ministry of Health, in collaboration with UNICEF and Alive & Thrive, a global nutrition initiative, showed that the effective implementation of maternity entitlements is not consistent across the economic sectors.
The study showed that predominantly in the informal sector, women do not benefit from maternal entitlements granted by law "largely because there is no institutionalised policy or guiding principle for these types of benefits."
The study drew more than 2,500 respondents, including public and private sector stakeholders and working mothers in the formal and informal sectors across the six geopolitical zones of the country.
The report shows there is a significant gap that exists in Nigeria's legislation despite the 1999 Constitution of the Federal Republic of Nigeria, the 2008 Public Service Rules, and the 2004 Nigeria Labour Law, which all recognise and assent to the provision of maternity entitlements.
It shows that the gaps include "the lack of clarity on whether organisations may face penalties if they deny women their maternity leave rights; what compensation women can claim when that right is denied; and the fact that large pockets of the population, such as those in the informal sector and men, are being overlooked under official law."
In 2021, the Nigerian government announced a review of its maternity entitlement policy by approving 14-day paternity for fathers of new babies.
The Head of Civil Service of the Federation, Folasade Yemi-Esan, said the approval of paternity leave was one of the major reforms introduced to the Nigerian Public Service Rules (PSR) since 2008 when it was last reviewed.
Meanwhile, the four-month maternity leave granted to mothers by the federal government still subsists, according to Mrs Yemi-Esan.
The policy permits pregnant mothers to take a month before birth and three months after. Also, nursing mothers are permitted to close early upon resumption until the baby is six months old.
However, there are efforts by some states of the federation to improve the maternity leave conditions for mothers.
Findings by PREMIUM TIMES show that Lagos, Ekiti, Oyo, Enugu, and Kaduna states have adopted the six-month maternity leave policy.
States like Bauchi, Delta, Osun, Sokoto, and the FCT have a four-month maternity leave policy for mothers, while Kano as well as the remaining 26 states maintain a three months maternity leave.
Lagos' policy ridiculous
The Managing Director of Milk Booster Lagos- arguably Nigeria's first private breast milk bank, Chinny Obinwanne, described the maternity leave policy by the Lagos State Government as ridiculous.
Mrs Obinwanne said it is not fair for the government to approve six months of maternity leave only twice for mothers.
"Are they saying that mothers are only allowed to give birth twice? If a mother gives birth to more than two children, the demand increases. She has to be home for up to six months to look after her baby," she said.
She said mothers are advised to practice exclusive breastfeeding but they are not well equipped to do it.
What corporate organisations offer
Meanwhile, a few corporate organisations considered in this report show that a three-month maternity leave policy is in place but its implementation also sometimes depends on workload, and sometimes "the disposition of the supervisors or heads of departments."
For instance, at the Dangote Group of Companies, PREMIUM TIMES learnt that new mothers are offered 90-day maternity leave with full salaries.
The human resource manager at its factory in Ibese, Ogun State, Peter Agba, said the company has also provided a creche facility where mothers can keep their babies when they resume.
"There are staffers at the creche whose duty is to take care of your baby while you go and do your work. The mothers can visit the creche during their breastfeeding time to feed the baby."
Mr Agba said the creche is for children between the ages of three months to two years.
He explained that mothers are also allowed to close earlier than others for another 90 days.
At Nestle Nigeria, an official of the Human Resource department, Edidiong Peters, said the company gives 18 weeks of paid leave to primary caregivers and four weeks of paid leave to secondary caregivers.
Ms Peters explained that the organisation has a creche where staff who are breastfeeding mothers bring their babies so that they can focus on work.
"This is also why for our corporate social responsibility programmes that have to do with building blocks of classrooms for schools, we also build creches so that breastfeeding staff who work in those schools can bring their children to the creche and focus on work," she said.
Health commissioner speaks
The Osun State Commissioner for Health, Rafiu Isamotu, told PREMIUM TIMES that the state gives four months to mothers but has made a provision for mothers to be able to breastfeed their babies at work.
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Mr Isamotu, a paediatrician, said: "Our offices at the state house secretariat have creches where mothers keep their babies until they close from work. They are encouraged to go there to breastfeed the babies.
"We also encourage private organisations to give their staff enough time to breastfeed their children exclusively before they resume and when they resume, keep their babies in creches where they can breastfeed."
He noted that the government had also considered increasing maternity leave to possibly six months but that it was still in the pipeline.
Experts speak
To protect more children from infections and early deaths, experts have recommended that more states must adopt the six-month maternity leave policy.
Garba Muhammed, a lecturer with the University of Maiduguri and a consultant at the University of Maiduguri Teaching Hospital in the Department of Pediatrics, said breast milk has a lot of benefits for the child, mother, family, and society.
The Professor of Infectious Diseases and Public Health Paediatrics said exclusive breastfeeding could reduce some childhood diseases like diarrhoea and pneumonia, reduce the frequency of hospitalisation and also prevent malnutrition in all its forms.
"It is the most appropriate in terms of composition and quantity. It also aids the development of all aspects of humans, especially cognitive functions.
"Research has already shown that those that are exclusively breastfed tend to do more after controlling a lot of other factors in such evaluation," he said.
He said baby-friendly initiatives must be encouraged.
"We advise that they give breast milk from 0-6 months and when the child is six months an appropriate complimentary food can be introduced to the child and this should continue to the age of two," he said.
He, therefore, advised the government to do more in terms of encouragement for nursing mothers, insisting that it is not enough to mouth exclusive breastfeeding, but that it must be supported by actions.
Also speaking, the founder of Divine Happiness Hospital, Ogun State, Adeosun Bolakale, said to get optimum breastfeeding benefits, mothers must breastfeed their babies between eight to ten times daily during the first few weeks of birth.
Mrs Bolakale, who is currently breastfeeding her fourth child, said mothers should breastfeed at the first sign of hunger.
"Do not wait until the baby cries, crying is often a late sign of hunger. Frequent breastfeeding is needed for the baby to gain weight and to stimulate the mother to produce plenty of milk," she said.
She said exclusive breastfeeding helps mothers to ensure the uterus and the womb contract as well as reduce the risk of diseases such as breast and ovarian cancer.
"Women who breastfeed have a lower risk of having high blood pressure, arthritis, heart disease and diabetes," she said.
