In Nigeria, exclusive breastfeeding is still not widely adopted. According to the 2016-2017 National Multiple Indicator Cluster Survey (MICS) Report, only 23.7% of infants aged five months and below are exclusively breastfed with only 15.3% of all children receiving the minimum acceptable diet. This is an abysmal figure when compared to the exclusive breastfeeding (EBF) prevalence goal of 50% set by the National Strategic Plan of Action on Nutrition to be achieved by December 2018.
Nigeria’s low EBF rates may likely be attributed to a combination of traditional and socio-cultural misconceptions about breastfeeding, ignorance about its importance, non-conducive work environments for breastfeeding, deceptive marketing of breast milk substitutes to health workers, and lack of awareness-creation on the part of health workers at the primary health care level. The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) both recommend that breastfeeding should be initiated within the first hour after birth, as the most critical time for good nutrition is in the 1,000-day period from the start of a woman’s pregnancy, until a child’s second birthday.
The evidence is clear that breast milk provides ideal food for the healthy growth and development of infants, and breastfeeding has important implications for the health of mothers. It has a nearly perfect mix of vitamins, protein, and fat — everything the baby needs to grow. Breastmilk contains antibodies that help the baby fight off viruses and bacteria. Babies who are breastfed exclusively for the first six months, without any formula, have fewer ear infections, respiratory illnesses, and bouts of diarrhoea. Breastfeeding is wonderful for developing the bond between mother and child, by releasing the “love” hormone oxytocin in the mother. The release of oxytocin after birth also aids in contracting the uterus to reduce postpartum bleeding and to reduce the uterus to pre-pregnancy size. Breast feeding helps new mothers lose the baby weight, and women have a decreased risk of iron-deficiency anaemia while nursing. In addition, fertility and the chance of becoming pregnant is greatly reduced in the first six months of exclusive breastfeeding, which aids in family planning.
Infants who are exclusively breastfed in early life present lower morbidity from gastrointestinal and allergic diseases. 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.
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 newborns to the breast within the first hour of life safeguards against newborn deaths. According to experts, the benefits of breastfeeding could be due to the presence of long-chain polyunsaturated fatty acids in breast milk. Breastfed infants have higher concentrations of these fatty acids that are positively associated with brain development.
Early initiation of breastfeeding, within the first hour of birth, reduces the risk of neonatal mortality while delaying breastfeeding from one day after the baby’s birth increased the risk of neonatal mortality. Early initiation of EBF ensures that the infant receives the colostrum (first milk), which is rich in protective factors. However, early initiation of EBF can substantially reduce child mortality and help prevent neonatal deaths caused by sepsis, pneumonia, and diarrhea. It may also prevent hypothermia-related deaths, especially in preterm and low birth weight infants. It also serves as the starting point for a continuum of care for mother and newborn that can have long-lasting effects on health and development.
Beyond the short-term benefits of exclusive breastfeeding, an argument for increasing awareness and the practice of EBF in Nigeria is due to its long-term benefits. Research suggests that breastfeeding an infant can lead to performing better on intelligence tests, especially if breastfed exclusively and for a longer period of time, and women who breastfeed have lower rates of ovarian and breast cancer. Adolescents and adults who were breastfed as babies are less likely to be overweight or obese. Breastfeeding not only improves intelligence up to adulthood, but may potentially increase educational attainment and earning ability.
From 6 months, breast milk may no longer be enough to meet the nutritional needs of the infant and the complementary foods added to a child’s diet between six months and two years should supplement the baby’s breast milk-based diet. The complementary foods that are given from 6 months up until 2 years of age should provide energy and essential nutrients required for growth and development. Complementary foods should be given in amounts, frequency, and consistency using a variety of foods to cover the nutritional needs of the growing child while maintaining breastfeeding. This is a critical time in a child’s development and it is important that the child receives a diverse diet of nutrient-rich food prepared in a clean space, in addition to breast milk to prevent the onset of malnutrition. A diet comprising at least four food groups a day is associated with improved growth in young children.
The benefits of exclusive breastfeeding cannot be overemphasized. Breastfeeding is about more than simply providing a child food; it helps ensure a child develops to full potential as an adult. Breastfeeding is central in giving children the right start to life during the 1,000-day window from a mother’s pregnancy to her child’s second birthday and remains pivotal in ensuring the good health of mothers and children. As a result, mothers and other caregivers require active support for establishing and sustaining appropriate breastfeeding practices. In addition, stricter regulations in the marketing of breastmilk substitutes is required to ensure that mothers are not misled into considering breastmilk substitutes as an alternative that can be used in place of breastmilk, before a baby reaches 6 months. Furthermore, the risk of illnesses like diarrhea is reduced where there is no reliable access to clean water. The cost-effectiveness of breastfeeding is also an additional bonus. It is estimated that for every $1 invested in breastfeeding, there is a $35 economic return, a clear economic win for families in lower income countries.
Finding innovative ways to encourage breastfeeding is one important step that Nigeria can take to build the foundation for a healthy and prosperous future. The Nigerian government, social institutions and the family unit must do more to help every child realise the life-saving benefits of breastfeeding. Religious, social and community influencers should be involved in supporting the early initiation of breastfeeding and exclusive breastfeeding for six months. Husbands, mothers-in-law, TBAs and Community Health Workers are also key influencers in sending the message of breastfeeding, thereby influencing and enabling better breastfeeding behaviours. Workplaces must also provide support with more flexible working options, ante-natal and post-natal care to continue support and encourage breastfeeding women. In addition, there is the need to ensure that health professionals are adequately trained to effectively communicate to women how to breastfeed and encourage continued exclusive breastfeeding up to the child’s sixth month.
The Nigerian mother benefits. The Nigerian child benefits. Our entire country benefits when our children are healthy and strong. When breastfeeding is encouraged and supported, all of us… win.