Nigeria has recorded an improvement with exclusive breastfeeding rate rising from 17 per cent in 2013 to 29 per cent in 2018. As the global community marks the World Breastfeeding Week, experts fear that amid COVID-19 pandemic, the increasing risk of food insecurity and malnutrition in the country may impact negatively on the gains achieved in Nigeria’s exclusive breastfeeding rate, reports APPOLONIA ADEYEMI
Breastfeeding is central to realising the global commitment to eliminate child malnutrition, yet achieving optimal breastfeeding in infants remains an uphill task. Although, majority of mothers, parents and caregivers are aware of the numerous benefits breastfeeding provides for infants, various factors have continued to hinder the provision of this natural diet for some babies that need it. From working mothers to female artisans, non-working housewives, among others the stories of challenges limiting exclusive breastfeeding are the same.
“Returning to work after my three-month maternity leave, continuing exclusive breastfeeding for my daughther was no longer feasible,” said Mrs Raliat Coker. “The only option before me was to wean my baby, which I promptly did and subsequently introduced her to baby formular feeding: Also, for Mrs Ebun Oluwa, carrying her two-month baby along on market trips which regularly takes her to Isheyin in far away Oyo State, was not convenient any more, prompting weaning the baby at just two months.
As for Rosetta Igwe, a non-working housewife, breastfeeding her twin babies became cumbersome six weeks after delivery, such that she had to abruptly stop them from taking breast milk. The factors hindering exclusive breastfeeding for infants in the country are numerous and that is why for several years, it was challenging achieving the 50 per cent exclusive breastfeeding target especially in developing countries including Nigeria. It is well known that in Nigeria the rate of exclusive breastfeeding, rather than improve stagnated at 17 per cent for several years. The good news is that all that has now changed.
Available statistics in Nigeria reveal that the average duration of exclusive breastfeeding is approximately three months, resulting in only three out of every 10 children under six months of age being exclusively breastfed; this is approximately 29 per cent rate. This is an improvement with exclusive breastfeeding rate rising from 17 per cent in 2013 to 29 per cent in 2018, according to data from the Nigeria Demographic and Health Survey (NDHS,2013; 2018).
However, this still falls significantly below the target of 50 per cent set by the World Health Assembly to be achieved in 2025 and the Sustainable Development Goal (SDG) target for 2030. Both the Executive Director of UNICEF, Henrietta Fore and the Director General of the World Health Organisation (WHO), Dr. Tedros Adhanom Ghebreyesus affirmed there has been progress in breastfeeding rates in the last four decades – with a 50 per cent increase in the prevalence of exclusive breastfeeding globally, but the COVID-19 pandemic highlights the fragility of those gains.
The duo, in a recent joint statement to mark the World Breastfeeding Week 2021, said, “In many countries, the coronavirus pandemic has caused significant disruptions in breastfeeding support services, while increasing the risk of food insecurity and malnutrition.
They said several countries have reported that producers of baby foods have compounded these risks by invoking unfounded fears that breastfeeding can transmit COVID-19 and marketing their products as a safer alternative to breastfeeding. On the contrary, Fore and Dr. Ghebreyesus said: “The initiation of breastfeeding within the first hour of birth, followed by exclusive breastfeeding for six months and continued breastfeeding for up to two years or beyond offer a powerful line of defense against all forms of child malnutrition, including wasting and obesity.”
Breastfeeding also acts as babies’ first vaccine, protecting them against many common childhood illnesses, added the duo. In Nigeria the impact of the pandemic on every aspect of life was well known and recorded. Exclusive breastfeeding similarly had its fare share of the problems. The lockdown resulted in majority of low-income and less privileged persons being cut off from their sources of income; the psychological and mental impact were tremendous.
Many couldn’t put needed food on the table and some nursing mothers missed basic nutrients. A nursing mother in Ikorodu then, Taiba Toye lamented that she wasn’t eating enough due to poverty and shouldn’t be expected to prioritise exclusive breastfeeding for her baby. Hunger in the land then was pervasive. A woman who spoke under the condition of anonymity, said she was not in a good frame of mind to continue breastfeeding her baby exclusively after eight weeks of delivery. Although, the lockdown is over the impact of the pandemic is still being felt especially with the current outbreak of the third wave and the more deadly Delta variant in the country. Now, experts said the pandemic will be with mankind for some time. There is no doubt that the pandemic negatively impacted exclusive breastfeeding. Another major factor hindering the achievement of exclusive breastfeeding target is givng babies that are exclusively breastfed water.
A Nutrition Expert with UNICEF, Dr. Ada Ezeugwu identified water as the greatest barrier to achieving success in exclusive breastfeeding. She said that giving babies water in addition to breast milk, was actually eroding the gains of exclusive breastfeeding. According to the expert, rather than get the optimal benefits of exclusively breastfeeding, the child that is given water in addition, often end up with diarrhoea and other water-borne diseases, sometimes resulting in child mortality. Exclusive breastfeeding means giving the child breast milk from human breast only for up to six months of age, meaning that the infant receives only breast milk. No other liquids or solids are given—not even water—with the exception of oral rehydration solution, or drops/syrups of vitamins, minerals, or medicines.
Although, the World Health Organisation (WHO) recommends that breast feeding should be initiated for the child within one hour of birth, the Federal Ministry of Health (FMOH) encourages mothers to initiate exclusive breastfeeding within 30 minutes of birth which should continue for six months.
Ezeugwu added: “This is called early initiation.” However, she blamed several factors for failure of achieving exclusive breastfeeding for the children in the country. Lamenting how many mothers cling to age-old culture that is promoting giving the baby water, she debunked the myth that babies need water in addition to breast milk.
“People are confused about the ‘no water’ guideline, which she described as the greatest barrier to exclusive breastfeeding in the country. She noted that some mothers confirm that they give babies water because they believe it is still necessary to give water to the baby. According to the nutrition specialist, the confusion about giving babies water, stems from the practice whereby people consume food and drink water.
In line with that approach, some mothers and parents perceive the breast milk as food which it is and believe that in addition to the food the baby needs water. However, the nutrition specialist said: “There is scientific evidence that the breast milk has enough water to meet the water needs of the child. Breast milk contains all the nutrients that the child needs to grow and survive and all the water needs of the baby.
“Over 80 per cent of the breast milk is water; so, mothers do not need to add any more water for the baby. Otherwise, the water will now take the place where nutrient in the breast milk will naturally occupy in the stomach of the child.” Moving forward, however, experts said in spite of the challenges posed by the pandemic and other factors hindering exclusive breastfeeding, all hands should be on deck to deliver breast milk unhindered, to infants so as to achieve the highlighted set targets