As Nigerians join the global community to mark the 2022 World Breastfeeding Week earlier this month, PUNCH HealthWise gives insight into the difficulties Nigerian women face to achieve exclusive breastfeeding.
Some Lagos mothers also share how they overcame challenges militating achieving the gold standard of six months of exclusive breastfeeding, ranging from poor institutional and family support, inadequate baby-friendly facilities, and lack of awareness, among others.
While some mothers see exclusive breastfeeding as a difficult exercise, to Hajia Sekinat Lawal, it is the best gift mothers can give to their children.
Sekinat, who exclusively breastfed her five children including a set of twins for six months, said with a supportive environment and determination, exclusive breastfeeding is less challenging.
According to her, a nursing mother should be encouraged by the gains her baby stands to get from exclusive breastfeeding rather than the discomfort she might go through during the exercise.
Sharing her experience, Sekinat who is a journalist said her husband’s support and her determination to give her children the best start in life made the practice an exciting experience for her despite the demanding nature of her job. She said:
“When we talk about exclusive breastfeeding, it’s the best gift we can give to our children and this is simply because when we breastfeed babies exclusively, we would have given them the best start in life because their immune system will be top-notch.
No regular hospital visits for exclusively breastfed babies
There won’t be a situation of several visits to hospitals for such children except to take immunisations.
You will not have to deal with the story of having children that are falling sick now and then aside from minor things that may occasionally come up.
Apart from exclusive breastfeeding also giving us as mothers the best shape after birth, our health would also benefit from it. You will thank God that you are exclusively breastfeeding your baby because it has so many benefits, even though there will be challenges.
For instance, when I was breastfeeding my twins, I exclusively breastfed them for six months but it wasn’t easy. When I am going to the office then when I resume my maternity leave, I will have to express the breast milk into two breastfeeding bottles for them.
This I know will be enough for them before I return from work in the afternoon. Expressing breast milk is usually not a tea party. It’s a whole lot of sacrifice. It is not easy especially if you are a working mother.
But doing exclusive breastfeeding is the best decision. I did not regret doing it for my five kids and I am reaping the benefits now. I have four girls and a boy and among them is a set of twins. I didn’t regret doing exclusive breastfeeding for six months for all of them and they are all doing great.”
The World Health Organisation recommends mothers worldwide exclusively breastfeed infants for the child’s first six months to achieve optimal growth, development, and health.
Thereafter, WHO said, babies should be given nutritious complementary foods and continue breastfeeding up to the age of two years or beyond.
Celebrated on August 1-7 every year, World Breastfeeding Week is a global campaign to raise awareness and galvanise action on themes related to breastfeeding.
World Breastfeeding Week has been celebrated since 1992. It was established by the joint efforts of the WHO, UNICEF, and the World Alliance for Breastfeeding Action.
The theme of World Breastfeeding Week 2022 is “Step Up for Breastfeeding: Educate and Support”.
Early initiation of breastfeeding within one hour of birth
The Federal Ministry of Health recommends early initiation of breastfeeding within one hour of birth, exclusive breastfeeding for the first six months of life, and continued breastfeeding up to two years of age or beyond, with the introduction of appropriate complementary foods from six months.
Sekinat, a former chairman, Nigeria Association of Women Journalists, Lagos State chapter told our correspondent that though expressing breast milk for her twin babies was not an easy task, she was however committed to doing it for the optimal growth and development of her babies who are now best brains in their tertiary education.
The mother of five recounted,
“Honestly speaking, most of the time, I will have to rest before expressing the breast milk. I might start expressing breast milk around 5:A.M and if I notice that the two breasts are empty already, I will go and have a hot bath or take something hot either pap or tea so that the breast will be full again for easier milk expression for them. So, if one is not really determined and committed, one might not be able to do that.
My husband sacrificed his enjoyment of the breasts for our kids
“And for their dad, we have some men that will be saying what is all these, is the breasts for the kids alone or something?
What I did was to educate their dad that this is like a sacrifice on our part for the kids. If we can do that, we will be spending less on hospital visits, treating infections, and ailments that will make children visit the doctor regularly and he agreed.
We need to let daddies know that the babies cannot be on the breasts 24 hours. The time the daddies would need to enjoy the breasts would not be up to an hour or two which at that time, the baby/ babies might be sleeping. After breastfeeding the babies, mothers should try and give daddies their own attention.”
The media professional noted that it was wrong for daddies to struggle over breasts with their babies, stressing that such an act could discourage mothers from embracing exclusive breastfeeding.
According to her, the breasts belong to babies during breastfeeding, stressing that husbands should support their wives and show understanding during the period of exclusive breastfeeding.
Continuing, she said,
“So, basically, it is just a matter of understanding. We let our husbands know that the baby needs the breast more than the enjoyment daddy might think he has in it to take.
“Apart from the challenges coming from the fathers and the challenges of having to sit for long hours trying to express the milk, if you are doing exclusive breastfeeding, even at the place of work, you will not feel relaxed.
“This is because the breasts would still be in that biological state of reminding you that the baby wants to feed.
“You will always have a full breast that will be making you uncomfortable. You might be having pains, headaches and sometimes, I might need to go to the ladies and try to express the milk out so that I will feel relieved. Though it is not comfortable, I believe as mothers, we should be willing, ready, and committed to exclusive breastfeeding.
“And whatever challenge that comes our way as we do it, we should find a way round it. As mothers, we have to be the ones making the necessary sacrifices to make it work. You have to sacrifice your sleep and comfort.”
80,000 child death prevented annually in Nigeria
According to the FMOH, the benefits of breastfeeding to both mother and baby cannot be over-emphasised.
“Breastfed babies have stronger immunity, reduce risk of infections and many childhood illnesses, and also have longer-term health benefits including reduced risk of overweight and obesity in childhood and adolescence.
“Studies have shown that obesity rates are 15-30 per cent lower in breastfed babies compared to formula-fed babies. Again, about 80,000 child deaths are reported to be prevented annually when optimal breastfeeding is practiced.
“Furthermore, breastfeeding provides huge health benefits to mothers. It helps to prevent post-partum bleeding, lowers the risk of breast and ovarian cancers, and many more. About 20,000 maternal deaths can be prevented annually when optimal breastfeeding is practiced,”
the FMOH said.
“According to the National Demographic and Health Survey 2018, the early initiation rate of breastfeeding is 42 per cent which clearly shows that not up to half of our children are breastfed within one hour of birth.
Also, the exclusive breastfeeding rate in Nigeria is 29 per cent indicating that only a mere percentage of infants aged 0-6 months are exclusively breastfed leaving a whopping 71 per cent of infants not enjoying the benefits of breast milk in their formative years. Only nine percent of organisations have a workplace breastfeeding policy,”
the health ministry stated further.
Also sharing her experience of breastfeeding with our correspondent, Mrs. Precious Chikezie, a 35-year-old mother of three who is delighted to do exclusive breastfeeding for two out of her three children, said that though the practice was difficult, she had to do it to protect the health of her children.
The Lagos housewife said,
“I regretted not doing exclusive breastfeeding for my first kid when I gave birth to her in 2017. I have heard of the benefits of exclusive breastfeeding and I was prepared to do it when I got married. But when I gave birth to my baby in 2017, my mother came for omugwo and punctured my efforts by introducing water to the child after three months.
She told me that breast milk only will not be enough for my baby and that was how we started giving water. After three months, she started having diarrhoea and infection.
We were always in and out of the hospital. Now, when I delivered my second baby in March 2020, my mother was not able to come to omugwo as a result of COVID-19 and so I was able to do exclusive breastfeeding for my second baby, a baby boy.
All through the six months that I did exclusive breastfeeding, he was never sick even when he was teething. I only took him to the hospital for immunisation.
That experience made me do the same for my last baby who is now 10 months old. Even since I gave bath to him, he has never been sick, and I regretted not doing that for my first baby. Well, it was ignorance actually. But my eyes have opened.
Even if I have 12 children, I will do exclusive breastfeeding for all of them even though it is not easy. At one point, my husband was complaining that my breasts were now only for my children.
So, I told him to leave the breasts alone for them all through the period and sacrifice his enjoyment of the breasts for six months. I begged him and he agreed.”
Another nursing mother, Mrs. Olachi Chibuike, 25, also disclosed that the benefits of exclusive breastfeeding on the health of her two babies were worth the challenges.
The businesswoman said,
“I have two kids for now and I did exclusive breastfeeding for them. I thank God for the grace to do it though it was not easy. I was always having headaches, and feeling dizzy and I was always hungry at that time.
“In the first three months into the exclusive breastfeeding it was easier for me and he needed little breast milk because his stomach had not expanded.See Also
“But from four months to six months, it became so challenging that my husband was buying blood tonic regularly for me. I became so emaciated to the point that if you see me, you will pity me.
“Nevertheless, I continued until both of them clocked six months and I am happy for them. When my husband tries to come and claim ownership of the breasts, I try to let him know that he has to wait and help ensure that we give our baby a good foundation for life.
Joke Gabriel and other mothers also shared similar experiences of benefits of exclusive while appealing to husbands to support their wives, stay away from the breasts, and allow babies to have unhindered access during the period of exclusive breastfeeding.
Need for support and enabling environment
Speaking in an interview with our Correspondent, a Professor of Public Health Nutrition at Obafemi Awolowo University, Ile-Ife, Osun State, Beatrice Ogunba, said though exclusive breastfeeding is a decision a mother has to take for the mental development of her baby, the right support and the enabling environment must be there for her to do it without difficulty.
The expert in maternal and child nutrition noted that Nigeria has policies relating to providing support and enabling environments for lactating mothers, but lamented that the policies are not being implemented.
“For working mothers, I must say that exclusive breastfeeding is a decision a mother has to take herself and that will depend on the knowledge about the benefits of exclusive breastfeeding for herself and her baby.
“For workplaces, we need an enabling environment and for that to happen, we need policies, especially implementation.
Implement baby-friendly policies
“We have a good policy on maternity leave for six months and if it’s implemented, exclusive breastfeeding is possible,”
The professor also revealed that only Lagos and Kaduna states, out of the 36 states of the federation, give six-month maternity leave to women, stressing that it would be difficult for Nigeria to meet the WHO 50 per cent exclusive breastfeeding recommendation without implementing policies on baby-friendly initiatives.
The nutritionist noted that while Nigeria is still hovering around a 29 per cent exclusive breastfeeding rate, Ghana and Kenya have surpassed the WHO 50 per cent target by being above 60 per cent.
Ogunba further said,
“For those who do not enjoy the six-month maternity leave, they can be provided workplace support such as crèches, lactation rooms, or fridges where they can store expressed breast milk.
“If the workplace provides an enabling environment, I think exclusive breastfeeding will not be a challenge for any mother that is willing to do it.
“It is not about timing. Some people have the time, yet, they are not doing it. Also, we need baby-friendly support initiatives in our communities.
“Mother-to-mother support for breastfeeding as well as community volunteers for exclusive breastfeeding will go a long way.
“So, we need to work on support on the part of the government, community, and workplace and also engage fathers for support.”
Encourage male involvement
Also speaking, a former president of the Nutrition Society of Nigeria, Dr. Bartholomew Brai, urged the government to extend maternity leave to almost or cover six-month exclusive breastfeeding periods through policy/law that would be enforced.
Dr. Brai, a lecturer in the Department of Biochemistry at the Federal University, Oye-Ekiti, Ekiti State, told our correspondent that male involvement needs to be encouraged by letting the men know the importance of exclusive breastfeeding and the need to support women in house chores. He said:
“There should be adequate provision of food at home; the breastfeeding mother should be given enough rest as well.
“Situations that could lead to anxiety, worry, and stress should be avoided to prevent complicating the stress of exclusive breastfeeding.”
National Zero Water campaign
He, however, said the government, with support from partners, is addressing traditional and cultural practices that encourage giving water to babies through the National Zero Water campaign aimed at promoting exclusive breastfeeding.
According to WHO, exclusive breastfeeding has many health benefits for both the mother and infant. WHO said:
“Breast milk contains all the nutrients an infant needs in the first six months of life. Breastfeeding protects against diarrhoea and common childhood illnesses such as pneumonia, and may also have longer-term health benefits for the mother and child, such as reducing the risk of overweight and obesity in childhood and adolescence.”