By Femi Oyelola
Every year from August 1–7, Nigeria joins over 170 countries globally to celebrate World Breastfeeding Week, (WBW). This is one of the greatest outreach vehicles for the promotion of optimal Infant and Young Child Feeding (IYCF) practices.
The event, formally endorsed by the 1990 WHO Innocenti Declaration and policymakers across the globe, reaffirms commitment to breastfeeding promotion, protection, and support. The theme for the WBW 2023 is “Let’s make breastfeeding and work, work!
Exclusive breastfeeding (EBF) according to the Project Manager of Accelerating Nutrition Results in Nigeria, (ANRiN), Dr. Zainab Muhammad-Idiris Kwaru is feeding the infant with only breast milk for 6 months without any additional food or drink, not even water.
She explained that it provides adequate nutrition required for optimal growth and development of infants in the first six months of life, saying thereafter, infants should receive adequate complementary foods with continued breastfeeding up to 2 years of age or beyond.
The World Health Organization (WHO) recommended 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.
The importance of breastfeeding as a determinant of infant nutrition, child mortality, and morbidity has long been recognized and documented in the public health literature.
Findings have shown that EBF practice is strongly linked with a significant reduction in the burden of infant and child morbidity and mortality, especially among children under Five years of age.
However, despite the enormous benefits of EBF practice, millions, of children in Kaduna State are still not exclusively breastfed in the first 6 months of life as recommended by WHO.
According to the 2018 NDHS, the percentage of exclusively breastfed infants in Kaduna State has risen from 30 percent to 41 percent.
Experts believe that the low adherence to EBF practice in the state is associated with diarrhea-related deaths among children younger than five years of age 10.
This is inimical to the realization of the Sustainable Development Goal (SDG) target of reducing infant and child mortality rates to a significantly low level by 2030.
Investigation revealed that Most (86.5 percent) of the nursing mothers had a piece of good knowledge and awareness about exclusive breastfeeding, and 94.3 percent of the mothers were able to correctly define exclusive breastfeeding as a practice of feeding infants with breast milk only for the first 6 months of life.
The advantages of breast milk over infant formula milk were well known to the mothers. The most frequently mentioned were its health benefits to the baby (59.1 percent), protection against infections (42.6 percent), the right amount of nutrients and water (30 percent), ready availability (19.6 percent), cheap (19.6 percent), and promotion of mother-child bonding (19.6 percent).
The majority (69.1 percent) of the mothers knew that breastfeeding should be initiated immediately after birth (within an hour), while 10 percent said it should be within 1-24 hours and 17.4 percent of the mothers felt it should be dependent on the mother or baby’s health.
Most (78.3 percent) of the mothers had received information about EBF from ante-natal clinics. Others got information from media (5.6 percent), friends/relations accounted for 2.2 percent of the source of information, 11.3 percent claimed they got the information from all the sources, while 2.6 percent of the mothers said they have never received information about EBF from any of these sources.
Giving credence to this, Kaduna State Deputy Governor, Dr. Hadiza Sabuwa Balarabe, said Breast Milk is the ideal food for infants, safe, clean, and contains antibodies that help protect against many common childhood illnesses.
She explained that breast milk provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs, during the second half of his/her first year, and up to one third during the second year of life.
“Breastfeeding has been shown to reduce the risk of many infections like ear infections, respiratory infections, and gastrointestinal illnesses.
“They are also at a lower risk of developing chronic diseases later in life, such as obesity, type 2 diabetes, and asthma. The benefits of breastfeeding are long-lasting and can continue into adulthood.
“Breastfeeding has many benefits for mothers as well. It can reduce the risk of certain cancers, including breast and ovarian cancer.
“Breastfeeding also promotes postpartum weight loss, as it burns calories and helps the uterus to contract back to its pre-pregnancy size,” Dr. Balarabe further explained.
Reacting to this, Dr. Zainab Muhammad-Idiris Kwaru, said In Nigeria, 45 percent of deaths among children under 5 years of age are linked to nutritional deficiencies.
She said ANRiN, apart from championing exclusive breastfeeding campaigns in the state, also provided deworming tablets and suspension to children, Vitamin A supplementation, Micronutrient powder, Iron/folic acid, and anti-malaria tablets for pregnant women, and ORS/zinc tablets to prevent diarrhea.
Dr. Kwaru added ANRiN as its contribution to the 2023 WBW engaged Non-state actors (NSAs) to provide these services using Interpersonal Communication Agents (IPCA) who go from house to house and offer these services in the communities. “This strategy has yielded positive results as people have been able to access services right in their homes,” she said.
To sustain the benefits of exclusive breastfeeding, the Country Director of Save the Children International, (SCI), Ms Famari Barro, calls for law and policy implementation that encourages exclusive breastfeeding and continuation of breastfeeding at workplaces and communities.
However, Traditional Birth Attendants, (TBA), seemed to have different opinions about exclusive breastfeeding as they harbour some myths and misconceptions that are causing barriers against the practice of exclusive breastfeeding.
In many low to middle-income Communities, traditional birth attendants (TBAs) play various roles (e.g., provision of health education, referral to hospitals, and delivery support) that can potentially improve women’s access to healthcare, however, the formal healthcare systems have not acknowledged the role of the TBAs. TBAs’ contributions are limited and are not well described in policy documents.
Health Journals recorded that Traditional birth attendants have since ancient times provided care to pregnant women. As such, collaboration with them can be an essential effort toward the reduction of maternal and neonatal mortality and morbidity rate especially in low- and middle-income Communities.
This is why there is a need for massive sensitization at the grassroots to educate and create awareness among the TBAs that breastfeeding is a foundation for life and the best milk for every baby.
The Civil Society-Scaling Up Nutrition in Nigeria, (CS-SUNN), recently took the bull by the horn by visiting the Igabi Local Government Area Primary Health Care facility, a rural community in Kaduna State to enlighten the TBAs on the importance of exclusive breastfeeding.
The TBAs no doubt are crucial in childbirth in Kaduna State as they are visible in the outermost rural communities. And getting them to be on the same page with the principle of exclusive breastfeeding will help reduce the burden of infant and child morbidity and mortality especially among children under five years of age in the state. also, the exercise will add more knowledge to women who will now be conscious of exclusive breastfeeding.
TBAs play an important role, as they promote the health and well-being of pregnant women and newborns within their communities and their overarching benefit in the campaign for Exclusive Breastfeeding will contribute to the Kaduna state reduction of maternal mortality rates
