The need to prioritise child’s health and survival by supporting exclusive breastfeeding can not be overemphasised.
Even though studies have shown that exclusive breastfeeding is the foundation of child’s survival, health, growth, and development as it provides every child with the best possible start in life, many children in Nigeria are not optimally breastfed.
According to the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) over 70 per cent of infants in Nigeria are denied the benefits of breast milk in their formative years.
The organisations also said that only nine per cent of establishments in Nigeria have a workplace breastfeeding policy, indicating that mothers lack the enabling environment to optimally breastfeed their babies.
The global health bodies said this has resulted in high stunting rates of 37 per cent of children Under-5, of which 21 per cent are severe, and wasting among children under five years of age (7 per cent).
It is estimated that about 25 million under-5 children in Nigeria are affected while more than 10 million children are stunted due to long-term insufficient nutrient intake.
Stunting is what happens to a child’s brain and body when they don’t get the right kind of food or nutrients in their first 1,000 days of life, said UNICEF.
The National Demographic and Health Survey (NDHS) 2018, had exposed the country’s poor breastfeeding indices with only 42 per cent of infants put to breast within one hour of birth and the proportion of exclusively breastfed children from 0 to six at 29 per cent.
Reports have also linked inadequate feeding practices and malnutrition which contributes to over 50 per cent of under-5 children mortality with 2/3 of these deaths occurring in the first year of life to poor breastfeeding practices.
These abysmal statistics have prompted the campaign for optimal breastfeeding and the commitment to eliminating stereotypes impeding exclusive breastfeeding at workplaces and in public.
This year’s World Breastfeeding Week, with the theme: ‘’Step up for Breastfeeding: Educate and Support” has heightened the call for a safe and breastfeeding-friendly environment for mothers.
Following suit, Save the Children International (SCI) and the Nigerian Governors’ Forum (NGF) have called on the government at all levels, public health experts, EOs, managers, captains of industries, workplaces and community gatekeepers to promote, protect, support and sustain breastfeeding-friendly environments for lactating mothers and their babies in the post-pandemic era.
The organisations believe that health workers, professionals, and their professional associations should be key advocates for breastfeeding and play an important role in influencing political support for breastfeeding in Nigeria.
The country director, Save the Children International Nigeria, Mr. Famari Barro, said “proper education of the mothers and their caregivers/support systems on the benefits of exclusive breastfeeding, can encourage them to practice it. All health workers, including health professionals and lay health workers, who come into contact with women, infants and families must be adequately trained to provide evidence-based breastfeeding support”.
Highlighting the importance of breastfeeding, nutrition experts said that 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 defence against all forms of child malnutrition, including wasting and obesity.
They also said that exclusive breastfeeding for six months can prevent childhood infections like diarrhoea and respiratory illnesses and provide all of the nutrients an infant requires for optimal growth and development.
Studies have shown that obesity rates are 15-30 per cent lower in breastfed babies compared to formula-fed babies.
About 80,000 child deaths and 20,000 maternal deaths are also reported to be prevented annually when optimal breastfeeding is practiced.
“Breastfeeding also acts as a baby’s first vaccine, protecting them from common childhood illnesses,” said UNICEF and WHO.
The organisations regretted that 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.
“Protecting, promoting, and supporting breastfeeding is more important than ever, not just for protecting our planet as the ultimate natural, sustainable, first food system, but also for the survival, growth, and development of millions of infants,” they said, while calling on governments, donors, civil society, and the private sector to step up efforts to prioritise investing in breastfeeding support policies and programmes, especially in fragile and food insecure contexts.
Also, on how marketing of formula milk influences decisions on infant feeding, a recent report by WHO and UNICEF revealed that 45 per cent of postpartum women in Nigeria had received a recommendation from a health professional to feed formula products.
The report hinted that contact with formula milk companies was extremely common in public and private health care settings in Nigeria.
“In Nigeria, where women ranked health professionals as their most important source of feeding advice, over one-third of surveyed pregnant women said they received a recommendation to formula feed by a health professional,” the report stated.
The organisations explained that in Nigeria 73 per cent of women expressed a strong desire to breastfeed exclusively. Yet the report details how a sustained flow of misleading marketing messages across countries is reinforcing myths about breastfeeding and breast milk, and undermining women’s confidence in their ability to breastfeed successfully.
“These myths include the necessity of formula in the first days after birth, the inadequacy of breast milk for infant nutrition, that specific infant formula ingredients are proven to improve child development or immunity, the perception that formula keeps infants fuller for longer, and that the quality of breast milk declines with time,” they said.
According to the director-general of WHO, Dr. Tedros Adhanom Ghebreyesus, “This report shows very clearly that formula milk marketing remains unacceptably pervasive, misleading and aggressive. Regulations on exploitative marketing must be urgently adopted and enforced to protect children’s health.”
The report noted that the effects of marketing in Nigeria are seen in recommendations from health professionals and on digital platforms, with companies using data-driven algorithms to target digital advertising to women whose online behavior suggests they may be pregnant.
“False and misleading messages about formula feeding are a substantial barrier to breastfeeding, which we know is best for babies and mothers,” said UNICEF executive director, Catherine Russell. “We need robust policies, legislation and investments in breastfeeding to ensure that women are protected from unethical marketing practices and have access to the information and support they need to raise their families.”
In the same vein, Civil Society Organisations (SCOs) have tasked the federal government on enforcement of the International Code of Marketing of Breast Milk Substitutes (BMS) to end the exploitative marketing of baby formula.
The chairman, steering committee, Civil Society-Scaling Up Nutrition in Nigeria (CS-SUNN) and advocacy campaign and policy manager/survive, Save the Children International, Ifedilichukwu Innocent, has advocated for the full implementation of the multi-sectoral plan of action for food and nutrition as well as strengthening efforts to perfect the creation of nutrition department and budget lines for nutrition activities in line ministries.
He also stressed the need for corporate policies that support exclusive breastfeeding at workplaces, saying “Employers should encourage exclusive breastfeeding by having corporate policies that support it, provide a conducive area for breastfeeding activities and prioritise maternal and paternal rights.
“Breastfeeding can suffer dramatically in an emergency situation. We need to set up mother and baby areas to ensure that mothers in refugee camps can receive advice, encouragement, and counseling on infant feeding practices.”
Meanwhile, the minister of health, Dr. Osagie Ehanire, has reiterated the federal government’s commitment to eradicating malnutrition from the country, noting that improving the nation’s breastfeeding rate is a cost-effective means towards achieving the 2025 World Health Assembly target of raising the rate of exclusive breastfeeding to at least 50 percent.
He said, “We recommend early initiation of breastfeeding within one hour of birth, exclusive breastfeeding for the first six months of life, continued breastfeeding up to two years of age or beyond, with the introduction of nutritionally adequate and safe complementary foods from six months.”
The minister, who spoke during the flag-off of the 2022 World Breastfeeding Week in Abuja, said the theme for this year’s celebration, “Step up for Breastfeeding: Educate and Support” focuses on strengthening the capacity of actors that are involved in the protection, promotion, and support of breastfeeding across different levels of society.
These actors, according to him, include governments, health systems, workplaces and communities.
Ehanire noted that over the years, evidence has shown that women need effective support both to initiate and sustain breastfeeding. However, he said many of the actors lack the necessary knowledge, attitudes, and skills to support these women. “Thus, there is the need to strengthen the capacity of all actors across the different levels to protect, promote and support breastfeeding.
“As a nation, breastfeeding is one of the smartest investments we can make towards human capital development. It offers children unparalleled health and brain-building benefits. It has the power to save the lives of women and children throughout the country and the power to help our national economy to grow through lower health care costs and smarter workforce,” he added.
The World Breastfeeding Week is an annual celebration which is held every year from the 1st to 7th of August in more than 120 countries, including Nigeria.
As part of activities to mark this year’s celebration, the Federal Ministry of Health in collaboration with its partners, took an exclusive breastfeeding campaign to Utako market in the Federal Capital Territory (FCT).
Addressing the traders, a representative of the Infant and Young Child Feeding (H/IYCF), Nutrition Division, Federal Ministry of Health, Dr. Temidayo Odebunmi, said the World Breastfeeding Week is celebrated to create awareness on the importance of breastfeeding to women, to country and the world at large.
She said “Nigeria is joining the world to carry out this campaign. The theme of this year is “Step Up for Breastfeeding, Educate and Support”. So we are standing up for breastfeeding, we are calling on men, women, and all the actors that are involved. These actors, globally, scientists call them the “one chain” actor,
“Without support, women cannot breastfeed successfully. For a woman to breastfeed successfully, she needs support from her husband and the family, the older women, nurses, and midwives, she needs support from the government even from the youth. The “one chain” actors are too many, this year we are going out to educate people. If they don’t know how to support, they will not go out to support, so we are here now to say everybody supports women to breastfeed their babies.”
One of the traders in the market, Amarachi Emmanuel, who acknowledged the benefits of exclusive breastfeeding said “My first daughter, I didn’t breastfeed her exclusively, I just did for three months and after three months, she was sick for over a year. But my second child, I breastfed him for six months, he is a year plus now and he has never been to the hospital except for immunisation.
On how she was able to achieve exclusive breastfeeding for six months, Amarachi said her husband supported her, so she was able to stay at home for those six months, adding that she only resumed her business after six months.
Amarachi urged other husbands to also support their wives to breastfeed their babies.
Also, as part of efforts to ensure breastfeeding-friendly environments, the federal government and key nutrition stakeholders have committed to creating an environment for women to breastfeed their children in workplaces and in public.
The minister of state for health, Joseph Ekumankama, who led the team to sign the commitment, noted that women occupy about 45 per cent of the country’s workforce adding that women need both emotional and moral support to nurse their babies.
He also assured that the ministry will continue to enforce the Code for the marketing of Breast milk Substitutes (BMS) to address threats that unwholesome marketing poses to optimal breastfeeding practice in Nigeria, through the National Agency for Food and Drugs Administration and Control (NAFDAC) and other stakeholders.
However, while Nigeria strives to meet the 2025 target on nutrition, all actors have been urged on collaborative efforts towards the attainment of the goal.
